May 15, 2000 (Chicago) -- Cocaine addicts in Brazil have begun using needles -- in order to quit. The five slim, silver acupuncture needles placed in the patients' ears don't hurt and don't deliver drugs, but may instead speed their recovery from drug addiction, according to a study reported here at the annual meeting of the American Psychiatric Association.
An unexpected choice was presented to cocaine abusers seeking help at the Institute of Psychiatry at the University of São Paulo, Brazil. The patients were offered a chance to add acupuncture treatment to the standard behavior-oriented group psychotherapy usually offered. Those who agreed underwent weekly, hour-long sessions in which acupuncture needles were stuck in their ears.
Half the patients got real acupuncture -- that is, the practitioner put the needles in "active" sites that are believed to work in Chinese medicine. The other half of the patients had the needles placed in "inactive" places on their ears believed to do neither good nor harm. These people served as the comparison group.
Lots of patients dropped out: Only two-fifths of the acupuncture patients and one-third of the mock-acupuncture patients finished all 12 weeks of their treatment. This isn't unusual for drug-abuse treatment programs, which have a high failure rate.
"Our dropout rate was exactly the same as that seen in other studies on this [group of patients]," Ceron says. Cocaine addiction is notorious among those in the know for being difficult to treat.
All the patients who completed treatment got better -- but the patients treated with acupuncture got better faster. After the first four weeks of treatment, the acupuncture patients were doing significantly better in terms of drug use, employment situation, family relationships, healthy leisure activities, and physical illness related to drug use.
"Acupuncture can be one of the treatments you give a patient in recovery," Ceron's co-investigator, André Malbergier, MD, tells WebMD. "You can decrease levels of anxiety and maintain them in recovery better."
Andrei A. Pikalov, MD, PhD, has studied acupuncture since 1983. Pikalov, who was not involved in the cocaine recovery study, says the results are encouraging, but that they do not prove that acupuncture works.
"From word of mouth, I know that many practitioners are excited about acupuncture for the reduction of craving in addiction," he tells WebMD. "I know of studies that use ear acupuncture for different drug addictions."
In a separate conference presentation, Pikalov reported that he had looked at every acupuncture study reported in the medical literature since 1966. After painstaking examination of 135 studies, he found only four that barely met the strict rules for a scientific study of a medical treatment.
"Those three studies on major depression had some interesting positive results," says Pikalov, a researcher at Kansas University Medical Center in Kansas City, Kan.
Nevertheless, strict analysis of these studies showed that their results could not be taken as proof that acupuncture really works. Part of the problem is that acupuncture is wholly based on Chinese medicine -- an art that cannot easily be translated into scientific terms.
"Acupuncture ideally requires re-evaluation of the patient's condition at every visit and change of the treatment on every visit to the practitioner," Pikalov says. "To standardize treatment is very difficult. In acupuncture, we are choosing five doctors and asking them to treat 10 patients with depression -- and we find that they will do completely different procedures. The results may be the same -- all of the patients may get better -- but the process will be very different. We can't afford that in research. We want every patient to receive very similar treatment."
Despite this essential problem, Pikalov believes the scientific study of acupuncture is both possible and necessary. "When you look into ... how acupuncture works, there is more and more data showing that the mechanisms involve [chemical signals] in the brain," he says. "This actually makes me excited and hopeful. ... There is a possible connection which I think we can show over time."