Auricular Detoxification-Acupuncture

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The NADA approach see : NADA South Africa

What is Auriculotherapy?

Auriculotherapy is the stimulation of the auricle of the external ear for the diagnosis and treatment of health conditions in other parts of the body. It is also known as ear acupuncture or auricular acupuncture when the stimulation is achieved by the insertion of acupuncture needles, whereas the term auriculotherapy often refers to electrical stimulation of the surface of ear reflex points. Specific points on the ear can also be stimulated by manual pressure, referred to as auricular acupressure or ear reflexology. Acupuncture points on the ear can also be stimulated with lasers, magnets, and ear pellets.

How is Auriculotherapy different from Acupuncture?

Auriculotherapy is typically considered one form of acupuncture, but there are both differences and similarities between the two procedures. Acupuncture is a form of medical treatment involving the stimulation of acupuncture points located on electrical channels extending over the surface of the body, which are known as meridians. From the philosophy of Taoism, there are six Yang meridians and six Yin meridians. In classical acupuncture, it is the Yang meridians that directly connect to the external ear. These energy lines of force are blocked or congested when there is some pathology in a specific area of the body. Insertion of acupuncture needles into specific acupoints can relieve the symptoms and underlying pathology of a particular health problem. Some of the meridian energy lines of force connect to the external ear, thus creating the field of auricular acupuncture. Different perspectives of auriculotherapy focus not on the acupuncture meridians but on the use of the ear as a localized reflex system connected to the central nervous system.

What is the History of Auriculotherapy?

The earliest written records of ear acupuncture date back to the Yellow Emperor's Classic of Internal Medicine, a compilation of acupuncture procedures that were in practice in 500 BC. Within this extensive text that covers a variety of acupuncture treatments, there is mention of specific acupuncture points on the external ear for the relief of certain medical disorders. However, the manner in which auricular acupuncture is practiced today in China is actually based upon more recent discoveries that occurred in France in the 1950's. The Traditional Oriental Medicine practiced in ancient China included just a scattered array of acupoints on the auricle for just a few health problems, whereas the current practice of auricular acupuncture shows a more complete organization of ear reflex points that can be used to relieve many health problems. In the West, the earliest references to ear treatments were referred to in medical records from ancient Egypt, Greece, and Rome. The most complete descriptions of medical treatments through the ear were recorded in ancient Persia. A trail of evidence of the use of auricular stimulation for the treatment of sciatica back pain can be followed from these Persian records through medieval Europe to modern France. Since the 1950's, the use of specific ear points as a complete reflex system that can alleviate many health problems has been utilized by clinical practitioners in other parts of Europe, in Asia, and in North and South America.

Who discovered Auriculotherapy?

While the earliest uses of ear acupuncture points dates back to ancient China, modern applications of auriculotherapy are based on the work of Dr. Paul Nogier of Lyon, France. In the 1950's, Dr. Nogier noticed a strange scar on the upper ear of some of his patients. He found that all of them had been treated for sciatica pain by a local lay practitioner. This woman had cauterized a specific area of the external ear in order to relieve their low back pain. Dr. Nogier conducted a similar procedure on his own sciatica patients and found that their back pain was also reduced. He then tried other means of stimulating this "sciatica point," including the use of acupuncture needles, and found that they too were effective in alleviating sciatica pain. The brilliance of Dr. Nogier was in extending this one observation into a more comprehensive model. Dr. Nogier theorized that if an area of the upper external ear is effective in treating low back pain, maybe other parts of the ear could treat other parts of the body. The ear is said to represent the whole anatomical body, but in an upside down orientation. Nogier's theory contended that the auricle could be compared to an inverted foetus, with the head represented on the lower ear lobe, the feet at the top of the external ear, and the rest of the body in-between. This model was first presented to naturopathic practitioners in France in 1957, then spread to acupuncturists in Germany, and finally was translated into Chinese. The Chinese seemed to have adopted the inverted foetus model of ear acupuncture in 1958.

How is Auriculotherapy related to other forms of Alternative Medicine?

Auriculotherapy is considered one form of alternative medicine, which also includes acupuncture, chiropractic manipulation, homeopathy, and biofeedback. All of these techniques are also referred to as Complementary Medicine, in that they are not only an alternative to conventional Western medical treatments, they can serve as an additional procedure which complement the practice conventional medicine. Auriculotherapy can reduce the tension, stress, and pain not fully relieved by other medical procedures, but works best when implemented as part of a multidisciplinary complement of multiple treatment approaches. While ear acupuncture is often used in conjunction with body acupuncture, auriculotherapy can also effectively relieve pain, stress and tension when used by itself.

Is Auriculotherapy accepted by Conventional Western Medicine?

While ear acupuncture has been practiced in Asia for over 2,000 years and auriculotherapy has been used in continental Europe for the past 40 years, it is only recently been considered by most medical doctors in the United States. Most MD's do not have sufficient information about auriculotherapy to make an informed comment on its effectiveness. In November of 1997, a consensus panel of the U.S National Institutes of Health gave conditional approval of the practice of acupuncture. They included an evaluation of those studies which supported the use of ear acupuncture for pain relief and addiction treatment. As more research accumulates on the efficacy of auriculotherapy, it is expected that even more physicians will acknowledge the benefits of auriculotherapy.

What is the role of Endorphins in Auriculotherapy?

The endorphins, endogenous morphine molecules that relieve pain in a manner similar to external opiate chemicals, have been used as one explanation for how auriculotherapy serves to relieve pain. Both animal research and human studies have shown that stimulation of ear acupuncture points appears to cause the systemic release of endorphins. Administration of the opiate antagonist naloxone partially blocks the analgesia produced by either auriculotherapy or by acupuncture.

Patient Concerns

What type of health care practitioners provide auriculotherapy?

Auriculotherapy is conducted by a variety of practitioners, including acupuncturists, biofeeback therapists, chiropractic doctors, dentists, medical doctors, naturopathic doctors, nurses, osteopathic doctors, physical therapists, psychotherapists, and reflexology therapists.

What health conditions are most helped by auriculotherapy?

Because every part of the external ear connects through the microsystem remote reflexes to every part of the body, a wide variety of health problems are relieved by auriculotherapy. Almost all health conditions can be affected to some degree by stimulating reactive ear points. The most commonly reported uses of auriculotherapy have been for the control of chronic pain, detoxification from addictive drugs, relief of nausea, and reduction of hypertension.

How does auriculotherapy affect drug abuse?

As with pain control, explanations for the effectiveness of auriculotherapy in facilitating the reduction of drug abuse derive from both a Western neurological conceptualization and a Traditional Oriental Medicine perspective. The first evidence of the power of auriculotherapy in reducing the substance cravings of drug addicts came from H.L. Wen of Hong Kong in the 1970's, and were expanded upon by Dr. Michel Smith, a physician who practices Oriental Medicine in New York City at Lincoln Memorial Hospital Recovery Centre. The Lung point on the ear used to relieve addiction disorders is said to affect the energy of the Lung meridian, which affects not only respiratory disorders but problems with detoxification. A Western neurological explanation of drug detoxification with auriculotherapy is based on the observation that the concha area of the ear which is used to treat addiction problems represents the control of the autonomic nervous system through the vagus nerve and through the hypothalamus of the brain.

Whilst studying at Lincoln, I was amazed to discover the effectiveness of acupuncture as a means of detox but also as a means of assisting recovery. In the first year of inception, of the 1613 crack addicts that were diverted to the programme, only 16 were rearrested! In Chinese medicine, the lung, liver and kidneys play a vital role in the stability of brain chemistry. When the organs are toxic, the brain chemistry becomes unstable. The western medicine approach to depression or psychosis is to prescribe drugs which influence and stabilize the chemistry of the brain. Whilst this may be essential in some cases, the drugs are again toxins which toxify the organs causing unstable brain chemistry and dependence. Acupuncture removes the toxins very quickly resulting in an emotionally stable, rational thinking patient. As the chemicals which are used to balance emotions and logic are stabilized, the patient is able to embark on a process of thought modification, through a recovery programme and experience behavioural change much faster. The method was introduced to Metro Dade County Prison Florida and within 4 months, the prison experienced a 60% reduction in violent crime. The prisoners were thinking more clearly and had become emotionally stable. In my opinion, incorporating the NADA 5 point acupuncture protocol into a recognized recovery programme, will ensure a far greater success rate for the centre and the patients.

 

How are other conditions relieved by auriculotherapy?

By facilitating a balancing of energy throughout the body macro systems or by correcting pathological reflex centres in the brain, stimulation of the auricular acupuncture micro system can lead to a homeostatic state whereby any form of stress or pain is lessened. Stimulation of the specific ear reflex points that correspond to a particular area of the body leads to either a reduction of excess stimulation or an enhancement of diminished under activity of the affected region. The overall effect of auriculotherapy is to create a more balanced condition throughout the body.

Can one do these treatments on one's self?

While the insertion of acupuncture needles into any part of the body requires approved training in acupuncture or medicine and the electrical stimulation or laser stimulation requires a comparable health care license, anyone can learn ear reflexology. By placing firm but gentle pressure on the relevant tender regions of the ear, one can achieve relief of discomfort in specific parts of the body.

Practitioner Concerns

How difficult is it to learn auriculotherapy treatment procedures?

Because of the simplicity of learning the inverted foetus somatotopic pattern on the ear, basic mastery of auriculotherapy skills can be achieved in just a few training sessions. The Auriculotherapy Manual by Dr. Terry Oleson provides a detailed description of over 250 ear reflex points and presents specific treatment plans for over 200 health conditions in a manner that is both comprehensive yet easy to understand. The International Handbook of Ear Reflex Points describes these same ear points in nine different languages in order to assist international communication regarding the location of these points.

How long do the benefits of auriculotherapy last?

The range of responses to an auriculotherapy session are quite varied, but it is common that a patient suffering from severe pain will notice mild to marked reduction of their complaint on the very first session. This reduction in their pain experience can actually improve for the next several hours after treatment, but the benefits often begin to subside several days after the first treatment. With each successive treatment, the degree of pain relief usually becomes more and more prominent and the duration of pain relief progressively extends from several days to several weeks. With smoking cessation and drug detoxification, the benefits of auriculotherapy can last several weeks after just one or two auricular treatments.

How many treatment sessions are needed to help patients?

There is no set number of treatments for any health condition treated by auriculotherapy, but it is common that the severity of most conditions are moderately reduced by four to six sessions and greatly alleviated by eight to twelve sessions. In the case of addiction to illegal drugs, up to 3 times daily for withdrawal for 5-7 days followed by daily treatments for one month. Thereafter every 3 days for a month and one per week for another month.

How many times per week are treatments provided?

The number of treatment sessions per week depends upon the schedule of the patients, as well as the severity of their health condition. When possible, severe conditions can be treated on a daily basis, but many patients are not available to come in that often. Typically, patients are given two treatments per week for two to three weeks, then once a week for several more weeks. The frequency of sessions progressively decreases to once a month as the medical disorder becomes less pronounced.

How long is a typical treatment session?

While the first auriculotherapy session requires greater time for an intake evaluation and patient history, a typical auriculotherapy treatment lasts 30 to 45 minutes. With auricular acupuncture, five acupuncture needles are inserted and left in place for approximately 45 minutes.

What are ear seeds or ear pellets?

Small adhesive band-aids are often used to hold a small grain or a small metal ball onto a specific area of the ear to allow for maintained pressure at that ear reflex point. These have been found to stabilise hyperactive children or children with ADD / ADHD. Whilst the acupunture can be used to detox the child from all the medication that they are on, the ear pellets keep them stable and focused. I have experienced a 95% success rate in children whom I have treated for ADD within a one month period using the combination of acupuncture and gold magnetic beads.

What are the contraindications for auriculotherapy?

As with other forms of acupuncture, there are few contraindications for the use of auriculotherapy. It is important not to treat any pain needed to diagnose an underlying problem, not to treat any pain needed to limit range of movement of an injured area of the body, not to treat women who are pregnant, and not to electrically stimulate the ear points of patients with a cardiac pace maker.

What are the side effects that occur from auriculotherapy?

Because tenderness of ear points is one of the primary diagnostic features of auriculotherapy, soreness on the ear points stimulated can sometimes continue for up to an hour after the treatment. Light headedness owing to the release of endorphins as well as headaches and joint pains the day following a drug or detox session.

The NADA Protocol for addiction treatment

In the mid-1970s, Michael Smith, a medical doctor at Lincoln Hospital in the South Bronx area of New York, modified an existing system of auricular acupuncture into a simple technique for the treatment of many common drug addictions as an alternative to methadone. This selection of ear points proved to be extremely effective in the treatment of addictions, and became what is now referred to as the “NADA protocol.”

NADA - which is Spanish for “nothing” - is also the acronym for the National Acupuncture Detoxification Association. NADA was founded in 1985 by Dr. Smith and others who were interested in promoting the integration of the protocol in the treatment of addiction.

 

The original NADA protocol consisted of electrical stimulation on the Lung point of a patient’s ear. It was soon discovered, however, that manual needling of the same point produced a more prolonged effect than that produced by electric stimulation. Gradually, the protocol was expanded by adding Shen Men, a well-known ear point that produces a sensation of relaxation. Over the next few years, other points were added based on pain resistance, sensitivity, and other clinical factors. The NADA protocol as it exists today consists of the insertion of small, stainless-steel, disposable acupuncture needles into five points on the outer surface of a person’s ear. The points used in the NADA protocol are Sympathetic, Shen Men, Kidney, Liver, and Lung.

 

In a typical session, both ears of the patient are needled at the same time, usually for between 30 minutes and 45 minutes. Unlike many forms of acupuncture, the NADA protocol is delivered in a group setting. This is done to help build support among those being treated, and to break down factors of isolation.

 

In most cases, patients are cared for in a quiet, comfortable room, which gives them ample space to relax. All patients are treated equally, using the same protocol, which allows patients to overcome feelings of denial, and allows a practitioner to treat many patients at the same time. Depending on the location offering care, patients are often allowed to remove the needles themselves when the treatment session is over.

 

Addicts treated with the NADA protocol often report an improved sense of well-being. Clients often state that they feel “energized,” “lighter” and “more relaxed” after undergoing a session. Some practitioners assert that the insertion of the needles also provides a non-verbal tool, which allows patients to sit in a safe, supportive environment, and helps them prepare for the next step in the detoxification process.

 

Dozens of studies have documented the effectiveness of the NADA protocol. Among the benefits reported by patients and health care providers are: improved retention in drug treatment programs; more optimistic attitudes about detoxification and recovery; reductions in cravings and anxiety; fewer episodes of sleep disturbance; and reduced need for pharmaceuticals.

 

While the NADA protocol is an important component of any detoxification program, it is by no means the only component. A patient’s behaviour and attitude, along with the perceptions of the clinician delivering care, are also integral to successful treatment. The NADA protocol is often used with other treatment modalities, such as counselling, support groups and self-help programs, to increase the overall effectiveness of care.

 

 

Auriculotherapy utilizes the principles of both Chinese medicine and Western chemical dependency therapies to bring significant benefit to persons in the process of recovery from all forms of drug addiction as well as alcoholism and a variety of mental disorders. The NADA protocol, a simplified “auricular” (ear-point) needling technique derived from acupuncture, and especially designed for this type of treatment, has been carefully developed and extensively tested.

 

"Nada," in Spanish, means "nothing." It signifies an abstinence-oriented, pharmaceutical-free no-nonsense approach. However, the NADA method can be used in conjunction with almost any existing type of addiction therapy, including 12 Step, therapeutic community, cognitive-behavioural, drug court, opiate-replacement, inpatient and outpatient. It is inexpensive and popular in most cultural circumstances.

In the RSA, the term “acupuncturist” ordinarily refers to a person who has completed advanced, often graduate-level, education in the general practice of Oriental medicine and who is prepared as a professional to diagnose and treat a wide variety of health conditions according to the principles of that teaching. Such a person may also be licensed, or certified or registered by a government agency that regulates health care and/or be granted professional recognition by a non-governmental credentialing organization such as the National Certification Commission on Acupuncture and Oriental Medicine (NCCAOM).

 

Many of the health professionals who have received NADA training are acupuncturists, but NADA training

alone would not be considered as qualification for that designation.

 

 

What is the “NADA Protocol”

At five designated earpoints in each auricle (outer ear), NADA-trained clinicians apply fine gauge, sterilized, one-time use stainless steel needles just under the skin, where they remain for up to an hour while the patient (in most circumstances) relaxes quietly in a comfortable chair. Ordinarily, groups of patients sit together while undergoing the treatment. The procedure functions as an adjunct to a comprehensive addiction treatment program offering the basic therapeutic elements of counselling, education, family involvement, mutual support group involvement, supportive health care of a general nature. Patients in all types of treatment settings including inpatient, outpatient, incarcerated, shelters, harm reduction and street outreach can utilize this treatment. Among the benefits reported by patients and clinicians are improved program retention, a more optimistic and cooperative attitude toward the process of recovery, as well as reductions in cravings, anxiety, sleep disturbance and need for pharmaceuticals.

Beyond the actual needling treatment, a key element of the protocol specifies qualities of behaviour and attitude on the part of the clinician, consistent with what is known as the Spirit of NADA.

 

 

What is the spirit of NADA?

Since the NADA Protocol works by mobilizing the existing internal resources of the patient, every aspect of a clinician’s interaction with persons in need is to help them help themselves. Opening access to the treatment itself comes first. This occurs through eliminating unnecessary bureaucratic, socio-economic and environmental barriers to starting a program of recovery. The next task is to create a zone of peace within which patients can begin to experience their own inner strengths. Finally, and in respect to the other aspects, keep it simple.

 

What is the evidence base for NADA?

A wide variety of controlled clinical trials, outcome summaries and anecdotal reports about the use of acupuncture in addiction treatment have been appearing since the 1970s in journals specializing in addictions, mental health, public health, criminal justice and acupuncture. These reports differed vastly in terms of methodology, populations studied, statistical sophistication and clinical relevance as well as in their findings about the value of acupuncture. A sub-category of this published work has focused specifically on the NADA protocol. Within this sub-category is found strong evidence for the effect of the NADA protocol in improving patient outcomes in terms of program retention, reductions in cravings, anxiety, sleep disturbance and need for pharmaceuticals. Regular updates on ongoing publications and reports about relevant clinical outcomes are found in Guidepoints. Many of the basic items in the literature of the field appear in the list of NADA reference materials. A bibliography of relevant publications is available from NADA.


 

 

Clinics, Drug Rehabs etc.

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