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April 10, 2002

Acupuncture for the Treatment of Cocaine Addiction

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(14):1800-1802. doi:10.1001/jama.287.14.1799

To the Editor: Dr Margolin and colleagues1 found that acupuncture was ineffective for treatment of cocaine addiction. This conclusion is not surprising in light of 2 previous meta-analyses that found that acupuncture was not effective for treating addiction.2,3 This trial, however, does not address whether there might be a self-selection effect for acupuncture treatment. Such a treatment effect would be conceivable for people with cocaine addiction who commit themselves to a series of acupuncture treatments and unleash a synergistic outcome between the acupuncture (or placebo acupuncture) and their choice, expectations, and beliefs.4 Another question that the trial does not answer is whether the modest reduction from baseline in both the real acupuncture and control groups has clinical significance. It is possible that acupuncture in this situation had a comparatively high or at least clinically significant placebo effect in at least some of these patients,5 which could make a difference for a population that has few other therapeutic options.

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