Pubdate: Wed, 23 Aug 2000 Source: Houston Chronicle (TX) Copyright: 2000 Houston Chronicle Contact: Viewpoints Editor, P.O. Box 4260 Houston, Texas 77210-4260 Fax: (713) 220-3575 Website: http://www.chron.com/ Forum: http://www.chron.com/content/hcitalk/index.html Author: Garret Condon DRUG TREATMENT STUDY LOOKS AT ACUPUNCTURE Acupuncture Can Really Stick It To Cocaine Addiction. A Yale University team, working with cocaine and heroin addicts, has found that an acupuncture technique already used with drug addicts was more effective than a placebo form of acupuncture or relaxation therapy. The study was the first to compare acupuncture to relaxation and a tested placebo. The finding holds promise not only for drug treatment but also for rigorous studies of alternative therapies, according to Arthur Margolin, the study's principal investigator and a research scientist at the Yale University School of Medicine. The study is published in the Archives of Internal Medicine. The study looked at 82 subjects who were addicted to heroin and cocaine and who were being treated with methadone for their heroin addiction. They were randomly assigned to one of three groups, which offered treatment five times a week for eight weeks. One group got the real thing, while another group got the sham acupuncture and a third received relaxation therapy. About half of those receiving the acupuncture technique -- 53.8 percent -- tested free of cocaine during the last week of treatment, compared to 23.5 percent in the placebo group and 9.1 percent in the relaxation group. Those who completed acupuncture treatment also had longer periods of sustained abstinence compared to participants in the other groups. Although acupuncture is among the most mainstream alternative therapies, there has been some controversy over how to scientifically evaluate it. In pharmaceutical tests, subjects are randomly assigned to receive either the active drug or a placebo -- an inert "sugar pill." Ideally, neither the patients nor those administering the pills know who is getting the real drug until the test is over. It is not quite so easy to create a placebo treatment when assessing acupuncture, which involves insertion of needles into a body along meridians or energy channels mapped out in traditional Asian medicine. The Yale team did preliminary work to find an area of the outer ear on which the needles would have little effect. As a result, the rolled, outer surface of the ear -- the helix -- was chosen as the needle site for the placebo group. For the real acupuncture, Margolin's group used the National Acupuncture Detoxification Association treatment protocol, developed more than a decade ago at New York's Lincoln Hospital. This method involves the insertion of three to five small needles into the "concha" of the outer ear -- the bowl-like surface near the ear canal. He acknowledged that while a host of theories attempt to explain how body acupuncture works, little research has been done on the mechanism through which acupuncture on the ear works to curb addiction. A leading theory, according to Janet Konefal, associate professor of psychiatry and behavioral sciences and chief of the division of complementary medicine at the University of Miami School of Medicine, is that acupuncture triggers a response among neurotransmitters -- the brain's messenger chemicals -- that interfere with the biochemical process of craving and addiction. Researchers in Hong Kong stumbled into this effect three decades ago when opium addicts volunteered for a study on acupuncture and pain, and reported that the technique decreased their craving for drugs. Margolin emphasized that the Yale study further opens the door on research into acupuncture and addiction, but is far from the last word. Subjects in the study received both individual and group psychotherapy, and he said more work needs to be done to determine the type of psychotherapy -- or mix of therapies -- that work best with acupuncture to fight addiction. - --- MAP posted-by: Larry Stevens