18 October 2010

Research on Addiction, Spirituality & Acupuncture

This is a response to a student paper on a research article using acupuncture to treat nicotine withdrawal--

The issue is very timely. Smoking does seem to be on the rise locally, though i've not seen statistics on it.
German research documented the carcinogenic effects of tobacco in 1935, before the chemical additives were used in manufacturing cigarettes. I mention it to patients who feel their smoking is OK, since they smoke 'natural' tobacco. Another point is that the active ingredient is identified in the death process caused by smoking, which knocks 13 years off a life.

Smoking is being promoted by the Chinese government, according to Dr Zwickey of our research department, since it generates revenue.

The problem with numerous studies are manifold. It gets into the heart of the problem with researching addictionology, and how research is missing the spiritual or inner dimension in healthcare.

First, how are patients recruited? This is seldom mentioned. Often though, in conventional trials, an ad is run and patients get paid.

Ever pay anyone to get off alcohol?

Could that ever work?

In acupuncture, the Nei Jing/Inner Classic of acupuncture says healing comes from within. Nowhere is this more clear than treating addictions. When the addict is ready to change, they will endure anything. If they are not ready, nothing changes.

This could be why studies on AA and 12-step programs--our main tool in addictionology--fail in RCTs. If we view a spiritual movement like Recovery as if it were a drug, it doesn't work: Funny!

Ask any worker in the field of addictions if Recovery programs work: They'll ask you, "What else is there?" While not perfect, they are organic, free, widely available, and seem to work. That was my impression, and those of my colleagues in the National Acudetox Association.

Statistics can be illuminating. Prozac got it's start with 5% upticks. 12 and 13 as found in comparing nicotine patches to acupuncture is significant in research. It's not enough for clinicians though.

Government research provided helpful information that most smokers quit on their 5-6th attempt. I tell smokers who fail that it takes multiple attempts (without mentioning a specific number). Some statistics do help us.

It's more the spirit in which they are provided. What we do in acupuncture and addictionolgy is not drug-like. I've yet to see a drug effectively treat chemical dependency. Acupuncture can work better than drugs, in that it has less side effects. But it has an inner aspect that conventional research is not measuring. The reason is that we are often providing an ulterior motive to study participants: cold cash.
The NY Times just had an article on the culture of professional research subjects. There is such a thing. Some make a living doing it.
My experience is that most research projects in Oregon, on the other hand, is with research subjects who possess a great sense of public service for low or no pay.

Qualitative research could assist. Comparing the writing of nicotine patch wearers to acupuncture patients would be something. Combining qualitative with quantitative research is bringing together yin and yang.

Research and all efforts in the field of quitting smoking will help this most difficult process our patients go through, as many of them attest.

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