Auriculotherapy: Stimulation of specific locations on the surface of the ears (the auricle) to influence emotional and physical wellbeing. Stimulation may result from insertion of needles, treatment by a cold laser, finger pressure, or application of magnets, beads, or seeds to the ear surface. What are stimulated are nerve branches inside the ears that lead to the brain and from there to the organs, glands, and peripheral nervous system. This isn’t the same mechanism of action as understood to be occurring in body acupuncture. Acupuncture points along meridians are always at the same location whether the person or animal is ill or well. In contrast, ear points shift according to the health of the individual. Beginning in the 1950s Paul Nogier, MD, of Lyons, France, extensively researched treatment of pathologies through stimulating points on the human ear and discovered three distinct phases of ear points, depending on whether the condition was acute or chronic. We will not be discussing the Nogier theories of auriculotherapy in this course, but if you are interested in delving deeper into his work you can look at www.auriculotherapyseminars.com, the website of his son Raphael Nogier, MD, who carries on his father’s work.
(SLIDE 16)Acupuncture: The word acupuncture can mean simply the insertion of needles into the skin for the purpose of initiating a healing response. Or, it can signify a comprehensive system of healing involving stimulation of any number from one to several dozen of potentially hundreds of points along the skin surface in an individualized prescription created by the licensed acupuncturist after careful analysis of the client’s history and current condition. The points can have healing power of their own or due to their location and relationship to other points along a designated channel called a meridian. These channels conduct light, which enters and exits the body at acupuncture points. There are 14 major meridians and numerous other minor ones and they exist in animals as well as humans. Each meridian has a specific direction of flow and an identifying color, season, taste, and symptoms of pathology.
(SLIDE 17) Acudetox Specialists or Ear Point Technicians: Although the terms vary depending on the state, these are trained providers of auriculotherapy for people in recovery from addiction, mental health conditions, or trauma. ADS/EPTes have graduated from the NADA curriculum or a similar curriculum approved in their state. Depending on the state, province, or country they may be licensed acupuncturists or physicians or, in 19 states and 3 provinces, they may be non-acupuncturists.
The term Acudetox Specialist or ADS has been almost universally used since NADA began teaching the technique, but licensed acupuncturists concerned with loss of control over what they consider their professional turf fight legalizing ADSes so we here in California prefer to use the term EPT meaning Ear Point Technician, which eliminates “acu” in the title. ADS/EPTes do not perform acupuncture as they are allowed legally to only perform the NADA five points and though to some it might be considered only semantics to those of us working to legalize EPTs it is an important distinction.
Why is having ADS/EPTs important? Because what they do is simple, repetitive, doesn’t involve diagnosis, and is readily available to any treatment program with staff willing to be trained to do it. It offers every treatment program a way to afford to have the NADA protocol and it expands exposure to the power of Chinese medicine to a population who would never otherwise fall in love with it. It directs more people to go to licensed acupuncturists when the clients in treatment tell their family and friends about their experience, and it offers licensed acupuncturists higher status and more pay as supervisors of multiple sites. One Licensed Acupuncturist in Baltimore was making $1,000 extra a month being a supervisor.
(SLIDE 18) Drug: A substance used to influence the workings of body or mind.
(SLIDE 19) Addiction: At the effect of a habit or drug that causes unacceptable discomfort upon cessation. Officially, one is addicted when one continues to use a substance in spite of negative consequences at work, at home, and elsewhere and in spite of the harm it causes oneself and others.
(SLIDE 20) Substance Use Disorders: The newer politically correct name for drug use. One can use a substance and even become addicted without abusing it. For example a person can take an opiate exactly as prescribed by her physician and become addicted to it. To be diagnosed as having a substance use disorder one must exhibit at least two of these four criteria: Wanting to reduce use but unable to do so, suffering consequences in relationships to others due to one’s use, using even when harmful to oneself or others, and exhibiting or reporting tolerance and withdrawal symptoms when one attempts to stop using. It is possible for someone to use a drug such as marijuana occasionally without becoming addicted or having noticeable harmful effects to anyone else or even the person smoking. It depends greatly on the biochemistry and genetics of the persons using the drug to what extent their use will take over their lives and they and others will suffer for it.
(SLIDE 21) Substance Abuse or Drug Abuse: Issues related to drugs fall along a continuum of increasing consequences to oneself and others. Use comes first, and may or may not involve addiction, then abuse and then dependence (see below). Abuse is indicated by failure to fulfill obligations at home, school, or work. Also continuing to use even when the situation is dangerous, involves the law, and causes continuing difficulties in relationships.
(SLIDE 22) Tolerance: Abuse is about behavior. Tolerance is about physiology. The body’s response to repeated doses of a drug in the body’s attempt to maintain homeostasis. The person feels less of an effect over time and needs more of the drug to force the desired high. Or, the person needs more to avoid withdrawal symptoms. Tolerance with alcohol means the body has been exposed to high levels of alcohol repeatedly so produces more of the enzyme that breaks down alcohol, processing out the alcohol more quickly. To maintain the desired state of intoxication the person must drink more and more. Tolerance leads to dependence.
(Slide 23) Dependence: In addition to the response of the body when a person is repeatedly inebriated, excessive use of a substance triggers neurotransmitter receptors to reduce the number of the sites open to receive those neurotransmitters. This is called “downregulation.” It too causes the person to need more and more of the drug to feel the same level of high as before. At some point the person’s body demands the drug just to avoid the unpleasant symptoms of withdrawal, no longer to get high. The drug has taken control. To prevent withdrawal the person spends an enormous amount of time searching for, obtaining, using, and recovering from use of the substance regardless of the consequences to others or him/her self.
(Slide 24) Behavioral Addictions: Similar to substance use disorders in being at the effect of a behavior, driven to perform that behavior in spite of negative consequences, and feeling severe discomfort upon cessation. Some examples are gambling, video gaming, online pornography, sexual promiscuity, shopping, and eating carbohydrates. Since all except gambling are outside the DSM, the Diagnostic and Statistical Manual that has become the bible of insurance company payments for medical encounters, clinicians often categorize these behaviors as impulse control disorders.
(Slide 25) Withdrawal: The body’s response to lowered doses or cessation of drug use after developing a tolerance to the drug. The results can run the gamut from annoying to fatal, involving, for example, the skin, nerves, bowels, stomach, muscles, and heart.
(Slide 26) Dual Diagnosis: One person diagnosed with both a mental health and substance use disorder.
(Slide 27) Recovery: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. (SAMHSA as of December 22, 2011)
(Slide 28) Neurotransmitters: Molecules that carry a message from the neuron releasing the neurotransmitter to a designated receptor site on a target cell across a space called a synapse. The message can involve an emotion, a memory, a sensation, or any number of other phenomena through the peripheral nervous system and into and out of the brain. Out of the more than a hundred known neurotransmitters there are five of special interest to those of us involved in addictive and mental health disorder treatment: serotonin, dopamine, norepinephrine, endorphins, and GABA.
(Slide 29) Receptor Sites: An individualized landing site for a specific kind of neurotransmitter. When a neurotransmitter that was released from one nerve cell locks into its receptor site it triggers a message down the receiving neuron, thus continuing the message through the system.