Acupuncture therapy for drug addiction (original) (raw)

Chinese Medicine volume 11, Article number: 16 (2016)Cite this article

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](/articles/10.1186/s13020-016-0088-7#ref-CR2 "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

              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR3 "Lin JG, Chan YY, Chen YH. Acupuncture for the treatment of opiate addiction. Evid Based Complement Alternat Med. 2012;. doi:
                10.1155/2012/739045
                
              .")\].

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](/articles/10.1186/s13020-016-0088-7#ref-CR4 "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

              .")\]. In 1996, the World Health Organization accepted acupuncture as a treatment for drug abuse \[[5](/articles/10.1186/s13020-016-0088-7#ref-CR5 "Organization WHO. WHO traditional medicine strategy 2002–2005. 2002.")\]. The latest modification to this treatment protocol was developed in 2005 by Dr. Ji Sheng from Peking University, Beijing, China \[[6](/articles/10.1186/s13020-016-0088-7#ref-CR6 "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
                
              .")\]. Currently, more than 700 addiction treatment centers use acupuncture as an adjunctive procedure \[[7](/articles/10.1186/s13020-016-0088-7#ref-CR7 "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
                
              .")\].

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](/articles/10.1186/s13020-016-0088-7#ref-CR8 "Cabioglu MT, Ergene N, Tan U. Smoking cessation after acupuncture treatment. Int J Neurosci. 2007;117(5):571–8. doi: 10.1080/00207450500535289

              .")\] that might mediate substance abuse. Acupuncture has been used to treat addiction for three decades \[[2](/articles/10.1186/s13020-016-0088-7#ref-CR2 "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
                
              .")–[89](/articles/10.1186/s13020-016-0088-7#ref-CR89 "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
                
              .")\]. For example, auricular acupuncture (AA) is effective in treating alcohol and drug abuse in both Europe and the United States \[[4](/articles/10.1186/s13020-016-0088-7#ref-CR4 "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
                
              .")\].

However, several clinical trials have indicated that acupuncture was not effective in treating addiction [[2](/articles/10.1186/s13020-016-0088-7#ref-CR2 "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

              ."), [3](/articles/10.1186/s13020-016-0088-7#ref-CR3 "Lin JG, Chan YY, Chen YH. Acupuncture for the treatment of opiate addiction. Evid Based Complement Alternat Med. 2012;. doi:
                10.1155/2012/739045
                
              ."), [31](/articles/10.1186/s13020-016-0088-7#ref-CR31 "Gates S, Smith LA, Foxcroft DR. Auricular acupuncture for cocaine dependence. Cochrane Database Syst Rev. 2006(1). doi:
                10.1002/14651858.CD005192.pub2
                
              ."), [67](/articles/10.1186/s13020-016-0088-7#ref-CR67 "Rabinstein AA, Shulman LM. Acupuncture in clinical neurology. Neurologist. 2003;9(3):137–48. doi:
                10.1097/00127893-200305000-00002
                
              ."), [69](/articles/10.1186/s13020-016-0088-7#ref-CR69 "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
                
              ."), [78](/articles/10.1186/s13020-016-0088-7#ref-CR78 "White AR, Rampes H, Campbell JL. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev. 2006;. doi:
                10.1002/14651858.CD0000009.pub2
                
              .")–[80](/articles/10.1186/s13020-016-0088-7#ref-CR80 "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
                
              .")\]. Thus, the efficacy of the NADA protocol has been reassessed over the last decade \[[7](/articles/10.1186/s13020-016-0088-7#ref-CR7 "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
                
              .")\]. 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

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

figure 1

Flow chart of selection process

Full size image

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

figure 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

Full size image

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

Full size table

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

figure 3

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

Full size image

Fig. 4

figure 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

Full size image

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

Full size table

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](/articles/10.1186/s13020-016-0088-7#ref-CR10 "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

              .")\], another study on 83 cocaine-dependent subjects found AA to be effective in reducing cocaine in only one of two trials \[[60](/articles/10.1186/s13020-016-0088-7#ref-CR60 "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
                
              .")\]. When the original study was repeated with 620 subjects, no effect was found \[[61](/articles/10.1186/s13020-016-0088-7#ref-CR61 "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
                
              .")\]. 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 \[[59](/articles/10.1186/s13020-016-0088-7#ref-CR59 "Margolin A, Avants SK, Arnold R. Acupuncture and spirituality-focused group therapy for the treatment of HIV-positive drug users: a preliminary study. J Psychoactive Drugs. 2005;37(4):385–90.")\].

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](/articles/10.1186/s13020-016-0088-7#ref-CR44 "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

              .")\]. By regulating neuronal activation in the nucleus accumbens (NAc) shell, acupuncture reduced stress-induced relapse \[[84](/articles/10.1186/s13020-016-0088-7#ref-CR84 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR42 "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
                
              .")\]. See Table [2](/articles/10.1186/s13020-016-0088-7#Tab2) 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](/articles/10.1186/s13020-016-0088-7#ref-CR55 "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

              .")\]. EA (2 Hz) at _Zusanli_ (ST36) and _Sanyinjiao_ (SP6) was effective in reducing active responses elicited by discrete cues in rats \[[56](/articles/10.1186/s13020-016-0088-7#ref-CR56 "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
                
              .")\]. The same EA treatment showed promise in treating heroin-seeking behaviors when combined with extinction therapy \[[33](/articles/10.1186/s13020-016-0088-7#ref-CR33 "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
                
              .")\]. EA (2 Hz) at the same points—_Zusanli_ (ST36) and _Sanyinjiao_ (SP6)—activated the endogenous opioid cannabinoid and the dopamine systems in rats \[[81](/articles/10.1186/s13020-016-0088-7#ref-CR81 "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
                
              .")\].

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](/articles/10.1186/s13020-016-0088-7#ref-CR37 "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

              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR17 "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
                
              .")\]. Transcutaneous electric acupoint stimulation was a possible adjunctive treatment to pharmacological treatments for heroin detoxification \[[62](/articles/10.1186/s13020-016-0088-7#ref-CR62 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR32 "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
                
              ."), [88](/articles/10.1186/s13020-016-0088-7#ref-CR88 "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
                
              .")\].

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](/articles/10.1186/s13020-016-0088-7#ref-CR11 "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

              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR57 "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."), [58](/articles/10.1186/s13020-016-0088-7#ref-CR58 "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
                
              .")\]. However, Chan et al. \[[22](/articles/10.1186/s13020-016-0088-7#ref-CR22 "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
                
              .")\] 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](/articles/10.1186/s13020-016-0088-7#Tab3) for study details.

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

Full size table

Nicotine

Acupuncture stimulation at Zusanli (ST36) exerted a therapeutic effect on nicotine detoxification [[21](/articles/10.1186/s13020-016-0088-7#ref-CR21 "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

              .")\] 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](/articles/10.1186/s13020-016-0088-7#ref-CR20 "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
                
              .")\]. Smoking withdrawal symptoms could be ameliorated by acupuncture treatment \[[18](/articles/10.1186/s13020-016-0088-7#ref-CR18 "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
                
              .")\]. In one study, acupuncture at _Shenmen_ (HT7) attenuated cigarette withdrawal symptoms more than acupuncture at _Shousanli_ (LI10) \[[19](/articles/10.1186/s13020-016-0088-7#ref-CR19 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR38 "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
                
              .")\].

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](/articles/10.1186/s13020-016-0088-7#ref-CR65 "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

              .")\]. Auricular transcutaneous electrical neurostimulation relieved withdrawal symptoms and decreased anxiety and stress levels during the detoxification period in a study of six smokers \[[15](/articles/10.1186/s13020-016-0088-7#ref-CR15 "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
                
              .")\]. Auricular transcutaneous electrostimulation therapy might be an acceptable alternative therapy for smoking cessation \[[72](/articles/10.1186/s13020-016-0088-7#ref-CR72 "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
                
              .")\]. See Table [4](/articles/10.1186/s13020-016-0088-7#Tab4) for study details.

Table 4 Original investigations of acupuncture therapy effects in nicotine-dependent subjects

Full size table

Alcohol

Conflicting results from two large randomized single-blind, placebo-controlled trials suggested that acupuncture was not effective in reducing alcohol use [[16](/articles/10.1186/s13020-016-0088-7#ref-CR16 "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

              ."), [39](/articles/10.1186/s13020-016-0088-7#ref-CR39 "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
                
              .")\]. However, promising results have been found using acupuncture as an adjunctive treatment to carbamazepine medication to reduce the severity of alcohol withdrawal symptoms \[[39](/articles/10.1186/s13020-016-0088-7#ref-CR39 "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
                
              .")\]. In one study, AA failed to reduce the duration and severity of alcohol withdrawal symptoms \[[43](/articles/10.1186/s13020-016-0088-7#ref-CR43 "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
                
              .")\]; another study found no advantage for laser AA in treating alcohol withdrawal \[[74](/articles/10.1186/s13020-016-0088-7#ref-CR74 "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
                
              .")\]. However, research indicated that laser therapy helps to promote the release of endorphins in the body and decreases discomfort accompanying alcohol withdrawal \[[87](/articles/10.1186/s13020-016-0088-7#ref-CR87 "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
                
              .")\]. It might therefore be a safe and painless beneficial adjunct treatment for alcoholism \[[87](/articles/10.1186/s13020-016-0088-7#ref-CR87 "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
                
              .")\].

Acupuncture at Zusanli (ST36) or Sanyinjiao (SP6) modulated postsynaptic neural activation in the striatum and NAc in rats [[89](/articles/10.1186/s13020-016-0088-7#ref-CR89 "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

              .")\]. Acupuncture at _Shenmen_ (HT7) normalized dopamine release in the mesolimbic system \[[89](/articles/10.1186/s13020-016-0088-7#ref-CR89 "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
                
              .")\], modulated mesolimbic dopamine release, and suppressed the reinforcing effects of ethanol \[[82](/articles/10.1186/s13020-016-0088-7#ref-CR82 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR64 "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
                
              .")\].

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](/articles/10.1186/s13020-016-0088-7#ref-CR85 "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

              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR28 "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
                
              .")\]. EA (2 Hz) at _Zusanli_ (ST36) could reduce voluntary intake of ethanol, but not sucrose, in rats \[[50](/articles/10.1186/s13020-016-0088-7#ref-CR50 "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
                
              .")\] and 100 Hz EA treatment at _Zusanli_ (ST36) effectively reduces preference for ethanol and its consumption in rats \[[49](/articles/10.1186/s13020-016-0088-7#ref-CR49 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR29 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR30 "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
                
              .")\]. See Table [5](/articles/10.1186/s13020-016-0088-7#Tab5) for study details.

Table 5 Original investigations of acupuncture therapy effects in alcohol-dependent subjects

Full size table

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](/articles/10.1186/s13020-016-0088-7#ref-CR52 "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

              .")\] for information on CPP) via activation of opioid receptors \[[75](/articles/10.1186/s13020-016-0088-7#ref-CR75 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR53 "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
                
              .")\]. In addition, EA suppression of opiate addiction might involve the release of endogenous μ-, δ-, and κ-opioid agonists in the NAc shell \[[52](/articles/10.1186/s13020-016-0088-7#ref-CR52 "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
                
              .")\] and might activate the cannabinoid, endogenous opioid, and dopamine systems to induce CPP in rats \[[81](/articles/10.1186/s13020-016-0088-7#ref-CR81 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR70 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR71 "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
                
              .")\]. Stimulation at _Zusanli_ (ST36) and _Sanyinjiao_ (SP6) (100 Hz) for 30 min normalized the activity of ventral tegmental area dopamine neurons \[[34](/articles/10.1186/s13020-016-0088-7#ref-CR34 "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
                
              .")\], downregulated p-cAMP response element binding, and accelerated dynorphin synthesis in the spinal cord \[[76](/articles/10.1186/s13020-016-0088-7#ref-CR76 "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
                
              .")\].

Some research suggests that 2 Hz EA is a potential complementary therapy for improving immune dysfunction in opiate addicts [[51](/articles/10.1186/s13020-016-0088-7#ref-CR51 "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

              .")\] and that 2 Hz or 100 Hz EA facilitates the recovery of male sexual behavior in rats during morphine withdrawal \[[27](/articles/10.1186/s13020-016-0088-7#ref-CR27 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR25 "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
                
              .")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR48 "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
                
              .")\].

EA at Shenshu (BL23) attenuated the expression of the proto-oncogene c-Fos in the central nucleus of the amygdala [[54](/articles/10.1186/s13020-016-0088-7#ref-CR54 "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

              .")\]. Acupuncture at _Shenmen_ (HT7) inhibited neurochemical and behavioral sensitization to morphine by decreasing dopamine release in the NAc \[[41](/articles/10.1186/s13020-016-0088-7#ref-CR41 "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
                
              .")\]. Acupuncture at _Shenmen_ (HT7) significantly suppressed morphine-induced increase in locomotor activity and Fos expression in the NAc and striatum \[[45](/articles/10.1186/s13020-016-0088-7#ref-CR45 "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
                
              .")\]. Acupuncture at _Yanggu_ (SI5) can reduce the reinstatement of morphine-seeking behaviors by mediating the gamma-aminobutyric acid receptor system \[[46](/articles/10.1186/s13020-016-0088-7#ref-CR46 "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
                
              ."), [47](/articles/10.1186/s13020-016-0088-7#ref-CR47 "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
                
              .")\]. See Table [6](/articles/10.1186/s13020-016-0088-7#Tab6) for study details.

Table 6 Original investigations of acupuncture therapy effects in morphine-dependent subjects

Full size table

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](/articles/10.1186/s13020-016-0088-7#ref-CR9 "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

              .")\], which was associated with a decrease in psychological distress \[[12](/articles/10.1186/s13020-016-0088-7#ref-CR12 "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
                
              .")\] and an increase in confidence \[[14](/articles/10.1186/s13020-016-0088-7#ref-CR14 "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.")\], but showed no efficacy for drug consumption and withdrawal symptoms \[[9](/articles/10.1186/s13020-016-0088-7#ref-CR9 "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
                
              ."), [12](/articles/10.1186/s13020-016-0088-7#ref-CR12 "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
                
              .")–[14](/articles/10.1186/s13020-016-0088-7#ref-CR14 "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.")\]. 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](/articles/10.1186/s13020-016-0088-7#ref-CR7 "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
                
              ."), [35](/articles/10.1186/s13020-016-0088-7#ref-CR35 "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
                
              ."), [36](/articles/10.1186/s13020-016-0088-7#ref-CR36 "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
                
              .")\], recent studies have shown an effect for AA \[[23](/articles/10.1186/s13020-016-0088-7#ref-CR23 "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
                
              ."), [24](/articles/10.1186/s13020-016-0088-7#ref-CR24 "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
                
              ."), [26](/articles/10.1186/s13020-016-0088-7#ref-CR26 "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."), [68](/articles/10.1186/s13020-016-0088-7#ref-CR68 "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
                
              ."), [73](/articles/10.1186/s13020-016-0088-7#ref-CR73 "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.")\] and transcutaneous electric acupoint stimulation \[[66](/articles/10.1186/s13020-016-0088-7#ref-CR66 "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
                
              .")\] per se or as adjunct treatments. Issues of safety and placebo effects suggest the need for further research \[[26](/articles/10.1186/s13020-016-0088-7#ref-CR26 "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."), [35](/articles/10.1186/s13020-016-0088-7#ref-CR35 "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
                
              ."), [36](/articles/10.1186/s13020-016-0088-7#ref-CR36 "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
                
              ."), [66](/articles/10.1186/s13020-016-0088-7#ref-CR66 "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
                
              .")\]. See Table [7](/articles/10.1186/s13020-016-0088-7#Tab7) for study details.

Table 7 Original investigations of acupuncture therapy effects in poly-drug and other substance abusers (NA not available)

Full size table

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.

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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article PubMed Google Scholar
  5. Organization WHO. WHO traditional medicine strategy 2002–2005. 2002.
  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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article PubMed Google 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.
    Article Google 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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article Google 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.
    Article PubMed Google 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.
    PubMed PubMed Central Google 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.
    Article Google 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.
    Article PubMed Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article Google 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.
    Article PubMed Google 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.
    Article Google 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.
    Article PubMed Google 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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed PubMed Central Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    PubMed PubMed Central Google 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.
    Article PubMed PubMed Central Google 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.
    Article PubMed Google 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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article CAS PubMed Google 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.
    Article Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    PubMed PubMed Central Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    PubMed Google 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.
    Article PubMed Google 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.
    Article PubMed Google 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.
    Article PubMed Google 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.
    Article PubMed Google 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.
    Article PubMed PubMed Central Google 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.
    PubMed Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    PubMed PubMed Central Google Scholar
  67. Rabinstein AA, Shulman LM. Acupuncture in clinical neurology. Neurologist. 2003;9(3):137–48. doi:10.1097/00127893-200305000-00002.
    Article PubMed Google 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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    Article Google 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.
    PubMed Google 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.
    Article Google 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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article CAS PubMed PubMed Central Google 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.
    Article PubMed Google 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.
    Article CAS PubMed PubMed Central Google 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.
    Article CAS PubMed Google 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.
    Article CAS PubMed Google 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.
    Article PubMed Google 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.
    Article PubMed PubMed Central Google 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.
    Article CAS PubMed Google Scholar
  90. Mayer DJ. Acupuncture: an evidence-based review of the clinical literature. Annu Rev Med. 2000;51(1):49–63.
    Article CAS PubMed Google 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.
    Article PubMed Google Scholar
  92. Head KA. Peripheral neuropathy: pathogenic mechanisms and alternative therapies. Alternative medicine review. 2006;11(4):294.
    PubMed Google Scholar
  93. Shi J. LU L. Traditional Chinese medicine in treatment of opiate addiction1. Acta Pharmacol Sin. 2006;27(10):1303–8.
    Article PubMed Google Scholar

Download references

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.

Author information

Authors and Affiliations

  1. Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia
    Farid Esmaeili Motlagh & Fatimah Ibrahim
  2. Centre for Innovation in Medical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia
    Farid Esmaeili Motlagh & Fatimah Ibrahim
  3. Centre of Addiction Sciences, University of Malaya, 21st Floor, Wisma Research and Development, Jalan Pantai Baru, 59200, Kuala Lumpur, Malaysia
    Farid Esmaeili Motlagh, Rusdi Abd Rashid, Tahereh Seghatoleslam & Hussain Habil
  4. Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Tahereh Seghatoleslam

Authors

  1. Farid Esmaeili Motlagh
    You can also search for this author inPubMed Google Scholar
  2. Fatimah Ibrahim
    You can also search for this author inPubMed Google Scholar
  3. Rusdi Abd Rashid
    You can also search for this author inPubMed Google Scholar
  4. Tahereh Seghatoleslam
    You can also search for this author inPubMed Google Scholar
  5. Hussain Habil
    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence toFatimah Ibrahim.

Rights and permissions

Open Access This 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.

Reprints and permissions

About this article

Cite this article

Motlagh, F.E., Ibrahim, F., Rashid, R.A. et al. Acupuncture therapy for drug addiction.Chin Med 11, 16 (2016). https://doi.org/10.1186/s13020-016-0088-7

Download citation

Keywords