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Qeadan F, Madden EF, Barbeau WA, Kroth PJ, Porucznik CA, English K, Komaromy M, Sulzer SH. Characteristics associated with the availability of therapeutic acupuncture in substance use disorder treatment facilities in the United States. J Addict Dis 2023; 41:41-52. [PMID: 35343390 DOI: 10.1080/10550887.2022.2056401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND We examine the characteristics associated with the availability of therapeutic acupuncture in substance use disorder (SUD) treatment facilities in the United States (US). METHODS This study utilizes data from the 2018 National Survey of Substance Abuse Treatment Services (N-SSATS). Multivariable logistic regression was performed. RESULTS Only 5.5% (n = 814) of all SUD treatment facilities offered acupuncture therapy. Facilities operating an opioid treatment program (OTP) were 1.60 times more likely to offer therapeutic acupuncture than non-OTP facilities. Facilities that offered oral naltrexone pharmacotherapy or buprenorphine with naloxone pharmacotherapy were 1.63 and 1.37 times more likely to offer therapeutic acupuncture, respectively, compared to facilities that did not offer these pharmacotherapies. Federal government facilities were over four times more likely to offer acupuncture than those operated by state governments and had triple the odds of having acupuncture than private nonprofit organizations. Tribal facilities were over five times more likely than state government-operated facilities to offer acupuncture. Facilities located in the Western region of the US were 1.59, 1.39, and 1.30 times more likely than Northeastern, Midwestern, and Southern US regions, respectively, to offer acupuncture therapy. CONCLUSIONS Although complementary and holistic approaches such as acupuncture are accepted adjunct methods to treat persons with SUD, the findings suggest that their utilization in SUD treatment facilities in the US is minimal. Results, however, highlight that facilities operated by tribal and federal governments, those that are located in the Western region of the US, and non-hospital facilities have the highest odds of incorporating therapeutic acupuncture as treatment for SUD. Supplemental data for this article is available online at https://doi.org/10.1080/10550887.2022.2056401 .
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Affiliation(s)
- Fares Qeadan
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
| | - Erin Fanning Madden
- Wayne State University, Department of Family Medicine and Public Health Sciences, Detroit, MI, USA
| | - William A Barbeau
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
| | - Philip J Kroth
- Department of Biomedical Informatics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Christina A Porucznik
- University of Utah School of Medicine, Department of Family and Preventive Medicine, Salt Lake City, UT, USA
| | - Kevin English
- Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA
| | - Miriam Komaromy
- Boston Medical Center (BMC), Boston University, Grayken Center for Addiction, Boston, MA, USA
| | - Sandra H Sulzer
- Utah State University, Department of Kinesiology & Health Science, Logan, UT, USA
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Lhommeau N, Huchet A, Castera P. [Acupuncture and smoking cessation, a review of the literature]. Rev Mal Respir 2020; 37:474-478. [PMID: 32416946 DOI: 10.1016/j.rmr.2020.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/24/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Tobacco smoking represents the main cause of death in industrialised countries. Acupuncture is proposed as an aid to stopping smoking. What are the current studies? BACKGROUND We found 23 controlled randomised studies with differing protocols in terms of intensity of treatment and methodology. The meta-analyses undertaken were contradictory. The short-term effect of acupuncture is well documented but the medium term effect is more uncertain. OUTLOOK The undertaking of well-standardised, high-intensity protocols is necessary to produce evidence of a medium term effect. CONCLUSION Acupuncture can be offered to patients wishing to stop smoking within the framework of a global management programme. The association of acupuncture with classical aids increases the chances of the patient stopping. The conditions of intervention should be defined precisely within the framework of a randomised controlled trial.
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Affiliation(s)
- N Lhommeau
- Rue Maurice-Daniel, 44230 Saint-Sébastien-sur-Loire, France.
| | - A Huchet
- Boulevard du Manoir-Saint-Lô, 44300 Nantes, France
| | - P Castera
- Département de médecine générale, université de Bordeaux, Bordeaux, France
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Zeng L, Tao Y, Hou W, Zong L, Yu L. Electro-acupuncture improves psychiatric symptoms, anxiety and depression in methamphetamine addicts during abstinence: A randomized controlled trial. Medicine (Baltimore) 2018; 97:e11905. [PMID: 30142795 PMCID: PMC6112927 DOI: 10.1097/md.0000000000011905] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND It aimed to observe the effect of electro-acupuncture on the improvement of psychiatric symptoms, as well as anxiety and depression in methamphetamine (MA) addicts during abstinence using randomized controlled trials. METHODS All patients in the present study received compulsory drug detoxification in Shanghai Drug Rehabilitation Center. All patients were enrolled consecutively from June 2014 to February 2015; data collection was completed in March 2015. According to the randomized, single-blind and control principle, 68 men MA addicts were randomly divided into 2 groups: electro-acupuncture (EA) and sham electro-acupuncture (sham-EA) groups. Patients were given 20 minutes EA or sham-EA treatment every Monday, Wednesday, and Friday, with a total of 4 weeks. Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) were used to evaluate the patients' psychotic symptoms, anxiety and depression before treatment and after receiving treatment with 1 to 4 weeks, respectively. RESULTS EA could effectively improve the symptoms of psychosis, anxiety, and depression during abstinence in patients with MA addiction. In terms of PANSS score, the scores for positive symptoms and general psychopathological symptoms in patients after receiving 1 to 4 weeks of treatment were significantly decreased compared with the control group, while the score for negative symptoms was significantly decreased after receiving 2 and 4 weeks of treatment. For the HAMA score, the psychotic anxiety scores in patients receiving 1 to 4 weeks of treatment were significant lower than the control group. In terms of HAMD score, there was a significant reduction in anxiety/somatization and sleep disturbance scores after the 4 weeks of EA treatment. CONCLUSION Electroacupuncture helps to improve psychiatric symptoms and anxiety and depression in MA addicts during abstinence, and promote rehabilitation of patients.
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Affiliation(s)
- Liang Zeng
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ying Tao
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenguang Hou
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Zong
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Yu
- Department of Genetics, Rutgers University, New Jersey
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Abstract
This article explores the possibilities of applying ear acupuncture to newborn infants. In addition to the use of needle acupuncture, there are also noninvasive applications that are preferred for patients in this particular age group. Based on the limited literature, ear acupuncture could be an effective nonpharmacologic approach for the treatment of pain in newborn infants and for addressing symptoms of neonatal abstinence syndrome. However, studies on safety, side-effects, and other indications are still lacking.
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Affiliation(s)
- Wolfgang Raith
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
- Research Group for Paediatric Traditional Chinese Medicine, TCM Research Centre Graz (Acupuncture Research), Medical University of Graz, Graz, Austria
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Wang R, Li X, Zhou S, Zhang X, Yang K, Li X. Manual Acupuncture for Myofascial Pain Syndrome: A Systematic Review and Meta-Analysis. Acupunct Med 2017; 35:241-250. [PMID: 28115321 DOI: 10.1136/acupmed-2016-011176] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2016] [Indexed: 12/11/2022]
Abstract
Objective To assess the efficacy of manual acupuncture (MA) in the treatment of myofascial pain syndrome (MPS). Methods We searched for randomised controlled trials (RCTs) comparing MA versus sham/placebo or no intervention in patients with MPS in the following databases from inception to January 2016: PubMed; Cochrane Library; Embase; Web of Science; and China Biology Medicine. Two reviewers independently screened the literature extracted data and assessed the quality of the included studies according to the risk of bias tool recommended by the Cochrane Handbook (V.5.1.0). Then, a meta-analysis was performed using RevMan 5.3 software. Results Ten RCTs were combined in a meta-analysis of MA versus sham, which showed a favourable effect of MA on pain intensity after stimulation of myofascial trigger points (MTrPs; standardised mean difference (SMD) −0.90, 95% CI −1.48 to −0.32; p=0.002) but not traditional acupuncture points (p>0.05). Benefit was seen both after a single treatment (SMD −1.05, 95% CI −1.84 to −0.27; p=0.009) and course of eight sessions (weighted mean difference (WMD) −1.96, 95% CI −2.72 to −1.20; p<0.001). We also found a significant increase in pressure pain threshold following MA stimulation of MTrPs (WMD 1.00, 95% CI 0.32 to 1.67; p=0.004). Two of the included studies reported mild adverse events (soreness/haemorrhage) secondary to MA. Conclusions Through stimulation of MTrPs, MA might be efficacious in terms of pain relief and reduction of muscle irritability in MPS patients. Additional well-designed/reported studies are required to determine the optimal number of sessions for the treatment of MPS.
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Affiliation(s)
- Rong Wang
- Department of Joint Surgery, Lanzhou General Hospital, Lanzhou Military Command, Lanzhou, China
- Gansu University of Chinese Medicine, Lanzhou, China
| | - Xiuxia Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Shenghu Zhou
- Department of Joint Surgery, Lanzhou General Hospital, Lanzhou Military Command, Lanzhou, China
| | - Xiaogang Zhang
- Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xusheng Li
- Department of Joint Surgery, Lanzhou General Hospital, Lanzhou Military Command, Lanzhou, China
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Carter K, Olshan-Perlmutter M, Marx J, Martini JF, Cairns SB. NADA Ear Acupuncture: An Adjunctive Therapy to Improve and Maintain Positive Outcomes in Substance Abuse Treatment. Behav Sci (Basel) 2017. [PMID: 28621706 PMCID: PMC5485467 DOI: 10.3390/bs7020037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The National Acupuncture Detoxification Association protocol (NADA) is an adjunctive therapy using 1 to 5 invariant ear acupuncture/acupressure points. This is a randomized prospective study to determine if NADA plus traditional treatment enhance outcomes: quality of life, depression, anxiety and abstinence from substance abuse. There were 100 patients enrolled in the Keystone Substance Abuse Services-Winthrop University Department of Sociology and Anthropology NADA study. All patients completed Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES) prior to starting the program and at program completion. Patients self-reported alcohol, tobacco, and drug use prior to starting the program at program completion and at 3 and 6 month follow- up. Patient characteristics are predictive of completion versus non-completion when race, criminal history and initial drug test is considered. Those identified as nonwhite, (p < 0.05) and patients with positive initial drug test, (p < 0.01) were more likely to complete treatment in the NADA group. Also, among patients with criminal history a higher percentage failed to complete the program in the control group (p < 0.05). Participation in NADA positively associated with Q-LES score (p < 0.05), feeling better about oneself and improved energy (p < 0.05), likelihood of employment upon discharge (p < 0.05), and decreased alcohol use at 3 month follow up (p < 0.05) and 6-month follow-up (p < 0.01). NADA group reported less tobacco use at 6 months (p < 0.05).
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Affiliation(s)
- Kenneth Carter
- Integrative Psychiatry Consultant, Keystone Substance Abuse Services, 199 S Herlong Ave, Rock Hill, SC 29732, USA.
| | - Michelle Olshan-Perlmutter
- Outpatient Psychiatry, Carolinas healthcare System BH, Charlotte 501 Billingsley Road, Charlotte, NC 28211, USA.
| | - Jonathan Marx
- Professor of Sociology, Winthrop University, 334 Kinard Hall, Rock Hill, SC 29730, USA.
| | - Janet F Martini
- NCC Executive Director Keystone Substance Abuse Services, PO Box4437/199 S. Herlong Avenue, Rock Hill, SC 29732, USA.
| | - Simon B Cairns
- Acupuncture Solutions, 220 Freeman Farm Road, Duncan, SC 29334, USA.
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Effects of Electroacupuncture on Methamphetamine-Induced Behavioral Changes in Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:5642708. [PMID: 28400844 PMCID: PMC5376430 DOI: 10.1155/2017/5642708] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/25/2016] [Accepted: 11/02/2016] [Indexed: 12/26/2022]
Abstract
Methamphetamine (METH) is a major drug of abuse worldwide, and no efficient therapeutic strategies for treating METH addiction are currently available. Continuous METH use can cause behavioral upregulation or psychosis. The dopaminergic pathways, particularly the neural circuitry from the ventral tegmental area to the nucleus accumbens (NAc), have a critical role in this behavioral stage. Acupuncture has been used for treating diseases in China for more than 2000 years. According to a World Health Organization report, acupuncture can be used to treat several functional disorders, including substance abuse. In addition, acupuncture is effective against opioids addiction. In this study, we used electroacupuncture (EA) for treating METH-induced behavioral changes and investigated the possible therapeutic mechanism. Results showed that EA at the unilateral Zhubin (KI9)–Taichong (LR3) significantly reduced METH-induced behavioral sensitization and conditioned place preference. In addition, both dopamine and tyrosine hydroxylase (TH) levels decreased but monoamine oxidase A (MAO-A) levels increased in the NAc of the METH-treated mice receiving EA compared with those not receiving EA. EA may be a useful nonpharmacological approach for treating METH-induced behavioral changes, probably because it reduces the METH-induced TH expression and dopamine levels and raises MAO-A expression in the NAc.
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Stuyt EB, Voyles CA. The National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives. Subst Abuse Rehabil 2016; 7:169-180. [PMID: 27994492 PMCID: PMC5153313 DOI: 10.2147/sar.s99161] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The National Acupuncture Detoxification Association (NADA)-standardized 3- to 5-point ear acupuncture protocol, born of a community-minded response to turbulent times not unlike today, has evolved into the most widely implemented acupuncture-assisted protocol, not only for substance abuse, but also for broad behavioral health applications. This evolution happened despite inconsistent research support. This review highlights the history of the protocol and the research that followed its development. Promising, early randomized-controlled trials were followed by a mixed field of positive and negative studies that may serve as a whole to prove that NADA, despite its apparent simplicity, is neither a reductive nor an independent treatment, and the need to refine the research approaches. Particularly focusing on the last decade and its array of trials that elucidate aspects of NADA application and effects, the authors recommend that, going forward, research continues to explore the comparison of the NADA protocol added to accepted treatments to those treatments alone, recognizing that it is not a stand-alone procedure but a psychosocial intervention that affects the whole person and can augment outcomes from other treatment modalities.
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Affiliation(s)
- Elizabeth B Stuyt
- Department of Psychiatry, University of Colorado Health Sciences Center, Pueblo, CO
| | - Claudia A Voyles
- Department of Clinical Studies, AOMA Graduate School of Integrative Medicine, Austin, TX, USA
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9
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Baker TE, Chang G. The use of auricular acupuncture in opioid use disorder: A systematic literature review. Am J Addict 2016; 25:592-602. [PMID: 28051842 DOI: 10.1111/ajad.12453] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 09/08/2016] [Accepted: 09/11/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Opioid use disorder (OUD) is a chronic disease with significant personal, societal, and public health consequences. Even for the minority who receive the most effective evidence-based treatments, morbidity, and mortality remain significant. These facts, along with the recovery movement calling for individualized, holistic, culturally sensitive care, have led to the exploration of adjunctive interventions including acupuncture. Despite hundreds of international trials, however, there is a lack of consensus regarding its efficacy in OUD due in large part to methodological issues of trials to date. In response to these issues, the National Acupuncture Detoxification Association (NADA) developed an operationalized manual auricular acupuncture protocol that has since become the most widely used in the US. This systematic review is the first to focus explicitly on randomized trials utilizing the NADA protocol as a complementary intervention to address OUD. METHODS The methods utilized to identify studies for inclusion are based on a 2009 protocol developed by the Cochrane Collaboration. RESULTS Four trials met inclusion criteria. Despite methodological issues, results indicate that while the NADA protocol may not be effective in reducing acute opiate craving or withdrawal, it may be effectively utilized as an adjunctive treatment to increase treatment retention and decrease methadone detoxification and maintenance dosages in OUD. CONCLUSION AND SCIENTIFIC SIGNIFICANCE Incorporation of the NADA protocol into existing evidence-based treatment approaches may facilitate recovery and, through its impact on treatment retention and completion, indirectly impact morbidity, and mortality in individuals with OUD. Given the limitations of the current review, conclusions are tentative and directions for future research are discussed. (Am J Addict 2016;25:592-602).
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Affiliation(s)
- Tanya E Baker
- Veterans Affairs Boston Healthcare System, Department of Psychiatry, Brockton, Massachusetts
| | - Grace Chang
- Veterans Affairs Boston Healthcare System, Department of Psychiatry, Brockton, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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10
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Ahlberg R, Skårberg K, Brus O, Kjellin L. Auricular acupuncture for substance use: a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services. Subst Abuse Treat Prev Policy 2016; 11:24. [PMID: 27451854 PMCID: PMC4959048 DOI: 10.1186/s13011-016-0068-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 06/28/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A common alternative treatment for substance abuse is auricular acupuncture. The aim of the study was to evaluate the short and long-term effect of auricular acupuncture on anxiety, sleep, drug use and addiction treatment utilization in adults with substance abuse. METHOD Of the patients included, 280 adults with substance abuse and psychiatric comorbidity, 80 were randomly assigned to auricular acupuncture according to the NADA protocol, 80 to auricular acupuncture according to a local protocol (LP), and 120 to relaxation (controls). The primary outcomes anxiety (Beck Anxiety Inventory; BAI) and insomnia (Insomnia Severity Index; ISI) were measured at baseline and at follow-ups 5 weeks and 3 months after the baseline assessment. Secondary outcomes were drug use and addiction service utilization. Complete datasets regarding BAI/ISI were obtained from 37/34 subjects in the NADA group, 28/28 in the LP group and 36/35 controls. Data were analyzed using Chi-square, Analysis of Variance, Kruskal Wallis, Repeated Measures Analysis of Variance, Eta square (η(2)), and Wilcoxon Signed Ranks tests. RESULTS Participants in NADA, LP and control group improved significantly on the ISI and BAI. There was no significant difference in change over time between the three groups in any of the primary (effect size: BAI, η(2) = 0.03, ISI, η(2) = 0.05) or secondary outcomes. Neither of the two acupuncture treatments resulted in differences in sleep, anxiety or drug use from the control group at 5 weeks or 3 months. CONCLUSION No evidence was found that acupuncture as delivered in this study is more effective than relaxation for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders. The substantial attrition at follow-up is a main limitation of the study. TRIAL REGISTRATION Clinical Trials NCT02604706 (retrospectively registered).
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Affiliation(s)
- Rickard Ahlberg
- />Faculty of Medicine and Health, University Health Care Research Center, Örebro University, P.O. Box 1613, SE-701 16 Örebro, Sweden
| | - Kurt Skårberg
- />Addiction Center, Faculty of Medicine and Health, Örebro University, P.O. Box 1613, SE-701 16 Örebro, Sweden
| | - Ole Brus
- />Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, P.O. Box 1613, SE-701 16 Örebro, Sweden
| | - Lars Kjellin
- />Faculty of Medicine and Health, University Health Care Research Center, Örebro University, P.O. Box 1613, SE-701 16 Örebro, Sweden
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11
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Impulsivity and Stillness: NADA, Pharmaceuticals, and Psychotherapy in Substance Use and Other DSM 5 Disorders. Behav Sci (Basel) 2015; 5:537-46. [PMID: 26703743 PMCID: PMC4695777 DOI: 10.3390/bs5040537] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 11/02/2015] [Accepted: 11/08/2015] [Indexed: 01/26/2023] Open
Abstract
Pharmaceuticals and psychotherapy are commonly used in the management of impulsivity. The National Acupuncture Detoxification Association (NADA) protocol is an adjunctive therapy that involves the bilateral insertion of 1 to 5 predetermined ear needle points. One of the main benefits reported by patients, providers, and programs utilizing NADA is the sense of stillness, centering, and well-being. The induction of this attitude is seen as contributing to improved clinical outcomes including engagement and retention. The attitude of stillness is also suggestive of a pathway to mitigating impulsivity. Impulsivity is associated with substance use disorders and other DSM 5 diagnoses. Impulsivity has characteristics that are manifested clinically in behaviors such as disinhibition, poor self-control, lack of deliberation, thrill seeking, risk-taking. NADA holds promise as a useful treatment adjunct in the comprehensive management of disorders for which impulsivity is a prominent component.
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12
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Raith W, Schmölzer GM, Resch B, Reiterer F, Avian A, Koestenberger M, Urlesberger B. Laser Acupuncture for Neonatal Abstinence Syndrome: A Randomized Controlled Trial. Pediatrics 2015; 136:876-84. [PMID: 26504123 DOI: 10.1542/peds.2015-0676] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Neonatal abstinence syndrome (NAS) is usually treated with opiate derivatives and supported with nonpharmacological treatment. METHODS This prospective, randomized, controlled, blinded, single-center study was carried out between March 2009 and November 2014. Newborn infants diagnosed with NAS after maternal opioid substitution therapy were eligible for inclusion. Infants were randomly allocated to the acupuncture group (combining laser acupuncture and pharmacological therapy of morphine and phenobarbital) or control group (pharmacological therapy alone). Laser acupuncture was performed with a LABpen MED 10 (675 nm/10 mW) at 5 ear and 4 body acupuncture points, bilaterally, and sessions were repeated every day. The primary outcome measure was duration of oral morphine therapy for NAS. Secondary outcomes included highest single Finnegan score, time to highest single Finnegan score, maximum amount of oral morphine solution (in milliliters per kilogram and milligrams per kilogram), time to maximum amount of oral morphine solution, and length of hospital stay. RESULTS Twenty-eight newborns (14 in each group) were eligible for analysis. Duration of oral morphine therapy was significantly reduced in the acupuncture group compared with the control group (28 vs 39 days, respectively, P = .019). In addition, we observed a significantly reduced length of hospital stay in the acupuncture group compared with the control group (35 days [interquartile range 25 to 47] vs 50 days [36 to 66], P = .048). CONCLUSIONS Adjunctive laser acupuncture significantly reduced the duration of morphine therapy in newborns with NAS.
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Affiliation(s)
- Wolfgang Raith
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Research Group for Paediatric Traditional Chinese Medicine, TCM Research Center Graz (Acupuncture Research),
| | - Georg M Schmölzer
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Department of Paediatrics, University of Alberta, Edmonton, Canada; Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada; and Alberta Health Services, Edmonton, Alberta, Canada
| | - Bernhard Resch
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine
| | - Fritz Reiterer
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine
| | - Alexander Avian
- Institutes for Medical Informatics, Statistics, and Documentation, and
| | - Martin Koestenberger
- Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Berndt Urlesberger
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Research Group for Paediatric Traditional Chinese Medicine, TCM Research Center Graz (Acupuncture Research)
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13
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McFadden DD, Chon TY, Croghan IT, Schroeder DR, Mallory MJ, Ebbert JO, Hays JT. Trial of intensive acupuncture for smoking cessation: a pilot study. Acupunct Med 2015; 33:375-80. [PMID: 26124197 DOI: 10.1136/acupmed-2015-010794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Despite the significant decline in smoking rates in the USA over the last 50 years, 42 million Americans continue to smoke. Although the combination of behavioural counselling with FDA-approved medications offers the best evidence-based treatment approach, 12-month relapse rates remain at >60%. Both healthcare providers and patients are searching for alternative treatment options. Most acupuncture trials have yielded poor results for smoking cessation; however, most trials have not used an intense treatment protocol and maintained treatment for at least 12 weeks. METHODS We designed a pilot study to address these methodological problems. Twenty-eight smokers were recruited to attend two 1 h acupuncture sessions weekly for 12 weeks. Primary endpoints included completion rate, acceptability of the protocol and side effects. Secondary endpoints included carbon monoxide (CO)-confirmed, 7-day point prevalence quit rates at 12 weeks and 26 weeks. RESULTS Sixteen of the 28 patients enrolled (57%) completed 12 weeks of treatment. Of the 17 patients who completed the end-of-study questionnaire, 94% (16/17) rated the programme as helpful, and 82% noted they would recommend it to friends for smoking cessation. Three of the 28 who initially enrolled in the study were confirmed abstinent at 12 weeks (10.7%); one of the 28 (3.6%) was abstinent at 26 weeks. CONCLUSIONS A larger study with a slightly less rigorous and more acceptable treatment protocol is feasible and should be considered.
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Affiliation(s)
- David D McFadden
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Tony Y Chon
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ivana T Croghan
- Nicotine Research Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Darrell R Schroeder
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Molly J Mallory
- Complementary and Integrative Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jon O Ebbert
- Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - J Taylor Hays
- Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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14
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Stuyt EB. Ear Acupuncture for Co-Occurring Substance Abuse and Borderline Personality Disorder: An Aid to Encourage Treatment Retention and Tobacco Cessation. Acupunct Med 2014; 32:318-24. [DOI: 10.1136/acupmed-2014-010540] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives Retention of individuals with co-occurring borderline personality disorder (BPD) and substance use disorders in treatment is known to be difficult. An outcome study of a tobacco-free 90-day inpatient dual-diagnosis treatment programme that uses several evidenced-based treatments in addition to ear acupuncture (acudetox) was undertaken to determine overall treatment effectiveness. Methods Between January 2009 and December 2011, 231 patients were treated in the programme, 88% with nicotine dependence and 79% with personality disorder diagnoses. All patients completing the programme were invited to enrol in a 1-year follow-up study in which they responded to monthly questionnaires to assess outcomes. Results 185 patients (80%) successfully completed the programme. There was no correlation between successful programme completion and gender, race, age, primary drug dependence diagnosis or primary psychiatric diagnosis. The use of acudetox was positively correlated with successful completion (p=0.006). Of the 78 patients with BPD, 100% of men and 83% of women successfully completed the programme. Their use of acudetox was positively correlated with successful completion (p=0.026). At the end of the year, 140 questionnaires were returned: 51 patients with BPD reported outcomes similar to the group as a whole, with 55% sober and doing well. Conclusions The use of acudetox was positively correlated with both successful completion of the programme for those with BPD as well as successful tobacco cessation, which ultimately improves the ability to maintain sobriety.
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Affiliation(s)
- Elizabeth B Stuyt
- Department of Psychiatry, University of Colorado, Denver, Colorado, USA
- Circle Program, Colorado Mental Health Institute at Pueblo, Pueblo, Colorado, USA
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