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Addiction

Acupuncture is used extensively, and worldwide, in substance misuse treatment centres. This stems from the development of a simple 5-point auricular acupuncture protocol at New York's Lincoln Hospital in the 1970's, originally for drug users but subsequently extended to tobacco, alcohol and other addictive substances and behaviours. The protocol was designed to operate within Western health settings and mutual peer support systems, not as an isolated treatment.

In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body's homeostatic mechanisms, thus promoting physical and emotional well-being. Stimulation of certain acupuncture points has been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the 'analytical' brain, which is responsible for anxiety and worry (Wu 1999).

Results from randomised controlled trials (Tian 2006; Berman 2001; Hyun 2010; Yeh 2009; Wu 2007) and systematic reviews (Cho 2009; Liu 2009; Gates 2006; White 2006; Jordan 2006; Mills 2005) looking at the effects of acupuncture on withdrawal symptoms and relapse rates related to alcohol, opiate, nicotine and cocaine misuse have been equivocal, mainly because of the poor quality of the research. The acupuncture provided in the trials has sometimes been inadequate, sham controls have often been inappropriate, many studies are too small and high dropout rates are common. Acupuncture has most commonly been evaluated against a sham control, which may in effect be no more than comparing two versions of acupuncture. There appears to be a discrepancy between results in experimental settings and those in normal practice, so context effects may be important (Margolin 2003). Better studies are required, especially those comparing acupuncture to usual care, and as an adjunct to usual care rather than a stand-alone intervention (See Table below).

Acupuncture may help relieve symptoms of drug withdrawal by:

  • normalising the release of dopamine in the mesolimbic system. This reduces the over-stimulating effects of abused drugs and modifies behaviours associated with addiction such as those around desire and reward. Several brain neurotransmitter systems, for example serotonin, opioid and GABA, are implicated in this (Lee 2009a, Yang 2008, Zhao 2006)

  • reducing anxiety (Samuels 2008). Acupuncture can alter the brain's mood chemistry, reducing serotonin levels (Zhou 2008) and increasing endorphins (Han 2004) and neuropeptide Y levels (Lee 2009b; Cheng 2009);

  • modulating postsynaptic neuronal activity in the nucleus accumbens and the striatum to reduce nicotine addiction (Chae 2004) and increasing corticotrophin-releasing factor  to attenuate anxiety-like behaviour following nicotine withdrawal (Chae 2008).

 

(Article from the British Acupuncture Council website)