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Acupuncture and Opiate Use: An overview of possibilities for withdrawal and pain modification for the workers' compensation patient
By Frances Kalfus, O.M.D., L.Ac.

There is abundant research regarding the effectiveness of particular acupuncture protocols in assisting the addicted person to withdraw from opiates. Acupuncture is an established modality used for treating workers’ compensation patients in the last two to three decades in California. Acupuncture is a modality identified in the medical treatment utilization schedule (MTUS) Chapter 4.5. Division of Workers’ Compensation, section 9792.24.1. Based on reams of studies and analyses, it is essential to recognize the formidable effects that acupuncture can provide to treat opioid addiction.

There is abundant research regarding the effectiveness of particular acupuncture protocols in assisting the addicted person to withdraw from opiates. One protocol, the most commonly used in over 250 hospital settings in the United States and United Kingdom, as well as by nearly 1000 licensed drug treatment programs in the U.S., was developed in the mid 1970s by Michael O. Smith, M.D., Medical Director of Substance Abuse Division at Lincoln Hospital in New York City. Historical perspective brings us to Hong Kong, 1972, when neurosurgeon Dr. H. L. Wen used acupuncture and electrostimulation at four body points and 2 ear points for surgical analgesia on his opioid addicted patient who later expressed amelioration of withdrawal symptoms. Dr. Smith read about this response in a medical journal, began working with addicted clients using acupuncture, developed a well established protocol and by 1985 founded the National Acupuncture Detoxification Association (NADA) to educate and train acupuncturists in his methodology, as well as help expand the use of acupuncture for treatment of drug addicted persons.

In 1996, the World Health Organization listed 64 medical problems considered suitable for acupuncture treatment including treatment of drug abuse for the opiate addicted. It was concluded that this form of treatment was inexpensive, had no side effects, and could be used for relapse.

Acupuncture is a modality identified in the medical treatment utilization schedule (MTUS) Chapter 4.5. Division of Workers’ Compensation, section 9792.24.1: (1) “Acupuncture” is used as an option when pain medication is reduced or not tolerated, it may be used as an adjunct to physical rehabilitation and/or surgical intervention to hasten functional recovery. It is the insertion and removal of filiform needles to stimulate acupoints (acupuncture points). Needles may be inserted, manipulated, and retained for a period of time. Acupuncture can be used to reduce pain, reduce inflammation, increase blood flow, increase range of motion, decrease the side effect of medication-induced nausea, promote relaxation in an anxious patient, and reduce muscle spasm. (2) “Acupuncture with electrical stimulation” is the use of electrical current (micro-amperage or milli-amperage) on the needles at the acupuncture site. It is used to increase effectiveness of the needles by continuous stimulation of the acupoint. Physiological effects (depending on location and settings) can include endorphin release for pain relief, reduction of inflammation, increased blood circulation, analgesia through interruption of pain stimulus, and muscle relaxation. It is indicated to treat chronic pain conditions, radiating pain along a nerve pathway, muscle spasm, inflammation, scar tissue pain, and pain located in multiple sites. (3) “Chronic pain for purposes of acupuncture” means chronic pain as defined in section 9792.20(c).

Acupuncture is an established modality used for treating workers’ compensation patients in the last two to three decades in California. It is prescribed when chronic pain conditions caused by injuries do not adequately reduce with use of pain medications, physical and occupational therapies, etc. Acupuncture treatment has increasingly been recognized as well by the western medical community for its effectiveness in reducing initial/acute pain syndromes before they become chronic and cause excessive use of pain medications.

Presently, workers’ compensation patients are experiencing an ever growing population of pain medication addiction. By definition, opioids are addictive. In order to maintain function, their addictive nature easily ensues. This is where the narrow overlap occurs between drug addicts and injured workers’ overuse of pain medications, and where research inquiries regarding effective treatment of acupuncture for treatment of drug-addicted persons can be applied to workers compensation patients.

In 2008 Yang, et.al. in “Acupuncture Treatment for Opiate Addiction” reviewed multiple studies exploring possible mechanisms underlying acupuncture's effectiveness in treating drug addicts. I include his references below.

There is a growing urgency to recognize the phenomenon of addiction to pain meds in the workers’ compensation patient population. In order to allay, reduce, and eventually eliminate this growing problem, several steps need to occur: 1. Recognition on the part of the prescribing practitioner; 2. Recognition by the patient; 3. Treatment and appropriate support to remove addiction.

Based on reams of studies and analyses, it is essential to recognize the formidable effects that acupuncture can provide to treat opioid addiction.

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Frances Kalfus is a Licensed Acupuncturist and has been practicing for thirty years in the San Francisco Bay Area. She has a private practice in Berkeley and has treated workers’ compensation patients spanning those years. She was trained by NADA (National Acupuncture Detoxification Association) in 1986 and has worked in clinics with drug addicted clients. Contact her at (510) 558-1911.

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