A randomized controlled trial of auricular acupuncture for cocaine dependence. Auricular acupuncture as an adjunctive treatment for cocaine addiction. A pilot study. Acupuncture for the treatment of cocaine addiction: a randomized controlled trial. Auricular acupuncture in the treatment of cocaine abuse. A study of efficacy and dosing. Acupuncture for crack-cocaine detoxification: experimental evaluation of efficacy. Acupuncture for the treatment of cocaine addiction. Investigation of a needle puncture control. Auricular electro-acupuncture as an additional perioperative analgesic method during oocyte aspiration in IVF treatment. A large randomized placebo controlled study of auricular acupuncture for alcohol dependence. Effectiveness of adjunct therapies in crack cocaine treatment.
Partly because of a lack of a conventional, effective treatment for cocaine addiction, auricular acupuncture is used to treat this disorder in numerous drug treatment facilities across the country for both primary cocaine-dependent and opiate-dependent populations.
                To evaluate the effectiveness of auricular acupuncture for the treatment of cocaine addiction.
                Eighty-two cocaine-dependent, methadone-maintained patients were randomly assigned to 1 of 3 conditions: auricular acupuncture, a needle-insertion control condition, or a no-needle relaxation control. Treatment sessions were provided 5 times weekly for 8 weeks. The primary outcome was cocaine use assessed by 3-times-weekly urine toxicology screens.
                Longitudinal analysis of the urine data for the intent-to-treat sample showed that patients assigned to acupuncture were significantly more likely to provide cocaine-negative urine samples relative to both the relaxation control (odds ratio, 3.41; 95% confidence interval, 1.33-8.72; P =. 01) and the needle-insertion control (odds ratio, 2.40; 95% confidence interval, 1.00-5.75; P =.05).
                Findings from the current study suggest that acupuncture shows promise for the treatment of cocaine dependence. Further investigation of this treatment modality appears to be warranted. The authors conducted a single-blind study of auricular acupuncture in 36 cocaine-dependent inpatient veterans on a substance abuse treatment unit to determine whether the treatment could help reduce craving, increase treatment retention, and prevent relapse. Acupuncture was given on a predetermined schedule to both treatment and control groups, with status assessed regularly by independent, blinded raters. The study failed to show a significant difference between treatment and control groups. However, the study patients, as a whole, did remain in treatment longer than a retrospectively analyzed group who received no acupuncture. 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.
                To investigate the effectiveness of auricular acupuncture as a treatment for cocaine addiction.
                Randomized, controlled, single-blind clinical trial conducted from November 1996 to April 1999.
                Six community-based clinics in the United States: 3 hospital-affiliated clinics and 3 methadone maintenance programs.
                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. Concurrent drug counseling was also offered to patients in all conditions.
                Cocaine use during treatment and at the 3- and 6-month postrandomization follow-up based on urine toxicology screens; retention in treatment.
                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.
                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. A single-blind, randomized, placebo-controlled study was performed to evaluate auricular acupuncture (AAc) in the treatment of cocaine addiction. Two linked but concurrent studies were done. In Study 1, residential clients (N = 236) were randomized to true acupuncture (Ac), sham Ac, and conventional treatment without Ac. Treatment group subjects received Ac at three ear points considered to be specific for the treatment of substance abuse (SA). Control subjects received three nonspecific (sham) points. In Study 2, day treatment clients (N = 202) were randomized to one of three dose levels of true Ac (28, 16, or 8 treatments). Subjects received Ac at five, rather than three, specific ear points. Nonspecific (sham) points were not used in Study 2. With rare exception, the data failed to identify significant treatment differences among the true and sham Ac, and psychosocial groups. Furthermore, no differences were observed among the three dose levels of true Ac. Anecdotal studies have reported acupuncture alleviating the severity of withdrawal symptoms associated with cocaine abuse. The efficacy of auricular (ear) acupuncture in reducing cocaine/crack craving and consumption was examined via a single-blind, placebo experiment. One hundred and fifty individuals seeking treatment for cocaine/crack abuse were randomly assigned to receive either experimental or placebo acupuncture treatments. Treatments were provided in an outpatient setting for a one-month period. Placebo treatments involved acupuncture at ear locations not used for drug treatment. Subjects provided urine specimens for drug content analysis after each acupuncture session. Urinalysis results over the one-month study period favored the experimental group. Experimental subjects in treatment over 2 weeks had significantly lower cocaine metabolite levels relative to placebo subjects in treatment for a comparable period. Treatment retention with both groups was similar. Relative to pretreatment usage, a significant decrease in cocaine consumption was reported by both groups. Self-report outcomes did not indicate significant between-groups differences. We conducted a 6-week, single-blind study of acupuncture for cocaine dependence in methadone-maintained patients (N = 40) for the purpose of identifying an appropriate needle puncture control for use in future large-scale clinical trials. Patients were randomly assigned to receive daily acupuncture in three auricular sites plus one body site (LI-4), or in control sites within 2-3 mm of the four active sites. Overall, there was a positive response to treatment on a variety of drug-related and psychosocial measures. Cocaine use decreased significantly for patients in both needle puncture groups. The only statistically significant difference between the two types of needle puncture was on ratings of craving. Subjects rated each type of needle puncture as equally credible and perceived no significant differences on the acute effects of the two types of needle insertions. Power calculations based on these findings suggest that very large sample sizes would be required to detect treatment differences between this control condition and active acupuncture. Alternative controls are suggested, and the challenges inherent in implementing controlled clinical trials of acupuncture are discussed. The aim of this study was to compare the pain-relieving effect and the subjective well-being between auricular electro-acupuncture (EA) analgesia, auricular acupuncture (A) and conventional analgesia with remifentanil (CO).
                A total of 94 women undergoing IVF were randomized to auricular acupuncture with (EA, n = 32) or without (A, n = 32) continuous 1 Hz auricular stimulation (using a battery-powered miniaturized stimulator, P-Stim) or with adhesive tapes instead of needles and no electrical stimulation (control group, CO, n = 30) at the auricular acupuncture points 29, 55 and 57. All patients received patient-controlled analgesia (PCA) with remifentanil. Pain intensity and psychological well-being were assessed by means of visual analogue scales (VAS); tiredness, nausea and vomiting and analgesic drug consumption were documented.
                Pain relief and subjective well-being were significantly greater in group EA during and after the procedure as compared with groups A and CO (P < 0.001). The patients were significantly more tired in group CO than in groups A and EA (P < 0.001). Consumption of the opioid remifentanil was significantly lower in group EA, comparable nausea (P < 0.001).
                Auricular EA significantly reduces pain intensity and analgesic consumption of the opioid remifentanil during oocyte aspiration in IVF treatment. We report clinical data on the efficacy of acupuncture for alcohol dependence. 503 patients whose primary substance of abuse was alcohol participated in this randomized, single blind, placebo controlled trial. Patients were assigned to either specific acupuncture, nonspecific acupuncture, symptom based acupuncture or convention treatment alone. Alcohol use was assessed, along with depression, anxiety, functional status, and preference for therapy. This article will focus on results pertaining to alcohol use. Significant improvement was shown on nearly all measures. There were few differences associated with treatment assignment and there were no treatment differences on alcohol use measures, although 49% of subjects reported acupuncture reduced their desire for alcohol. The placebo and preference for treatment measures did not materially effect the results. Generally, acupuncture was not found to make a significant contribution over and above that achieved by conventional treatment alone in reduction of alcohol use.
                Copyright 2002 Elsevier Science Inc. Although intensive outpatient therapy is recommended for treatment of cocaine, psychosocial characteristics associated with crack cocaine abuse are also implicated in attrition from outpatient programs. Acupuncture, medications, and brainwave therapy (biofeedback), have all been used to encourage treatment retention and drug use outcomes. The effectiveness of three adjunct therapies in improving retention and drug use outcomes in intensive outpatient cocaine treatment was tested in a primarily young, indigent African-American sample of crack cocaine users at a community hospital in a low-income, high drug use neighborhood in Houston. Subjects were assigned to receive either neurobehavioral treatment alone or neurobehavioral with one of three adjunct therapies. These included acupuncture, anticraving medication, or brainwave therapy. Comparative results indicated that dosage of any adjunct therapy was associated with days in treatment and standard treatment sessions attended, and that standard treatment sessions attended was associated with negative urinalysis results at follow-up. None of the adjunct therapies were directly associated with drug use outcomes.
There is currently no evidence that auricular acupuncture is effective for the treatment of cocaine dependence. The evidence is not of high quality and is inconclusive. Further randomised trials of auricular acupuncture may be justified.