Acupuncture and Addiction
By Emma Suttie, D.Ac
Acupuncture has been successfully used to treat addictions for many years in the West. It has been used in hospitals in conjunction with standard Western treatments, like methadone for heroin addictions, and many addiction clinics operate using acupuncture to combat the symptoms and root causes of addiction.
The ancient healing art of Chinese medicine has been used to treat illness and disease for thousands of years, but it is only relatively recently that it has been used in the West to specifically combat the effects of addiction. Acupuncture has been proven effective for treating many types of addictions, from cocaine and heroin, to nicotine and even overeating.
A Tale Of Success
There is excellent clinical evidence that acupuncture is effective in treating addictions. The first acupuncture detoxification clinic in the United States, called The Lincoln Clinic, opened in 1974 in the South Bronx borough of New York. At first, heroin addicts were being treated with a combination of acupuncture and methadone. The acupuncture treatments proved so successful however, that methadone was dropped from the program. According to Dr. Michael Smith, the clinic’s director, the success rate using acupuncture is substantially higher than with other, more conventional programs.
Here is some information about The Lincoln Clinic, taken from an article about Acupuncture and Addiction:
The Lincoln Clinic
The Lincoln Clinic in New York City is the premiere detoxification center utilizing acupuncture in the U.S. Its director, Dr. Michael Smith, says the need for effective substance abuse treatment in the clinic's neighborhood is evident:
The South Bronx is a racially marginalized, high poverty, high unemployment, high crime, high infant mortality, low literacy neighborhood devastated by several decades of substance abuse.
When the doctors at the Lincoln Clinic read in 1974 that a neurosurgeon in Hong Kong, Dr. H.L. Wen, had noticed a reduction in the withdrawal symptoms of opiate-addicted patients to whom he had been giving acupuncture treatments, they decided to experiment with the procedure at what had been until then a methadone clinic. Over the years they developed a protocol that they have taught to more than 500 clinicians in 150 different programs.
The Lincoln Clinic protocol relies on four major tools in helping serious addicts recover: acupuncture detoxification, urine testing, individual counseling, and participation in 12-step group-based therapy. Smith argues that the advantages of integrating acupuncture into more traditional treatment programs are overwhelming. The primary value of acupuncture, however, is that its immediate effect is often a cessation of withdrawal symptoms, encouraging patients to come again for treatment in the future.
Smith cites a few remarkable statistics to support the effectiveness of the Lincoln Clinic method. Among pregnant women with a history of abusing crack cocaine, those who receive acupuncture have higher birth weight babies than those who do not receive the treatment. Mothers with more than 10 visits have babies with an average weight of 6lbs. 10oz, while those with less than 10 visits have babies weighing an average of 4lbs. 8oz.
A seven-day inpatient drug treatment program in Delaware using the Lincoln Clinic method reported a decline in rates of recidivism from 87% to 18% one year after the date of admission.
Dr. Smith attributes this effectiveness to a number of factors. One of acupuncture's greatest strengths, he argues, is that it forges a bond between doctor and patient even before verbal communication is established: "acupuncture will be just as effective even when the patient lies to us." Unlike verbal counseling, during which the patient may be in denial or feel angry or intimidated, acupuncture's immediate effects are not dependent on the cooperation of the patient.
As stated previously, acupuncture's primary effect is to stimulate relaxation. "In addition to reducing withdrawal symptoms acupuncture provides a strong calming effect on substance abusers and substantially reduces drug craving. Clients describe the effects of acupuncture as allowing them to feel relaxed yet alert," according to Dr. Smith. That feeling of relaxation is the essential benefit of the acupuncture protocol. Unlike methadone treatment, acupuncture affects the patient's state of mind during withdrawal, not the body's need for a drug.
Addicts enrolled in the program reported a marked reduction in cravings for drugs, feeling more relaxed and less anxious, relief from symptoms of withdrawal and improved sleep. The success of The Lincoln Clinic and its results have inspired the opening of publicly funded acupuncture detoxification programs across the country and abroad.
How and Why it Works
Auricular - Acupuncture of the Ear
Addiction treatments with acupuncture are done with acupuncture points (specific anatomical locations) in the ear. There is an entire branch of Chinese medicine dedicated to treating the body and its disorders using only the ear. Acupuncture practiced specifically on the ear is called auricular acupuncture. An important discovery occurred in 1955 by a French doctor - Dr. Paul Nogier, who, by testing electrical activity on the surface of the skin found that every traditional acupuncture point had a corresponding point on the human ear. Through his discovery, auricular acupuncture was created. Auricular has been the most effective treatment for addictions, and has the advantages of not requiring privacy (no need to remove clothing so points can be applied), and thus, the ability to treat many patients in the same room at the same time. Many standard auricular addiction protocols have been developed, and their ease of use makes them easy to teach to both physicians and acupuncturists.
Western Medicine
In Western medical terms, the positive effect of acupuncture for treating addiction can be attributed to the fact that research has shown acupuncture to raise endorphin levels in the nervous system. Endorphins are the body’s natural painkillers and are similar in structure and function to opiates (heroin) which also have a strong analgesic effect. Research suggests that combating the strong withdrawal symptoms for people suffering from addictions to drugs is to raise endorphin levels in the nervous system. The desire to eat is also mediated by endorphin levels, which would also explain why acupuncture has a beneficial effect on people trying to lose weight by helping to control their appetites.
Traditional Chinese Medicine
Chinese medicine has its own way of explaining why it is so effective in treating addictions. Chinese medicine is a holistic system where every part of the body works synergistically. It is a unified system. The concept of yin and yang is at the core of Chinese medical theory. Yin and yang are two opposing forces, and when a person is in good health, yin and yang are seen to be in relative balance. Yang is the “fire” aspect, and yin is the “water”. Yang is substance, yin is function. Yang consumes and yin nourishes. Addicts are very often deficient in yin. Physiologically, an excess of yang causes hyperactivity, restlessness and an excess of frenetic energy, behaviours which push an addict to constantly seek out drugs. Psychologically, excess yang causes anxiety, agitation and anger.
These yang attributes are dominant because there is not enough yin (or water) in the body, to balance, or tame the yang (or fire). An abundance of fire (yang) drives the addict to use, which exacerbates fire and depletes yin (water). Narcotics also are considered yang, which continues the cycle. Addicts feel anxious and restless, seeking out drugs to make them feel “better”, which in turn introduces more yang into the body, further depleting the yin they desperately need to rebalance the system. A vicious cycle.
The treatment involves nourishing yin by doing acupuncture points in the ear. There are several protocols, but usually 1-5 points are needled in each ear and retained from 30-45 minutes. The patient can be lying down or seated, and most patients find the treatment is very relaxing and calming to the mind and body, adding to a sense of well being which is so often absent for the anxious patient suffering with addiction. As an adjunct, and especially helpful in treating addiction, ear seeds are used in between treatments. These are tiny metal balls, or natural seeds (vaccaria seeds are most often used) applied to the acupuncture points of the ear with stickers, and patients are told to press on them to stimulate the points in between treatments to help with cravings and withdrawal symptoms. Points on the ear for treating addiction include the lung, kidneys and liver, the major organs of elimination that aid in removing toxins from the body, imperative in treating addiction.
The frequency of treatment for addiction depends on the substance. People addicted to “hard drugs” are advised to have treatment daily until they are clean and then a couple of times a week thereafter until they feel able to manage cravings on their own and are not tempted to use. Alcoholics also receive daily treatments in the initial stages of treatment, and it tapers off as their symptoms decrease. Interestingly, alcoholics receiving acupuncture rarely suffer from seizures during the withdrawal period.
Nicotine addictions are in a different category as nicotine is seen as a milder drug. It does not produce the dramatic physical effects “hard drugs” do, but is more prevalent and may be seen as more insidious. Treatments are usually not needed daily and smokers usually notice a drastic decrease in cravings for nicotine after the second or third treatment. Duration of treatment is dramatically less for smokers, and the average length of treatment is 2-3 weeks. After 4 or 5 treatments spread out over a 2-3 week period, 7 out of 10 patients have kicked the habit. Others will have drastically cut down on the number of cigarettes smoked daily. Ear seeds will be applied to the ears with instructions for patients to apply pressure to them often which will help with cravings and withdrawal symptoms in between treatments.
The Desire to Quit
The desire to quit cannot be overstated. As with most things, change cannot happen without first the acknowledgement of the problem, and the desire to make that change. Acupuncture, or any other treatment cannot be effective without the participation and desire of the patient. Treatment is always a joint effort, and the patient's desire is paramount for a favourable outcome.
For treatment of something as complex as addiction, acupuncture cannot exist in isolation. Addiction is not solely a physiological issue, it has deep psychological implications which must be addressed for recovery to be achieved. Acupuncture in conjunction other modalities such as therapy which addresses the psychological aspect as well as a strong support system are important parts of a complete treatment program. The relapse rate for addicts is high, so it is important that these treatments exist not only during the treatment itself, but remain afterwards to support the recovering addict on the long and often difficult road to recovery.
*Footnotes
“The Lincoln Clinic”
http://www.ndsn.org/sept95/guest.html
