New York Times
August 15, 2000
Acupuncture appears to help some cocaine addicts escape their dependence on the drug, according to a report published today by researchers at Yale University.
Experts on drug abuse say cocaine addiction is one of the most difficult forms of drug dependency to treat. And while many treatment centers have been using acupuncture for some time, usually in combination with other therapies, scientific studies of its effectiveness in treating cocaine addiction have been inconclusive.
In the Yale study, 53.8 percent of the subjects who had needles inserted In four acupuncture “zones” in the ear five times a week tested free of cocaine at the end of the eight-week study period. In comparison, 23.5 percent of control subjects given “sham” acupuncture treatments and 9.1 percent of subjects who watched relaxation videos tested free of the drug during the final week of the study.
The report appears in the August issue of the journal Archives of Internal Medicine.
The study involved 82 men and women in the New Haven area who were addicted to both heroin and cocaine. They were 1 receiving methadone treatment for heroin addiction, but were still using cocaine regularly.
Thirty of the subjects however, were dropped from the study after missing sessions.
The researchers called the findings promising but cautioned that the study was relatively small and that more research needed to be done to confirm the results.
They also said that acupuncture was not a panacea and suggested that it should be used along with other therapies like counseling.
ÒThese are a difficult group of people to deal with,” said Dr. Herbert D. Kleber, the medical director of the National Center on Addiction and Substance Abuse in New York and a professor of psychiatry at Columbia University, who is familiar with the study.
“We don’t have medicine treating cocaine addiction, and acupuncture appears to be a useful adjunct for decreasing dependence,” Dr. Kleber said.
Dr. Arthur Margolin, a research scientist in the department of psychiatry at YaleÕs medical school and lead author of the report, said that among the benefits of acupuncture were its low cost and lack of side effects.
And unlike pharmaceutical treatments, Dr. Margolin said, it can be offered to pregnant women.
The study’s findings are also encouraging, he added, because “they suggest that with the proper groundwork we can conduct rigorous trials of complementary or alternative therapies.”
One obstacle that has confronted researchers trying to determine whether acupuncture works has been the difficulty of finding convincing ÒplaceboÓ treatments to act as scientific controls. For the sham needle treatment, the Yale researchers inserted four needles along the rim of the ear, in spots that are not commonly used in acupuncture treatment and had little effect when stimulated in preliminary tests. The relaxation tapes were used to control for the possibility that simply sitting quietly for 45 minutes in a darkened room might itself produce an effect.
In the acupuncture treatment, the needles were inserted five times a week for about 45 minutes per session, according to guidelines developed at Lincoln Hospital in the Bronx, and adopted by the National Acupuncture Detoxification Association.
Urine samples were taken three times a week to test for cocaine use. All the subjects in the study, which was financed by the National Institute on Drug Abuse, also received psychotherapy as part of the treatment program.
Dr. Margolin said that scientists did not yet understand how acupuncture might work to curb addiction but that there were a variety of theories. For example, acupuncture has been linked to the release of opioids, the body’s natural painkillers, which might help reduce the craving for cocaine.
Or the procedure might stimulate the vagus nerve that runs through the center of the ear, producing a relaxing effect.
In Chinese medicine, Dr. Margolin added, the stimulation points used in the study are associated with a diagnosis called “empty fire.”
“This is a pretty good either metaphorical or literal description of a cocaine-addicted individual,” he said.