Acupuncture detoxification

(Also known as acu detox, the five point protocol (5NP), and the NADA (National Acupuncture Detoxification Association) protocol)

According to the National Acupuncture Detoxification Association's (NADA) website, the protocol, also known as acu detox, the five-point protocol, 5NP, or the NADA protocol, has been used over the past 40 years in addictions, mental health and trauma treatment in over 2000 sites around the world. Over 25,000 health workers have been trained in the protocol, described on NADA's website:

"At five designated ear points in each auricle (outer ear), clinicians trained through NADA apply fine gauge, sterilized, one-time use stainless steel needles just under the skin, where they remain for up to an hour while the patient (in most circumstances) relaxes quietly in a comfortable chair. Ordinarily, groups of patients sit together while undergoing the treatment. The procedure functions as an adjunct to a comprehensive addiction treatment program offering the basic therapeutic elements of counseling, education, family involvement, mutual support group involvement, supportive health care of general nature. Patients in all types of treatment settings including inpatient, outpatient, incarcerated, shelters, harm reduction and street outreach can utilize this treatment. Among the benefits reported by patients and clinicians are improved program retention, a more optimistic and cooperative attitude toward the process of recovery, as well as reductions in cravings, anxiety, sleep disturbance and need for pharmaceuticals."

NADA (National Acupuncture Detoxification Association)

NADA conducts education and training related to the use of the specific auricular (ear) acupuncture NADA protocol within comprehensive addiction treatment programs to relieve suffering during detoxification, prevent relapse and support recovery. In line with the spirit of NADA, the organization strives to make acupuncture-based, barrier-free addiction treatment accessible to all communities and to ensure its integration with other treatment modalities. NADA is an educational, not for profit, tax-exempt corporation.

The National Acupuncture Detoxification Association is a nonprofit association that conducts training and provides public education about the use of acupuncture as an adjunctive treatment for addictions and mental disorders.

Understanding the principles of both Chinese medicine and chemical dependency can lead to significant benefit in recovery from all forms of drug addiction as well as alcoholism and a variety of mental disorders.

The National Acupuncture Detoxification Association has specific protocols for this type of treatment, which have been carefully developed and extensively tested. Experienced clinicians provide training in a variety of locations nationwide and in coordination with an annual conference.

More than 1500 clinical sites in the US, Europe, Australia and the Caribbean currently use these protocols.

NADA Training

According to NADA's website, "In the USA, the term "acupuncturist" ordinarily refers to a person who has completed advanced, often graduate-level, education in the general practice of Oriental medicine and who is prepared as a professional to diagnose and treat a wide variety of health conditions according to the principles of that teaching. Such a person may also be licensed, or certified or registered by a government agency that regulates health care and/or be granted professional recognition by a non-governmental credentialing organization such as the National Certification Commission on Acupuncture and Oriental Medicine. Many of the health professionals who have received NADA training are acupuncturists, but NADA training alone would not be considered as qualification for that designation. NADA directs its training sites towards persons in helping roles who are experienced in the field of addiction treatment and who have a commitment to helping those who still suffer."

NADA's Mission

According to NADA's website: "The NADA mission exists to utilize the principles of both Chinese medicine and Western chemical dependency therapies to bring significant benefit to persons in the process of recovery from all forms of drug addiction as well as alcoholism and a variety of mental disorders. The NADA protocol, a simplified "auricular" (ear-point) needling technique derived from acupuncture, and especially designed for this type of treatment, has been carefully developed and extensively tested. A NADA clinic can function in any location where people being treated can sit in a group. NADA is a catalyst for social development."

History of NADA

The technique was pioneered at the Lincoln Memorial Hospital in New York City by psychiatrist Michael Smith during a period of high heroin use in the 1970s.

"In 1985, following 10 years of their experience developing the basic five ear-points NADA protocol for treatment of addiction, the staff and other professionals associated with the South Bronx's Lincoln Hospital determined a need for a national-level organization to expand training capacity and awareness of the value of acupuncture as a tool of recovery. NADA was then established to enroll members, establish a collection of related reference materials, codify a training curriculum and develop a flexible system for registering qualified trainers and delivering trainings. NADA has since trained more than 10,000 health professionals, including counselors, social workers, nurses, medical doctors, psychologists, acupuncturists, chiropractors, outreach workers, drug court judges, corrections officers and others to use the protocol."

Treatment Locations

"NADA estimates that more than 2000 such sites exist worldwide since NADA training and treatments have taken root in many locales outside North America. These are found in nearly every European country including Russia, plus the Middle East, South and Southeast Asia, Australia, South America, the Caribbean and Mexico. Independently operating branches of NADA function in Denmark, Israel, the United Kingdom, Ireland, Germany, Sweden, Italy, Finland, Hungary, Russia, Switzerland, Nepal, the Philippines, Thailand and India. Globally, more than 25,000 health workers have completed the NADA training."

"While derived originally from the Chinese medicine theory of detoxification, the NADA method is adaptable to almost all cultural milieus and physical environments. NADA treatment is feasible, even in settings where threats of violence had previously made it difficult to serve clients."

Publications: Guidepoints: News From NADA

"Guidepoints has been published since 1993 as the only healthcare field publication exclusively devoted to the subject area of acupuncture-based treatment of addictions and related disorders. Subscribers have included government agencies, college and university libraries, addiction treatment agencies, psychiatric facilities, drug courts and a wide variety of individual health professionals including acupuncturists, medical doctors, registered nurses, addictions counselors and social workers. The publication became the official membership newsletter of NADA in January 2004.

In addition to reports on journal articles and other news about relevant clinical outcomes, the six times per year newsletter covers related policy and funding developments in the general addiction medicine field as well as personal news about the activities of NADA members. Organizations desiring to receive Guidepoints may do so by have an individual staff member joining NADA as an Associate Member."

Governance

"In the USA and Canada, many localities encourage the full NADA program through regulations allowing the training and utilization of non-acupuncturist health providers in the NADA protocol, always under the supervision of a licensed acupuncturist or medical doctor. Among these states and provinces are: Arizona, Connecticut, Delaware, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Missouri, New Mexico, New York, Nova Scotia, Ontario, Prince Edward Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington. Some other jurisdictions continue to restrict any application of acupuncture needles to licensed acupuncturists or the equivalent."

Evidence base for acupuncture detoxification

The U.S. Department of Health and Human Services' Treatment Improvement Protocol (TIP 45) for Detoxification and Substance Abuse Treatment notes acu detox's effectiveness for reducing cravings and withdrawal while improving program retention rates. The 1997 National Institute of Health Consensus Statement on acupuncture also affirms NADA's contention that acupuncture is beneficial as part of integrative addictions treatment. NADA's member publication, Guidepoints, has provided reports on relevant clinical outcomes that have been collected since the early 1970's when acupuncture detoxification was first used to treat heroin addiction in the South Bronx.

Ongoing debate about the effectiveness of acupuncture detoxification, and what is considered "evidence," continues. According to NADA's website: "A wide variety of controlled clinical trials, outcome summaries and anecdotal reports about the use of acupuncture in addiction treatment have been appearing since the 1970s in journals specializing in addictions, mental health, public health, criminal justice and acupuncture. These reports differed vastly in terms of methodology, populations studied, statistical sophistication and clinical relevance as well as in their findings about the value of acupuncture." Reviews of randomized controlled studies have pointed out that there is insufficient evidence and/or a lack of properly-designed trials that demonstrate its effectiveness.. Others have cited one randomized placebo trial as evidence that the treatment shouldn't be used at all. While not a cure for addiction, the empirical base for acu detox has demonstrated its wide acceptance, having been integrated into thousands of programs around the world and in the United States. Acu detox remains one of the most widely accepted, cost-effective modalities of Complementary and Alternative Medicine available.