THE NADA PROTOCOL – APPLICATIONS & OUTCOMES excerpt from Smith, Brewington, Culliton (1998)
Acudetox is being used in numerous diverse treatment settings. Outcome reports have been published only to a limited degree because of an emphasis on placebo controlled studies. Unless otherwise noted these outcomes are based on clinical experiences at Lincoln Hospital or personal observation of other programs made by Dr. Michael Smith.
Opiate addiction was first treated by Dr. Wen in Hong Kong and has been treated at Lincoln Hospital since 1974. Acudetox provides nearly complete relief of acute observable opiate withdrawal symptoms in 5 – 30 minutes. This effect lasts for 8 to 24 hours. The duration of this effect increases with the number of serial treatments provided. Patients often sleep during the session and may feel hungry afterward.
Patients who are acutely intoxicated at the time acupuncture is administered will behave in a much less intoxicated manner after the session. These patients are gratified by this result, in contrast to patient reports of discomfort after Narcan administration.
Acudetox for opiate addiction is typically administered 2 – 3 times daily in acute detoxification settings. Alternatively, it may be administered only once a day with Clonidine or Methadone on an outpatient basis. Many patients do well on once daily Acudetox because they taper their illicit opiate usage over a 3 – 4 day period.The addition of an acupuncture component to an opiate detoxification program typically leads to a 50% increase in retention for completion of the recommended length of stay. Program retention is most strongly correlated with treatment success.
Alcohol addiction: Directors of the Acudetox social setting detox program conducted by the Tulalip Tribe at Marysville, Washington estimate a yearly saving of $148,000 due to less frequent referrals to hospital programs. Inpatient alcohol detoxification units typically combine acupuncture and herbal “sleep mix” with a tapering benzodiazepine protocol. Patients report few symptoms and better sleep. Their vital signs indicate stability and hence, there is much less use of benzodiazepines. One residential program in Connecticut noted a 90% decrease in Valium use when herbal “sleep mix” alone was added to their protocol.
Retention of alcohol detox patients generally increases by 50% when an Acudetox component is added to conventional settings. Some alcoholics who receive acupuncture actually report an aversion to alcohol. Woodhull Hospital in Brooklyn reported that 94% of the patients in the Acudetox supplement group, remained abstinent as compared to 43% of the control group who only received conventional outpatient services. The widely quoted placebo controlled study by Bullock (1989) showed a 52% retention of alcoholic patients receiving true Acudetox compared to a 2% sham Acudetox retention rate.
Cocaine addiction: has provided a most important challenge for Acudetox treatment because there are no significant pharmaceutical agents for this condition. Acudetox patients report more calmness and reduced craving for cocaine even after the first treatment. The acute psychological indications of cocaine toxicity are visibly reduced during the treatment session. This improvement is sustained for a variable length of time after the first Acudetox treatment. After 3 – 7 sequential treatments the anti-craving effect is more-or-less continuous as long as Acudetox is received on a regular basis.
Researchers from the substance abuse treatment unit at Yale describe thirty-two cocaine-dependent methadone-maintained patients who received an 8-week course of auricular Acudetox for the treatment of cocaine dependence. Fifty percent completed treatment; 88% of study completers attained abstinence, defined as providing cocaine-fee urine samples for the last 2 weeks of the study, yielding overall abstinence rate of 44%. Abstainers reported decreased depression, a shift in self-definition, decreased craving and increased aversion to cocaine-related cues. Post-hoc comparisons to pharmacotherapy with desipramine (DMI), amantadine (AMA), and placebo revealed a higher abstinence rate for acupuncture (44%) than for AMA (15%) or placebo (13%), but not statistically significantly higher than or DMI (26%0. (Margolin 1993).
Urinalysis outcomes were examined for Lincoln Hospital patients with cocaine or crack addiction who had more than 20 treatment visits and were active during the one week study period in March 1991. At Lincoln patients typically provide urine samples for testing during each visit. Of the entire study group of 226 patients, 149 had more than 80% negative tests during their entire treatment involvement. Of the remaining patients, 39 had at least 80% negative tests during the two weeks prior to data collection.
The beneficial effects of acupuncture in cocaine treatment often lead to dramatic increases in retention of cocaine patients. Women in Need, a program located near Times Square in New York, reported the following outcome figures in their treatment for pregnant crack using women.