Acupuncture for the Treatment of Cocaine Addiction: A Randomized Controlled Trial
2002
ContextAuricular acupuncture is widely used to treat cocaine addiction in the
United States and Europe. However, evidence from controlled studies regarding
this treatment's effectiveness has been inconsistent.ObjectiveTo investigate the effectiveness of auricular acupuncture as a treatment
for cocaine addiction.DesignRandomized, controlled, single-blind clinical trial conducted from November
1996 to April 1999.SettingSix community-based clinics in the United States: 3 hospital-affiliated
clinics and 3 methadone maintenance programs.PatientsSix hundred twenty cocaine-dependent adult patients (mean age, 38.8
years; 69.2% men); 412 used cocaine only and 208 used both opiates and cocaine
and were receiving methadone maintenance.InterventionPatients were randomly assigned to receive auricular acupuncture (n
= 222), a needle-insertion control condition (n = 203), or a relaxation control
condition (n = 195). Treatments were offered 5 times weekly for 8 weeks. Concurrent
drug counseling was also offered to patients in all conditions.Main Outcome MeasuresCocaine use during treatment and at the 3- and 6-month postrandomization
follow-up based on urine toxicology screens; retention in treatment.ResultsIntent-to-treat analysis of urine samples showed a significant overall
reduction in cocaine use (odds ratio, 1.40; 95% confidence interval, 1.11-1.74; P = .002) but no differences by treatment condition (P = .90 for acupuncture vs both control conditions). There
were also no differences between the conditions in treatment retention (44%-46%
for the full 8 weeks). Counseling sessions in all 3 conditions were poorly
attended.ConclusionsWithin the clinical context of this study, acupuncture was not more
effective than a needle insertion or relaxation control in reducing cocaine
use. Our study does not support the use of acupuncture as a stand-alone treatment
for cocaine addiction or in contexts in which patients receive only minimal
concurrent psychosocial treatment. Research will be needed to examine acupuncture's
contribution to addiction treatment when provided in an ancillary role.
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