How Acupuncture, Yoga, and Meditation are becoming Evidence-based Treatment Options for Opioid Addiction

Above a salon on the shores of Scituate harbor, fourteen victims of the opioid epidemic sit. Silent, they bathe in the cool waters of relief. Two more sit anxious in the hall, waiting their turn. Crammed into a small room, these embattled citizens sit silent under a dim light as their racing thoughts slow to a crawl.

When trying to break the cycle of addiction, moments of relaxation are a distant memory. That’s why the room is full this Wednesday, full of people looking for peace. Full of people turning to the needle.

A nervous energy fills the room as first timers tense up, legs fidgeting as their turn comes around. A clenched jaw eases with a wince, as the relief they came for sets in. Complete relaxation follows the insertion of the needle. It slides in almost unnoticed, especially for those who know the pierce of the hypodermic needle.

The needles used at this acupuncture detox clinic are ten times thinner than that of the thick, hollow syringe.

Every Wednesday night Kathy Duggan, licensed acupuncturist, performs the service at South Shore Peer Recovery in Scituate. New and repeat clients come to SSPR to take part in the free clinic. The aim, to use acupuncture therapy to alleviate withdrawal symptoms. Many are seeking out more holistic methods such as acupuncture to aid recovery and prevent addiction, as the opioid epidemic continues taking its toll on the Commonwealth.

The latest data from the Governor’s office shows estimates of 1,200 unintentional and undetermined opioid deaths in 2014. Since 2000, the number of overdose deaths has risen 228% in Massachusetts from 5.3 to 17.4 deaths per 100,000 residents. Initial findings for 2015 showed 1,100 opioid deaths between January and September alone. Governor Charlie Baker signed legislation in March, stepping up the state’s response.

“The Commonwealth stands in solidarity to fight the opioid and heroin epidemic that continues to plague our state and burden countless families and individuals,” Governor Baker said in a statement.

The bill was the first in the nation to limit an opioid prescription to a 7-day supply for first-time adult prescriptions. The Governor called for doctors to discuss “alternatives” to opioid prescriptions with patients, but it is unclear how large of a role acupuncture will have in the discussion.

The Center for Disease Control and Prevention adjusted their guidelines for opioid prescribing the following day. The new guidelines make no mention of acupuncture, instead referencing “evidence based” treatments.

Every Wednesday night at South Shore Peer Recovery’s two room office, all non-essential furniture is folded up and tucked away. The room is cleared to make space for a circle of plastic folding chairs. People begin to file in as Kathy Duggan, licensed acupuncturist and certified Acupuncture Detox Specialist, prepares to direct the clinic. Those who have been coming every week since the program started in March, chat, while new faces fill in the vacant chairs.

Kathy is joined by Linda Coventry, licensed acupuncturist from Bridgewater. The two start the procedure from opposite sides of the room. Kathy inserts the first needle in the lowest tip of the sacral spine area of the ear, called the sympathetic point.

The second needle is inserted in the Shen Men ear point. According to Traditional Chinese Medicine, the needling of this point calms the mind, promotes lower abdominal circulation, harmonizes the liver, and reduces high blood pressure. It is the first point along the “addiction axis line,” one of five points in the National Acupuncture Detox Association’s protocol.

After Kathy and Linda finish needling, the lights are lowered and soft music accompanies a 30- minute period of meditation.

“It’s certainly an alternative to medication,” John Kimmett, co-founder of South Shore Peer Recovery said. Kimmett a person in long-term recovery, is a retired licensed and certified Alcohol and Drug Counselor and Recovery Coach. He launched SSPR after hosting a special screening of the film “The Anonymous People.”

The documentary focuses on Americans in long-term recovery and the overall view and stigma of addiction. The free showing drew a crowd of more than 165 people to the Mill Wharf Cinema in Scituate, as staff scrambled to provide extra seating. That showing and the community meetings that followed led to the opening of the SSPR office, which aims to connect people in recovery to various resources.

Kimmett views acupuncture and other holistic practices like yoga and meditation as viable and important tools to aid in recovery. There is data to support that view.

A review by Evidence-Based Complementary and Alternative Medicine shows that a majority of clinical trials found acupuncture effective as a strategy to treat opiate addiction. The review stops short of endorsement however, as many of the studies were classified as “low quality”. It suggests further research using “well designed, high quality randomized controlled studies.”

Kathy Duggan who practices in Norwell, sees clients for many conditions ranging from anxiety to allergies. She says her most common treatments involve pain issues.

The American Society of Addiction Medicine says 4 in 5 new heroin users start after misusing prescription painkillers. The same report showed a 37% per year increase in heroin overdoses from 2010-2013. The report also shows overdoses rising in concert with the sales of prescription pain relievers, nationally. Patients with concerns about these drugs and potential for addiction, are asking their physicians about alternatives like acupuncture.

A 2010 survey from Massachusetts General Hospital, showed an “overwhelming majority” of physicians in agreement on the subject. The survey showed many physicians considered acupuncture a “useful alternative modality” for pain management. The study also showed that lack of insurance coverage was one of the main impediments in making acupuncture referrals.

Medicare currently does not cover acupuncture services. As of 2014 MassHealth coverage has expanded for the treatment of some pain conditions, once a number of conditions are met. Those conditions and other hurdles are what lead acupuncturists like Kathy Duggan to offer paid receipts for clients to negotiate with insurance companies on their own.

“It’s too spotty,” Kathy said. “Right now for me to deal with every insurance company and what they want, it’s a nightmare from what I hear.” Members of the acupuncture community are watching legislation in Massachusetts, which attempts to ease that burden.

Bill H.930, introduced by State Representative William Pignatelli of Lennox, seeks to establish a commission on acupuncture and wellness to “investigate the potential for better integrated use of acupuncture services.” The bill also looks to expand health insurance coverage for certain acupuncture services. The bill, introduced over a year ago, coincides with other states expanding their plans to include acupuncture.

Covered California, California’s health insurance exchange, has listed acupuncture as an “essential health benefit,” and has covered certain services since 2014. The Oregon Health Authority expanded its health plan on July 1st to include acupuncture and chiropractic manipulation, as a treatment for back pain. The expansions come as concern and mistrust over opioid pain relievers grow.

Purdue Pharma has come under even greater scrutiny after a report from the Los Angeles Times showed the company’s OxyContin used misleading claims regarding its pain relief. The report continues to support the view that OxyContin and its 12-hr pain-relief claims were the spark which ignited the opioid epidemic.

An epidemic which leads more people to recovery centers like South Shore Peer Recovery.

Kathy Duggan is just one of the volunteers including yoga instructors, mindfulness teachers, and meditation experts waiting to get involved as South Shore Peer Recovery expands. She describes acupuncture as “another tool in the toolbox,” for people in long term recovery.

“People in new recovery have trouble keeping their feet and their heads in the same room,” said John Kimmett as his wife Nancy untangled purple balloons in the other room. Later in the evening, a tent set up on the corner will represent SSPR along the annual Scituate Harbor Cultural Council Art Walk.

Coloring pages will fill the table as South Shore Peer Recovery explores the use of art therapy. The purple balloons will line the street, go up the stairs, and to the office. A multi-resource facility open to all available methods. And as initial response waves fail to curb the opioid epidemic, more people are turning to different treatments, different needles, in their search for relief.

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