Auricular acupuncture for substance use: a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services

Abstract

BackgroundA common alternative treatment for substance abuse is auricular acupuncture. The aim of the study was to evaluate the short and long-term effect of auricular acupuncture on anxiety, sleep, drug use and addiction treatment utilization in adults with substance abuse.MethodOf the patients included, 280 adults with substance abuse and psychiatric comorbidity, 80 were randomly assigned to auricular acupuncture according to the NADA protocol, 80 to auricular acupuncture according to a local protocol (LP), and 120 to relaxation (controls). The primary outcomes anxiety (Beck Anxiety Inventory; BAI) and insomnia (Insomnia Severity Index; ISI) were measured at baseline and at follow-ups 5 weeks and 3 months after the baseline assessment. Secondary outcomes were drug use and addiction service utilization. Complete datasets regarding BAI/ISI were obtained from 37/34 subjects in the NADA group, 28/28 in the LP group and 36/35 controls. Data were analyzed using Chi-square, Analysis of Variance, Kruskal Wallis, Repeated Measures Analysis of Variance, Eta square (η2), and Wilcoxon Signed Ranks tests.ResultsParticipants in NADA, LP and control group improved significantly on the ISI and BAI. There was no significant difference in change over time between the three groups in any of the primary (effect size: BAI, η2 = 0.03, ISI, η2 = 0.05) or secondary outcomes. Neither of the two acupuncture treatments resulted in differences in sleep, anxiety or drug use from the control group at 5 weeks or 3 months.ConclusionNo evidence was found that acupuncture as delivered in this study is more effective than relaxation for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders. The substantial attrition at follow-up is a main limitation of the study.Trial registrationClinical Trials NCT02604706 (retrospectively registered).

Efeitos da auriculoterapia sobre o estresse, ansiedade e depressão em adultos e idosos: revisão sistemática

“…As a result, 51 articles were read in full, of which 27 were excluded and 24 included in the qualitative analysis ( Figure 1). The included articles were carried out in hospitals (n = 14) (1,4,(14)(15)(16)(18)(19)(21)(22)24,(26)(27)(29)(30) , universities (n = 2) (11,16) , specialized medical centers (n = 4) (2)(3)17,27) , one non-governmental organization (n = 1) (23) , and one long-term institution (n = 1) (20) , among others (13,23) . Of these, 22 were developed in Western countries, and two in Eastern countries (24,30) .…”

“…The main lines of reasoning used in studies for auriculotherapy application were Chinese (1)(2)4,11,(13)(14)(15)(16)(17)(18)(19)(20)(24)(25)27,30) , the National Acupuncture Detoxification Association (NADA) protocol (3,(28)(29) , the French line (21,26) , The Auricular Protocol for Pain & Anxiety (APPA) (22) , and the Gold Protocol (17) . Two of the studies did not define the theoretical foundation (12,23) .…”

“…The basic training of therapists was nursing (n = 8) (1)(2)(14)(15)(16)18,20,22) , medicine (n = 5) (2,17,(26)(27)29) , dentistry (n = 2) (13,23) and psychology (n = 2) (14,22) ; five of these had a specialization in acupuncture (2,(14)(15)20,22) . Furthermore, four studies only characterized the interventionists as acupuncturists (12,21,(24)(25) , two reported that the professionals took a course (28)(29) and five did not define the training area of the therapist (3)(4)11,19,30) . The experience time in the area varied between two and twenty years (12,18,(20)(21)24,29) .…”

“…Scientific evidence points to the effects of this intervention on stress (1,(3)(4)(14)(15) , anxiety (2,(11)(12)(13)(16)(17)(18)(19)(20)(21)(22) and depression (23) in isolation or only in associating anxiety and depression (24)(25)(26)(27)(28)(29) . However, there are few studies to date which have evaluated the three outcomes together (30) .…”

The National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives

“…Ahlberg et al attempted to devise a large, RCT that compared the NADA protocol for 15 sessions versus a local protocol “LP” which was essentially the same NADA protocol for 10 sessions versus a music listening relaxation control on self-report measures of anxiety, sleep, and substance use over a 3-month period 58. They reported finding that acupuncture was no more effective than relaxation for any of the studied measures.…”