Sticking cocaine addicts with pins: Acupuncture study

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Acupuncture appears to help some cocaine addicts escape their dependence, according to a report published this week by researchers at Yale University.

Experts say cocaine addiction is one of the hardest drug dependencies to treat. And while many treatment centres have been using acupuncture for some time, usually together with other therapies, scientific studies of its effectiveness in treating cocaine addiction have been inconclusive.

In the Yale study, 53.8% of the subjects who had needles inserted in four acupuncture "zones" in the ear five times a week tested free of cocaine after eight weeks. In comparison, 23.5% of control subjects given "sham" acupuncture treatments and 9.1% of subjects who watched relaxation videos tested free of the drug during the last week of the study.

The report is in the August issue of 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 receiving methadone treatment for the 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 quite small and that more research needed to be done to confirm the results.

They also said acupuncture was not a panacea and should be used along with other therapies such as counselling.

"These are a difficult group of people to deal with," said Herbert 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 for treating cocaine addiction, and acupuncture appears to be a useful adjunct for decreasing dependence," Kleber said.

Arthur Margolin, a research scientist in the department of psychiatry at Yale's medical school and lead author of the report, said that among the benefits of acupuncture are its low cost and lack of side effects.

And unlike pharmaceutical treatments, Margolin said, it can be offered to pregnant women.

Convincing "placebos" to act as scientific controls have been hard to find in acupuncture studies. 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 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 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 New York, and adopted by the National Acupuncture Detoxification Association.

Urine samples were taken three times a week to test for cocaine use. All the subjects also received psychotherapy.

Margolin said 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 may stimulate the vagus nerve that runs through the centre of the ear, producing a relaxing effect.

In Chinese medicine, 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.