Tuesday, February 24, 2009

Treating Addiction with Auricular Therapy

The use of auricular therapy for treating drug withdrawal began in Hong Kong in 1972. Dr. Wen, a neurosurgeon, made a discovery “by accident”. He was doing surgery and administering auricular acupuncture anesthesia to a patient that happened to be a heroin addict in the midst of withdrawal symptoms. The patient had relief of his withdrawal symptoms following the procedure. Further studies were done to confirm that specific points on the ear could reduce cravings for opiates.

Research shows that acupuncture stimulates the production of endorphins, the body’s natural opiates. This would explain why treatments stimulating acupuncture points of the ear would reduce cravings. If the body is producing opiates, patients don’t need to seek them from the outside.

In 1973, Dr. Michael Smith was working out of the Lincoln Hospital in the South Bronx, operating a standard drug detox program. Seeking to improve results, he experimented with different auricular treatments. His research with auricular treatment greatly enhanced patient results. Due to the success of adding auricular treatment to the existing program, he founded the National Acupuncture Detox Association (NADA). NADA teaches a 5 point protocol to specialists in the detox profession.

Other examples of the success of auricular therapy include Hooper Memorial Detox Center in Portland, Oregon. In 1987, they implemented auricular acupuncture in their 5 day alcohol detox program. Clients using the auricular therapy were 6 times less likely to return in 6 months than clients who did not have auricular therapy. Overall completion rate also increased from 60% to 92% with the addition of auricular therapy. (Lane, 1988)

On the other side of the country, a clinical program for substance abuse sponsored by the Jersey City Dept. of Health reported the following results using auricular therapy: 84% improvement in mood, 81% improvement in withdrawal symptoms, 93% reduction in cravings and 70% improvement in overall wellness.

So how can massage therapists and others use this information to help their patients? Remember: acupressure is another way to stimulate acupuncture points. Acupressure can be applied with the fingers by compressing the point between two fingers and kneading, or with a 1 mm tip probe for precise point massage. Massage for 10 to 30 seconds with firm, but tolerable, pressure. Also, acupressure pellets can be placed in the ear for continued stimulation and pressed by the patient for self-treatment. Pellets should be removed by the patient in 3 to 5 days.

By the way, don’t feel that you’re doing second rate treatment by using acupressure pellets instead of needles. Pellets are the most common form of auricular treatment in China.

Is this in a massage therapists scope of practice? Yes. As an acupuncturist and LMT, I see many people who still feel the need for more support than they get from their other treatments. Adding this protocol to your massage sessions could provide another dimension of relief for those dealing with addictions, whether it’s alcohol, cigarettes, food or drugs. Also, as massage therapists, we are not treating the addiction. We’re treating the patient to help relieve the stress and physical discomfort associated with the addiction.

Obviously, massage is one of the best treatments for stress reduction and to help people feel more grounded in their bodies. Adding this reflex treatment of the ear simply takes advantage of information gleaned from other sources and allows a massage therapist to enhance their results.

This auricular stimulation is intended to enhance, not replace, conventional medical treatment for addictions. The NADA protocol was added to existing programs that included, 12-step meetings, individual counseling, appropriate medications, etc.

The points Dr. Smith found most useful for substance abuse were: Shen Men, Kidney, Liver, Lung and Sympathetic Nerve. These points can be easily found on ear models labeled for auricular therapy. They help calm the mind while supporting the detoxification of the body.

While there are other protocols more specific to smoking, food, and other addictions, the NADA protocol is a good general treatment if a therapist has limited training in auricular therapy.

You can easily integrate this into your general massage sessions when massaging the ear. If you choose to do point massage and acupressure pellets, it’s wise to spend some time educating your patient regarding the more specific nature of this technique.

Monday, February 16, 2009

Battlefield Acupuncture

I spend a good deal of my time educating people about therapies that are not well known in America. Even though acupuncture gets plenty of good press, there are many other sub categories related to acupuncture that are obscure, yet very effective. You can see my previous post on Auricular Therapy (January 2009) for a brief look at that specialty.

Even the U.S. military is now using auricular therapy to treat pain. It was developed by Richard C. Niemtzow, MD at Malcolm Grow Medical Center, Andrews AFB, MD.

There are many effective protocols for treating pain and Dr. Niemtzow has created a simple way to address this issue without the need for extensive training.

Dr. Niemtzow was kind enough to share the details of this protocol with me. I’ll summarize it here. Those of you trained in auricular therapy can experiment to see how it works for you. Even though his technique uses semi-permanent needles, similar results can be achieved with electro stim, point massage and acupressure pellets.

Here is a chart locating the 5 points used in this protocol.

Start with the Cingulate Gyrus. I would suggest starting on the side where the pain is located or the dominate ear if it the pain is in the midline or bilateral. You can use electro stim or point massage and then place an acupressure pellet on it. Have the patient walk around for 2 minutes and evaluate the level of relief.

If there is still some pain, stimulate the Cingulate Gyrus on the other ear and again let the patient move around a few minutes and reevaluate.

Determine which ear seemed to give the most relief, then treat the other points on that ear in this order: Thalamus, Omega 2, Point Zero, Shen Men. If there is still some pain, you can treat the other ear in the same fashion.

I consider auricular treatment to only be a part of my approach. It often reduces pain considerably making more direct reatment with massage or other modailties more comfortable and more effective.

Dr. Niemtzow says that relief may last from minutes to months, depending on various factors. If people expect 100% permanent relief from any treatment they will be disappointed. As a component of a multifaceted treatment however, auricular therapy is a powerful tool.

The advantage of this protocl is the short learning curve and general effectiveness, the disadvantage is it may not be specific enough for some situations. As such, it may not replace an approach based on corresponding points or 5 element points. Just consider it another option for your patients. And, of course, do other appropriate treatment within your scope of practice.

My thanks to Dr. Niemtzow for his service to our country and for bringing a powerful pain relief modality to our soldiers.