Acudetox is finding its place in a small but growing number of addiction treatment centers around the country.
Andres Demoya recently found himself sitting with needles sticking out of his ears. The 33-year-old Florida resident was in treatment to end an opioid addiction that began six years ago, following pain from a car accident, and was experiencing an ear acupuncture treatment as part of a comprehensive detox program. “I didn’t expect it to make a difference,” he says. After all, coming off the drugs had left him restless and mentally muddled, and stress was exacerbating his chronic lower back pain. “But as soon as the first session ended, my pain and concentration improved.”
Called acudetox, or the NADA protocol, this method of needling is finding a place in a small but growing number of addiction treatment centers around the country. Proponents would like to see it everywhere, touting it as a fast and effective tool for easing the turmoil that accompanies physical and emotional withdrawal. The experts I spoke to emphasize, though, that this is not a cure for drug addiction on its own.
“It seems to initiate a balancing process that allows the body to come back into homeostasis more easily. If there is one tool in my toolbox that helps most people most predictably most of the time, this is it,” says Kenneth Carter, a psychiatrist and medical director at SalusCare, a comprehensive behavioral and addiction car
e provider in Fort Myers, Florida. (The NADA protocol is seen as so valuable for soothing stress that the Red Cross funded a pop up acudetox stress reduction clinic in Manhattan after 9/11. More than a thousand treatments were provided.)
Unlike with traditional acupuncture, where practitioners personalize the placement of dozens of needles in points all over the body, with acudetox just five needles go into standardized spots on each ear.
Carter first stumbled upon the method while in medical school in the 1980s, when he took some time off to work at a community detox clinic in the Bronx. The program was experimenting with using acudetox after learning that a Hong Kong neurosurgeon a decade earlier had coincidentally discovered that ear acupuncture used for preoperative anesthesia helped soothe opioid withdrawal symptoms, he says.
The clinic played around with various protocols over the years, until settling on the five of the NADA protocol (named for the National Acupuncture Detoxification Association that advocates its use). The 5 points include two known for their calming effect: the sympathetic nervous system point, where the ear connects to the temple, and Shen Men, or heavenly gate, inside the upper fold, believed to be the most powerful stress reducer. The other three correspond to organs that help the body detox: kidney (center of the ear), liver (on the outside rim), and lung (just above the earlobe).
Early studies of the method were mixed, but advocates blame the study designs more than the needles. In fact, as far back as 1997, the National Institutes of Health issued a consensus statement naming addiction as one of the methods where acupuncture seemed to be a valuable adjunct to comprehensive management programs. Recent research has more firmly documented its benefit as a detox aid. A 2016 study in mice showed that a NADA intervention reduced opioid cravings in addicted rodents.
In a study of 100 people in an outpatient substance abuse program published in the journal Behavioral Science in 2017, Carter found that adding acudetox to conventional treatment improved energy and self-esteem during treatment; most important, participants were less likely than others to be drinking alcohol in the months that followed.
“These results put numbers to what practitioners of the protocol have been seeing for years: that the benefits of the acupuncture persist even when we stop doing it, because it initiates a healing process that can start to take on a life of its own,” Carter says. In most substance abuse treatment settings, acudetox is done in a group, with the lights lowered to facilitate relaxation. The practitioner places the needles into each person’s ears, then leaves them there for 45 minutes. The needles don’t hurt, although some people are mildly bothered by a sting at their insertion, and some are self-conscious about how ridiculous they look—another plus for the dimmed lights in the room. Occasionally, a tiny bit of blood appears if a capillary is broken.
“People feel calm yet focused almost immediately,” says Glenda Harris, a senior acupuncturist at the University of Miami’s Miller School of Medicine. Harris became a believer years ago, when she worked at a clinic that used the method for people arrested for minor drug offenses. Many of them were experiencing withdrawal symptoms. It helped their mood so strikingly, causing even the angriest people to calm down and focus, she says.
Rather than sedatives that muddle thinking and cause sleepiness, the NADA protocol keeps people relaxed during withdrawal, but alert enough to work through their psychological issues during counseling sessions, Carter says.
Jesse Reynolds, 27, now the president of his own New York City public relations firm, credits acudetox with helping him relax during his heroin detox seven years ago, and allowing him to subsequently embrace other alternative practices that helped him uncover the psychological reasons for his addiction. “If you allow yourself to keep an open mind, you can benefit from this,” Reynolds says.
The National Acupuncture Detox Association would like to see more substance abuse centers add this to their offerings, which executive director Sara Bursac notes is currently offered only in about 5 percent of them nationwide.
That number is expected to grow as more states change legislation to be favorable to NADA. Just under half the states now allow a licensed acupuncturist to generally oversee the program, but let counselors and other workers in the treatment center administer the needles. This compares to laws requiring that a more expensive licensed acupuncturist be on site.
With the opioid addiction crisis worsening, more states are looking to remove obstacles to treatments that help. New Hampshire last year became the most recent state to pass a bill that will enable more people to receive the treatment.
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