The National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives

Figures & data

Figure 1 NADA protocol points-Sympathetic, Shen Men, Kidney, Liver, and Lung.

Abbreviation: NADA, National Acupuncture Detoxification Association.

Table 1 Overview of studies addressing the NADA protocol for behavioral health 2011–2016

First author/year	Study type	N	Population	Design	Treatment frequency	Outcome measures	Results	Comments
Carter/2011^Citation46	Prospective	167	Addiction in-patients	NADA + UC vs UC alone	NADA 2× per week for 4 weeks 30–45 min	Self-report 7 common BH symptoms, psychological, and physical	Positive, reduction in all symptoms vs UC	Self-selected not randomized
Black/2011^Citation47	RCT	140	Addiction outpatients withdrawing from psychoactive drugs	NADA + UC vs sham + UC vs relaxation + UC	3 NADA sessions; over 2 weeks, 45 min	STAI scale, heart rate, blood pressure pre- and posttests	Negative, reduction for all, no significant difference	All subjects in same room, no UC control, minimal treatment
Janssen/2012^Citation48	RCT	89	Pregnant opiate dependent mothers and NAS in newborn infants	NADA + methadone vs methadone alone	Daily NADA sessions; 45 min	Number of days of treatment of newborn with morphine	Positive, decrease in number of days and NAS symptoms with NADA	Only 28% compliant with the NADA protocol
Chang/2014^Citation49	RCT	67	Homeless veterans addiction program	NADA + UC, RR + UC, UC alone	NADA 2× per week for 10 weeks, 30 min	Cravings, anxiety	Positive, decrease in cravings and anxiety with both	Both equally effective vs UC
Stuyt/2014^Citation50	Outcome	231	Dual diagnoses; 90-day inpatient treatment	NADA + UC vs UC	NADA 4–5× per week for 12 weeks; 45 min	Program completion, tobacco cessation, sobriety	Positive, NADA use correlated with positive outcomes	Self-selected not randomized
Bergdahl/2014^Citation54	Qualitative	15	Addiction outpatients experiencing protracted withdrawal	Experience of NADA treatment during protracted withdrawal	NADA 2× per week for 5 weeks; 40 min	Positive and negative side effects, cravings, withdrawal symptoms	Positive, no major negative symptoms, improved positive symptoms	Very small; qualitative
Reilly/2014^Citation55	Mixed methods	37	Health care providers in inpatient surgical burn/trauma ICU	Effects of NADA on reducing stress/anxiety in health care workers	5 NADA sessions over 16-week period; 25 min	Pretest, posttest surveys, anxiety, burnout, compassion fatigue	Positive, significant improvement state/trait anxiety, burnout, compassion	Pre- and posttest design; self-selected, not randomized
Bergdahl/2016^Citation59	RCT	67	Patients with chronic insomnia >6 months	NADA vs CBT-i	NADA 2× per week for 4 weeks; 45 min	ISI scores pre and posttests and 6 months follow-up	Positive, both resulted in decrease in ISI, but CBT-i was superior to NADA	Would be interesting to see the combination of both treatments
DeLorent/2016^Citation57	Prospective parallel group clinical trial	162	Psychiatric patients with AD or MDD in UC	NADA vs PMR	NADA 2× per week for 4 weeks 30 min	VAS tension, anxiety, mood, anger, aggression	Positive, both showed improvement on all items	No control for UC
Ahlberg/2016^Citation58	RCT	280	Addiction in inpatients and outpatients	NADA + UC vs LP + UC vs relaxation + UC	NADA 15× over 5 weeks; LP 10× over 4 weeks, same ear points	BAI and ISI pre and posttests and 3-month follow-up	Negative, no difference between NADA, LP, or relaxation control	No control for UC, high attrition, design concerns

Abbreviations: NADA, National Acupuncture Detoxification Association; RCT, randomized-controlled trial; BH, behavioral health; STAI, Spielberger State–Trait Anxiety Inventory; UC, usual care; NAS, neonatal abstinence syndrome; ICU, intensive care unit; RR, relaxation response; AD, anxiety disorders; MDD, major depressive disorders; CBT-i, cognitive behavioral therapy-insomnia; ISI, Insomnia Severity Index; PMR, progressive muscle relaxation; VAS, visual analog scale; LP, local protocol; BAI, Beck Anxiety Inventory.

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