Open Access

Acupuncture therapy for drug addiction

  • Farid Esmaeili Motlagh1, 2, 3,
  • Fatimah Ibrahim1, 2Email author,
  • Rusdi Abd Rashid3,
  • Tahereh Seghatoleslam3, 4 and
  • Hussain Habil3
Chinese Medicine201611:16

https://doi.org/10.1186/s13020-016-0088-7

Received: 12 September 2014

Accepted: 29 March 2016

Published: 5 April 2016

Abstract

Acupuncture therapy has been used to treat substance abuse. This study aims to review experimental studies examining the effects of acupuncture on addiction. Research and review articles on acupuncture treatment of substance abuse published between January 2000 and September 2014 were searched using the databases ISI Web of Science Core Collection and EBSCO’s MEDLINE Complete. Clinical trial studies on the efficacy of acupuncture therapy for substance abuse were classified according to substance (cocaine, opioid, nicotine, and alcohol), and their treatment protocols, assessments, and findings were examined. A total of 119 studies were identified, of which 85 research articles addressed the efficacy of acupuncture for treating addiction. There were substantial variations in study protocols, particularly regarding treatment duration, frequency of electroacupuncture, duration of stimulation, and choice of acupoints. Contradictory results, intergroup differences, variation in sample sizes, and acupuncture placebo effects made it difficult to evaluate acupuncture effectiveness in drug addiction treatment. This review also identified a lack of rigorous study design, such as control of confounding variables by incorporating sham controls, sufficient sample sizes, reliable assessments, and adequately replicated experiments.

Background

In 1997, the National Institutes of Health accepted acupuncture therapy as an acceptable procedure complementary to Western medicine [1]. Evidence for its therapeutic effects comes mainly from clinical practice and research into pain control, fibromyalgia, headaches, Parkinson’s disease, schizophrenia, and depression [2]. Acupuncture therapy can be administered using either manual insertion of needles or electroacupuncture (EA), a mild electrical stimulation of acupoints. Extended acupuncture methods may involve finger pressure (acupressure) and laser therapy [3].

In 1985, Dr. M. Smith finalized the National Acupuncture Detoxification Association (NADA) protocol that is currently practiced in over 250 hospitals in the United Kingdom and United States [4]. In 1996, the World Health Organization accepted acupuncture as a treatment for drug abuse [5]. The latest modification to this treatment protocol was developed in 2005 by Dr. Ji Sheng from Peking University, Beijing, China [6]. Currently, more than 700 addiction treatment centers use acupuncture as an adjunctive procedure [7].

Prominent effects of acupuncture are increases in the levels of enkephalin, epinephrine, endorphin, serotonin, norepinephrine, and dopamine in the central nervous system and plasma [8] that might mediate substance abuse. Acupuncture has been used to treat addiction for three decades [289]. For example, auricular acupuncture (AA) is effective in treating alcohol and drug abuse in both Europe and the United States [4].

However, several clinical trials have indicated that acupuncture was not effective in treating addiction [2, 3, 31, 67, 69, 7880]. Thus, the efficacy of the NADA protocol has been reassessed over the last decade [7]. Several factors have been studied to evaluate the efficacy of acupuncture therapy; for example, treatment protocol, choice of acupoints, duration of acupuncture, study design diversity, sample size, addiction history, and assessment techniques.

This study aims to review the published research on acupuncture therapy for substance abuse in relation to study type, authors, funding agencies, countries, agonist substances, and acupoints used for stimulation. Experimental studies published between January 2000 and September 2014 were systematically reviewed and analyzed to try to resolve the lack of agreement about acupuncture’s efficacy for substance abuse.

Review

Literature search

A search of the ISI Web of Science Core Collection and EBSCOHost (MEDLINE Complete) databases for the period January 2000 to September 2014 was conducted to identify acupuncture clinical trials. Keywords, topics available in the databases, and titles were searched for the following terms: “acupuncture,” “electroacupuncture,” “acupoint stimulation,” “transcutaneous,” and “electrostimulation” as single words or combinations (total number of articles: 25 358). The results were refined to exclude non-English language materials. The preliminary findings of the first phase were refined by several parallel filters to identify documents relevant to acupuncture treatment of substance abuse. The operator between the filters was the “OR” command. Single, relevant words were selected for each filter and included any combination of the following: “alcohol,” “addict,” “opioid,” “heroin,” “cigarette,” “nicotine,” “tobacco,” “cocaine,” and “substance” as title, topic, keywords, or abstract text (total number of articles: 230) from both searched databases. The search results were collated and filtered to exclude proceedings papers and letters, yielding 161 studies. The abstracts of these documents were reviewed to exclude papers related to other addiction fields such as the Internet, food, or games; 119 documents comprised the refined, selected results. Three authors (FEM, RR, and TS) independently assessed studies for eligibility and crosschecked the material for study relevance. The publication selection process was shown in Fig. 1.
Fig. 1

Flow chart of selection process

The articles were classified according to their specifications, including publication date, number of citations, source, authors, organization, and funding agencies. All original research papers were examined for their efficacy and method of treating different categories of addiction to agonist substances (e.g., cocaine, opioid and opiate, nicotine, alcohol, morphine). Original clinical trials that investigated the efficacy of acupuncture therapy were divided into six categories based on substance dependence (cocaine, opioid and opiate, nicotine, alcohol, morphine, and other substances) with a narrative review of their methods and results. Although morphine is an opioid, it has been assigned its own section because of the high number of publications on this topic. Heroin, methadone, and opiates are discussed in the opioid section.

The findings are discussed and compared according to type of addictive substance. There were 96 articles and 29 review papers; 83 articles were original investigations (76 of which were clinical trials of acupuncture efficacy), with 45 articles involving human beings and 38 involving animals. Figure 2 shows the percentage of all documents in each type of category. Original investigations of humans and animals were classified separately according to type of substance dependence. These articles placed more of an investigative emphasis on morphine and alcohol than on other substances.
Fig. 2

Classification of selected articles into review papers and original investigations on humans and animals. The lower diagram shows the number of original clinical investigations according to substance. Morphine and alcohol have the most articles. Each of the columns is described separately in Tables 2, 3, 4, 5, 6, 7

The total number of citations for all documents was 1495 (mean = 15.83 and standard deviation = 15.27, citation range 2–87 by excluding 29 articles cited zero times or only once). The top ten most cited articles were shown in Table 1. The United States (43 articles) and China (40 articles) published almost 70 % of all articles. Among the Asian countries, China and South Korea published 59 articles, comprising 50 % of publications. Their funding agencies were also the top supporters in this field. Peking, Kyung Hee, and Daegu Haany Universities were the top three organizations, publishing 40 articles since 2000.
Table 1

Top 10 most cited articles from 2000 to 2014

Title

First author

Source title

Publication year

Total citations

Acupuncture: An evidence-based review of the clinical literature [90]

Mayer DJ

Annual Review of Medicine

2000

87

A randomized controlled trial of auricular acupuncture for cocaine dependence [10]

Avants SK

Archives of Internal Medicine

2000

67

Acupuncture for the treatment of cocaine addiction—a randomized controlled trial [61]

Margolin A

Journal of the American Medical Association

2002

66

Clinical research on acupuncture: Part l. What have reviews of the efficacy and safety of acupuncture told us so far? [91]

Birch S

Journal of Alternative and Complementary Medicine

2004

64

Peripheral neuropathy: Pathogenic mechanisms and alternative therapies [92]

Head, Kathleen A

Alternative Medicine Review

2006

50

Acupuncture and related interventions for smoking cessation [78]

White AR

Cochrane Database of Systematic Reviews

2006

43

A large randomized placebo controlled study of auricular acupuncture for alcohol dependence [16]

Bullock ML

Journal of Substance Abuse Treatment

2002

41

Peripheral electric stimulation inhibits morphine-induced place preference in rats [75]

Wang B; Luo, F

NeuroReport

2000

39

Acupuncture in clinical neurology [67]

Rabinstein AA

Neurologist

2003

37

Traditional Chinese medicine in treatment of opiate addiction [93]

Shi, Jie

Acta Pharmacologica Sinica

2006

34

The published articles were associated with various research areas (Fig. 3). About 80 % of the articles focused on neuroscience and neurology, substance abuse, and integrative complementary medicine research areas. Published articles for each year were shown in Fig. 4.
Fig. 3

Number of research articles in each area. Neuroscience, substance abuse, and complementary medicine are ranked highest

Fig. 4

Number of publications (top) and citations (bottom) per year. This figure shows that since 2008, the number of citations has increased to 200 per year. Before 2008, it was about 50 per year

Original experimental research articles were reviewed according to type of substance dependence (Fig. 2); the treatment method, subjects, objectives, and assessments of clinical trials for each group were shown in Tables 2, 3, 4, 5, 6, 7.
Table 2

Original investigations of acupuncture therapy effects in cocaine-dependent subjects

Publication year; first author

Objectives

Subjects

Stimulated acupoints (acupuncture type, acupoints, frequency)

Assessments

Outcomes

2000

Avants [10]

To evaluate the AA efficacy in cocaine addiction treatment compared to needle-insertion and no-needle relaxation control conditions

82 Cocaine-dependent, methadone-maintained patients

Auricular acupuncture at 4 NADA points (sympathetic, lung, liver, and Shenmen (HT7)), 5 times a week for 8 weeks

Urine toxicology screens 3-times-weekly

Acupuncture showed positive results compared to control groups for treatment of cocaine dependence

2002

Margolin [60]

To Compare two cocaine addiction clinical trials of AA to explore consistency of treatment effects

165 Cocaine-dependent, methadone-maintained patients (Study 1, n = 82; Study 2, n = 83)

Auricular acupuncture at 4 NADA points (sympathetic, lung, liver, and Shenmen (HT7)), 5 times a week for 8 weeks

Urine toxicology screens 3-times-weekly, retention in treatment, treatment attendance, treatment credibility, therapeutic alliance, and acute effects

The results of two groups were controversial and no conclusion could be made regarding the effectiveness of AA

2002

Margolin [61]

To evaluate the AA efficacy in cocaine addiction treatment

620 Cocaine-dependent methadone-maintained patients. 412 Cocaine only and 208 opiates + cocaine

Auricular acupuncture at 4 NADA points (sympathetic, lung, liver, and Shenmen (HT7)), 5 times a week for 8 weeks

Urine toxicology during treatment and at the 3- and 6-month post randomization follow-up, and retention in treatment

acupuncture was not more effective than a needle insertion or relaxation control in reducing cocaine use

2005

Margolin [59]

To evaluate effects of acupuncture and spirituality, therapy in the treatment of HIV-positive drug users

40 HIV-seropositive, cocaine-dependent, methadone-maintained patients

Auricular acupuncture at 5 NADA points, 5 times weekly for 8 weeks

Urine toxicology twice weekly, depression and anxiety at pre- and post-treatment

acupuncture and a spirituality-focused psychotherapy was effective in reducing the cocaine use

2009

Lee and Bombi [44]

To investigate the effects of acupuncture on the repeated cocaine-induced neuronal and behavioral sensitization alternations

32 Male Sprague–Dawley rats, n = 15 acupuncture

Acupuncture bilaterally at Shenmen (HT7) for 1 min

Cocaine-induced locomotor activity and the expression of tyrosine hydroxylase (TH) in the brain

acupuncture was effective for inhibiting the behavioral effects of cocaine by possible modulation of the central dopaminergic system

2012

Yoon [84]

To investigate the effects of acupuncture on cocaine-seeking and the expression of c-Fos and the transcription factor cAMP response element-binding protein (CREB)

24 Male Sprague–Dawley rats, n = 6 EA

Acupuncture at Shenmen (HT7) as study and Yangxi (LI5) as control for 1 min

Cocaine-seeking behavior, surface expression, and phosphorylated CREB (pCREB) activation in the NAc shell

acupuncture attenuated stress-induced relapse by

regulating neuronal activation in the NAc shell

2013

Kim and Seol Ah [42]

To explore the peripheral mechanisms underlying acupuncture treatment for drug addiction

12 Male Sprague–Dawley rats

Acupuncture at Shenmen (HT7) as study and Yangxi (LI5) as control for 1 min

Suppression of cocaine-induced locomotor activity

acupuncture inhibited the cocaine-induced locomotor activity

Acupoints in NADA protocol are located at (sympathetic: in the deltoid fossa at the junction of the infra-antihelix crus and the medial order of the helix, lung: in the center of the cavum concha, liver: located in the posterior to upper portion of the helix crus, kidney: in the cleft between the upper plateau, and the helix)

Cocaine

Avants and Margolin have evaluated the efficacy of AA for cocaine addiction treatment in four studies on human subjects. Although promising results were reported in their first study on 82 cocaine-dependent subjects [10], another study on 83 cocaine-dependent subjects found AA to be effective in reducing cocaine in only one of two trials [60]. When the original study was repeated with 620 subjects, no effect was found [61]. These researchers also conducted a study in 2005 on 40 cocaine abusers who had tested positive for the human immunodeficiency virus and were under methadone maintenance; no difference was found between the standard and reduced NADA protocols for cocaine use [59].

Three studies on rats were conducted to explore the effects of bilateral stimulation at the Shenmen (HT7) points. Modulation of the central dopaminergic system by acupuncture might be effective in preventing the behavioral effects of cocaine in rats [44]. By regulating neuronal activation in the nucleus accumbens (NAc) shell, acupuncture reduced stress-induced relapse [84]. The effect of acupuncture on the inhibition of cocaine-induced locomotor activity was mediated by A-fiber activation of the ulnar nerve in rats [42]. See Table 2 for study details.

Opioids and opiates

In 2002, Montazeri investigated the efficacy of acupuncture at Hegu (LI4), Neiguan (PC6), Shenmen (HT7), Taichong (LR3), Zusanli (ST36), Dazhui (DU14), and Baihui (DU20) in 40 male adult heroin- or opium-addicted patients. The severity of withdrawal symptoms declined when acupuncture was used in rapid opiate detoxification [63]. Liu (2007) used functional magnetic resonance imaging to show that hypothalamus activation associated with manual acupuncture at Zusanli (ST36) was more robust in heroin addicts compared with healthy subjects [55]. EA (2 Hz) at Zusanli (ST36) and Sanyinjiao (SP6) was effective in reducing active responses elicited by discrete cues in rats [56]. The same EA treatment showed promise in treating heroin-seeking behaviors when combined with extinction therapy [33]. EA (2 Hz) at the same points—Zusanli (ST36) and Sanyinjiao (SP6)—activated the endogenous opioid cannabinoid and the dopamine systems in rats [81].

An evaluation of the event-related potentials of heroin addicts before and after acupuncture at Neiguan (PC6) and Zusanli (ST36) suggested that EA might potentially lower relapse rates by inhibiting attention bias to heroin [37]. The presentation of heroin cues could induce activation in craving-related brain regions, which are involved in reward, learning and memory, cognition, and emotion. Acupuncture at Zusanli (ST36) rapidly suppressed the activation of these specific brain regions related to craving [17]. Transcutaneous electric acupoint stimulation was a possible adjunctive treatment to pharmacological treatments for heroin detoxification [62]. Acupuncture at Dazhui (GV14) and Baihui (DU20) prevented brain cell apoptosis in heroin-readdicted rats, normalized neuronal ultrastructure in the ventral tegmental area of heroin relapse rats, and protected nerve cells against injury in heroin relapse rats [32, 88].

Recent studies of acupuncture’s effectiveness as an adjunct therapy in methadone maintenance programs have been controversial. In 2009, Bearn demonstrated a lack of effect for adjunctive methadone maintenance treatment with AA upon withdrawal severity or craving [11]. In 2013, Pei Lin showed a lack of AA effectiveness on the number of daily consumed cigarettes, relapse rate, and withdrawal symptoms, and examined patients’ satisfaction and coping with AA as an adjunct treatment to methadone maintenance treatment among Malaysian subjects [57, 58]. However, Chan et al. [22] claimed that 2 weeks of acupuncture therapy reduced the daily dose of methadone and was also associated with greater improvement in sleep latency. See Table 3 for study details.
Table 3

Original investigations of acupuncture therapy effects in opioid- and opiate-dependent subjects

Publication year, first author

Objectives

Subjects

Stimulated acupoints. (acupuncture type, acupoints, frequency)

Assessments

Outcomes

2002

Montazeri, Kamran [63]

To identify the effects of body acupuncture on rapid opiate detoxification

40 Opioid addicts during ROD by naloxone, n = 20 acupuncture

Bilaterally acupuncture at Hegu (LI4), Neiguan (PC6), Shenmen (HT7), Taichong (LR3), Zusanli (ST36), Baihui (DU20) and Dazhui (DU14) 30 min for 3 days

Severity of withdrawal reaction (Clinical Institute Narcotic Assessment (CINA) score)

acupuncture reduced the severity of withdrawal symptoms associated with rapid opiate detoxification

2007

Liu [55]

To investigate the activation in the hypothalamus associated with acupuncture stimulation

Six healthy men and six heroin addicts

Acupuncture at Zusanli (ST36) with rotation for 11 min

fMRI, Cortisol level and psychophysical responses, including the deqi sensation, anxiety, and sharp pain

Acupuncture caused activation of the hypothalamus among addicts

2009

Bearn [11]

To investigate AA effects as an adjunct to MMT upon withdrawal severity or craving

83 Opioid users under MMT

Acupuncture at 5 points of cartilage ridge area in the ear, 30–40 min for 14 days

Daily measures of withdrawal severity and craving using the short opiate withdrawal scale and an eight-item craving questionnaire

AA had no effect upon withdrawal severity or craving when provided as an adjunct to a standard methadone detoxification treatment

2010

Meade [62]

To evaluate the effectiveness of TEAS as an adjunctive treatment for inpatients receiving opioid detoxification

48 Men and women under detoxification with buprenorphine-naloxone

2 and 100 Hz TEAS at Hegu (LI4) and Neiguan (PC6), 30 min daily for 4 days

The addiction severity index, opioid withdrawal scale, brief pain inventory, the Pittsburgh sleep quality index, physical and mental health status by the medical outcomes survey

TEAS was effective in using drugs and improving the pain interference and physical health

2011

Xia [81]

To investigate the rewarding effect of EA

68 Male Sprague–Dawley rats

2 Hz EA at Neiguan (PC6) and Zusanli (ST36), 30 min for 5 days

Conditioned place preference (CPP)

EA was capable of inducing CPP in the rat via the activation of the endogenous opioid-, cannabinoid- and dopamine-systems

2011

Jiang [37]

To compare the changes of cognitive attention-related brain function before and after EA

Ten Heroin addicts and ten healthy subjects

2 Hz bilateral EA at Neiguan (PC6) and Zusanli (ST36)

ERP at 64 electrode spots before and after EA intervention task on the positive emotional clue (PEG), negative emotional clues (NEC), and heroin-related clue (HRC). The P200 amplitude components on (Fz, Cz, and Pz)

Electroacupuncture effectively inhibited the attention bias to heroin

2012

Cai [17]

To understand the influence of heroin cue exposure on brain activation

12 Heroin addicts and 12 healthy subjects

non-twirled acupuncture and twirled acupuncture at bilateral Zusanli (ST36) for 1 min

fMRI during heroin cue exposure

Acupuncture can rapidly suppress the activation of specific brain regions related to craving as an intervention for drug craving

2012

Liu [56]

To investigate the beneficial effects of EA on heroin-seeking behavior

40 Male Sprague–Dawley rats, n = 10 EA

2 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6), once a day for 14 days during heroin abstinence

Contextual and discrete cue-induced reinstatement of active responses. Fos-positive nuclei detection in the nucleus accumbens (NACc) core and shell

acupuncture was effective in preventing relapse to drug addiction

2013

Hu [33]

To investigate the effects of EA on the extinction of heroin-seeking behavior

18 Male Sprague–Dawley rats, n = 6 EA

2 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6), once a day for 7 days

The extinction response of heroin associated cues and applied immunohistochemistry to detect FosB-positive nuclei in the nucleus accumbens core

Acupuncture enhanced extinction learning when combined with extinction therapy for the treatment of heroin addiction

2013

Lua, Pei Lin [57]

To find the effects of AA in number of consumed daily cigarettes, relapse rate, and withdrawal symptoms

40 MMT, 29 MMT + AA human subjects

Auricular acupuncture at 5 points NADA points, 3 times a week

Malay HOQOLBREF, withdrawal symptoms

Acupuncture adjunct to MMT was beneficial in managing addiction behaviors

2013

Lua, Pei Lin [58]

To examine the patients’ satisfaction and coping with AA as an adjunct treatment to MMT

40 MMT, 29 MMT + AA human subjects

Auricular acupuncture at 5 points NADA points, 3 times a week

Patient satisfaction with pharmaceutical care questionnaire (PSPCQ) and Malay brief COPE-27

Acupuncture adjunct to MMT did not influence patient satisfaction and their coping ways

2014

Chan [22]

To examine the effectiveness of acupuncture for heroin addicts on methadone maintenance

60 Heroin addicts in MMP

EA at Hegu (LI4), Zusanli (ST36) and Shenmen (HT7), twice a week for 4 weeks

Daily consumption of methadone, variations in the 36-item Short Form Health Survey-36 (SF-36) and the Pittsburgh Sleep Quality Index (PSQI) scores, and heroin craving

Acupuncture adjunct to MMT was useful in reducing the daily dose of methadone and great improvement in sleep latency at follow-up

2014

Hou [32]

To observe cell apoptosis in the hippocampus and frontal lobe of heroin readdicted rats by electron microscopy.

40 Wistar rats during the detoxificstion by methadone

Acupuncture at Baihui (GV20) and Dazhui (GV14), 30 min for 5 successive days

Morphology of nerve cells, Bax expression and Bcl-2 expression in the frontal cortex and hippocampus

Acupuncture was effective in preventing brain cell apoptosis in heroin readdicted rats

2014

Zhang [88]

To verify the relationship between acupuncture, neurotrophic factor expression and brain cell structural changes

32 Wistar rats, n = 16 acupuncture

Acupuncture at Baihui (DU20) and Dazhui (DU14) for 30 min, once a day for five consecutive days

The neuronal ultrastructure of the ventral tegmental area, brain-derived and glial cell line-derived neurotrophic factor expression in the ventral tegmental area

Acupuncture protected brain neurons against injury in rats with heroin relapse

Acupoints in NADA protocol are located at (sympathetic in the deltoid fossa at the junction of the infra-antihelix crus and the medial order of the helix, lung in the center of the cavum concha, liver located in the posterior to upper portion of the helix crus, kidney in the cleft between the upper plateau, and the helix)

Nicotine

Acupuncture stimulation at Zusanli (ST36) exerted a therapeutic effect on nicotine detoxification [21] and acupuncture at Zusanli (ST36) or Shenmen (HT7) might attenuate anxiety-like behavior following nicotine withdrawal by modulating corticotrophin-releasing factor in the amygdala [20]. Smoking withdrawal symptoms could be ameliorated by acupuncture treatment [18]. In one study, acupuncture at Shenmen (HT7) attenuated cigarette withdrawal symptoms more than acupuncture at Shousanli (LI10) [19]. Real acupuncture (as opposed to sham acupuncture) at Shenmen (HT7) alleviated cue-induced cravings through the regulation of activity in brain regions (medial prefrontal cortex, premotor cortex, amygdala, hippocampus, and thalamus) related to craving scores in the initial abstinence phase [38].

However, one study failed to find any effect of acupuncture on cotinine serum levels, carbon monoxide exhalation, and smoking quit rate in 59 smokers [83]. It has been suggested that DRD2 gene TaqI A polymorphism was related to AA response in smoking cessation treatment [65]. Auricular transcutaneous electrical neurostimulation relieved withdrawal symptoms and decreased anxiety and stress levels during the detoxification period in a study of six smokers [15]. Auricular transcutaneous electrostimulation therapy might be an acceptable alternative therapy for smoking cessation [72]. See Table 4 for study details.
Table 4

Original investigations of acupuncture therapy effects in nicotine-dependent subjects

Publication year; first author

Objectives

Subjects

Stimulated acupoints (acupuncture type, acupoints, frequency)

Assessments

Outcomes

2004

Chae [21]

To investigate the acupuncture effects on the functional alterations of the mesolimbic dopaminergic systems

35 Male Sprague–Dawley rats

Acupuncture at Zusanli (ST36), Shenmen (HT7), or Taiyuan (LU9) for 4 days

Nicotine-induced FLI in the striatum and the nucleus accumbens

acupuncture had a therapeutic effect on nicotine addiction

2005

Park [65]

To examine whether the DRD2 TaqI A polymorphism is associated with the response to acupuncture

231 Healthy Korean male smokers

AA at lung, throat, Shenmen (HT7), and endocrine

points for 96 s, 3 times for a week

Cigarette consumption, the desire to smoke, and Genomic DNA extracted from blood samples

Acupuncture was effective to influence the DRD2 TaqI A polymorphism

2008

Chae [20]

To investigate the effect of acupuncture on anxiety-like behavior and corticotrophin-releasing factor (CRF) and neuropeptide Y (NPY) mRNA expression in the amygdala during nicotine withdrawal

38 Male Sprague–Dawley rats, n = 18 acupuncture

Acupuncture at Zusanli (ST36), Shenmen (HT7), 30 s for 3 days

The anxiogenic response by using an elevated plus maze. CRF and NPY mRNA levels by using reverse transcription polymerase chain reaction (RT-PCR) analysis

acupuncture attenuated anxiety-like behavior following nicotine withdrawal

2008

Bonnette [15]

To explore the effects of ATENS in combination with addiction education, behavioral training and coaching

6 Smokers

Acupuncture at 5 NADA protocol or 1-3 points, 5 times a week for 8 weeks

In-depth interviews for withdrawal symptoms, anxiety and stress levels

auriculotherapy relieved withdrawal symptoms and reduced anxiety and stress levels during the detoxification

2009

Yeh [83]

To evaluate the effects of a 6-week acupoint stimulation program for quitting

59 Smokers

Acuouncture at Shenmen (HT7), lung, stomach, mouth and endocrine and Tim mee for 20 min, once a week for 6 weeks

Demographic factors, serum cotinine, carbon monoxide exhalation, daily tobacco consumption, and quit smoking rate of participants before and after the 6-week intervention

Acupuncture showed no statistically significant effect on quitting smoking

2010

Thanavaro [72]

To explore the efficacy of ATET as an adjunctive treatment to intensive individual counseling on smoking cessation

29 Subjects

Auricular transcutaneous electrostimulation therapy at 10 areas on the pinna

The “Fagerstrom Test for Nicotine Dependence,” the “What Are Your Triggers Test” and the “Why Do I Smoke Quiz.”

individual counseling may produce smoking cessation rates comparable to counseling with pharmacotherapy

2010

Chae [18]

To investigate the effect of acupuncture on the selective attention to smoking-related visual cues

29 Smokers

Acupuncture, Shenmen (HT7), (NA)

The attentional bias and cigarette withdrawal scale

Acupuncture ameliorated the smoking withdrawal symptoms as well as the selective attention to smoking-related visual cues

2011

Chae [19]

To investigate effects of acupuncture on ameliorating cigarette withdrawal symptoms

29 Smokers, n = 15 acupuncture

Acupuncture at Shenmen (HT7) or Shousanli (LI10), 20 min for 3 days

The cigarette withdrawal scale (CWS), comparing the low-frequency/high-frequency (HF/LF) ratio in the HRV of the RA and SA groups

acupuncture attenuated withdrawal symptoms and smoking cues-induced autonomic responses

2013

Kang [38]

To investigate acupuncture effects on ameliorating cravings induced by smoking-related visual cues

25 Male smokers

Acupuncture at Shenmen (HT7) for 1 min

fMRI and craving scores to smoking-related visual cues were assessed before and after RA or sham treatment

acupuncture alleviated cue-induced cravings through the regulation of activity in brain regions involved in attention, motivation, and reward

Acupoints in NADA protocol are located at (sympathetic: in the deltoid fossa at the junction of the infra-antihelix crus and the medial order of the helix, lung: in the center of the cavum concha, liver: located in the posterior to upper portion of the helix crus, kidney: in the cleft between the upper plateau, and the helix)

Alcohol

Conflicting results from two large randomized single-blind, placebo-controlled trials suggested that acupuncture was not effective in reducing alcohol use [16, 39]. However, promising results have been found using acupuncture as an adjunctive treatment to carbamazepine medication to reduce the severity of alcohol withdrawal symptoms [39]. In one study, AA failed to reduce the duration and severity of alcohol withdrawal symptoms [43]; another study found no advantage for laser AA in treating alcohol withdrawal [74]. However, research indicated that laser therapy helps to promote the release of endorphins in the body and decreases discomfort accompanying alcohol withdrawal [87]. It might therefore be a safe and painless beneficial adjunct treatment for alcoholism [87].

Acupuncture at Zusanli (ST36) or Sanyinjiao (SP6) modulated postsynaptic neural activation in the striatum and NAc in rats [89]. Acupuncture at Shenmen (HT7) normalized dopamine release in the mesolimbic system [89], modulated mesolimbic dopamine release, and suppressed the reinforcing effects of ethanol [82]. Activation of the endogenous opiate system might be responsible for Zusanli (ST36) and Sanyinjiao (SP6) stimulation effects on alcohol intake in alcohol-dependent rats [64].

EA applied at Zusanli (ST36) was more effective than EA at Shenshu (BL23) at normalizing alcohol-drinking behavior in rats [86]; the activity of serotonergic neurons in the reward system pathway of the brain might be increased and prolonged by acupuncture [85]. EA at the combination Zusanli (ST36) and Neiguan (PC6) (but not at either point alone) prevented sensitization of the mesocorticolimbic pathway induced by ethanol in mice and modulated both the expression of the protein homer1A and glutamatergic plasticity [28]. EA (2 Hz) at Zusanli (ST36) could reduce voluntary intake of ethanol, but not sucrose, in rats [50] and 100 Hz EA treatment at Zusanli (ST36) effectively reduces preference for ethanol and its consumption in rats [49]. In one study, 2 Hz EA at Zusanli (ST36) and Neiguan (PC6) or 100 Hz EA at Dazhui (DU14) and Baihui (DU20) inhibited CB1R upregulation in ethanol-withdrawn mice [29]. The behavioral effects of 2 Hz EA at Dazhui (DU14) and Baihui (DU20), but not 100 Hz EA at Zusanli (ST36) and Neiguan (PC6), depended on extracellular signal-regulated kinase signaling [30]. See Table 5 for study details.
Table 5

Original investigations of acupuncture therapy effects in alcohol-dependent subjects

Publication year; first author

Objectives

Subjects

Stimulated acupoints (acupuncture type, acupoints, frequency)

Assessments

Outcomes

2001

Yoshimoto [86]

To investigate the effect of EA on changes in alcohol-drinking behavior in rats challenged with restriction and immobilization stress

8–12 Male Sprague–Dawley rats

1 Hz and 100 Hz EA at Zusanli (ST 36) and Shenshu (BL 23) for 10 min, twice a week for 1–3 weeks

Time-access alcohol-drinking behavior, brain dopamine (DA) level

Acupuncture at Zusanli (ST 36) was more effective for reducing the increased alcohol-drinking behavior

2002

Bullock [16]

To report the clinical data on the efficacy of acupuncture for alcohol dependence

503 Alcoholics

AA at Shenmen (HT7), lung, sympathetic, and liver for 40 min, 6 days a week for 3 weeks

Alcohol use, depression, anxiety, functional status, and preference for therapy

acupuncture was not found to be effective in reduction of alcohol use alone

2002

Karst [39]

To investigate the acupuncture effects on alcohol withdrawal therapy with carbamazepine

34 Alcoholics

AA at Sympathetic, Shenmen (HT7), kidney, liver, lung, Baihui (GV20), extra1, and He Gu (Li4), daily for 10 days

Clinical Institute Withdrawal Assessment (CIWA-Ar-scale)

Acupuncture as an adjunctive treatment to carbamazepine medication shows promise for the treatment of alcohol withdrawal symptoms

2003

Trumpler [74]

To compare auricular laser and needle acupuncture with sham laser stimulation in reducing the duration of alcohol withdrawal

48 alcoholics undergoing alcohol withdrawal with clomethiazole n = 17 laser, n = 15 needle

AA (2-10 out of 24 points) for 30-45 min, laser AA at 24 pints (1 min for each point), 3-4 days

The duration of withdrawal symptoms (nurse-rated scale), duration of sedative prescription

Acupuncture showed no relevant benefit for alcohol withdrawal

2004

Zalewska-Kaszubska [87]

To intensify AA method by additional biostimulation of the whole organism

53 Alcoholics under daily helium–neon laser for neck biostimulation

Laser AA at concha points for 4 periods of ten times applied every 2nd day

The Beck Depression Inventory-Fast Screen (BDI-FS), beta-endorphin plasma concentration by using the radioimmunoassay (RIA)

laser therapy was useful as an adjunct treatment for alcoholism

2005

Kim [40]

To investigate the effects of acupuncture on alcohol withdrawal syndrome (AWS) and Fos-like immunoreactivity (FLI) in the striatum and the nucleus accumbens (NAC) of rats

24 Male Sprague–Dawley rats

Acupuncture at Zusanli (ST36) and Sanyinjiao (SP6) for 3 days

Alcohol withdrawal syndrome (AWS) and Fos-like immunoreactivity (FLI) in the striatum and the nucleus accumbens (NAC)

acupuncture was useful in the treatment of alcoholism by modulating post-synaptic neural activation in the striatum and NAC

2006

Yoshimoto [85]

To investigate the neuropharmacological mechanisms of oriental acupuncture

24 Male Sprague–Dawley rats, n = 16 acupuncture

unilateral or bilateral acupuncture at Shenshu (BU23) acupoint, 60 min

Dopamine (DA) and serotonin (5-HT) contents of the microdialysates in the ACC

Acupuncture was effective for treatment of emotional disorders and laconism by increasing and prolonging the activity of serotonergic neurons

2006

Zhao [89]

To investigate the effects of acupuncture on chronic ethanol-induced changes in extracellular dopamine levels in the nucleus accumbens shell

35 Male Sprague–Dawley rats, n = 21 sham or real acupuncture

Bilateral acupuncture at Shenmen (HT7) point or Neiguan (PC6) or tail) for 1 min

Extracellular dopamine levels in the nucleus accumbens shell (using in vivo microdialysis in unanesthetized rats)

Acupuncture at HT7 was effective to normalize the release of dopamine in the mesolimbic system following chronic ethanol treatment

2007

Kunz [43]

To compare auricular needle acupuncture with aromatherapy in reducing the duration and severity of symptoms of alcohol withdrawal with carbamazepine, oxcarbazepine, and benzodiazepines

74 alcoholics, n = 36 acupuncture, n = 38 aromatherapy

AA at 5 NADA points, 45 min for 5 days

Alcohol-withdrawal syndrome (AWS scale), subjective visual analog scale of craving and the Self-Assessment Manikin (SAM)

acupuncture was not more effective than the control therapy on alcohol withdrawal symptoms

2008

Overstreet [64]

To investigate the EA effects for reducing voluntary alcohol intake in alcohol-preferring rats

18 inbred alcohol-preferring P rats (IP), n = 9 EA

2 and 100 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6) for 30 min

Alcohol intake

Acupuncture affected on alcohol intake in the alcohol-dependent IP rats

2009

Dos Santos [28]

To investigate the effects of EA over locomotor sensitization induced by ethanol in mice

12 Male Swiss mice

2 Hz EA at Zusanli (ST36) and/or Neiguan (PC6) for 10 min

The locomotor activity, the expression of homer1A mRNA assessed by PCR

EA modulated homer1A expression and glutamatergic plasticity

2010

Yang [82]

To evaluate the effects of HT7 acupuncture on VTA GABA neuron excitability, ethanol inhibition of VTA GABA neuron firing rate, and ethanol self-administration

32 Male Wistar rats

2 Hz EA at Shenmen (HT7) or Neiguan (PC6) for 1 min

Ethanol-Reinforced Responding, VTA GABA Neuron Activity, VTA GABA Neuron Firing Rate

acupuncture reduced ethanol suppression of VTA GABA neuron firing rate, and reduced ethanol self-administration without affecting sucrose consumption

2011

Li [50]

To demonstrate that SD rats escalated their ethanol intake and subsequently developed ethanol dependence under the IE procedure

26 Male Sprague–Dawley rats

2 and 100 HZ EA at Zusanli (ST36) for 20 min

Intake of and preference for ethanol

EA treatments decreased the intake of and preference for ethanol, without resulting in a rebound increase in ethanol intake when the EA treatments were terminated

2012

Li [49]

To test the hypothesis that EA suppression on alcohol consumption may be mediated by transcription factors, such as FosB/ΔFosB protein in reward-related brain regions

33 Male Sprague–Dawley rats

2 and 100 HZ EA at Zusanli (ST36), 30 min for 6 days

The expression of FosB/ΔFosB in several reward-related brain regions using immunohistochemistry

EA treatment effectively reduced ethanol consumption and preference in rats by down-regulation of FosB/ΔFosB in reward-related brain regions

2012

Escosteguy-Neto [29]

To investigate EA effects during ethanol withdrawal on CB1R immunoreactivity

12 Male Swiss mice

2 and 100 Hz EA at Zusanli (ST36)/Neiguan (PC6) or Dazhui (DU14)/Baihui (DU20), 10 min for 4 days

CB1R in the prefrontal cortex, striatum, hippocampus, amygdala and ventral tegmental area

EA inhibited CB1R upregulation which depended on acupoints association and frequency of stimulation

2012

Fallopa [30]

To investigate whether EA reverses locomotor sensitization induced by ethanol is parallel to ERK signaling

12 Male Swiss mice

2 and 100 Hz EA at Zusanli (ST36)/Neiguan (PC6) or Dazhui (DU14)/Baihui (DU20), 10 min for 4 days

pERK immune-histochemistry

EA increased CB1R in the prefrontal cortex, striatum, hippocampus, amygdala and ventral tegmental area

Acupoints in NADA protocol are located at (sympathetic: in the deltoid fossa at the junction of the infra-antihelix crus and the medial order of the helix, lung: in the center of the cavum concha, liver: located in the posterior to upper portion of the helix crus, kidney: in the cleft between the upper plateau, and the helix)

Morphine

Compared with 100 Hz, 2 Hz peripheral electric stimulation (PES) at Zusanli (ST36) and Sanyinjiao (SP6) inhibited the expression of morphine-induced conditioned place preference (CPP) (see [52] for information on CPP) via activation of opioid receptors [75]. One study found that the release and synthesis of enkephalin in the NAc was accelerated by 2 Hz stimulation of Zusanli (ST36) and Sanyinjiao (SP6) [53]. In addition, EA suppression of opiate addiction might involve the release of endogenous μ-, δ-, and κ-opioid agonists in the NAc shell [52] and might activate the cannabinoid, endogenous opioid, and dopamine systems to induce CPP in rats [81]. PES (100 Hz) at Zusanli (ST36) and Sanyinjiao (SP6) activated the suprasegmental δ- and κ-opioid receptors in the central nervous system, which cause the anticraving effects of PES in rats [70]. It was also found that the expression of preproenkephalin and preprodynorphin mRNAs in the NAc was mediated by 2 Hz or 100 Hz PES, with the release of endogenous μ-, δ-, and κ-opioid agonists to suppress morphine-induced CPP [71]. Stimulation at Zusanli (ST36) and Sanyinjiao (SP6) (100 Hz) for 30 min normalized the activity of ventral tegmental area dopamine neurons [34], downregulated p-cAMP response element binding, and accelerated dynorphin synthesis in the spinal cord [76].

Some research suggests that 2 Hz EA is a potential complementary therapy for improving immune dysfunction in opiate addicts [51] and that 2 Hz or 100 Hz EA facilitates the recovery of male sexual behavior in rats during morphine withdrawal [27]. Thirty minutes of EA of 2 Hz or 100 Hz at Zusanli (ST36) and Sanyinjiao (SP6) reversed the morphological alterations induced by chronic morphine administration [25]. In addition, by increasing NREM sleep, REM sleep, and total sleep time, EA could be a potential treatment for sleep disturbance during morphine withdrawal [48].

EA at Shenshu (BL23) attenuated the expression of the proto-oncogene c-Fos in the central nucleus of the amygdala [54]. Acupuncture at Shenmen (HT7) inhibited neurochemical and behavioral sensitization to morphine by decreasing dopamine release in the NAc [41]. Acupuncture at Shenmen (HT7) significantly suppressed morphine-induced increase in locomotor activity and Fos expression in the NAc and striatum [45]. Acupuncture at Yanggu (SI5) can reduce the reinstatement of morphine-seeking behaviors by mediating the gamma-aminobutyric acid receptor system [46, 47]. See Table 6 for study details.
Table 6

Original investigations of acupuncture therapy effects in morphine-dependent subjects

Publication year; first author

Objectives

Subjects

Stimulated acupoints (acupuncture type, acupoints, frequency)

Assessments

Outcomes

2000

Wang [75]

To observe the effect of peripheral electric stimulation (PES) on morphine-induced Conditioned place preference CPP

57/82 Male Sprague–Dawley rats

2 and 100 Hz PES at Zusanli (ST36) and Sanyinjiao (SP6) for 30 min

Conditioned place preference

2 Hz PES could specifically inhibit the expression of morphine-induced CPP

2003

Shi [70]

To examine the effect of 100 Hz peripheral electric stimulation (PES) on the expression of morphine-induced CPP

48 Male Sprague–Dawley rats

100 Hz PES at Zusanli (ST36) and Sanyinjiao (SP6), 30 min a day for 3 days

Conditioned place preference

Repeated 100 Hz PES had anti-craving effects by activating supra-segmental δ- and κ-opioid receptors

2004

Shi [71]

To elucidate if preproenkephalin (PPE) and preprodynorphin (PPD) mRNAs in the nucleus accumbens (NAc) play a role in PES suppressing morphine-induced CPP

48 Male Sprague–Dawley rats

2 and 100 Hz PES at Zusanli (ST36) and Sanyinjiao (SP6), 30 min a day for 3 days

Conditioned place preference

PES suppressed both the expression of morphine-induced CPP and the reinstatement of extinguished CPP

2004

Cui [27]

To investigate the effect of EA on the sexual behavior of male rats undergoing morphine withdrawal

41 Male Sprague–Dawley rats

2 and 100 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6), 30 min a day for 7 days

Total serum testosterone (TST) concentrations

EA facilitated the recovery of male sexual behavior and increased TST concentrations

2005

Kim [41]

To investigate the effect of acupuncture on repeated morphine-induced changes in extracellular dopamine levels

31 Male Sprague–Dawley rats

Acupuncture at Shenmen (HT7) for 1 min

Dopamine release in the nucleus accumbens and behavioral hyperactivity

Acupuncture decreased both dopamine release in the nucleus accumbens and behavioral hyperactivity

2005

Liu [54]

To evaluate the effect of EA on morphine withdrawal signs and c-Fos expression of the amygdala

21 Male Sprague–Dawley rats

100 Hz EA at Shenshu (BL23) for 30 min

Corticosterone levels and behavioral responses during EA stimulation

EA significantly reduced the signs of morphine withdrawal

2008

Chu [25]

To observe the effect of EA on chronic morphine-induced neuronal morphological changes in the ventral tegmental area (VTA)

12 Male Sprague–Dawley rats

2 and 100 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6), 30 min for 3 days

The rough endoplasmic reticulum, membrane configuration of the nucleus and mitochondria, and structure of myelin sheath

EA reversed the morphological alterations induced by chronic morphine administration

2009

Hu [34]

To examine alterations in the firing rate of Dopamine neurons in 100 Hz EA treatment

40 Male Sprague–Dawley rats

100 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6), 30 min for 10 days

Conditioned place preference

EA was effective for the treatment of opiate addiction by normalizing the activity of VTA DA neurons

2010

Liang [53]

To find the Role of enkephalin in the nucleus accumbens mediating the effects of EA

218 Male Sprague–Dawley rats

2 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6), 30 min for 1-3 days

Conditioned place preference

EA up-regulated the mRNA level of preproenkephalin in the NAc

2010

Lee [45]

To investigate the effect of acupuncture on morphine-induced behavioral sensitization and the neuronal changes in NAc and striatum

14 Male Sprague–Dawley rats

Acupuncture at Shenmen (HT7), 1 min for 3 days

Morphine-induced changes of locomotor activity and Fos expression

acupuncture suppressed the morphine-induced increases in the locomotor activity and Fos expression in the NAc and striatum

2011

Li [48]

To observe whether EA could modulate the immune status of morphine dependence and withdrawal mice

40 Male BALB/c mice

2 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6), 30 min for 5 days

Splenic T Lymphocyte Proliferation, IL-2 Production, CD4+/CD8+ Ratio

EA raised IL-2 and normalized chronic morphine exposure-induced immune dysfunctions

2011

Li [51]

To investigate the effect of 2 and 100 Hz EA of the sleep disturbance during morphine withdrawal

15 Male Sprague–Dawley rats

2 and 100 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6), 30 min twice a day for 3 days

Electroencephalogram and electromyogram

EA decreased NREM/REM and total sleep time, while the sleep latency prolonged significantly during acute morphine withdrawal

2011

Wang [76]

To find the optimum protocol for EA effective for alleviating withdrawal syndrome

40 Male Sprague–Dawley rats

100 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6) for 30 min

Conditioned place preference

EA down-regulated of p-CREB and accelerated of dynorphin synthesis in spinal cord

2011

Xia [81]

To investigate whether EA by itself will produce some rewarding effect

44 Male Sprague–Dawley rats

2 Hz EA at Zusanli (ST36) and Sanyinjiao (SP6) for 30 min

Conditioned place preference

EA was capable of inducing CPP in the rat via the activation of the endogenous opioid-, cannabinoid- and dopamine-systems

2012

Lee [47]

To investigate the role of acupuncture in the reinstatement of morphine seeking

15 Male Sprague–Dawley rats

Acupuncture, Yanggu (SI5) or Yangxi (LI5) for 1 min

Morphine reinstatement

acupuncture attenuated the reinstatement of morphine seeking behavior by blocking the GABA receptor antagonists

2013

Lee [46]

To investigate whether acupuncture could suppress the reinstatement of morphine-seeking behavior

28 Male Sprague–Dawley rats

Acupuncture, Yanggu (SI5) or Yangxi (LI5) or Zusanli (ST36) for 1 min

Morphine-seeking behavior

acupuncture suppressed morphine injection perfectly

Acupoints in NADA protocol are located at (sympathetic: in the deltoid fossa at the junction of the infra-antihelix crus and the medial order of the helix, lung: in the center of the cavum concha, liver: located in the posterior to upper portion of the helix crus, kidney: in the cleft between the upper plateau, and the helix)

Other substances

Studies of methamphetamine, cannabis, illicit/psychoactive drugs, and polydrug users are shown in Table 7. Twelve studies used the NADA 5-point protocol and AA as their treatment method. The findings indicated that people dependent on drugs preferred acupuncture treatment [9], which was associated with a decrease in psychological distress [12] and an increase in confidence [14], but showed no efficacy for drug consumption and withdrawal symptoms [9, 1214]. However, the conflicting nature of the research findings remains a controversial issue. Although there was evidence against the effectiveness of acupuncture in drug addiction treatment [7, 35, 36], recent studies have shown an effect for AA [23, 24, 26, 68, 73] and transcutaneous electric acupoint stimulation [66] per se or as adjunct treatments. Issues of safety and placebo effects suggest the need for further research [26, 35, 36, 66]. See Table 7 for study details.
Table 7

Original investigations of acupuncture therapy effects in poly-drug and other substance abusers (NA not available)

Publication year; first author

Objectives

Subjects

Stimulated acupoints (acupuncture type, acupoints, frequency)

Assessments

Outcomes

2000

Russell [68]

To compare the behavior of addicts in a treatment center with archived information from no-acupuncture (NA) patients

86 Patients (Methamphetamine was the primary drug of choice for 44)

AA at 5 NADA points, 45 min for 9 weeks

Program retention, new arrests incurred, drug-positive urinalysis results, and number of days needed to progress from entry level to secondary level treatment

Acupuncture improved program retention up to 30 days among methamphetamine-addicted patients

2000

Song Bernstein [14]

To explore the meaning of substance abusers’ experience while receiving acupuncture as a part of the treatment for substance dependence

8 Human Subjects

AA, (NA), once a week

Interviews, researcher’s field notes, and demographic data obtained from the participants’ medical records

Acupuncture caused anticipation of pain, apprehension concerning a new experience, mood elevation, inability to describe the experience, physical sensation, relaxation, and improved sleep

2004

Berman [13]

To compare the experimental NADA-Acudetox protocol with a non-specific helix control protocol in a randomized trial

174 Inmates

Auricular acupuncture at 5 NADA points, 40 min for 4 weeks

A simple drug use questionnaire, the Acupuncture Treatment Assessment Scale (ATAS), a Swedish research version of the Symptom Check List 90

Acupuncture had no significant efficiency over the placebo

2005

Janssen [36]

To examine the utility of acupuncture treatment in reducing substance use in the marginalized, transient population

261 Humans

AA at 5 NADA points for 40 min

Questionnaire, Drug use symptomatology, severity of withdrawal symptoms

Acupuncture caused reduction in overall use of substances and decrease in intensity of withdrawal symptoms

2006

Tian [73]

To examine the efficacy of AA in addition to usual care in substance abuse treatment

17 Humans

AA at 5-points NADA, once a week for 6 consecutive weeks

The Hopkins Symptom Checklist (SCL-20) depression scale, brief substance craving scale

there was a positive response to the specific auricular acupressure treatment on psychological distress, craving, and drug/alcohol use measures

2007

Courbasson and Christine [26]

To evaluate the benefits of adding AA to a 21-day outpatient structured psychoeducational treatment program

185 Women with concurrent substance use problems, anxiety, and depression

AA at 5 points NADA for 45 min, 3 times a week

Physiological cravings for substances, depression, and anxiety

AA as an adjunct therapy to a comprehensive psychoeducational treatment was effective and more viable treatment alternative to anxiolytics

2009

Ashton [9]

To describe the characteristics of clients choosing AA or counseling to treat dependence at a UK self-referral center

162 Humans, n = 36 acupuncture, n = 126 counselling

AA at 5-points NADA, 45 min, once a week for 11 weeks

Psychometric variables (anxiety, depression, dependence severity, readiness to change), and alcohol and drug consumption

Acupuncture was preferred by clients and follow up assessments showed a significant decrease in psychological distress and reduction of alcohol consumption

2014, 2010

Chang and Bei-Hung [23, 24]

Examine the effects of acupuncture and related response (RR) on reducing craving

23 Acupuncture, 23 RR, 21 controls (homeless military veterans)

AA at 5-points NADA, 45 min twice a week

Degree of craving and anxiety levels

acupuncture and the relaxation reduced craving and anxiety levels

2011

Black, S. [7]

To test the hypothesis if AA reduces the anxiety associated with withdrawal from psychoactive drugs.

101 Patients recruited from an addiction treatment service

AA at 5-points NADA 45 min for 3 days

Anxiety state by using a pretest–posttest treatment design

The NADA protocol was not more effective than sham or treatment setting control in reducing anxiety

2012

Janssen [35]

To test the ability of maternal acupuncture treatment among mothers who use illicit drugs to reduce the frequency and severity of withdrawal symptoms among their newborns

50 Women using acupuncture, 39 women standard care

AA at 5-points NADA for 45 min

Days of neonatal morphine treatment for symptoms of neonatal withdrawal. Neonatal outcomes included admission to a neonatal ICU and transfer to foster care

length of treatment for neonatal abstinence syndrome showed no efficiency of acupuncture

2012

Penetar [66]

To investigate the effects of TEAS on drug addiction

9 Cocaine-dependent, 11 Cannabis-dependent

2 and 100 Hz at Neiguan (PC6)/Waiguan (TH5) and Hegu (LI4)/Laogong (PC8) stimulation, Twice-daily 30-minute sessions of for 3.5 days

Drug use and drug cravings, cue-induced craving EEG evaluation, and P300 ERP

TEAS did not reduce drug use or drug cravings, or alter the ERP peak voltage or latency but modulated several self reported measures of mood and anxiety

2014

Bergdah [12]

To describe patients’ experiences of receiving AA during protracted withdrawal

15 Human subjects

AA at 5-points NADA 40 min, twice a week for 5 weeks

Interview

AA reinforced sense of relaxation and well-being, peacefulness and harmony, and new behaviors

Acupoints in NADA protocol are located at (sympathetic: in the deltoid fossa at the junction of the infra-antihelix crus and the medial order of the helix, lung: in the center of the cavum concha, liver: located in the posterior to upper portion of the helix crus, kidney: in the cleft between the upper plateau, and the helix)

Conclusion

AA and NADA protocols failed to show a strong therapeutic effect for cocaine, nicotine, and alcohol addiction treatment. However, some studies discussed here indicate that acupuncture at Shenmen (HT7), Zusanli (ST36), and Sanyinjiao (SP6) acupoints can affect drug-induced physiological activities.

Declarations

Authors’ contributions

FEM, FI, RAR, and TS designed and conceived the study. FEM, RR, TS, FI, and RAR carried out the article searches. FEM performed the statistical analysis. FEM and TS wrote the manuscript. FI, RAR, and HH revised the manuscript. All authors read and approved the final manuscript.

Acknowledgements

We would like to acknowledge and thank the University of Malaya and Ministry of Higher Education for providing High Impact Research Grant, account codes E000007-20001 to fund this project.

Competing interests

The authors declare that they have no competing interests.

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Department of Biomedical Engineering, Faculty of Engineering, University of Malaya
(2)
Centre for Innovation in Medical Engineering, Faculty of Engineering, University of Malaya
(3)
Centre of Addiction Sciences, University of Malaya
(4)
Shahid Beheshti University of Medical Sciences

References

  1. Pelletier KR, Marie A, Krasner M, Haskell WL. Current trends in the integration and reimbursement of complementary and alternative medicine by managed care, insurance carriers, and hospital providers. Am J Health Promot. 1997;12(2):112–22.View ArticlePubMedGoogle Scholar
  2. Jordan JB. Acupuncture treatment for opiate addiction: a systematic review. J Subst Abuse Treat. 2006;30(4):309–14. doi:10.1016/j.jsat.2006.02.005.View ArticlePubMedGoogle Scholar
  3. Lin JG, Chan YY, Chen YH. Acupuncture for the treatment of opiate addiction. Evid Based Complement Alternat Med. 2012;. doi:10.1155/2012/739045.Google Scholar
  4. Cowan D. Methodological issues in evaluating auricular acupuncture therapy for problems arising from the use of drugs and alcohol. Acupunct Med. 2011;29(3):227–9. doi:10.1136/aim.2010.003772.View ArticlePubMedGoogle Scholar
  5. Organization WHO. WHO traditional medicine strategy 2002–2005. 2002.Google Scholar
  6. Cui CL, Wu LZ, Luo F. Acupuncture for the treatment of drug addiction. Neurochem Res. 2008;33(10):2013–22. doi:10.1007/s11064-008-9784-8.View ArticlePubMedGoogle Scholar
  7. Black S, Carey E, Webber A, Neish N, Gilbert R. Determining the efficacy of auricular acupuncture for reducing anxiety in patients withdrawing from psychoactive drugs. J Subst Abuse Treat. 2011;41(3):279–87. doi:10.1016/j.jsat.2011.04.001.View ArticlePubMedGoogle Scholar
  8. Cabioglu MT, Ergene N, Tan U. Smoking cessation after acupuncture treatment. Int J Neurosci. 2007;117(5):571–8. doi:10.1080/00207450500535289.View ArticlePubMedGoogle Scholar
  9. Ashton H, Nodiyal A, Green D, Moore B, Heather N. Acupuncture or counselling: outcomes and predictors of treatment choice in a non-statutory addiction service. J Subst Use. 2009;14(3–4):151–60. doi:10.1080/14659890802659002.View ArticleGoogle Scholar
  10. Avants SK, Margolin A, Holford TR, Kosten TR. A randomized controlled trial of auricular acupuncture for cocaine dependence. Arch Intern Med. 2000;160(15):2305–12. doi:10.1001/archinte.160.15.2305.View ArticlePubMedGoogle Scholar
  11. Bearn J, Swami A, Stewart D, Atnas C, Giotto L, Gossop M. Auricular acupuncture as an adjunct to opiate detoxification treatment: effects on withdrawal symptoms. J Subst Abuse Treat. 2009;36(3):345–9. doi:10.1016/j.jsat.2008.08.002.View ArticlePubMedGoogle Scholar
  12. Bergdahl L, Berman AH, Haglund K. Patients’ experience of auricular acupuncture during protracted withdrawal. J Psychiatr Ment Health Nurs. 2014;21(2):163–9. doi:10.1111/jpm.12028.View ArticlePubMedGoogle Scholar
  13. Berman AH, Lundberg U, Krook AL, Gyllenhammar C. Treating drug using prison inmates with auricular acupuncture: a randomized controlled trial. J Subst Abuse Treat. 2004;26(2):95–102. doi:10.1016/s0740-5472(03)00162-4.View ArticlePubMedGoogle Scholar
  14. Bernstein KS. The experience of acupuncture for treatment of substance dependence. In: J Nurs Scholarsh. Wiley, United States. 2000. http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=12462821&site=ehost-live. Accessed 3 32.
  15. Bonnette ML. Auricular transcutaneous electrical neuro-stimulation, addiction education, behavioral training, coaching support and the nicotine addiction treatment process. J Addict Nurs. 2008;19(3):130–40. doi:10.1080/10884600802305976.View ArticleGoogle Scholar
  16. Bullock ML, Kiresuk TJ, Sherman RE, Lenz SK, Culliton PD, Boucher TA, et al. A large randomized placebo controlled study of auricular acupuncture for alcohol dependence. J Subst Abuse Treat. 2002;22(2):71–7. doi:10.1016/s0740-5472(01)00217-3.View ArticlePubMedGoogle Scholar
  17. Cai X, Song X, Li C, Xu C, Li X, Lu Q. Acupuncture inhibits cue-induced heroin craving and brain activation. Neural Regen Res. 2012;7(33):2607–16. doi:10.3969/j.issn.1673-5374.2012.33.006.PubMedPubMed CentralGoogle Scholar
  18. Chae Y, Kang OS, Lee HJ, Kim SY, Lee H, Park HK, et al. Effect of acupuncture on selective attention for smoking-related visual cues in smokers. Neurol Res. 2010;32:S27–30. doi:10.1179/016164109x12537002793805.View ArticleGoogle Scholar
  19. Chae Y, Park H-J, Kang OS, Lee H-J, Kim S-Y, Yin C-S, et al. Acupuncture attenuates autonomic responses to smoking-related visual cues. Complement Ther Med. 2011;19:S1–7. doi:10.1016/j.ctim.2010.09.003.View ArticlePubMedGoogle Scholar
  20. Chae Y, Yeom M, Han J-H, Park H-J, Hahm D-H, Ac IS, et al. Effect of acupuncture on anxiety-like behavior during nicotine withdrawal and relevant mechanisms. Neurosci Lett. 2008;430(2):98–102. doi:10.1016/j.neulet.2007.10.026.View ArticlePubMedGoogle Scholar
  21. Chae YY, Yang CH, Kwon YK, Kim MR, Pyun KH, Hahm DH, et al. Acupuncture attenuates repeated nicotine-induced behavioral sensitization and c-Fos expression in the nucleus accumbens and striatum of the rat. Neurosci Lett. 2004;358(2):87–90. doi:10.1016/j.neulet.2003.12.121.View ArticlePubMedGoogle Scholar
  22. Chan YY, Lo WY, Li TC, Shen LJ, Yang SN, Chen YH, et al. Clinical efficacy of acupuncture as an adjunct to methadone treatment services for heroin addicts: a randomized controlled trial. Am J Chin Med. 2014;42(3):569–86. doi:10.1142/s0192415x14500372.View ArticlePubMedGoogle Scholar
  23. Chang BH, Sommers E, Herz L. Acupuncture and relaxation response for substance use disorder recovery. J Subst Use. 2010;15(6):390–401. doi:10.3109/14659890903580466.View ArticleGoogle Scholar
  24. Chang B-H, Sommers E. Acupuncture and relaxation response for craving and anxiety reduction among military veterans in recovery from substance use disorder. Am J Addict. 2014;23(2):129–36. doi:10.1111/j.1521-0391.2013.12079.x.View ArticlePubMedGoogle Scholar
  25. N-n Chu, Xia W, Yu P, Hu L, Zhang R, Cui C-L. Chronic morphine-induced neuronal morphological changes in the ventral tegmental area in rats are reversed by electroacupuncture treatment. Addict Biol. 2008;13(1):47–51. doi:10.1111/j.1369-1600.2007.00092.x.View ArticleGoogle Scholar
  26. Courbasson CMA, de Sorkin AA, Dullerud B, Van Wyk L. Acupuncture treatment for women with concurrent substance use and anxiety/depression—an effective alternative therapy? Fam Community Health. 2007;30(2):112–20.View ArticlePubMedGoogle Scholar
  27. Cui GH, Ren XW, Wu LZ, Han JS, Cui CL. Electroacupuncture facilitates recovery of male sexual behavior in morphine withdrawal rats. Neurochem Res. 2004;29(2):397–401. doi:10.1023/B:NERE.0000013743.53827.ad.View ArticlePubMedGoogle Scholar
  28. dos Santos JG, Filev R, Coelho CT, Yamamura Y, Mello LE, Tabosa A. Electroacupuncture inhibits ethanol-induced locomotor sensitization and alters homer1A mRNA Expression in mice. Alcohol Clin Exp Res. 2009;33(8):1469–75. doi:10.1111/j.1530-0277.2009.00977.x.View ArticlePubMedGoogle Scholar
  29. Escosteguy-Neto JC, Fallopa P, Varela P, Filev R, Tabosa A, Santos JG. Electroacupuncture inhibits CB1 upregulation induced by ethanol withdrawal in mice. Neurochem Int. 2012;61(2):277–85. doi:10.1016/j.neuint.2012.05.014.View ArticlePubMedGoogle Scholar
  30. Fallopa P, Escosteguy-Neto JC, Varela P, Carvalho TN, Tabosa AMF, Santos JG. Electroacupuncture reverses ethanol-induced locomotor sensitization and subsequent pERK expression in mice. Int J Neuropsychopharmacol. 2012;15(8):1121–33. doi:10.1017/s1461145711001325.View ArticlePubMedGoogle Scholar
  31. Gates S, Smith LA, Foxcroft DR. Auricular acupuncture for cocaine dependence. Cochrane Database Syst Rev. 2006(1). doi:10.1002/14651858.CD005192.pub2.
  32. Hou XR, Zhang RJ, Lv H, Cai XH, Xie GC, Song XG. Acupuncture at Baihui and Dazhui reduces brain cell apoptosis in heroin readdicts. Neural Regen Res. 2014;9(2):164–70. doi:10.4103/1673-5374.125345.View ArticlePubMedPubMed CentralGoogle Scholar
  33. Hu AR, Lai MJ, Wei JZ, Wang LN, Mao HJ, Zhou WH, et al. The effect of electroacupuncture on extinction responding of heroin-seeking behavior and FosB expression in the nucleus accumbens core. Neurosci Lett. 2013;534:252–7. doi:10.1016/j.neulet.2012.12.021.View ArticlePubMedGoogle Scholar
  34. Hu L, Chu NN, Sun LL, Zhang R, Han JS, Cui CL. Electroacupuncture treatment reverses morphine-induced physiological changes in dopaminergic neurons within the ventral tegmental area. Addict Biol. 2009;14(4):431–7. doi:10.1111/j.1369-1600.2009.00163.x.View ArticlePubMedGoogle Scholar
  35. Janssen PA, Demorest LC, Kelly A, Thiessen P, Abrahams R. Auricular acupuncture for chemically dependent pregnant women: a randomized controlled trial of the NADA protocol. Subst Abuse Treat Prev Policy. 2012;. doi:10.1186/1747-597x-7-48.PubMedPubMed CentralGoogle Scholar
  36. Janssen PA, Demorest LC, Whynot EM. Acupuncture for substance abuse treatment in the downtown eastside of Vancouver. J Urban Health. 2005;82(2):285–95. doi:10.1093/jurban/jti054.View ArticlePubMedPubMed CentralGoogle Scholar
  37. Jiang YP, Liu H, Xu P, Wang Y, Lu GH. Effect of electro-acupuncture intervention on cognition attention bias in heroin addiction abstinence-a dot-probe-based event-related potential study. Chin J Integr Med. 2011;17(4):267–71. doi:10.1007/s11655-011-0698-y.View ArticlePubMedGoogle Scholar
  38. Kang OS, Kim SY, Jahng GH, Kim H, Kim JW, Chung SY, et al. Neural substrates of acupuncture in the modulation of cravings induced by smoking-related visual cues: an FMRI study. Psychopharmacology. 2013;228(1):119–27. doi:10.1007/s00213-013-3015-y.View ArticlePubMedGoogle Scholar
  39. Karst M, Passie T, Friedrich S, Wiese B, Schneider U. Acupuncture in the treatment of alcohol withdrawal symptoms: a randomized, placebo-controlled inpatient study. Addict Biol. 2002;7(4):415–9. doi:10.1080/1355621021000006017.View ArticlePubMedGoogle Scholar
  40. Kim JH, Chung JY, Kwon YK, Kim KJ, Yang CH, Hahm DH, et al. Acupuncture reduces alcohol withdrawal syndrome and c-Fos expression in rat brain. Am J Chin Med. 2005;33(6):887–96. doi:10.1142/s0192415x0500348x.View ArticlePubMedGoogle Scholar
  41. Kim MR, Kim SJ, Lyu YS, Kim SH, Lee YK, Kim TH, et al. Effect of acupuncture on behavioral hyperactivity and dopamine release in the nucleus accumbens in rats sensitized to morphine. Neurosci Lett. 2005;387(1):17–21. doi:10.1016/j.neulet.2005.07.007.View ArticlePubMedGoogle Scholar
  42. Kim SA, Lee BH, Bae JH, Kim KJ, Steffensen SC, Ryu Y-H, et al. Peripheral afferent mechanisms underlying acupuncture inhibition of cocaine behavioral effects in rats. PLoS One. 2013;. doi:10.1371/journal.pone.0081018.Google Scholar
  43. Kunz S, Schulz M, Lewitzky M, Driessen M, Rau H. Ear acupuncture for alcohol withdrawal in comparison with aromatherapy: a randomized-controlled trial. Alcohol Clin Exp Res. 2007;31(3):436–42. doi:10.1111/j.1530-0277.2006.00333.x.View ArticlePubMedGoogle Scholar
  44. Lee B, Han S-M, Shim I. Acupuncture attenuates cocaine-induced expression of behavioral sensitization in rats: possible involvement of the dopaminergic system in the ventral tegmental area. Neurosci Lett. 2009;449(2):128–32. doi:10.1016/j.neulet.2008.10.089.View ArticlePubMedGoogle Scholar
  45. Lee B, Shim I, Lee H, Yin CS, Park HK, Yang JS, et al. Morphine-induced locomotor response and Fos expression in rats are inhibited by acupuncture. Neurol Res. 2010;32:S107–10. doi:10.1179/016164109x12537002794444.View ArticleGoogle Scholar
  46. Lee BH, Lim SC, Jeon HJ, Kim JS, Lee YK, Lee HJ, et al. Acupuncture suppresses reinstatement of morphine-seeking behavior induced by a complex cue in rats. Neurosci Lett. 2013;548:126–31. doi:10.1016/j.neulet.2013.05.026.View ArticlePubMedGoogle Scholar
  47. Lee BH, Ma JH, In S, Kim HY, Yoon SS, Jang EY, et al. Acupuncture at SI5 attenuates morphine seeking behavior after extinction. Neurosci Lett. 2012;529(1):23–7. doi:10.1016/j.neulet.2012.09.020.View ArticlePubMedGoogle Scholar
  48. Li HY, Zhang R, Cui CL, Han JS, Wu LZ. Damage of splenic T lymphocyte proliferation and differentiation and its normalization by electroacupuncture in morphine-dependent mice mode. Evid Based Complement Alternat Med. 2011;. doi:10.1155/2011/424092.Google Scholar
  49. Li J, Sun YA, Ye JH. Electroacupuncture decreases excessive alcohol consumption involving reduction of FosB/Delta FosB levels in reward-related brain regions. PLoS One. 2012;7(7):12. doi:10.1371/journal.pone.0040347.Google Scholar
  50. Li J, Zou YH, Ye JH. Low frequency electroacupuncture selectively decreases voluntarily ethanol intake in rats. Brain Res Bull. 2011;86(5–6):428–34. doi:10.1016/j.brainresbull.2011.08.013.PubMedPubMed CentralGoogle Scholar
  51. Li YJ, Zhong F, Yu P, Han JS, Cui CL, Wu LZ. Electroacupuncture treatment normalized sleep disturbance in morphine withdrawal rats. Evid Based Complement Alternat Med. 2011;. doi:10.1093/ecam/nep133.Google Scholar
  52. Liang J, Li YJ, Ping XJ, Yu P, Zuo YF, Wu LZ, et al. The possible involvement of endogenous ligands for mu-, delta- and kappa-opioid receptors in modulating morphine-induced CPP expression in rats. Peptides. 2006;27(12):3307–14. doi:10.1016/j.peptides.2006.08.011.View ArticlePubMedGoogle Scholar
  53. Liang J, Ping XJ, Li YJ, Ma YY, Wu LZ, Han JS, et al. Morphine-induced conditioned place preference in rats is inhibited by electroacupuncture at 2 Hz: role of enkephalin in the nucleus accumbens. Neuropharmacology. 2010;58(1):233–40. doi:10.1016/j.neuropharm.2009.07.007.View ArticlePubMedGoogle Scholar
  54. Liu S, Zhou WH, Liu HF, Yang GD, Zhao WK. Electroacupuncture attenuates morphine withdrawal signs and c-Fos expression in the central nucleus of the amygdala in freely moving rats. Brain Res. 2005;1044(2):155–63. doi:10.1016/j.brainres.2005.02.075.View ArticlePubMedGoogle Scholar
  55. Liu S, Zhou WH, Ruan XZ, Li RH, Lee TT, Weng XC, et al. Activation of the hypothalamus characterizes the response to acupuncture stimulation in heroin addicts. Neurosci Lett. 2007;421(3):203–8. doi:10.1016/j.neulet.2007.04.078.View ArticlePubMedGoogle Scholar
  56. Liu S, Zhu FL, Lai MJ, Sun LM, Liu YJ, Zhou WH. Electroacupuncture suppresses discrete cue-evoked heroin-seeking and Fos protein expression in the nucleus accumbens core in rats. Evid Based Complement Alternat Med. 2012;. doi:10.1155/2012/286404.Google Scholar
  57. Lua PL, Talib NS. Auricular acupuncture for drug dependence: an open-label randomized investigation on clinical outcomes, health-related quality of life, and patient acceptability. Altern Ther Health Med. 2013;19(4):28–42.PubMedGoogle Scholar
  58. Lua PL, Talib NS, Ismail Z. Methadone maintenance treatment versus methadone maintenance treatment plus auricular acupuncture: impacts on patient satisfaction and coping mechanism. J Pharm Pract. 2013;26(6):541–50. doi:10.1177/0897190013489574.View ArticlePubMedGoogle Scholar
  59. Margolin A, Avants SK, Arnold R. Acupuncture and spirituality-focused group therapy for the treatment of HIV-positive drug users: a preliminary study. J Psychoactive Drugs. 2005;37(4):385–90.View ArticlePubMedGoogle Scholar
  60. Margolin A, Avants SK, Holford TR. Interpreting conflicting findings from clinical trials of auricular acupuncture for cocaine addiction: does treatment context influence outcome? J Altern Complement Med. 2002;8(2):111–21. doi:10.1089/107555302317371398.View ArticlePubMedGoogle Scholar
  61. Margolin A, Kleber HD, Avants SK, Konefal J, Gawin F, Stark E, et al. Acupuncture for the treatment of cocaine addiction—a randomized controlled trial. JAMA. 2002;287(1):55–63. doi:10.1001/jama.287.1.55.View ArticlePubMedGoogle Scholar
  62. Meade CS, Lukas SE, McDonald LJ, Fitzmaurice GM, Eldridge JA, Merrill N, et al. A randomized trial of transcutaneous electric acupoint stimulation as adjunctive treatment for opioid detoxification. J Subst Abuse Treat. 2010;38(1):12–21. doi:10.1016/j.jsat.2009.05.010.View ArticlePubMedPubMed CentralGoogle Scholar
  63. Montazeri K, Farahnakian M, Saghaei M. The effect of acupuncture on the acute withdrawal symptoms from rapid opiate detoxification. Acta Anaesthesiol Sin. 2002;40(4):173–7.PubMedGoogle Scholar
  64. Overstreet DH, Cui CL, Ma YY, Guo CY, Han JS, Lukas SE, et al. Electroacupuncture reduces voluntary alcohol intake in alcohol-preferring rats via an opiate-sensitive mechanism. Neurochem Res. 2008;33(10):2166–70. doi:10.1007/s11064-008-9791-9.View ArticlePubMedGoogle Scholar
  65. Park HJ, Kim ST, Yoon DH, Jin SH, Lee SJ, Lee HJ, et al. The association between the DRD2 TaqI A polymorphism and smoking cessation in response to acupuncture in Koreans. J Altern Complement Med. 2005;11(3):401–5. doi:10.1089/acm.2005.11.401.View ArticlePubMedGoogle Scholar
  66. Penetar DM, Burgos-Robles A, Trksak GH, MacLean RR, Dunlap S, Lee DYW, et al. Effects of transcutaneous electric acupoint stimulation on drug use and responses to cue-induced craving: a pilot study. Chin Med. 2012;. doi:10.1186/1749-8546-7-14.PubMedPubMed CentralGoogle Scholar
  67. Rabinstein AA, Shulman LM. Acupuncture in clinical neurology. Neurologist. 2003;9(3):137–48. doi:10.1097/00127893-200305000-00002.View ArticlePubMedGoogle Scholar
  68. Russell LC, Sharp B, Gilbertson B. Acupuncture for addicted patients with chronic histories of arrest—a pilot study of the consortium treatment center. J Subst Abuse Treat. 2000;19(2):199–205. doi:10.1016/s0740-5472(00)00118-5.View ArticlePubMedGoogle Scholar
  69. Samuels N, Gropp C, Singer SR, Oberbaum M. Acupuncture for psychiatric illness: a literature review. Behav Med. 2008;34(2):55–62. doi:10.3200/bmed.34.2.55-64.View ArticlePubMedGoogle Scholar
  70. Shi XD, Ren W, Wang GB, Luo F, Han JS, Cui CL. Brain opioid-receptors are involved in mediating peripheral electric stimulation-induced inhibition of morphine conditioned place preference in rats. Brain Res. 2003;981(1–2):23–9. doi:10.1016/s0006-8993(03)02798-7.View ArticlePubMedGoogle Scholar
  71. Shi XD, Wang GB, Ma YY, Ren W, Luo F, Cui CL, et al. Repeated peripheral electrical stimulations suppress both morphine-induced CPP and reinstatement of extinguished CPP in rats: accelerated expression of PPE and PPD mRNA in NAc implicated. Brain Res Mol Brain Res. 2004;130(1–2):124–33. doi:10.1016/j.molbrainres.2004.07.016.View ArticlePubMedGoogle Scholar
  72. Thanavaro JL, Delicath TA. Auricular Transcutaneous Electrostimulation Therapy and Intensive Counseling for the Treatment of Smoking Cessation in a Primary Care Practice. J Addict Nurs. 2010;21(4):215–24. doi:10.3109/10884602.2010.515694.View ArticleGoogle Scholar
  73. Tian XW, Krishnan S. Efficacy of auricular acupressure as an adjuvant therapy in substance abuse treatment: a pilot study. Altern Ther Health Med. 2006;12(1):66–9.PubMedGoogle Scholar
  74. Trumpler F, Oez S, Stahli P, Brenner HD, Juni P. Acupuncture for alcohol withdrawal: a randomized controlled trial. Alcohol. 2003;38(4):369–75. doi:10.1093/alcalc/agg091.View ArticleGoogle Scholar
  75. Wang B, Luo F, Xia YQ, Han JS. Peripheral electric stimulation inhibits morphine-induced place preference in rats. NeuroReport. 2000;11(5):1017–20. doi:10.1097/00001756-200004070-00024.View ArticlePubMedGoogle Scholar
  76. Wang GB, Wu LZ, Yu P, Li YJ, Ping XJ, Cui CL. Multiple 100 Hz electroacupuncture treatments produced cumulative effect on the suppression of morphine withdrawal syndrome: central preprodynorphin mRNA and p-CREB implicated. Peptides. 2011;32(4):713–21. doi:10.1016/j.peptides.2010.12.006.View ArticlePubMedGoogle Scholar
  77. Wen H, Cheung S. Treatment of drug addiction by acupuncture and electrical stimulation. Asian J Med. 1973;9:138–41.Google Scholar
  78. White AR, Rampes H, Campbell JL. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev. 2006;. doi:10.1002/14651858.CD0000009.pub2.Google Scholar
  79. White AR, Rampes H, Liu JP, Stead LF, Campbell J. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev. 2011;. doi:10.1002/14651858.CD000009.pub3.Google Scholar
  80. White AR, Rampes H, Liu JP, Stead LF, Campbell J. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev. 2014;. doi:10.1002/14651858.CD000009.pub4.Google Scholar
  81. Xia W, Chu NN, Liang J, Li YJ, Zhang R, Han JS, et al. Electroacupuncture of 2 Hz Has a rewarding effect: evidence from a conditioned place preference study in rats. Evid Based Complement Alternat Med. 2011;. doi:10.1093/ecam/nen043.Google Scholar
  82. Yang CH, Yoon SS, Hansen DM, Wilcox JD, Blumell BR, Park JJ, et al. Acupuncture Inhibits GABA neuron activity in the ventral tegmental area and reduces ethanol self-administration. Alcohol Clin Exp Res. 2010;34(12):2137–46. doi:10.1111/j.1530-0277.2010.01310.x.View ArticlePubMedPubMed CentralGoogle Scholar
  83. Yeh M-L, Chang C-Y, Chu N-F, Chen H-H. A 6-week acupoint stimulation intervention for quitting smoking. Am J Chin Med. 2009;37(5):829–36.View ArticlePubMedGoogle Scholar
  84. Yoon SS, Yang EJ, Lee BH, Jang EY, Kim HY, Choi SM, et al. Effects of acupuncture on stress-induced relapse to cocaine-seeking in rats. Psychopharmacology. 2012;222(2):303–11. doi:10.1007/s00213-012-2683-3.View ArticlePubMedPubMed CentralGoogle Scholar
  85. Yoshimoto K, Fukuda F, Hori M, Kato B, Kato H, Hattori H, et al. Acupuncture stimulates the release of serotonin, but not dopamine, in the rat nucleus accumbens. Tohoku J Exp Med. 2006;208(4):321–6. doi:10.1620/tjem.208.321.View ArticlePubMedGoogle Scholar
  86. Yoshimoto K, Kato B, Sakai K, Shibata M, Yano T, Yasuhara M. Electroacupuncture stimulation suppresses the increase in alcohol-drinking behavior in restricted rats. Alcohol Clin Exp Res. 2001;25(6):63S–8S.View ArticlePubMedGoogle Scholar
  87. Zalewska-Kaszubska J, Obzejta D. Use of low-energy laser as adjunct treatment of alcohol addiction. Lasers Med Sci. 2004;19(2):100–4. doi:10.1007/s10103-004-0307-9.View ArticlePubMedGoogle Scholar
  88. Zhang RJ, Cai XH, Song XG, Dong CY, Hou XR, Lv L. Normalization of ventral tegmental area structure following acupuncture in a rat model of heroin relapse. Neural Regen Res. 2014;9(3):301–7. doi:10.4103/1673-5374.128228.View ArticlePubMedPubMed CentralGoogle Scholar
  89. Zhao RJ, Yoon SS, Lee BH, Kwon YK, Kim KJ, Shim I, et al. Acupuncture normalizes the release of accumbal dopamine during the withdrawal period and after the ethanol challenge in chronic ethanol-treated rats. Neurosci Lett. 2006;395(1):28–32. doi:10.1016/j.neulet.2005.10.043.View ArticlePubMedGoogle Scholar
  90. Mayer DJ. Acupuncture: an evidence-based review of the clinical literature. Annu Rev Med. 2000;51(1):49–63.View ArticlePubMedGoogle Scholar
  91. Birch S, Hesselink JK, Jonkman FA, Hekker TA, Bos A. Clinical research on acupuncture: part 1. What have reviews of the efficacy and safety of acupuncture told us so far? The. J Altern Complement Med. 2004;10(3):468–80.View ArticlePubMedGoogle Scholar
  92. Head KA. Peripheral neuropathy: pathogenic mechanisms and alternative therapies. Alternative medicine review. 2006;11(4):294.PubMedGoogle Scholar
  93. Shi J. LU L. Traditional Chinese medicine in treatment of opiate addiction1. Acta Pharmacol Sin. 2006;27(10):1303–8.View ArticlePubMedGoogle Scholar

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