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More
than 100 counselors, Social workers, Doctors, Yoga therapists and
Peer Support Counselors from different parts of India have been
trained to use ear acupuncture for addiction treatment and Rehabilitation
as per NADA five-point treatment protocol. These people who are
already working in different addiction treatment settings have completed
seventy hour apprenticeship training as Acupuncture Detoxification
Specialist (ADS). The model put forth by NADA allows an ADS to practice
the limited, pre-defined five point needle protocol for the treatment
of addictions. The ADSs do not do differential diagnosis or treatment;
their role is somewhat analogous to a technician, although the word
specialist more accurately captures the clinical reality of providing
addiction treatment. As stated in the NADA brochure, "If ADS
training and practice were restricted to acupuncturists and physicians,
a very few treatments would be done and a great resource would be
lost." These ADS are using ear acupuncture in therapeutic community
(T.C.) based Drug treatment programs, Drug Counseling centers, Govt.
run Beggars Homes and Workplace Alcohol and Drug prevention program
and Govt. funded De-addiction and Counseling centers.
There are State education approved training sites in Sullivan country,
Kingston, Albany, Syracuse and Rochester. Since the landmark legislation
was passed in 1988, more that 150 programs in New York are using
acupuncture as an adjunct for drug and alcohol treatment. The Lincoln
acupuncture model is used by 1,000-program worldwide. Most of this
expansion has occurred in public institutions like hospitals, correctional
facilitates, and street out-reach components. These programs represent
a broad range of cultural settings including Saudi Arabia, India,
Nepal, and Trinidad, in addition to most Western and Eastern European
countries. Independent NADA training, treatment, and certification
programs have been established in more than ten countries during
the last decade.
The Lincoln Hospital (New York) model can be summarized and defined
as follows: (1) Clinicians use three to five, ear acupuncture points
- including sympathetic, shenmen, lung, kidney, liver. (2) Treatment
is provided in a group setting for duration of 40-50 minutes. (3)
Acupuncture treatment is integrated with conventional elements of
psychosocial rehabilitation. (4) Several components of the Lincoln
program are frequently combined with acupuncture in other treatment
facilities. These items include: a supportive non-confrontational
approach to individual counseling; an emphasis on Narcotics Anonymous
and other 12- Step activities early in the treatment process. The
NADA was established in 1985 to increase the use of the Lincoln
model and to maintain quality and responsibility in the field. (NADA
Literature clearinghouse is listed as a reference).
H.L.Wen, MD, of Hong Kong was the first physician to report successful
use of acupuncture treatment of addiction withdrawal symptoms (Wen
1973). He observed that opium addicts receiving electro-acupuncture
as post-surgical analgesia experienced relief of withdrawal symptoms.
The lung ear point was used. Subsequently, Wen conducted several
basic clinical pilot studies that formed the basis of further research.
It is very important to realize that acupuncture is only one component
of substance abuse treatment. The value of acupuncture lies partly
in the relief of withdrawal symptoms, but the more critical goal
is to prepare the client to participate effectively in all phase
of treatment and rehabilitation.
Acupuncture has many characteristics in common with 12-Step programs
followed by Alcoholic Anonymous (AA )and Narcotic Anonymous( NA).
It uses group process in a tolerant, support-live, and present -
time oriented manner. Participation is independent of diagnosis
and level of recovery. Both approaches are simple, reinforcing,
nurturing, and conveniently available. The emphasis on 'self - responsibility'
is common to both systems. In practice, acupuncture provides an
excellent foundation for 12 Step recovery. Patients seem less fearful
and more receptive when they first enter the meeting. The traditional
advice: listen to learn and learn to listen fits this model well.
There is less guarding and greater ability to support each other
warmly. The ability to use 12-Step meetings, provides more stable
support for continuing treatment on an outpatient basis.
• Ear Acupuncture is a non - verbal process.
• The treatment will be just as helpful if the patient lies
to us.
• The treatment will be just as helpful if the patient is ashamed
to speak about certain issues.
• Patients will be able to learn about themselves and process
troublesome issues more gradually and comfortably.
• The patient can be engaged in helpful treatment even before
they are able to tolerate intense or personalized, one to one sessions.
• The process of transference can be delayed.
• Needy, fearful patients can be engaged in treatment before
they can tolerate a bonding relationship with staff.
• Paranoid, antagonistic patients are able to accept help in
spite of their lack of trust.
• Patients with low self-esteem and a lack of hope can begin
their treatment participation at a realistic level.
• Patients who are also trauma victims will be able to participate
in treatment even though they are fearful of interpersonal relations
• A much wider selection of patients can be introduced to substance
abuse treatment.
• Acupuncture provides a solution to some of the paradoxical
problems in addiction treatment.
• Patients can be treated before assessment and diagnosis are
completed so that the patient can be calm and cooperative enough
for a useful diagnosis to be made.
• Confrontation about drug use is not necessary because a patient
can be helped even while they are in denial about the need for treatment.
• It is possible to provide kind, soothing, attention without
the risk of enabling the addictive process.
• Developing trust between the therapist and patient is much
easier.
• The patient can relax without losing control.
• Indeed, the whole program can relax without losing control.
• Acupuncture helps the development of a meditation like state.
• Patients become comfortable with their own thoughts.
• Patients become comfortable with their own physical processes.
• Patients learn to "let go" of tension and preoccupations.
• Patients develop their own spatial comfort zones.
• Patients learn that their private internal processes can
be a source of strength and renewal.
• Patients are able to remain comfortable while focused on
source of activities.
• The calm stability in the acupuncture setting creates a relatively
timeless process. There is much less pressure to improve according
to guilt- related standards.
• Ear Acupuncture treatment in a group setting creates an environment,
which is reassuring and validating. As therapists, we are welcome
to join this setting. We are able to be supportive witnesses for
the patient's development.
• Hence, patients learn and remember without being overwhelmed
by distractions.
In summary, Ear acupuncture helps patients to participate in individual
and group treatment sessions more effectively. It is a nonverbal,
nonthreatening, "first step" intervention, that has an
immediate calming effect on patients. Initial participation with
Ear acupuncture has been found to improve patients' overall treatment
retention, and to facilitate their subsequent involvement in rehabilitation.
The paper was presented jointly by Dr.Michael O. Smith and Mr. Suneel
Vatsyayan at 4th FINGODAP Conference funded by Ministry of Social
Justice and Empowerment, Government of India, UNDCP and UNAID at
Kolkotta, India, held from 3rd Jan-5th Jan 2003.
** MICHAEL O. SMITH, MD,Dac
Chairmen & Founder NADA International
*** SUNEEL VATSYAYAN MSW, ADS (NADA)
Director, Caring Foundation India
Email - suneel40@mantraonline.com
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