Date of Award

2019

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is acupuncture effective in reducing opioid cravings in detoxifying opioid abusing adults?”

STUDY DESIGN: A review of three RCTs published in English, each of which was published in 2009, 2013 and 2014 respectively.

DATA SOURCES: Three randomized controlled trials (RCTs) published in peer-reviewed journals that evaluate the effectiveness of acupuncture to reduce opioid cravings found via PubMed and ScienceDirect.

OUTCOMES MEASURED: Opioid cravings via 100 millimeter analog scale score, the Maudsely craving score consisting of five-point Likert scales and withdraw symptoms as measured by a 4-point scale questionnaire.

RESULTS: Two RCTs found no significant difference between the acupuncture and control groups in opioid withdraw cravings. Chan et al. established a decrease in opiate cravings in both the control and experimental groups, but the decrease was statistically insignificant (p=0.101). Moreover, the craving means measured throughout 14 days by Bearn et al. found no statistical difference in placebo vs. auricular acupuncture cravings (p=0.283). Conversely, Lua and Talib compared pre and post intervention mean cravings within their experimental acupuncture group, resulting in a significant craving reduction of 20.8% after intervention (p=0.011).

CONCLUSIONS: It is not clear the effect that acupuncture has on opiate cravings after detoxification, as two of the RCTs addressed in this paper revealed no improvment and one RCT showed positive results in craving decreases. Additional trials, specifically in countries where acupuncture is less familiar, are necessary to deduce the efficiency of acupuncture as an adjunctive treatment for opiate addiction.

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