Arizona Acupuncture Board Tackles Opioid Crisis


Tim Royan

Cronkite News

The State of Arizona Acupuncture Board of Examiners has entered the fight against opioid abuse, approving chemical dependency programs for a form of acupuncture that involves the outer ear. Proponents say auricular acupuncture helps people break free from addiction, but a skeptic says there is no evidence that acupuncture relieves any condition.

“I don’t think (auricular acupuncture is) the complete answer, but I think it can be a real game-changer,” said Dr. Mario Fontes, director of the natural medicine and detox clinic in the Phoenix Center, which offers a board-approved program. chemical dependency program.

Opioids in Arizona have killed more than 3,000 people in the past two years alone, and more than 21,000 suspected overdoses have occurred in the same period, according to Data from the Arizona Department of Health Services.

First developed by French physician Paul Nogier in the 1950s, auricular acupuncture, also known as acu-detox, uses needles placed in one to five acupuncture points in the outer ear. Proponents say the practice offers a non-pharmacological approach to managing a range of issues, from pain and stress to post-traumatic stress disorder and opiate withdrawal.

The acupuncture board has made efforts to make it easier for ear acupuncturists to become certified over the past few years to help address the opioid crisis, said board executive director David Geriminski. .

“We hope that by providing chemical dependency programs, auricular acupuncture will become more accessible to more people and to more parts of the state, especially in rural areas,” he said.

The program’s current status, approved in March last year, allows certified ear acupuncturists to apply to operate in approved chemical dependency programs under the supervision of a licensed acupuncturist, Geriminski said.

Ear acupuncturists, who are certified to perform acupuncture for the treatment of chemical dependence and addiction, are required to complete a training course through the National Acupuncture Detoxification Association, in addition to a course on clean needling technique.

They must also be board examined and fingerprinted. They are then certified to perform acupuncture only on the five ear points for treatment purposes, Geriminski said.

Meanwhile, fully licensed acupuncturists are required to complete what is essentially a master’s degree program, consisting of 1,850 hours of training, of which 800 hours must be practiced in a clinical setting, Geriminski said.

Fontes, who is also a member of the Arizona State Acupuncture Examining Board, said this rigorous licensing process is there to protect the public. His clinic was the first to be approved by the board; since then, two more have been approved as chemical dependency programs.

Fontes said auricular acupuncture is a powerful tool in all stages of opiate addiction, and he criticized the medical establishment for its role in the opioid crisis.

“A lot of addictions start with the prescription pad at the doctor’s office,” Fontes said. “You have someone who comes in with a legitimate medical complaint and is prescribed an addictive substance. There are non-pharmacological approaches to pain management.

For Fontes, acupuncture can also help existing addictions by shifting a person suffering from drug withdrawal or craving from what he calls a sympathetic state, or a “fight or flight” response, to parasympathetic dominance, or a “rest and digest” response.

Ear acupuncture “helps keep you from freaking out,” Fontes said. “We don’t heal when we run away from the tiger.”

He also says studies show that patients are more likely to stay in treatment if they also have acupuncture, which increases the likelihood of better results.

But he recognizes the limits of any treatment for opiate addiction.

“I’ll tell you, percentage-wise, all treatment centers are pretty low,” Fontes said. “People tend to change when they are ready.”

Acupuncture, which the National Center for Biotechnology Information originated in China 3,000 years ago and spread to the West from the 16th century, remains controversial.

“Acupuncture points don’t exist,” said Dr. Steven Novella, assistant professor of neurology at Yale University. “There is absolutely no physiology, no basic science, no clinical evidence, nothing either theoretically or directly that establishes their existence.”

Creation of Novella science-based medicinea website promoting evidence-based medicine that critiques alternative treatments, including acupuncture.

The website’s “About” page states that online information about alternative medicine “is extremely gullible and uncritical, and even the mainstream media and some medical schools have bought into the hype and not posed the questions.” difficult questions”.

For Novella, licensing and government certifications for acupuncturists amount to sanctioning a fraudulent practice.

“They’ll say… ‘It’s to protect patients from bad acupuncturists,’ but, really, what they’re looking for is legitimacy,” Novella said. “It is the Trojan horse that enters the door.”

Novella said ear acupuncture in particular “has another layer of nonsense.” He describes it as “a kind of homunculus where different parts of the ear are said to correspond to different parts of the body. … There’s no science behind it, it’s just performance magic.

Although some individual studies
show some benefit of acupuncture for a variety of conditions, Novella said meta-analyses — large-scale systematic reviews of existing, smaller studies — demonstrate that acupuncture is little more than a placebo . This includes reviews of smaller studies claiming to show benefits for opioid use disorders. He also said that many small-scale studies show only secondary benefits and exaggerate the benefits of acupuncture.

“The only thing that seems to affect the patient’s response to treatment is their interaction with the acupuncturist,” Novella said. “If acupuncturists are instructed to be supportive and friendly, people get a better subjective response. All of this strongly suggests that acupuncture is just a placebo treatment.

Despite characterizing acupuncture as a placebo, Novella argues that the practice is far from harmless.

“Patients think it works. And then what do acupuncturists do? They use it to treat cancer,” he said. “They use the legitimacy they derive from the subjective placebo effect. And then they say, ‘Yes, it’s a real medicine that treats a real disease.’ »

Fontes said he’s faced critics like Novella throughout his career, but he doesn’t let that deter him.

“Whenever there is something that is not mainstream, it eventually fits in, and there will always be people who will oppose it,” he said. “People who want our help, we are there for them. People who don’t, it’s fine.

Fontes argues that acupuncture has been practiced for millennia, so it must involve something more than a placebo effect, when drugs we’ve only had for a century, like antibiotics, are already failing.

“It’s the prevailing belief that the real road to health is through drugs, radiation and surgery,” Fontes said. “I just don’t believe it.”

Looking to the future, Fontes hopes that auricular acupuncture will become more widely accepted, and not just for chemical dependency, but also for PTSD and stress management.

Ultimately, Fontes would like to see acupuncture more widely accepted in hospitals, as well as prisons and prisons.

“A lot of times our system is punitive,” Fontes said. “Instead of being helped with your drug problem, you are being punished for the consequences of your drug problem. So if we can use the current infrastructure to be helpful, rather than just punitive, we can change outcomes.

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