Although acupuncture has been utilized more every year since the declaration of the opioid crisis in 2017, there is still a stigma surrounding opioid use disorder and the treatments options for it. This includes easy access or coverage for the helpful treatment options, and therefore still continuing to feed into the opioid epidemic. As of 2022, more than 27 million Americans had some type of drug use disorder losing one American every five minutes.
The worst part is that due to many factors, there are still so many Americans dying from lack of access to alternative or necessary treatments, in fact, four out of five Americans that are addicted to opioids are not in treatment. These figures are astronomical, and with alternative treatments like acupuncture more accessible to suffering patients, the amount of deaths that can be prevented is worth insurance companies, law-makers, prescribing providers, and the government addressing.
The Opioid Crisis Explained
Opioids; a type of drug that includes both prescription pain killers like fentanyl, oxycodone, morphine, and hydrocodone as well as illicit drugs like heroin. These particular types of drugs bond to the opioid receptors in the body to decrease pain and induce a feeling of euphoria and relaxation. For many years, opioids were the number one go-to treatment for both western medicine doctors and patients alike leading to a misuse of prescription and non-prescription opioids. Misusing these drugs floods the brain with dopamine encouraging a repeat in this behavior and causing addiction. Although there has been a place or reason initially for utilizing opioids like surgeries, cancer treatment, insomnia, and tooth decay prevention, it is now more than ever recreationally used.
Factors Contributing to the Opioid Crisis:
- Over-prescription of opioids – although this has decreased, opioid deaths continue to increase.
- Synthetic/Semi-Synthetic opioid options – these are alternative options aquired from the illegal market, and its use has increased every year.
- Pharmaceutical Companies – the influence of these companies over both insurance companies and patients far exceeds the common person’s understanding, but there are far reaching issues with these companies taking advantage of those struggling.
- Insufficient regulation – there is not enough research and regulation on these drugs, nor is there enough regulating the amount allowed or prescribed.
There are over 60,000,000 people worldwide are dealing with opioid addiction killing more than 100,000 people each year, and access to helpful treatments, although better since 2017, is still severely lacking. It is important as providers to understand the signs or symptoms of misuse of opioids as well as signs that the patient may be at risk of overdose in which case 911 must be called.
Signs of Misuse:
- Slurred speech
- Fading in and out of consciousness while sitting up or in social groups
- Disoriented or drowsy
Signs of Overdose:
- Small pupils
- Vomiting
- Shallow, dangerously slow breathing
- Limp body
- Choking sounds
- Pale, cold skin
- Purple fingernails and/or lips
- Faint heart rate due to the opioid suppressing neurological signals
Being that these have a highly addictive nature, it is no surprise that they eventually did lead to overuse and misuse over time. Prescription opioids are only second in terms of addictive power to heroin and LSD which are arguably the most addictive drugs on the planet.
Insurance Companies Role in the Opioid Epidemic
Although all of the major insurance companies have improved their coverage since 2017 in regards to addiction support, they are nowhere near what they should be in order to make a dent in this crisis. Insurance has been a huge barrier for patients since their inception, and many times are often the reason treatment isn’t sought out by those addicted. In the western medicine world, many insurance companies still require pre-authorization for medications used to control opioid cravings, and many times has played into a addict’s death. These authorization restrictions are obviously not across the board and vary by state and insurance company, but is a problem contributing to the opioid epidemic nonetheless.
Additionally, insurance premiums are more expensive than ever, and coverage for alternative options or helpful medications are still on the back burner for many companies. Considering insurance companies are on the front line to aid in the opioid epidemic, they can make a huge difference with changing and updating their policies regarding alternative medicine as well as less addictive treatment options.
Lastly, with the way that insurance companies currently operate, health plans pay providers a lower rate for alternative treatments as well as behavioral health, and a higher rate for medical care. This alone has the danger of deterring providers from not only specializing in addiction treatment, but also from the desire to treat opioid use disorder patients altogether.
There is a pathetic fraction of the population that actually has coverage for things like acupuncture and treatment centers which have been shown to help greatly in the road to recovery. The window to help patients who are willing to be treated is extremely narrow, and with many insurance companies still requiring long forms, approvals, urine drug tests, dosage limits, and more, it is difficult to provide treatment to those who desperately need it before it’s too late especially in the western medicine sector.
Acupuncture for Opioid Use Disorder
As with the other helpful medications addressed, acupuncture has been found to be very helpful for addict patients in curbing cravings and withdrawal symptoms as well as mental health overall. It has even been found in a recent study in 2024 to reduce the need of methadone treatment. Acupuncture was initially introduced as a treatment for substance abuse in Lincoln Memorial Hospital in New York finding it more effective than methadone, and Dr. Michael O. Smith founded the National Acupuncture Detoxification Association in 1985.
NADA Protocol for Auricular Acupuncture:
- Shen Men
- Sympathetic
- Kidney
- Liver
- Lung
It is important as an acupuncture provider to also recognize any underlying health problems that could potentially contribute to addiction.
Benefits of Acupuncture for Opioid Use Disorder:
- Decrease cravings – acupuncture stimulates the release of endorphins decreasing the desire for opioids.
- Ease other withdrawal symptoms (also providing decreased risk of relapse)
- Decrease physical pain from both the addiction and the withdrawal
- Increase in retention at rehab facilities
- Decrease anxiety and stress/regulate emotions – acupuncture promotes relaxation and decreases depression and anxiety through a therapeutic environment for emotional healing during the recovery stages.
- Boost sleep quality
- Improve quality of life – acupuncture brings the body back to homeostasis to address both pre-existing imbalances as well as those caused by opioid misuse.
- Improves detoxification in the body – acupuncture reinforces the body’s detox processes by improving lymphatic flow, supporting the elimination of toxins in the body, and increasing blood circulation.
Acupuncture for opioid use disorder works on the central nervous system to decrease the severity of common withdrawal symptoms like cravings, anxiety, depression, digestive problems, insomnia, and muscle cramps and aches. The less withdrawal symptoms, the more likely it is that the patient will recover and not relapse. Acupuncture treatment plays a crucial role in addiction treatment with benefits for inpatient and outpatient facilities.
Additionally, and perhaps most importantly, is acupuncture is a non-pharmacological treatment modality to manage symptoms of withdrawal. This is without a doubt the most important thing to note. While there is a time, place, and specific scenarios in which western medicine methods are needed in conjunction, treating opioid use disorder with more medication seems counterintuitive for the most part. There have been studies, especially in recent years with the opioid epidemic in which acupuncture proved itself to be a competitive treatment option for those suffering from opioid use disorder.
Bidirectional Role of Acupuncture in the Treatment of Drug Addiction, 2021:
- The goal of this study was to look into the neurobiological mechanisms providing acupuncture’s drug addiction treatment efficacy.
- The study concluded that “acupuncture may reduce relapse to drug-seeking behavior by regulating neurotransmitters involved in drug craving modulation via somatosensory afferent mechanisms.” Additionally, they stated “acupuncture may reduce drug craving by correcting both dysfunctions of the mesolimbic dopamine pathway.”
Effect of Acupuncture for Methadone Reduction, 2024:
- The goal of this study was to discover the effectiveness of acupuncture on methadone dose reduction compared to sham acupuncture.
- Included in the study were adults that had been using MMT for a minimum of 6 weeks. 118 patients aged 65 and younger were assigned at random to receive sham acupuncture or traditional acupuncture. Patients were not informed which they were receiving.
- 62% of the participants receiving traditional acupuncture after 8 weeks were able to reduce their methadone dosage by a minimum of 20%. Alternatively, only 29% of participants getting sham acupuncture were able to decrease their methadone dosage by a minimum of one-fifth.
- This study overall concluded that traditional acupuncture treatment was far superior to sham acupuncture in decreasing both opioid cravings and methadone dosage.
The opioid crisis is far from over, and although the healthcare industry has made great strides, there is still so far to go. Even now, in 2024, there was a budget proposal in congress to take funds from the state opioid response grants putting life-saving treatment options at risk.
Additionally, there are a multitude of insurance companies that still don’t cover beneficial treatments for opioid addicts like acupuncture. It is vital for us as acupuncture providers to do our part in not only educating our patients in the benefits of acupuncture for opioid use disorder, but also to advocate and remove the stigma surrounding these patients as well. Acupuncture treatment and medications for opioid use disorder could mean the difference between recovery and another relapse or casualty.