NADA 5-Point Ear Protocol Training

On Acudetox Research

ON ACUDETOX RESEARCH

 

H.L. Wen of Hong Kong was the first physician to report successful treatment of addiction withdrawal symptoms with acupuncture (Wen, 1973). He observed that an opium addict receiving electro acupuncture as pre-surgical analgesia experienced relief of withdrawal symptoms. The point stimulated was the ear acupuncture point corresponding to the Lung. Subsequently Wen conducted several basic clinical pilot studies which formed the basis of subsequent research.

Bullock (1987) studied 54 chronic alcohol abusers in an inpatient (although they could leave during the day), AA-based setting that were randomly assigned to either the NADA treatment or needling at nearby ear points (the “sham” group). Acudetox receivers showed significantly better outcomes regarding attendance, self-reported desire for alcohol and drinking episodes, and readmission for detoxification.

Bullock (1989) replicated that study with 80 chronic alcohol abusers. Twenty-one (21) of the 40 patients in the NADA protocol group completed the 8 week treatment program as compared to 1 of the 40 sham in the sham group. Sham receivers self reported twice the number of drinking episodes and were more than twice as likely to be readmitted for detoxification within 6 months. This study, published in the esteemed British medical journal, The Lancet, garnered considerable attention and credibility for acudetox.

Washburn (1993) reported that opiate addicted individuals receiving correct site acupuncture showed significantly better program attendance relative to subjects receiving acupuncture on placebo sites.

Results from then available placebo-designed studies support the conclusion that acupuncture’s effectiveness in facilitating abstinence with alcohol, opiate and cocaine addicted subjects is not due to a simple placebo effect (Brewington, 1994).

Konefal (1995) examined the efficacy of different ear acupuncture protocols with patients with various addiction problems. Subjects (n=321) were randomly assigned to one of three groups; a one needle protocol using the Shen Men point; the five-needle NADA acudetol protocol; or the five-needle acudetox protocol plus selected body points for self-reported symptoms. All groups showed an increase in the proportion of drug-free urine tests over the course of treatment. (Subjects with the single needle protocol showed significantly less improvement compared to the other two groups.)

Shwartz, Saitz, Mulvey and Brannigan (1999) published a multi-variant, retrospective cohort study of 8,011 clients discharged from publicly funded detoxification programs in Boston. Comparison of outpatient (acudetox plus traditional detoxification/counseling) programs with residential (short-term detoxification without acudetox), showed acudetox recipients less likely to relapse. Only 18% of the acudetox clients readmitted to treatment within six months as opposed to 36% of the residential clients.

A pilot study in Klamath Falls, Oregon by Russell, Sharp and Gilbertson (2000) of 86 addicted clients with chronic histories of arrest found a statistically significant increase in program retention for acudetox outpatient treatment as opposed to a historical no-acupuncture control group. Researchers noted positive trends towards fewer new arrests, fewer positive urinalysis results, and a shorter time needed to move through treatment phases/levels.

A Yale University study (Avants, 2000) of 82 cocaine-dependent methadone-maintained subjects, randomly assigned to three groups, found statistically significant results for cocaine- free urines: fifty-eight (58 %) of the acudetox group as compared to 24% of the sham control group and 9% of the relaxation video control group.

The Yale study was a pilot for a larger, six-site nationwide study that yielded less favorable findings (Margolin, et al, 2002). This trial published in Journal of the American Medical Association (JAMA) found no statistically significant difference between the acudetox group and the control groups concluding, “Our study therefore does not support the use of acupuncture as a stand-alone treatment for cocaine addiction.” (Of note, between the first Yale study and the larger study, the protocol was modified slightly with less clinical recovery support offered to the study subjects and with reimbursement for study participation regardless of use. The study’s conclusion is noteworthy in that NADA has always supported the concept and practice of acudetox as an adjunctive treatment which should not be used as a stand-alone recovery intervention.)

Researchers in Arizona (Bier et al, 2002) studied acudetox for nicotine dependent subjects (141). At one month, 10% of subjects receiving acudetox only were not smoking as compared to those receiving sham acupuncture along with education/counseling (22%) or those receiving real acudetox along with the clinical intervention (40%).

While originally discovered and developed as an adjunct intervention for acute opiate withdrawal, the NADA protocol has since proved an effective tool across various addictions, both substance and behavioral “process” type addictions, across different client populations, and across the continuum of care. Over the last thirty years, NADA practitioners have found acudetox helpful in treating persons dependent upon opiates, alcohol, cocaine, poly-substances, marijuana, methamphetamine, prescription medication, as well as those addicted to acting out with food, sex, gambling, etc.

References

Avants SK, Margolin A, Holford TR, Kosten TR (2000). A randomized controlled trial of auricular acupuncture for cocaine dependence. Archives of Internal Medicine, 160(5): 2305-2312.

Bier ID, Wilson J, Studt, P, Shakleton, M (2002).  Auricular acupuncture, education and 
smoking cessation: A randomized, sham controlled trial.  American Journal of Public Health, 92, 1642 – 1647.

Brewington V, Smith M, Lipton D (1994). Acupuncture as a detoxification treatment: An  analysis of controlled research. Journal of Substance Abuse Treatment, 11(4): 289-307.

Bullock ML, Culliton PC, Olander RT (1989, June 24). Controlled trial of acupuncture for severe recidivistic alcoholism. The Lancet,1435-1439. 

Bullock ML, Ulmen AJ, Culliton PD, and Olander RT (1987 May-June). Acupuncture treatment of alcohol recidivism.  Alcoholism: Clinical and Experiential Research, 11(3): 292-295.

Konefal J, Duncan R, Clemence C (1995). Comparison of three levels of auricular acupuncture in an outpatient substance abuse treatment program. Alternative Medicine Journal, 2(5)1.

Margolin A, Kleber HD, Avants SK, et al (2002).  Acupuncture for the treatment of cocaine addiction: A randomized controlled trial.  JAMA, 287(1): 55-63.

Russell LC, Sharp B, Gilbertson B (2000).  Acupuncture for addicted patients with chronic histories of arrest. A pilot study of the Consortium Treatment Center. Journal of Substance Abuse Treatment, 19: 199-205.

Shwartz M, Saitz R, Mulvey K, Brannigan P (1999). The value of acupuncture detoxification programs in a substance abuse treatment system. Journal of Substance Abuse Treatment, 17(4): 305-312.

Smith MO Brewington V, and Culliton P (1998) Acupuncture in addiction treatment. In  Sherman, B. R., Sanders, L.M., Trinh, C. (Eds.) Addiction and Pregnancy: Empowering  Recovery Through Peer Counseling.  Praeger Publishing.

Washburn AM, Fullilove RE, Fullilove MT, et al (1993 July / August). Acupuncture heroin  detoxification: A single blind clinical trial. Journal of Substance Abuse Treatment, 10 (4):  345-351.

Wen HL. Cheng SYC (1973). Treatment of drug addiction by acupuncture and electrical  stimulation. Asian Journal of Medicine, 9, 138-141.

 

From the NADA Training Resource Manual (2010) Includes excerpted material from Smith, Brewington, Culliton (1998)