Pubdate: Tue, 15 Aug 2000
Source: New York Times (NY)
Copyright: 2000 The New York Times Company
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Author: Erica Goode

ACUPUNCTURE AIDS SOME AS THERAPY FOR COCAINE

Acupuncture appears to help some cocaine addicts escape their dependence on
the drug, according to a report published today by researchers at Yale
University.

Experts on drug abuse say cocaine addiction is one of the most difficult
forms of drug dependency to treat. And while many treatment centers have
been using acupuncture for some time, usually in combination with other
therapies, scientific studies of its effectiveness in treating cocaine
addiction have been inconclusive.

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

The report appears in the August issue of the journal 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 relatively small and that more research needed to be done to confirm the
results.

They also said that acupuncture was not a panacea and suggested that it
should be used along with other therapies like counseling.

"These are a difficult group of people to deal with," said Dr. Herbert D.
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," Dr. Kleber said.

Dr. 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 were its low cost and lack of side effects.

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

The study's findings are also encouraging, he added, because "they suggest
that with the proper groundwork we can conduct rigorous trials of
complementary or alternative therapies."

One obstacle that has confronted researchers trying to determine whether
acupuncture works has been the difficulty of finding convincing "placebo"
treatments to act as scientific controls. 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 treatment 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 itself 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 the Bronx, and adopted by the National Acupuncture
Detoxification Association.

Urine samples were taken three times a week to test for cocaine use. All the
subjects in the study, which was financed by the National Institute on Drug
Abuse, also received psychotherapy as part of the treatment program.

Dr. Margolin said that 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 might stimulate the vagus nerve that runs through the
center of the ear, producing a relaxing effect.

In Chinese medicine, Dr. 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.
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