Auricular acupuncture in prescription drug dependence detoxification

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Published: Report no: ut202028 Registration no: SBU 2020/381

Question

What systematic reviews are there on the effect of auricular acupuncture, or NADA protocol auricular acupuncture, on the prescription drug detoxification process?

Identified literature

One relevant systematic review was identified [1], see Table 1. Two primary studies were identified [2,3]. The primary studies were not assessed for risk of bias.

Table 1. Systematic reviews with low/medium risk of bias

Included studies Population/Intervention Outcome
Baker et al, 2016 [1]
4 RCTs Adults with Opioid Use Disorder.
n=350
Auricular acupuncture according to the NADA protocol.		 Primary:
Reduction in opiate dependence, craving or frequency of use.
Treatment retention.

Secondary:
Opiate withdrawal symptoms. Side effects of auricular acupuncture.
Other psychological or emotional symptoms of Opioid Use Disorder.
Authors' conclusion:
“While AA [Auricular Acupuncture] may not be beneficial in decreasing craving or withdrawal symptoms associated with OUD [Opioid Use Disorder], in conjunction with MAT [Medical Assisted Therapy] it may allow for reduced methadone doses, aid in treatment retention and completing, and be a useful adjunct to address psychosocial aspects of recovery.”

References

  1. Baker TE, Chang G. The use of auricular acupuncture in opioid use disorder: A systematic literature review. American Journal on Addictions 2016;25:592-602.
  2. Bergdahl L, Broman JE, Berman AH, Haglund K, von Knorring L, Markström A. Auricular acupuncture versus cognitive behavioural therapy in the discontinuation of hypnotic drug usage, and treatment effects on anxiety, depression and insomnia symptoms − a randomised controlled study. European Journal of Integrative Medicine 2017;16:15-21.
  3. Black S, Carey E, Webber A, Neish N, Gilbert R, Black S, et al. Determining the efficacy of auricular acupuncture for reducing anxiety in patients withdrawing from psychoactive drugs. Journal of Substance Abuse Treatment 2011;41:279-287.

Literature search

MedLine (Ovid) 20200305
Auricular acupuncture in prescription drug misuse
Search terms Items found
Population:
1. Substance-Related Disorders/ 94 711
2. Opioid-Related disorder/ 14 511
3. Substance Withdrawal Syndrome/ 21 220
4. Addiction Medicine/ 88
5. exp Hypnotics and sedatives/ 122 583
6. Analgesics, Opioid/ 43 712
7. exp Benzodiazepines/ 65 079
8. Morphine/ 37 993
9. benzodiazepin*.ab.kf.ti 35 011
10. opioid*.ab,kf,ti 89 599
11. analgesic*.ab.kf.ti 84 238
12. addiction.ab.kf.ti 46 565
13. detox*.ab.kf.ti 44 210
14. ((substance or drug) adj4 (abuse or misuse)).ab,kf.ti 48 703
15. ((prescript* or pharmaceutic*) adj2 drug*).ab.kf.ti 16 907
16. (sleep* adj2 (air* or pill* or agent* or induc*)).ab,kf,ti 6 861
17. Or/1-16 546 708
Intervention:
18. Acupuncture, Ear/ 418
19. ear acupuncture.ab,kw,ti 156
20. auricular acupuncture.ab,kw,ti 380
21. NADA protocol.ab,kw,ti 20
22. or/18-21 725
Combined sets:
23. 17 and 22 142
Limits:
24. 2000 - 127
Final   127

 

Scopus via scopus.com 20200305
Auricular acupuncture in prescription drug misuse
Search terms Items found
Population:
1. TITLE-ABS-KEY(benzodiazepin*) 97 413
2. TITLE-ABS-KEY(opioid*) 130 066
3. TITLE-ABS-KEY(analgesic*) 213 738
4. TITLE-ABS-KEY(addiction) 140 168
5. TITLE-ABS-KEY(detox*) 72 167
6. TITLE-ABS-KEY((prescripti* OR pharmaceutic*) W/1 drug*) 67 511
7. TITLE-ABS-KEY(sleep*W/1 (aid* OR pill* OR agent* OR induc*)) 9 321
8. TITLE-ABS-KEY((substance OR drug) W/3 (abuse OR misuse)) 164 587
9. 1 OR 2 OR […] 8 727 617
Intervention:
10. TITLE-ABS-KEY((ear OR auricular) W/2 acupuncture) 1 302
11. TITLE-ABS-KEY(“nada protocol”) 49
12. 10 OR 11 1 315
Combined sets:
13. 9 AND 12 273
Limits:
14. 2000 - 224
Final   224

 

Embase via embase.com 20200305
Auricular acupuncture in prescription drug misuse
Search terms Items found
Population:
1. ‘hypnotic sedative agent’/exp 378 869
2. ‘narcotic analgesics agent’/exp 339 724
3. ‘benzodiazepine derivative’/exp 229 928
4. ‘drug detoxification’/de 4 614
5. ‘drug withdrawal’/de 193 035
6. ‘drug dependence’/exp 249 388
7. ‘drug craving’/de 677
8. ‘withdrawal syndrome’/de 29 857
9. ‘addiction’/de 54 134
10. ‘drug abuse’/exp 117 227
11. ‘substance abuse’/de 53 284
12. ‘benzodiazepin*’:ti,ab,kw 50 414
13. ‘opioid*’:ti,ab,kw 124 089
14. ‘analgesic*’:ti,ab,kw 120 403
15. ‘addiction’:ti,ab,kw 69 800
16. ‘detox*’:ti,ab,kw 53 786
17. ((prescripti* OR pharmaceutic*) NEAR/2 drug*):ti,ab,kw 26 369
18. (sleep* NEAR/2 (aid* OR pill* OR agent* OR induc*)):ti,ab,kw 9 860
19. ((substance OR drug) NEAR/4 (abuse OR misuse)):ti,ab,kw 68 842
20. 1 OR 2 OR […] 14 1 380 100
Intervention:
21. ‘auricular acupuncture’/de 353
22. ((ear OR auricular) NEAR/2 acupuncture):ti,ab,kw 970
23. ‘nada protocol’:ti,ab,kw 56
24. 16 OR 17 OR 18 1 147
Combined sets:
25. 20 AND 24 298
Limits:
26. 2000 - 250
Final   250

 

CINAHL via ebsco.com 20200305
Auricular acupuncture in prescription drug misuse
Search terms Items found
Population:
1. MH “Substance Withdrawal Syndrome” 3 688
2. MH “Anianxiety Agents, Benzodiazepine+” 10 302
3. MH “Analgesics, Opioid” 18 194
4. MH “Hypnotics and Sedatives+” 18 467
5. MH “Substance Use Disorders” 37 126
6. MH “Substance Dependence” 10 475
7. MH “Substance Abuse” 34 184
8. MH “Addictions Nursing” 555
9. MH “Detoxification, Alternative Therapy” 1 112
10. TI ( (benzodiazepi* OR opioid* OR analgesic* OR addiction OR detox* OR ((prescription OR pharmaceutic) N2 drug) OR (sleep* N2 (aid OR pill OR agent OR induc*)) OR ((substance OR drug) N4 (abuse OR misuse)) ) OR AB ( (benzodiazepi* OR opioid* OR analgesic* OR addiction OR detox* OR ((prescription OR pharmaceutic) N2 drug) OR (sleep* N2 (aid OR pill OR agent OR induc*)) OR ((substance OR drug) N4 (abuse OR misuse)) ) OR SU ( (benzodiazepi* OR opioid* OR analgesic* OR addiction OR detox* OR ((prescription OR pharmaceutic) N2 drug) OR (sleep* N2 (aid OR pill OR agent OR induc*)) OR ((substance OR drug) N4 (abuse OR misuse)) ) 152 003
11. 1 OR 2 OR […] 10 192 401
Intervention:
12. MH “Acupuncture, Ear” 360
13. TI((ear OR auricular) N2 acupuncture) OR AB((ear OR auricular) N2 acupuncture) OR SU((ear OR auricular) N2 acupuncture) 639
14. TI “NADA protocol” OR AB “NADA protocol” OR SU “NADA protocol” 19
15. 12 OR 13 OR 14 646
Combined sets:
16. 11 AND 15 143
Limits:
17. 2000 - 134
Final   134
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