The National Acupuncture Detoxification Association (NADA)-standardized 3- to 5-point ear acupuncture protocol, born of a community-minded response to turbulent times not unlike today, has evolved into the most widely implemented acupuncture-assisted protocol, not only for substance abuse, but also for broad behavioral health applications. This evolution happened despite inconsistent research support. This review highlights the history of the protocol and the research that followed its development. Promising, early randomized-controlled trials were followed by a mixed field of positive and negative studies that may serve as a whole to prove that NADA, despite its apparent simplicity, is neither a reductive nor an independent treatment, and the need to refine the research approaches. Particularly focusing on the last decade and its array of trials that elucidate aspects of NADA application and effects, the authors recommend that, going forward, research continues to explore the comparison of the NADA protocol added to accepted treatments to those treatments alone, recognizing that it is not a stand-alone procedure but a psychosocial intervention that affects the whole person and can augment outcomes from other treatment modalities.

Because it has been seen repeatedly that using another addictive drug frequently leads to relapse to using the initial drug of choice, most chemical-dependence treatment specialists recognize the necessity of addressing all drugs of abuse in the same treatment setting. This treatment philosophy, however, does not appear to apply to the drug nicotine. Although a significant number of persons with alcohol/ drug dependence use tobacco on a regular basis, there do not appear to have been any studies conducted on the effect of nicotine use on outcome after treatment for alcohol/drug dependence. In a prospective study, the authors compared 12-month recovery rates after inpatient treatment for alcohol/ drug dependence in tobacco users and non-tobacco users. Significantly better recovery rates were discovered for non-tobacco users than tobacco users, especially if the drug of choice was a sedative, such as alcohol or narcotics. Data presented here support the theory that continued nicotine use may be a relapse factor for resuming alcohol use.

This retrospective study of patients treated in a ninety-day, inpatient, dual-diagnosis treatment program examined antipsychotic effectiveness in this population using length of stay in treatment and successful program completion as outcome measures. All patients with co-occurring substance dependence and schizophrenia or schizoaffective disorder treated with olanzapine, risperidone, ziprasidone, and typical depot neuroleptics from January 2001 to December 2003 (N = 55) are the subjects of this study. Patients stayed longer in treatment when taking risperidone (82 +/- 19 days) or ziprasidone (74 +/- 21 days) compared with olanzapine (44 +/- 30 days) or typicals (47 +/- 36 days). Eighty-eight percent of risperidone patients and 64% of ziprasidone patients successfully completed the program, while only 33% of olanzapine patients and 40% of patients on typicals successfully completed the program. Risperidone and ziprasidone were associated with significantly better program performance than olanzapine or depot typicals in this population. Possible reasons for this difference are discussed.