Acupuncture stimulates specific locations on the body with the goal of altering and improving bodily function. The needles used in addiction treatment penetrate 1/8 inch on the outside surface of the ear. This nearly painless procedure causes the onset of a gratifying sense of comfort and homeostasis. Many prospective patients express concern about the pain of needle insertion, but this concern subsides when they observe other patients undergoing the actual treatment process.

Acupuncture brings a non-verbal component to the addiction treatment process. While acupuncture does not supplant the need for the counselor to talk with the patient, it allows the verbal interaction to be quite flexible so that a patient who does not feel like talking can be accommodated easily and naturally. Acupuncture will be just as effective even when the patient lies to us.

The most difficult paradox in addiction medicine is the common reality that addicted persons usually deny their need for help. Such patients do not say anything helpful in the treatment process. Nevertheless, resistant patients often find themselves in a treatment setting due to referral or other pressures. Using acupuncture can bypass much of the verbal denial and resistance that otherwise limit retention of new and relapsed patients.

The Lincoln Hospital treatment model
Acupuncture treatment for drug and alcohol problems was primarily developed at Lincoln Hospital, a New York City-owned facility in the impoverished South Bronx. The Lincoln Recovery Center is a state-licensed treatment program that has provided more than 500,000 acupuncture treatments in the past 20 years.

The Lincoln Hospital model can be summarized and defined as follows:

• Clinicians use three to five ear acupuncture points.
• Treatment is provided in a group setting for a duration of 40-45 minutes.
• Acupuncture treatment is integrated with conventional elements of psychosocial rehabilitation.
• Several components of the Lincoln program are frequently combined with acupuncture in other treatment facilities. These items include: a supportive, non-confrontational approach to individual counseling; an emphasis on Narcotics Anonymous and other 12-Step activities early in the treatment process; an absence of screening for “appropriate” patients (so as to lessen unnecessary barriers); the use of herbal sleep mix; the use of frequent urinalysis; a willingness to work with court-related agencies; and a tolerant, informal, family-like atmosphere.

A wide range of patients can be accepted for the initial stage of treatment because there is no verbal motivational requirement. Also, acupuncture is effective for most drugs and a wide range of psychological states. Problems relating to language and cultural differences are diminished. For new patients, frequent acupuncture treatment permits the gradual completion of assessment on a more accurate basis. Patients can be evaluated and triaged according to their daily response to treatment and testing rather than merely on the basis of the initial interview.

Bypassing barriers to effective treatment
The tolerant, non-verbal aspect of acupuncture facilitates retention during periods when the patient would otherwise be ambivalent, fearful, or resentful within a more intense verbal interpersonal setting. The acupuncture makes it easy to provide outpatient treatment on demand, without appointments, while the patients are being acclimated to the interpersonal treatment setting. Patients are often willing to be urine-tested even when they know that their toxicology result is positive, thereby showing respect for the value system of the overall treatment process. Those same patients may be unable or unwilling to share their crisis and failure verbally until they have time to reach more solid ground. In the acupuncture setting, time is on our side.

In practice, acupuncture provides an excellent foundation for 12-Step recovery. Patients seem less fearful and more receptive when they first enter the meetings. The traditional advice “listen to learn and learn to listen” fits this model well. Acupuncture reduces white-knuckle sobriety considerably. There is less guarding and greater ability to support each other warmly. The increased ability to use 12-Step meetings provides more stable support for continuing treatment on an outpatient basis.

Patients referred by court-related agencies often enter treatment in total denial or with a basic conflict with the referring agency. The non-verbal aspect of acupuncture allows the intake staff to get beyond these protests and offer acupuncture for stress relief, instead of forcing the issue. Using acupuncture we are able to wait until the patients feel more comfortable and less threatened so that they can admit their addiction and ask for help.

The nature of recovery from addiction is that patients often have quickly changing needs for crisis relief and wellness treatment. Many persons in recovery have relatively high levels of wellness functioning. Even so, a crisis of craving or past association may reappear at any time. Acupuncture provides either crisis or wellness treatment using the same ear point formula. The non-verbal, present time aspects of the treatment make it easy to respond to a patient in whatever stage of crisis or denial that may exist.

When talking hurts, and verbal bonds threaten
Addiction patients often cannot tolerate intense interpersonal relationships. Using a conventional one-to-one approach often creates a brittle therapeutic connection. It is easily broken by events or any stress. Patients have difficulty trusting a counselor’s words when they can hardly trust themselves. Even after confiding in a counselor during an intake session, a patient may feel frightened and confused about expanding that relationship. Many of their concerns are so complex and troublesome that talking honestly about their lives could be difficult in the best of circumstances. The ambivalence typical of addicts makes it easy to develop misunderstandings. All of these factors support the usefulness of non-verbal technique during early and critical relapse phases of treatment and critical periods of relapse.

A woman six months pregnant entered our clinic several years ago. She said, “I can’t tell you much about myself because my husband is out in the street with a baseball bat, he’ll hit me in my knees if I say too much.” We provided an emergency acupuncture treatment and conducted a simplified intake interview. Two weeks later, this patient told us, “This is my husband, he doesn’t have a drug problem, but he is nervous, can you help him?”

Both the woman and her husband received acupuncture that day. The woman needed non-verbal access to treatment because of real physical danger. Overprotective spouses often forcefully oppose all social contacts outside the marriage. This patient was protected because there was no premature verbal bonding that would have threatened the husband. The whole process was so supportive that the husband was able to trust his wife and seek help himself. Like many fearful people, he was literally unable to make any verbal approach on his own.

Adjusting the tone of treatment
Treatment programs without acupuncture are compelled to screen for patients who are able to talk readily with authority figures. Many verbally needy patients become quite dependent on the program and quite involved with numerous staff members. Such patients may be the focus of many conferences, but they are often too needy to remain drug-free outside the treatment setting. In contrast, acupuncture-assisted intake can retain patients who are relatively more paranoid, independent, assertive, and hostile. Noisy, troublesome patients who are frustrated with the world and with themselves actually may be more likely to sustain a drug-free lifestyle than patients with verbal dependency needs.

Acupuncture helps a program develop an underlying environment of acceptance, tolerance, and patience. There is ample space for the ambivalence and temporary setbacks that are a necessary part of any transformation. Patients can have a quiet day by attending the program and receiving acupuncture without having to discuss their status with a therapeutic authority figure. Since acupuncture reduces the agitated, defensive tone in the whole clinical environment, patients are able to interact with each other on a much more comfortable level. Their increased ability to listen to others and accept internal changes have a profound effect on the quality and depth of communication in group therapy sessions and 12-Step meetings.

For further information, contact the National Acupuncture Detoxification Association (NADA), P.O. Box 1927, Vancouver, WA 98668-1927; phone: (888) 765-NADA; fax: (360) 260-8620; e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Michael O. Smith, MD, DAc, a psychiatrist, is director of the Lincoln Recovery Center in Bronx, NY. He was a co-founder of the National Acupuncture Detoxification Association and is a speaker and consultant for addiction treatment programs in the U.S. and internationally.

This article is published in Counselor, The Magazine for Addiction Professionals, December 2003, v.4, n.6, pp. 50-51.

---

Comments

Add New Search RSS

Write comment
Name:
Email:	do not notifynotify
Title:
UBBCode:	-color-aquablackbluefuchsiagraygreenlimemaroonnavyolivepurpleredsilvertealwhiteyellow -size-tinysmallmediumlargehuge
	Please input the anti-spam code that you can read in the image.

Powered by !JoomlaComment 3.25

3.25 Copyright (C) 2007 Alain Georgette / Copyright (C) 2006 Frantisek Hliva. All rights reserved."