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Acupuncture not effective as a stand-alone treatment for cocaine addiction

Yale University : 02 January, 2002  (New Product)
Contrary to previous Yale findings showing beneficial effects of acupuncture for treating cocaine addiction, a new large-scale study published in the January 2 issue of the Journal of the American Medical Association, shows that acupuncture is not effective as a primary treatment for this disorder.
The multi-site study-one of the largest controlled clinical trials of any 'complementary' therapy conducted to date-was organized by the National Center on Addiction and Substance Abuse at Columbia University, and was based on methodology for conducting controlled acupuncture research developed at Yale University School of Medicine.

'We've found that acupuncture is not an effective stand-alone treatment for cocaine addiction and should not be offered to patients in contexts in which they receive either little or no concurrent drug counseling,' said Arthur Margolin, the study's first author and research scientist in psychiatry at Yale School of Medicine. 'Whether or not acupuncture has a role to play in the treatment of cocaine addiction as an ancillary intervention, or as one component within a comprehensive treatment program, is something that needs to be addressed in future research.'

For their new study, researchers recruited 620 cocaine-addicted individuals at six sites across the country; 208 were both cocaine and opiate dependent and were maintained on methadone, and 412 were dependent on cocaine only. Subjects were randomized to one of three treatment groups: in one group, acupuncture needles were inserted in points commonly used to treat cocaine addiction; in another group, needles were inserted into points on the rim of the ear not used to treat addiction; and a third group watched relaxing videos.

Treatments in all three conditions lasted 40 minutes and were offered to patients five times a week for eight weeks. In addition to the study treatments, the methadone-maintained patients received counseling as part of standard care and the primary cocaine users were offered individual weekly counseling. Researchers assessed cocaine use three times a week with urine screens.

Findings showed that while there was a slight overall reduction in cocaine use in all three groups, cocaine use remained at fairly high levels. The subjects receiving acupuncture did not use less cocaine than subjects in the other two groups, and retention was not better in the acupuncture group. Attendance at psychological counseling sessions was poor in all three groups.

These new findings contradict results from a previous acupuncture study by Margolin and colleagues at Yale that used a similar research design, and found that acupuncture was more effective in reducing cocaine use compared to two control treatments. Margolin notes that there were some differences between the two studies, including the kinds of counseling patients received.

'Our previous study had a richer psychosocial context, furthermore, the multi-site study offered patients cash incentives for attending treatment sessions, possibly retaining patients primarily interested in receiving the money, rather then achieving abstinence from cocaine,' said Margolin. 'It is possible that differences between the two studies accounted for the different findings, but at this point we are not entirely sure how to understand the discrepancy.'

Other researchers on the study include Herbert D. Kleber, M.D., principal investigator, of CASA and Columbia University School of Medicine; S. Kelly Avants of Yale; Janet Konefal of the University of Miami School of Medicine; Frank Gawin, M.D. and Elena Stark, M.D., of the UCLA Laboratory of the Study of Addictions; James Sorensen and Eleanor Midkiff of UCSF; Elizabeth Wells and T. Ron Jackson of Evergreen Treatment Services; Milton Bullock, M.D., and Patricia D. Culliton of Hennepin County Medical Center; and Sharon Boles and Roger Vaughan of CASA and Columbia University School of Medicine.
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