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Margolin A, Kleber HD, Avants SK, et al. Acupuncture for the Treatment of Cocaine Addiction: A Randomized Controlled Trial. JAMA. 2002;287(1):55–63. doi:10.1001/jama.287.1.55
Author Affiliations: Yale University School of Medicine, New Haven, Conn (Drs Margolin and Avants); National Center on Addiction and Substance Abuse, Columbia University, New York, NY (Drs Kleber, Boles, and Vaughan); Columbia University School of Medicine, New York, NY (Drs Kleber and Vaughan); University of Miami School of Medicine, Miami, Fla (Dr Konefal); UCLA Laboratory for the Study of Addiction, Los Angeles, Calif (Drs Gawin and Stark); University of California, San Francisco, and San Francisco General Hospital (Drs Sorensen and Midkiff); Evergreen Treatment Services, Seattle, Wash (Dr Wells and Mr Jackson); and Hennepin County Medical Center, Minneapolis, Minn (Dr Bullock and Ms Culliton).
Context Auricular acupuncture is widely used to treat cocaine addiction in the
United States and Europe. However, evidence from controlled studies regarding
this treatment's effectiveness has been inconsistent.
Objective To investigate the effectiveness of auricular acupuncture as a treatment
for cocaine addiction.
Design Randomized, controlled, single-blind clinical trial conducted from November
1996 to April 1999.
Setting Six community-based clinics in the United States: 3 hospital-affiliated
clinics and 3 methadone maintenance programs.
Patients Six hundred twenty cocaine-dependent adult patients (mean age, 38.8
years; 69.2% men); 412 used cocaine only and 208 used both opiates and cocaine
and were receiving methadone maintenance.
Intervention Patients were randomly assigned to receive auricular acupuncture (n
= 222), a needle-insertion control condition (n = 203), or a relaxation control
condition (n = 195). Treatments were offered 5 times weekly for 8 weeks. Concurrent
drug counseling was also offered to patients in all conditions.
Main Outcome Measures Cocaine use during treatment and at the 3- and 6-month postrandomization
follow-up based on urine toxicology screens; retention in treatment.
Results Intent-to-treat analysis of urine samples showed a significant overall
reduction in cocaine use (odds ratio, 1.40; 95% confidence interval, 1.11-1.74; P = .002) but no differences by treatment condition (P = .90 for acupuncture vs both control conditions). There
were also no differences between the conditions in treatment retention (44%-46%
for the full 8 weeks). Counseling sessions in all 3 conditions were poorly
Conclusions Within the clinical context of this study, acupuncture was not more
effective than a needle insertion or relaxation control in reducing cocaine
use. Our study does not support the use of acupuncture as a stand-alone treatment
for cocaine addiction or in contexts in which patients receive only minimal
concurrent psychosocial treatment. Research will be needed to examine acupuncture's
contribution to addiction treatment when provided in an ancillary role.
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