The SSA’s Rob Calder and Natalie Davies describe acupuncture.
Acupuncture involves a practitioner inserting fine needles for therapeutic or preventative purposes.
Acupuncture is a key component of traditional Chinese medicine, and is based on the belief that acupuncture can restore the flow of Qi (an energy or ‘life force’) through the body.
It is also practiced under the umbrella of western medicine, although is still considered a complementary or alternative therapy. Western medical acupuncture is used to treat medical problems or symptoms, by triggering the release of naturally-released substances, such as pain-relieving endorphins.
How do you deliver acupuncture?
The National Institute for Health and Care Excellence (NICE) currently only recommends considering acupuncture as a treatment option for chronic (long-term) pain, chronic tension-type headaches, and migraines. However, acupuncture is also often used to treat other musculoskeletal conditions and pain conditions, including joint pain, dental pain, and post-operative pain.
Acupuncture is sometimes available on the NHS (e.g. from GP surgeries or physiotherapists), but most acupuncture patients pay for private treatment. An initial acupuncture session usually lasts 20 minutes to 1 hour, and includes an assessment of the person’s general health and medical history.
There is currently no statutory regulation of acupuncture in England.
The National Health Service (NHS) website provides more information about the procedure, including safety information.
Is acupuncture effective?
A 2006 Cochrane review investigated whether acupuncture at sites on the ear has helped in the treatment of cocaine dependence. The conclusion was, “There is currently no evidence that auricular acupuncture is effective for the treatment of cocaine dependence.” However, evidence was limited and from methodologically poor studies, so the review could not say for sure that acupuncture was ineffective.
In 2011, the UK’s National Institute for Health and Care Excellence (NICE) reviewed the evidence for acupuncture in relation to alcohol treatment and withdrawal. The advisory body concluded:
- “There is an evidence base for acupuncture in reducing craving but not alcohol consumption in a number of small trials.”
- “Anecdotal evidence suggests that acupuncture, like psychological treatment, is valued by service users both in alcohol misuse and substance misuse services (although the evidence base for effectiveness is weak).”
A 2014 Cochrane review of acupuncture for smoking cessation found no evidence of any sustained benefit (6 months or more). However, its authors concluded that acupuncture is a popular and safe intervention, which justifies further research.
Some later reviews have found modest, positive results associated with acupuncture. These reviews tend to be based on a very small number of studies. For example, a review published in 2016 reported the potential for acupuncture to reduce alcohol craving and withdrawal symptoms, but this was based on only two studies of the 15 randomised controlled trials assessed.
Equality and diversity considerations
A commentary published in Acupuncture in Medicine discussed whether acupuncture has the potential to improve the health outcomes of marginalised populations. The rationale was that “acupuncture has been used by low-income, refugee, veteran and ethnic minority groups to manage chronic pain, substance use disorders, stress and the impacts of trauma”, and these are populations and conditions for which there are numerous barriers to accessing traditional healthcare services.
Acupuncture may indeed have a lower barrier of entry than formal models of treatment and support. However, at present, there is very little evidence of effectiveness for substance use problems. Furthermore, according to the NHS website, “most acupuncture patients pay for private treatment” in England, so there may be a pay barrier to receiving this complementary or alternative therapy.
Where can I read more?
- Drug and Alcohol Findings published an article in 2018 about acupuncture and the ‘placebo effect’.
- Cynical of the benefits of acupuncture, pharmacologist David Colquhoun and neurologist Steven Novella argued in Anesthesia & Analgesia in 2013 that “the benefits of acupuncture [were] likely nonexistent, or at best…too small and too transient to be of any clinical significance”.
- The pro-acupuncture counter-argument published in the same journal, written by Shu-Ming Wang and colleagues, concluded that: “Instead of criticizing this ancient art with arguments culled from modern medicine and science, physicians and scientists should try to integrate current knowledge into this ancient, yet ever-evolving practice so it may be used to treat conditions for which pharmaceutical interventions are ineffective and/or potentially dangerous.”
by Rob Calder and Natalie Davies
The opinions expressed in this post reflect the views of the author(s) and do not necessarily represent the opinions or official positions of the SSA.
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