Six hundred twenty cocaine-dependent adult patients(mean age, 38.8 years; 69.2% men); 412 used cocaine only and 208 used both opiates and cocaine and were receiving methadone maintenance. Patients were randomly assigned to receive auricular acupuncture (n=222), a needle-insertion control condition(n=203), or a relaxation control condition (n = 195). Treatments were offered 5 times weekly for 8 weeks.
Sample Count
620
Control
Placebo
relaxation control condition(n=195)
Experiment
auricular acupuncture(n=222); needle-insertion control condition(n=203)
Indicator
Cocaine amount and frequencyAddiction severity index(ASI)
Auxiliary Medication
Methadone-maintained patients continued to receive standard methadone maintenance, which included drug counseling.
Stimulation Method
MS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
-
-
-
-
-
40 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
0.2×15.0 mm
Seirin Co Ltd, Shimizu-City, Japan
-
Description Needles were inserted into the auricles bilaterally at 4 points in or near the concha, which are commonly used in addiction treatment:”sympa- thetic", “lung”, “liver”, and “shen men”. The single-use stainless steel needles (Seirin Co Ltd, Shimizu-City, Japan) were 0.2 mm wide and 15.0 mm long.
Exclusion criteria wereas follows: (l) being dependent on anysubstance besides opiates, cocaine, ornicotine,(2)currently receiving treat-ment for cocaine dependence,(3)currently taking a prescription benzodiaz-epine, (4)currently taking any otherpsychotropic medication unless main-tained on this medication for at least 90days,(5)currently receiving acupunc-ture treatment or having had acupunc-ture in the previous 30 days, and (6)being actively suicidal or psychotic.
Contraindications
Being actively suicidal or psychotic
Effector
Intent-to-treat analysis of urine samples showed a significant overall reduc tion in cocaine use (odds ratio, 1.40; 95% confidence interval,1.11-1.74; P=0.002) but no differences by treatment condition (P=0.90 for acupuncture vs both control conditions). There were also no differences between the conditions in treatment retention (44%-46% for the full 8 weeks). Counseling sessions in all 3 conditions were poorly attended. Within the clinical context of this study, acupuncture was not more effective than a needle insertion or relaxation control in reducing cocaine use. Our study does not support the use of acupuncture as a stand-alone treatment for cocaine addiction or in contexts in which patients receive only minimal concurrent psychosocial treatment. Research will be needed to examine acupuncture's contribution to addiction treatment when provided in an ancillary role.
Acupuncture for the treatment of cocaine addiction: a randomized controlled trial.
Abstract
CONTEXT: Auricular acupuncture is widely used to treat cocaine addiction in the United States and Europe. However, evidence from controlled studies regarding this treatment's effectiveness has been inconsistent. OBJECTIVE: To investigate the effectiveness of auricular acupuncture as a treatment for cocaine addiction. DESIGN: Randomized, controlled, single-blind clinical trial conducted from November 1996 to April 1999. SETTING: Six community-based clinics in the United States: 3 hospital-affiliated clinics and 3 methadone maintenance programs. PATIENTS: Six hundred twenty cocaine-dependent adult patients (mean age, 38.8 years; 69.2% men); 412 used cocaine only and 208 used both opiates and cocaine and were receiving methadone maintenance. INTERVENTION: Patients were randomly assigned to receive auricular acupuncture (n = 222), a needle-insertion control condition (n = 203), or a relaxation control condition (n = 195). Treatments were offered 5 times weekly for 8 weeks. Concurrent drug counseling was also offered to patients in all conditions. MAIN OUTCOME MEASURES: Cocaine use during treatment and at the 3- and 6-month postrandomization follow-up based on urine toxicology screens; retention in treatment. RESULTS: Intent-to-treat analysis of urine samples showed a significant overall reduction in cocaine use (odds ratio, 1.40; 95% confidence interval, 1.11-1.74; P =.002) but no differences by treatment condition (P =.90 for acupuncture vs both control conditions). There were also no differences between the conditions in treatment retention (44%-46% for the full 8 weeks). Counseling sessions in all 3 conditions were poorly attended. CONCLUSIONS: Within the clinical context of this study, acupuncture was not more effective than a needle insertion or relaxation control in reducing cocaine use. Our study does not support the use of acupuncture as a stand-alone treatment for cocaine addiction or in contexts in which patients receive only minimal concurrent psychosocial treatment. Research will be needed to examine acupuncture's contribution to addiction treatment when provided in an ancillary role."
Souce
JAMA. 2002 Jan 2;287(1):55-63. doi: 10.1001/jama.287.1.55.
