We read with interest the randomized controlled trial by Avants et al1 suggesting that auricular acupuncture may reduce cocaine dependence. The authors made a laudable effort to develop adequate controls for auricular acupuncture treatment in a series of trials.2-4 We would like to suggest a sham acupuncture method that offers the advantage of patient-blinding and avoidance of needle insertion (which some authors believe has physiological effects and therefore is an "unfair" placebo).5