Efficacy of acupuncture for psychological symptoms associated with opioid addiction: a systematic review and meta-analysis

Zhang Boyuan, Chen Yang, Cheng Ke, Shen Xueyong, Liu Sheng, Zhang Boyuan, Chen Yang, Cheng Ke, Shen Xueyong, Liu Sheng

Abstract

This review systematically assessed the clinical evidence for and against acupuncture as a treatment for psychological symptoms associated with opioid addiction. The database was accessed from MEDLINE and China Knowledge Resource Integrated Database. We included all randomized clinical trials published in Chinese and English regardless of their controls. Meta-analysis was performed using the RevMan software, version 5.2. We conducted a literature search of 16 databases from their inception to January 2014. Four studies from Western countries did not report any clinical gains in the treatment of psychological symptoms associated with opioid addiction. 10 of 12 studies from China have reported positive findings regarding the use of acupuncture to treat the psychological symptoms associated with opioid addiction. The methodological quality of the included studies was poor. The meta-analysis indicated that there was a significant difference between the treatment group and the control group for anxiety and depression associated with opioid addiction, although groups did not differ on opioid craving. This review and meta-analysis could not confirm that acupuncture was an effective treatment for psychological symptoms associated with opioid addiction. However, considering the potential of acupuncture demonstrated in the included studies, further rigorous randomized controlled trials with long followup are warranted.

Figures

Figure 1
Figure 1
Flow diagram showing the number of studies included and excluded from the systematic review.
Figure 2
Figure 2
Meta-analysis of acupuncture for opioid craving.
Figure 3
Figure 3
Meta-analysis of acupuncture for anxiety associated with opioid addiction.
Figure 4
Figure 4
Meta-analysis of acupuncture for depression associated with opioid addiction.

References

    1. Comer S. D., Sullivan M. A., Yu E., Rothenberg J. L., Kleber H. D., Kampman K., Dackis C., O'Brien C. P. Injectable, sustained-release naltrexone for the treatment of opioid dependence: a randomized, placebo-controlled trial. Archives of General Psychiatry. 2006;63(2):210–218. doi: 10.1001/archpsyc.63.2.210.
    1. O'Connor P. G. Methods of detoxification and their role in treating patients with opioid dependence. The Journal of the American Medical Association. 2005;294(8):961–963. doi: 10.1001/jama.294.8.961.
    1. Amato L., Davoli M., Ferri M., Gowing L., Perucci C. A. Effectiveness of interventions on opiate withdrawal treatment: an overview of systematic reviews. Drug and Alcohol Dependence. 2004;73(3):219–226. doi: 10.1016/j.drugalcdep.2003.11.002.
    1. Kessler R. C., Wang P. S. The descriptive epidemiology of commonly occurring mental disorders in the United States. Annual Review of Public Health. 2008;29:115–129. doi: 10.1146/annurev.publhealth.29.020907.090847.
    1. Merikangas K. R., Kalaydjian A. Magnitude and impact of comorbidity of mental disorders from epidemiologic surveys. Current Opinion in Psychiatry. 2007;20(4):353–358. doi: 10.1097/YCO.0b013e3281c61dc5.
    1. Kavanagh D. J., Mueser K. T., Baker A. Management of comorbidity. In: Teesson M., Proudfoot H., editors. Cormorbid Mental Disorders and Substance Use Disorders: Epidemiology, Prevention and Treatment. Canberra, Australia: Commonwealth of Australia; 2003. pp. 78–120.
    1. Llorente del Pozo J. M., Fernández Gómez C., Gutiérrez Fraile M., et al. Psychological and behavioural factors associated with relapse among heroin abusers treated in therapeutic communities. Addictive Behaviors. 1988;23(2):155–169.
    1. Kaplan H. B., Meyerowitz J. H. Social and psychological correlates of drug abuse: a comparison of addict and non-addict populations from the perspective of self-theory. Social Science and Medicine. 1970;4(2):203–225. doi: 10.1016/0037-7856(70)90116-2.
    1. Heiwe S., Lönnquist I., Källmén H. Potential risk factors associated with risk for drop-out and relapse during and following withdrawal of opioid prescription medication. European Journal of Pain. 2011;15(9):966–970. doi: 10.1016/j.ejpain.2011.03.006.
    1. Sullivan M. D., Edlund M. J., Zhang L., Unützer J., Wells K. B. Association between mental health disorders, problem drug use, and regular prescription opioid use. Archives of Internal Medicine. 2006;166(19):2087–2093. doi: 10.1001/archinte.166.19.2087.
    1. NIH consensus development panel of acupuncture. Acupuncture. The Journal of the American Medical Association. 1998;280:1518–1524.
    1. Dundee J. W., Ghaly R. G., Lynch G. A., Fitzpatrick K. T. J., Abram W. P., Lynch G. A. Acupuncture prophylaxis of cancer chemotherapy-induced sickness. Journal of the Royal Society of Medicine. 1989;82(5):268–271.
    1. Christensen P. A., Noreng M., Andersen P. E., Nielsen J. W. Electroacupuncture and postoperative pain. British Journal of Anaesthesia. 1989;62(3):258–262. doi: 10.1093/bja/62.3.258.
    1. Martelete M., Fiori A. M. C. Comparative study of the analgesic effect of transcutaneous nerve stimulation (TNS); electroacupuncture (EA) and meperidine in the treatment of postoperative pain. Acupuncture and Electro-Therapeutics Research. 1985;10(3):183–193.
    1. Patel M., Gutzwiller F., Paccaud F., Marazzi A. A meta-analysis of acupuncture for chronic pain. International Journal of Epidemiology. 1989;18(4):900–906. doi: 10.1093/ije/18.4.900.
    1. Shlay J. C., Chaloner K., Max M. B., Flaws B., Reichelderfer P., Wentworth D., Hillman S., Brizz B., Cohn D. L. Acupuncture and amitriptyline for pain due to HIV-related peripheral neuropathy: a randomized controlled trial. The Journal of the American Medical Association. 1998;280(18):1590–1595. doi: 10.1001/jama.280.18.1590.
    1. Ter Riet G., Kleijnen J., Knipschild P. Acupuncture and chronic pain: a criteria-based meta-analysis. Journal of Clinical Epidemiology. 1990;43(11):1191–1199. doi: 10.1016/0895-4356(90)90020-P.
    1. Beal M. W. Acupuncture and acupressure: applications to women's reproductive health care. Journal of Nurse-Midwifery. 1999;44(3):217–230. doi: 10.1016/S0091-2182(99)00054-3.
    1. Gerhard I., Postneek F. Auricular acupuncture in the treatment of female infertility. Gynecological Endocrinology. 1992;6(3):171–181.
    1. Han J. S., Zhang R. L. Suppression of morphine abstinence syndrome by body electroacupuncture of different frequencies in rats. Drug and Alcohol Dependence. 1993;31(2):169–175. doi: 10.1016/0376-8716(93)90069-3.
    1. Avants S. K., Margolin A., Chang P., Kosten T. R., Birch S. Acupuncture for the treatment of cocaine addiction: investigation of a needle puncture control. Journal of Substance Abuse Treatment. 1995;12(3):195–205. doi: 10.1016/0740-5472(95)00014-V.
    1. Bullock M. L., Culliton P. D., Olander R. T. Controlled trial of acupuncture for severe recidivist alcoholism. The Lancet. 1989;1(8652):1435–1439.
    1. Washburn A. M., Fullilove R. E., Fullilove M. T., Keenan P. A., McGee B., Morris K. A., Sorensen J. L., Clark W. W. Acupuncture heroin detoxification: a single-blind clinical trial. Journal of Substance Abuse Treatment. 1993;10(4):345–351. doi: 10.1016/0740-5472(93)90019-X.
    1. Wells E. A., Jackson R., Diaz O. R., Stanton V., Saxon A. J., Krupski A. Acupuncture as an adjunct to methadone treatment services. The American Journal on Addictions. 1995;4(3):198–214. doi: 10.3109/10550499509038105.
    1. McLellan A. T., Grossman D. S., Blaine J. D., Haverkos H. W. Acupuncture treatment for drug abuse: a technical review. Journal of Substance Abuse Treatment. 1993;10(6):569–576. doi: 10.1016/0740-5472(93)90061-6.
    1. Margolin A. Acupuncture for substance abuse. Current Psychiatry Reports. 2003;5(5):333–339. doi: 10.1007/s11920-003-0065-6.
    1. Yang C. H., Lee B. H., Sohn S. H. A possible mechanism underlying the effectiveness of acupuncture in the treatment of drug addiction. Evidence-based Complementary and Alternative Medicine. 2008;5(3):257–266. doi: 10.1093/ecam/nem081.
    1. Lin J.-G., Chan Y.-Y., Chen Y.-H. Acupuncture for the treatment of opiate addiction. Evidence-based Complementary and Alternative Medicine. 2012;2012 doi: 10.1155/2012/739045.739045
    1. Ter Riet G., Kleijnen J., Knipschild P. A meta-analysis of studies into the effect of acupuncture on addiction. British Journal of General Practice. 1990;40(338):379–382.
    1. Jordan J. B. Acupuncture treatment for opiate addiction: a systematic review. Journal of Substance Abuse Treatment. 2006;30(4):309–314. doi: 10.1016/j.jsat.2006.02.005.
    1. Margolin A., Avants S. K., Kleber H. D. Investigating alternative medicine therapies in randomized controlled trials. Journal of the American Medical Association. 1998;280(18):1626–1628. doi: 10.1001/jama.280.18.1626.
    1. Gordon J. R., Marlatt G. A. Relapse Prevention. 1985. Relapse prevention: theoretical rationale and overview of the model; pp. 250–280.
    1. Jadad A. R., Moore R. A., Carroll D., Jenkinson C., Reynolds D. J. M., Gavaghan D. J., McQuay H. J. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Controlled Clinical Trials. 1996;17(1):1–12. doi: 10.1016/0197-2456(95)00134-4.
    1. Wu Z., Sullivan S. G., Wang Y., Rotheram-Borus M. J., Detels R. Evolution of China's response to HIV/AIDS. The Lancet. 2007;369(9562):679–690. doi: 10.1016/S0140-6736(07)60315-8.
    1. Brewington V., Smith M., Lipton D. Acupuncture as a detoxification treatment: an analysis of controlled research. Journal of Substance Abuse Treatment. 1994;11(4):289–307. doi: 10.1016/0740-5472(94)90040-X.
    1. Smith M. O., Khan I. An acupuncture programme for the treatment of drug-addicted persons. Bulletin on Narcotics. 1988;60(1):35–41.
    1. Olivo S. A., Macedo L. G., Gadotti I. C., Fuentes J., Stanton T., Magee D. J. Scales to assess the quality of randomized controlled trials: a systematic review. Physical Therapy. 2008;88(2):156–175. doi: 10.2522/ptj.20070147.
    1. Review Manager (RevMan) [Computer Program] Version 5.1. Copenhagen, Denmark: The Nordic Cochrane Centre, The Cochrane Collaboration; 2011.
    1. Higgins J. P. T., Thompson S. G., Deeks J. J., Altman D. G. Measuring inconsistency in meta-analyses. British Medical Journal. 2003;327(7414):557–560. doi: 10.1136/bmj.327.7414.557.
    1. Lua P. L., Talib N. S. Auricular acupuncture for drug dependence: an open-label randomized investigation on clinical outcomes, health-related quality of life, and patient acceptability. Alternative Therapies in Health and Medicine. 2013;19(4):28–42.
    1. Bearn J., Swami A., Stewart D., Atnas C., Giotto L., Gossop M. Auricular acupuncture as an adjunct to opiate detoxification treatment: effects on withdrawal symptoms. Journal of Substance Abuse Treatment. 2009;36(3):345–349. doi: 10.1016/j.jsat.2008.08.002.
    1. Avants S. K., Margolin A., Holford T. R., Kosten T. R. A randomized controlled trial of auricular acupuncture for cocaine dependence. Archives of Internal Medicine. 2000;160(15):2305–2312. doi: 10.1001/archinte.160.15.2305.
    1. Meade C. S., Lukas S. E., McDonald L. J., Fitzmaurice G. M., Eldridge J. A., Merrill N., Weiss R. D. A randomized trial of transcutaneous electric acupoint stimulation as adjunctive treatment for opioid detoxification. Journal of Substance Abuse Treatment. 2010;38(1):12–21. doi: 10.1016/j.jsat.2009.05.010.
    1. Wu J.-M., Wei D.-Y., Luo Y.-F., Xiang X.-Y. Clinic research on heroin de-addiction effects of acupuncture and its potentiality of preventing relapse. Zhong Xi Yi Jie He Xue Bao. 2003;1(4):268–272.
    1. Song X.-G., Li X.-L., Wei K.-C., Xu D.-B., Li H., Shi F.-Z., Zhao Y., Teng Y.-S. Influence of acupuncture on sleep disorders and anxiety in patients with heroin dependence. Journal of Acupuncture and Tuina Science. 2012;10(3):150–154. doi: 10.1007/s11726-012-0592-y.
    1. Zeng X., Lei L., Lu Y., Wang Z. Treatment of heroinism with acupuncture at points of the Du Channel. Journal of Traditional Chinese Medicine. 2005;25(3):166–170.
    1. Mu J.-M., Liu L., Fang W., Cheng J.-M., Zhao L. Effect of electroacupuncture at Jiaji (EX-B 2) on drug craving of heroin addicts and beta-EP and Dyn-A in plasma. Zhongguo Zhen Jiu. 2010;30(11):881–885.
    1. Zhang B., Luo F., Liu C. Treatment of 121 heroin addicts with Han's acupoint nerve stimulator. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2000;20(8):593–595.
    1. Yang Y., Gao Y. J., Yang L. M. Clinical observation of acupuncture treatment of heroin addicts protracted withdrawal symptoms. Lishizhen Medicine and Materia Medica Research. 2007;18(4):947–948.
    1. Hou W. G., Liang Y., Wang Y. X., Zong L., Chen Y. L. Clinical observation of electro-acupuncture intervention on depression of heroin addicts after withdrawal. Chinese Journal of Drug Abuse Prevention and Treatment. 2009;15(1):11–13.
    1. Wen T. Q., Yang Z. J., Lei X. L. Clinical application of acupuncture for treatment of heroin withdrawal syndrome. Zhongguo Zhen Jiu. 2005;25(7):449–453.
    1. Zhan H. R. Clinical study on treatment of acupuncture in improving methadone maintenance patients craving [Dissertation] Guangzhou University of Chinese Medicine; 2011.
    1. Mu J. P., Liu L., Cheng J. M., et al. Clinical study of electroacupuncture treatment for post-withdrawal anxiety and depression in drug addicts. Shanghai Journal of Acupuncture and Moxibustion. 2008;27(10):1–3.
    1. Yang L., Chen J., Xu X., et al. Acupuncture combined with Chinese medicine in the treatment of abstinence syndrome of opioid drug addiction. Shanghai Journal of Acupuncture and Moxibustion. 2011;27(8):7–9.
    1. Rong J., Liu Z. Y., Asihae G. Clinical study on Heroin Withdrawal syndrome treated by scalp acupuncture in addicts. Chinese Journal of Drug Abuse Prevention and Treatment. 2006;12(4):205–208.
    1. Luo H. C., Shen Y. C., Jia Y. K. Clinical study of electro-acupuncture on 133 patients with depression in comparison with tricyclic amitriptyline. Chinese Journal of Integrated Traditional and Western Medicine. 1988;8(2):77–68.
    1. Zhang B., Ma W. Y., Zhang B. T., et al. A control study of clinical therapeutic effects of laser-acupuncture on depressive neurosis. World Journal of Acupuncture-Moxibustion. 1996;6(2):12–17.
    1. Röschke J., Wolf C., Müller M. J., Wagner P., Mann K., Grözinger M., Bech S. The benefit from whole body acupuncture in major depression. Journal of Affective Disorders. 2000;57(1–3):73–81. doi: 10.1016/S0165-0327(99)00061-0.
    1. Stux G., Pomeranz B. Basics of Acupuncture. Volume 4. 3rd. Berlin, Germany: Springer; 1995. (no. 60, pp. 230–236).
    1. Yoon S. S., Kwon Y. K., Kim M. R., Shim I., Kim K. J., Lee M. H., Lee Y. S., Golden G. T., Yang C. H. Acupuncture-mediated inhibition of ethanol-induced dopamine release in the rat nucleus accumbens through the GABA B receptor. Neuroscience Letters. 2004;369(3):234–238. doi: 10.1016/j.neulet.2004.07.095.
    1. Chae Y., Yang C. H., Kwon Y. K., Kim M. R., Pyun K.-H., Hahm D.-H., Lee H.-J., Shim I. Acupuncture attenuates repeated nicotine-induced behavioral sensitization and c-Fos expression in the nucleus accumbens and striatum of the rat. Neuroscience Letters. 2004;358(2):87–90. doi: 10.1016/j.neulet.2003.12.121.
    1. Liu S., Zhou W., Liu H., Yang G., Zhao W. Electroacupuncture attenuates morphine withdrawal signs and c-Fos expression in the central nucleus of the amygdala in freely moving rats. Brain Research. 2005;1044(2):155–163. doi: 10.1016/j.brainres.2005.02.075.
    1. Xue Y.-X., Luo Y.-X., Wu P., Shi H.-S., Xue L.-F., Chen C., Zhu W.-L., Ding Z.-B., Bao Y.-P., Shi J., Epstein D. H., Shaham Y., Lu L. A memory retrieval-extinction procedure to prevent drug craving and relapse. Science. 2012;336(6078):241–245. doi: 10.1126/science.1215070.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅