Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
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.
Kaptchuk TJ. Acupuncture for the Treatment of Cocaine Addiction. JAMA. 2002;287(14):1800-1802. doi:10.1001/jama.287.14.1799