6 Reasons To Consider Acupuncture Instead of Opioids

Six acupuncture organizations have released a 20 page white paper that outlines the profession’s value as an alternative to opioid medication for pain relief. The white paper is the product of a Joint Opioid Task Force established by the American Society of Acupuncturists and the Acupuncture Now Foundation.

Other participating organizations include the American Alliance for Professional Acupuncture Safetuy, the American TCM Association, the American TCM Society and the National Fedreation of TCM Organizations.

Here are some of the major points, each of which features extensive detail and supporting references:

acupuncture for opioid addiction
  • “Acupucnture is an effective, safe, and cost-effective treatment for numerous types of acute and chronic pain. Acupuncture should be recommended as a first line treatment for pain before opiates are prescribed, and may reduce opioid use.”
  • “Acupuncture’s analgesic mechanisms have been extensively researched and acupuncture can increase the production and release of edogenous opioids in animals and humans.”
  • “Acupuncture is effective for the treatment of chronic pain involving maladaptive neroplasticity.”
  • “Acupuncture is a useful adjunctive therapy in opiate dependency and rehabilitation.” Opioid Addiction Treatment
  • “Acupuncture has been recommended as a first line non-pharmacologic therapy by the FDA, as well as the National Academies of Sciences, Engineering and Medicine in coping with the opioid crisis. The Join Commission has also mandated that hospitals provide non-pharmacologic pain treatment modalities.”
  • “Among most non-pharmacological managements for pain relief now available, acupuncture therapy is the most effective and specific for opioid abuse and overuse.”

This above article was originally published in Acupuncture Today Magazine in the November 2017 issue.

Reducing Opioid Use After Surgery with Acupuncture

Opioid overprescription and overreliance following surgery has become a major contributor to the opioid epidemic. Surgeons and dentists are among the top prescribers of opioids, with 80-94% of patients undergoing even low-risk surgical procedures being prescribed opioids within a week of the operation. This leads to over 70% of prescribed opioid pills going unused by surgical patients. Worryingly, the risk of developing persistent opioid use after surgery in previously opioid-naive patients is estimated to be around 6%.

Acupuncture represents a promising adjunctive analgesic therapy to significantly reduce the reliance on opioids after surgery and mitigate the risk of persistent opioid use. Multiple studies have demonstrated acupuncture’s opioid-sparing effects across a variety of surgical contexts:

Use in Specific Surgeries

  • Cardiac surgery: Acupuncture has been shown to reduce opioid requirements.
  • Thoracic surgery: Electro-acupuncture before video-assisted thoracic surgical procedures decreased perioperative anesthetic dosages required.
  • Craniotomy: Acupuncture decreased post-operative pain and improved recovery after neurosurgical brain procedures.

Evidence from Meta-Analyses

A 2017 meta-analysis in JAMA Surgery focused on non-pharmacological adjuncts for reducing pain after total knee arthroplasty. The analysis found moderate evidence that electro-acupuncture therapy reduced opioid use and delayed the time to first opioid dose compared to standard care alone.

Another meta-analysis concluded that acupuncture was effective for reducing opioid consumption after a variety of surgical procedures, with some studies showing over 60% less opioid use when acupuncture was added.

Acupuncture may also help ameliorate opioid-induced side effects like postoperative ileus, expediting recovery after colorectal cancer resection surgeries.

With such promising evidence, acupuncture offers surgeons and patients a safe, effective adjunct for achieving adequate pain relief while minimizing opioid exposure and risk of persistent use after operations.

Mechanisms of Acupuncture for Opioid Addiction Treatment

Opioid System Modulation

A 2012 meta-analysis concluded that acupuncture is an effective strategy for treating opiate addiction, with the benefits stemming from modulation of the mesolimbic dopamine system involved in addiction. Neurochemical evidence shows acupuncture can reduce the positive and negative reinforcement underlying opiate dependence.

Role of Dynorphins and Kappa Opioid Receptors

More specifically, the mechanism by which acupuncture helps counter opioid addiction appears to be mediated by the endogenous opioid peptide dynorphin binding to kappa-opioid receptors. Animal studies have demonstrated that suppression of morphine withdrawal symptoms by electroacupuncture involves dynorphin and activation of these kappa receptors.

Supporting Endogenous Opioid Release

Broadly, acupuncture has been found to stimulate the production and release of multiple endogenous opioids like enkephalins, endorphins, dynorphins, endomorphins and nociceptin. By boosting the body’s own opioid systems, acupuncture can provide analgesia and counter opioid cravings without the addictive potential of exogenous opioid drugs.

Acupuncture therefore represents a powerful non-pharmacological approach to opioid addiction treatment by rehabilitating the dysregulated opioid receptor systems underlying addiction through neuromodulation of endogenous opioid pathways.

Acupuncture in the Military for Opioid Management

VA and Military Adoption Recognizing acupuncture’s potential for pain management and opioid abuse mitigation, the Veterans Administration (VA) and US military branches are increasingly integrating this modality into their healthcare services.

At the Air Force’s Cincinnati Air Force Medical Center, implementation of an acupuncture program led to dramatic reductions in opioid prescriptions (45% decrease), muscle relaxants (34% decrease), NSAIDs (42% decrease) and benzodiazepines (14% decrease) among personnel.

The VA is looking to incorporate acupuncture system-wide, with growing physician training programs. Similarly, the Army, Navy and Air Force are all rapidly expanding acupuncture’s availability for service members struggling with pain and opioid dependence.

Ideal Modality for Military Setting

Acupuncture’s non-pharmacologic nature, amenability to field operations, and utility across a spectrum of conditions from combat injuries to postoperative pain to opioid withdrawal symptoms make it ideally suited for military medical care. Its safety profile is also highly advantageous when treating active duty personnel.

As the opioid crisis continues unabated, safe and effective non-drug therapies for pain management and addiction treatment are urgently needed. The evidence summarized above clearly demonstrates acupuncture’s value as a frontline treatment that can reduce opioid exposure while providing analgesia through neuromodulation of endogenous opioid systems. Its adoption by major healthcare systems like the VA and US military underscores acupuncture’s emerging role in combating the opioid epidemic plaguing the nation.