Pubdate: Thu, 03 Jan 2002
Source: New York Times (NY)
Section: Health
Copyright: 2002 The New York Times Company
Contact:  http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Erica Goode
Bookmark: http://www.mapinc.org/coke.htm (Cocaine)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

STUDY FINDS BEATING COCAINE TAKES MORE THAN ACUPUNCTURE

Acupuncture is widely used as a treatment for cocaine addiction. But the 
results of a large clinical trial suggest that when used alone without 
other treatments the therapy is not effective in reducing cocaine 
dependency, researchers report yesterday.

Needles inserted into four acupuncture zones in the ear that are commonly 
used in treating addiction did no more to curtail cocaine use than 
relaxation exercises or a sham procedure in which needles were inserted 
into the rim of the ear. The study participants received the acupuncture or 
the other treatments five times a week for eight weeks.

Dr. Arthur Margolin, a research scientist at Yale's School of Medicine and 
the main author of the study, said that based on the findings, "the 
recommendation would be that acupuncture not be used by itself as a 
treatment for addiction, or in a setting where there is only minimal 
counseling or therapy."

But Dr. Margolin added, "I don't think this trial shows that acupuncture is 
ineffective across the board."

Some practitioners who use acupuncture to treat cocaine addiction did not 
dispute the study's findings but said the technique was rarely used alone 
and was usually combined with other treatments. The way that acupuncture 
might work to treat addiction remains unclear.

A report on the study appeared yesterday in The Journal of the American 
Medical Association.

Earlier studies of acupuncture as a treatment for cocaine dependency, one 
of the most difficult forms of drug addiction to combat, have emerged with 
mixed results. A smaller trial at Yale last year found the therapy to be 
effective in helping some people reduce their reliance on the drug.

Experts on addiction said the new trial -- by Dr. Margolin, Dr. Herbert D. 
Kleber, of Columbia University's National Center on Addiction and Substance 
Abuse, and more than a dozen collaborators at six community-based drug 
dependency clinics around the country -- was the largest to test 
acupuncture's effectiveness for drug addiction and among the largest to 
examine the method's usefulness in any medical condition.

The acupuncture procedure used in the trial followed guidelines developed 
at Lincoln Medical and Mental Health Center in the Bronx and adopted by the 
National Acupuncture Detoxification Association.

Of the 620 adults who initially enrolled in the trial, 208 of whom 
regularly used heroin as well as cocaine, almost half dropped out before 
the study's completion, as is common in studies of addiction treatment.

Those who remained showed a significant reduction in cocaine use, as 
measured by urine samples. But the extent of the reduction was the same no 
matter which treatment the subjects received.

And while some experts have argued that acupuncture helps people with drug 
problems stay in treatment, the subjects who received acupuncture were no 
more likely to finish the trial or to attend the counseling sessions 
offered to participants.

Dr. Margolin said the findings were unexpected in light of the earlier, 
positive results from the smaller Yale trial.

"It's not unusual when you have successive trials of similar treatments to 
have different findings, but to go from a fairly strong finding for 
acupuncture to no finding was surprising," he said.

In their report, Dr. Margolin and his colleagues suggest that the 
difference may be explained by the fact that the subjects in the smaller 
study received more intensive individual counseling and weekly group 
therapy in addition to acupuncture. And unlike the subjects in the smaller 
study, the participants in the national trial were paid $2 per session and 
an additional $10 at the end of each week for their participation. Those 
who remained in the study until the end were the most severely addicted and 
the least motivated to conquer their dependency.
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