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Table 3 Original investigations of acupuncture therapy effects in opioid- and opiate-dependent subjects

From: Acupuncture therapy for drug addiction

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
  1. 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)