A study released in the Journal of the American Medical Association on Jan. 2 found that Auricular (Ear) Acupuncture treatment—one of the most widely used methods for treating cocaine addiction—is ineffective as a stand-alone treatment, according to researchers from The National Center on Addiction and Substance Abuse (CASA) at Columbia University, Columbia's College of Physicians and Surgeons, Yale University and five other major research institutions across the nation.
More than 400 substance abuse clinics in the United States and Europe are currently offering this form of acupuncture. Researchers have been considering a variety of different alternatives for helping approximately 3.3 million chronic cocaine users in the United States.
"This is the largest and best-controlled study ever done of the role of acupuncture in the treatment of cocaine addiction," said Dr. Herbert Kleber, former executive vice president and medical director at CASA and the principal investigator and organizer of the CASA project. "The study cannot rule out a possible role of acupuncture as an ancillary treatment combined with other forms of therapy in cocaine abuse. But our study suggested that it should not play a primary role."
The study was based on a design from Yale researcher Arthur Margolin. CASA researchers Roger Vaughn, head of CASA's Substance Abuse Data Analysis Center (SADAC) and Sharon Boles, also helped design and evaluate this randomized, controlled trial. Over a three-year period, 620 cocaine-dependent adult patients were recruited at six community-based programs including three hospital-affiliated clinics and three methadone maintenance programs.
"This study gives us hard evidence that we are pumping money into treatment programs that don't work," said Joseph A. Califano Jr., CASA president and former U.S. Secretary of Health, Education and Welfare. "The federal government must invest more money in treatment research or we will continue to squander our dollars on treatment that is expensive and ineffective and fail to help individuals seeking to conquer their addiction."
Participants were randomly assigned to one of three groups. The first group received a form of auricular acupuncture under the guidelines set forth by the National Acupuncture Detoxification Association (NADA), with needles inserted into the four commonly used zones of the ear—the sympathetic, lung, liver and shen men zones. The second group underwent fake ear acupuncture using three zones not commonly used for this procedure. The third group received no acupuncture, instead participating in audiovisual relaxation techniques such as listening to soft music and viewing nature scenes.
Researchers were surprised to find that there was no significant difference in cocaine use for participants in each of the three treatment models at the end of the eight-week period. Although there was a slight reduction in overall cocaine use, the data indicated that the acupuncture was no more effective than the other methods of needle insertion or relaxation control.
Funding for the study was provided principally by the Conrad N. Hilton Foundation with additional funding from the Office of National Drug Control Policy (ONDCP), the National Institute on Drug Abuse (NIDA) and the National Institute of Justice. Working with CASA, participating institutions included Columbia's College of Physicians and Surgeons, Yale University, University of Miami School of Medicine, UCLA Laboratory for the Study of Addiction, the University of California at San Francisco and San Francisco General Hospital, Evergreen Treatment Services (Seattle, Washington), and Hennepin County Medical Center (Minneapolis, Minnesota).