Acupuncture as an Adjunct in Drug and Alcohol Withdrawal - Essay Example

?QUESTION Annotated Bibliography Ryan, D., McDonough, M., and Berryman, C. (2008). Acupuncture in Drug and Alcohol Withdrawal at the Community Residential Withdrawal Unit, Footscray Hospital, Melbourne. Aust J Acupunct Chin Med, 3(2): pp. 5–12. This paper sought to identify client and staff perceptions on the benefits and limitations of acupuncture in the Community Residential Withdrawal Unit (CRWU) program. It was carried out through semi-structured interviews which were able to establish an understanding of client and staff experiences on acupuncture. A thematic method of analysis was used and a comparative analysis of client and staff views was carried out in order to evaluate convergences and divergences of views. This study was able to establish that there was a strong consensus among clients and staff interviewed that acupuncture had a beneficial impact in terms of helping patient relax, reducing his anxiety and pain. 2. Mills, E., Wu, P., Gagnier, J., and Ebbert, J., (2005). Efficacy of acupuncture for cocaine dependence: a systematic review & meta-analysis. Harm Reduction Journal 2(4), pp. 1-6. In this paper, the authors systematically evaluated and analyzed the randomized controlled trials on acupuncture in the management of cocaine addiction. The authors were able to cover 10 databases using different inclusion criteria. All in all, the authors established that the meta-analysis does not support the use of acupuncture in the management of cocaine dependence. However, most of the trials had issues with a significant loss in their follow-up, thus lessening the impact of the inferences drawn. 3. Black, S., Carey, E., Webber, A., Neish, N., and Gilbert, R. (2011). Determining the efficacy of auricular acupuncture for reducing anxiety in patients withdrawing from psychoactive drugs. J Subst Abuse Treat., 41(3):279-87 This study hypothesized that auricular acupuncture can reduce the anxiety caused by withdrawal from psychoactive drugs. It used a randomized controlled trial covering 101 patients from various addiction treatment centers. Subjects were grouped in three treatment groups with auricular acupuncture, AA at sham points, and control group. Their anxiety was measured. The study’s hypothesis was not confirmed. The auricular acupuncture was not more effective than sham or control treatments in reducing anxiety and the use of acupuncture in the management of drug withdrawal is still controversial. 4. Killeen, T. and Brady, K. (1997). A preliminary study of the effects of auricular acupuncture on alcohol and drug withdrawal symptoms. Substance Abuse, 18(3). The authors set out to evaluate the impact of auricular acupuncture in reducing stress in drug withdrawal patients. About 60 patients were covered by this paper with questionnaires used after initial treatment with acupuncture. Their rate of distress was measured. The authors were able to establish that there were statistically significant improvements seen on all measures for the subjects during the pre and post testing period. QUESTION 2 Literature Review Introduction Alternative and complementary medicine has long been part of our conventional medicine practice, especially in many parts of Asia and in the African region. For the West, their focus has always been on conventional and modern medicine and the adaptation of alternative therapies has not found widespread acceptance. There are various risks involved in the use of alternative and complementary medicine, especially as its applications are not supported by scientific studies and research. This paper shall establish a critical analysis of literature on acupuncture and its impact on drug withdrawal. This paper shall provide a critical analysis based on specific literature on the subject matter. First, an overview of the acupuncture shall be discussed, along with a general description of drug withdrawal. Secondly, an overview of available literature on the subject matter shall be presented. Thirdly, a critical analysis of gaps within these studies will be discussed. Lastly, a summary and general conclusion shall be drawn from this discussion. Body Acupuncture is considered a form of alternative medicine where thin and solid needles are inserted into acupuncture points in the skin (Deadman, et.al., 2007). This form of medicine has originated from China and based on their traditional methods, it is a form of treatment which seeks to manage imbalances in the flow of qi via channels which are known as meridians (Deadman, et.al., 2007). In general, acupuncture is based on the idea that regular body processes are managed through the qi flowing through the body, and changes in the flow of qi are said to be responsible for any illness. Acupuncture involves various procedures which seek to manage imbalances in the qi through stimulation of specific anatomical points under the skin (Jin, 2006). The scientific basis of qi flow and other principles relating to acupuncture are however not specifically supported by science, hence controversy surrounds its use and application. Drug withdrawal often manifests where the patient is trying to stop the abuse or the excessive use of drugs. Withdrawal from drugs presents with symptoms like: agitation, sweating, high blood pressure, and insomnia (Foster, 2009). This process can be difficult for patients with the severity of the symptoms depending on the type of drug involved or the extent of drug abuse. The following withdrawal symptoms can sometimes manifest: anxiety, insomnia, increased heart rate, nausea, vomiting, excessive fatigue, depression, increased breathing rates, hallucinations, convulsions, muscle pain, delirium, sensitivity to light, sound, taste, and smell, ringing in the ears, and numbness (Foster, 2009). In order to address the various issues in relation to drug withdrawal, acupuncture seeks to bring about major improvements in the patient’s coping mechanism (Skok, 2004). Chinese medicine and acupuncture has been successful in assisting in drug detoxification with the use of auricular acupuncture in managing drug withdrawal starting in Hong Kong in 1972 (Skok, 2004). However, China has already a long history of opiate use starting in early 18th century. In 1729, Emperor Yung Chen sought to stop the use of opium. Opiate use became a major health issue in early 20th century China and soon enough, there were thousands of opium addicts in China (Skok, 2004). Acupuncture and traditional Chinese Medicine was used to support the management of addicts at this point. Acupuncture follows the following mechanism of action in relation to substance abuse. First, the acupuncture increases the levels of endogenous endorphins in the body (Skok, 2004). The endorphins then directly impact on the central nervous system and higher levels of endorphins lead to an increased circulation. With higher levels of circulation, the immune system is stimulated, allowing the body to fight off any unfavorable anatomical and emotional developments (Skok, 2004). In conjunction with current issues on the use of acupuncture in the management of drug withdrawal and drug use, the Mills study (2004) indicates that their systematic review does not support the use of acupuncture in the management of cocaine dependence. This study clearly presents the research question, and their research question is very much relevant to the current subject matter. However, the focus of their discussion encompasses the entire drug abuse management process of which drug withdrawal is only a small portion. Nevertheless, the subject matter is a relevant topic in terms of seeking improvements in the management of drug withdrawal. The hypothesis is clear and is in line with the overall goals of the study. The literature review also provides sufficient background on the subject matter, seeking to establish a foundation for the query now being raised by this study. The method of the study is also clear and appropriate for the current subject matter. Moreover, these methods provide the essential information on the impact of acupuncture on drug withdrawal. The studies included in their systematic review allowed a bigger population to be covered through the different studies carried out. However, the volume of data does not necessarily provide clear answers to the issue raised. Nevertheless, the studies chosen provide sufficient background information on the existing data on the topic. The method of the study also seeks to gather cumulative data on the topic, thereby ensuring a more objective assessment of acupuncture in relation to drug withdrawal and drug use. The results are clearly presented based on the different results from numerous studies on the subject matter. The discussion is founded on the variables presented and the interrelationships of the different studies. Clear links and relations between the studies were established. Limitations emerged in terms of remaining subjects for the study, which have dropped significantly to lower figures. In effect, the results did not establish clear patterns of relations between these variables. Nevertheless, these studies do acknowledge that the use of acupuncture in drug withdrawal cases do not appear to yield significant results. In an older study however, Killeen and Brady (1997), the authors declare that the use of aurical acupuncture seems to present with significantly favored results. The study presented a study which was relevant even back in the 1990s. The research problem was clearly presented and the parameters of the research were also clear. Moreover, the researchers provided clear guidelines on the methods of the study, especially in terms of designations in treatment. This study covered selected respondents who passed inclusion standards. The methodology is replicable and uses variables which seek to measure the response of the patients to acupuncture, in terms of a more relaxed accommodation to the drug rehabilitation process. Limitations for this study however are mostly based on a limited population which does not allow for a greater generalizability of the study results. The results are nevertheless well explained and presented by the authors and are adequately supported within the text by the respondent trends and previously cited studies. The conclusion is also based on the discussion and the results which are coordinated with each other in relation to the original issue being raised. The Kunz, et.al., (2007) present a more current evaluation of the subject matter. Its results negate the conclusion drawn in the Killeen study. The Kunz study also notes that drug withdrawal from cocaine does not seem to be affected by acupuncture. However, loss of subject matter was also apparent in this study, as was also apparent in the Mills study. Nevertheless, this Kunz study provides a relevant subject matter, one which seeks to evaluate the impact of alternative methods of treatment for drug abusers and those undergoing withdrawal. With improved management methods for drug withdrawal, the outcome of the drug rehabilitation may also improve. However, the research and science on this topic is still very much lacking. The authors were however able to utilize appropriate and adequate means in developing their study and in establishing relevant results. The Kunz study however covers a small population as well, and as a result, the generalizability of its results is very much limited. The process of choosing and of assigning treatment modes was randomized and this helped support the validity of research results and subjects. While the Kunz and the Mills study argue that there is no sufficient evidence supporting the use of acupuncture in the management of drug withdrawal symptoms, in a recent study, Ryan and colleagues (2008) discussed that staff and clients do not believe that acupuncture is a beneficial approach to drug dependency and withdrawal. The authors presented their research topic and problem in a clear manner, with variables adequately considered for the text. The method applied was appropriate for the research topic and the data collection process helped support the research methodology. It is also a different angle on the topic, based on a qualitative research approach. In effect, it has established a more detailed and in-depth evaluation of the topic. The results were able to express feelings on the use of acupuncture which seemed to provide favorable results for the respondents. Conclusion Based on the above discussion, it is apparent to note that the use of acupuncture in cases of drug withdrawal is still very much controversial because of conflicting research results. The above results indicate unclear answers, although the research processes are clearly and appropriately undertaken. All variables have been considered and the methods applied are replicable. Limitations also emerge in terms of population covered and generalizability of results. Future studies can be considered to cover a bigger population, randomly chosen, with random designations of treatment, and using quantitative methods of evaluation. Such studies can help provide a more appropriate and more detailed evaluation of this subject matter. References Black, S., Carey, E., Webber, A., Neish, N., and Gilbert, R. (2011). Determining the efficacy of auricular acupuncture for reducing anxiety in patients withdrawing from psychoactive drugs. J Subst Abuse Treat., 41(3):279-87 Deadman, P., Baker, K., and Al-Khafaji, M. (2007). A manual of acupuncture. Journal of Chinese Medicine Publications. Foster, L., (2004). Understanding drug addiction withdrawal. Retrieved 07 July 2012 from http://www.everydayhealth.com/addiction/drug-alcohol-withdrawal-and-detox.aspx Jin, G (2006). Contemporary medical acupuncture – a systems approach (English). New York: Springer. Killeen, T. and Brady, K. (1997). A preliminary study of the effects of auricular acupuncture on alcohol and drug withdrawal symptoms. Substance Abuse, 18(3). Mills, E., Wu, P., Gagnier, J., and Ebbert, J., (2005). Efficacy of acupuncture for cocaine dependence: a systematic review & meta-analysis. Harm Reduction Journal 2(4), pp. 1-6. Ryan, D., McDonough, M., and Berryman, C. (2008). Acupuncture in drug and alcohol withdrawal at the community residential withdrawal unit, Footscray Hospital, Melbourne. Aust J Acupunct Chin Med, 3(2): pp. 5–12. Skok, S., Ming Dong Li, and Eisenstark, D. (2004. Treatment of withdrawal symptoms associated with substance abuse detox with acupuncture: a case study. Acupuncture.com. Retrieved 06 July 2012 from http://www.acupuncture.com/newsletters/m_july04/main1.htm Read More