Clinical trials are currently underway to determine the effectiveness of acupuncture in the treatment of drug addiction. While there are still many unanswered questions about the basic mechanisms of acupuncture, some evidence exists to suggest that acupuncture can play an important role in reducing reinforcing effects of abused drugs.
Acupuncture and Dopamine
The neurochemical and behavioral evidence showed that acupuncture's role in suppressing the reinforcing effects of abused drugs takes place by modulating mesolimbic dopamine neurons.
Dopamine is assumed to be the final common pathway for drugs such as cocaine, morphine and alcohol. It is also believed by many to be directly responsible for the exhilarating rush that reinforces the desire to take drugs in drug addicts and plays a pivotal role in the development of drug addiction. These drugs of abuse-induced changes in brain levels of dopamine are associated with feelings of well being and pleasure and provide positive reinforcement; contributing to the continued drug abuse.
Thus, there is lot of interest in gaining a better understanding of how acupuncture works in the brain to influence addictive behaviors.
Treatment of addiction in Acupuncture practice
Acupuncture as a therapeutic intervention has been widely practiced for the treatment of many functional disorders including substance abuse and mental illness in Eastern countries through diverse methods such as manual acupuncture, electroacupuncture and acupoint nerve stimulation.Importantly, acupuncture has become a standard procedure in many detoxification programs for drugs, worldwide.
While more scientific studies are needed to confirm the efficacy and define the physiological mechanisms of acupuncture, the National Institutes of Health Consensus Development Panel issued a report in 1977 stating 'Acupuncture may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program'.
Also, in 1997, a consensus panel issued by the NIH cautiously concluded that acupuncture might be efficacious in the treatment of post-operative and chemotherapy nausea and vomiting, nausea of pregnancy and post-operative dental pain, including drug addiction. Addiction treatment programs increasingly use a combination of conventional and complementary/alternative medicine (CAM) method as acupuncture. Many studies in acupuncture have used auricular acupuncture for the treatment of addictions in patients, stimulating on a 3–4 point including Shenmen auricular point.
Some evidence exists to suggest that acupuncture can be beneficial in the treatment of cocaine addiction as an adjunctive therapy. Importantly, there is considerable evidence to support that electroacupuncture at body points is also particularly effective in alleviating the withdrawal syndrome in heroin addicts. These findings are intriguing in light of the fact that recent clinical studies have brought the search for the difference between body and auricular points in the efficacy of acupuncture in the treatment of drug addiction.
Additionally, results of some animal studies regarding drug addiction have provided evidence for the involvement of neurotransmitters in the action of acupuncture. For example, electroacupuncture at the specific point ST36 in rat effectively reduced the increase in alcohol-drinking behavior. Another searches suggest that stimulation of Zusanli(St36) or Sanyinjiao (Sp6) accupuncture points may be effective in suppressing alcohol withdrawal syndrome and minimizing sensitization may be one of mechanisms whereby acupuncture reduces drug craving in addicts.
A number of studies with rats have shown that high-frequency electroacupuncture increases dynorphin release and it was more effective in suppressing morphine withdrawal syndrome compared to low-frequency electroacupuncture .The same research proved that low-frequency electroacupuncture appears to play a critical role in attenuating the motivational aspects of drug withdrawal, while high-frequency electroacupuncture may be most effective in reducing withdrawal symptoms.
These results provided clear evidence for the biological effects of acupuncture that ultimately may help us to understand how acupuncture can be used to treat abused drugs.
While little is known about the basic mechanism of acupuncture in treating drug addiction, the neurochemical and behavioral data reviewed earlier showed that acupuncture directly or indirectly affects the mesolimbic dopamine system.These results suggest that acupuncture helps to maintain the homeostasis and balance between positive and negative processes involved in drug addiction.
Moreover, in a more general sense, these results suggest that acupuncture can be used as a therapeutic intervention for correcting reversible malfunction of the body by directing brain pathways and thus contributes to balance in the central nervous system by regulating neurotransmitters.