Drink and Drugs News DDN July 2018 | Page 9

More on treatment options at www.drinkanddrugsnews.com Acupuncture is commonly used as a complementary therapy in the substance use field. But how effective is it, asks Natalie Davies placebos were ultimately a lie. Not coming down so harshly on placebos, the NHS website at one time reminded readers in the context of alternative and complementary therapies that ‘for many health conditions, there are treatments that work better than placebos […and by choosing] a treatment that only provides a placebo effect, [the patient] will miss out on the benefit that a better treatment would provide’. However, it stated ‘improvement in a health condition due to the placebo effect is still improvement, and that is always welcome’. Interestingly, in the last few months these comments appear to have been removed. lthough acupuncture specifically has drawn protestations of ‘sham procedure’ and ‘theatrical placebo’, it has also been able to elicit a certain generosity of hope of the type that may be reserved for interventions of a transcendental nature. Furthermore, as it has fallen between the gaps of alternative and conventional therapies for treating health conditions, whether delivered in a high street clinic or A www.drinkanddrugsnews.com ‘Patients absorbing the cues of the environment and culture may have found themselves yielding to something which at once seems a legitimate medical treatment and an ancient form of healing.’ mainstream healthcare space, patients absorbing the cues of the environment and culture may have found themselves yielding to something which at once seems a legitimate medical treatment and an ancient form of healing. Shu-Ming Wang and colleagues wrote in Anesthesia and Analgesia that ‘Instead of criticizing [the] ancient art [of acupuncture] 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’ 3 . erhaps instead of removing acupuncture from the ambit of science as this comment suggested, it could be incorporated within the ‘common factors’ framework as a vehicle for delivering the essence of an effective psychosocial therapy – a credible procedure which offers an explanation for the patient’s condition and a credible remedy that the patient believes in, delivered in a context which gives it the aura of a bona fide clinical treatment. If there is not so much a ‘lie’ as a false impression at the heart of acupuncture, it may be that it is presented as a physical treatment rather than vehicle for the common factors found in psychosocial therapies. But without that sincerely held conviction, those common factors would be undermined and with them any benefit to be gained. P Natalie Davies is co-editor of Drug and Alcohol Findings http://findings.org.uk/PHP/dl.php?file=acupuncture.hot&s=dd https://doi.org/10.1002/14651858.CD005192.pub2 Gates, S. (2006). Auricular acupuncture for cocaine dependence. The Cochrane Library. 2 https://doi.org/10.1080/15265160903234078 Braillon, A. (2009). Placebo Is Far From Benign: It Is Disease-Mongering. The American Journal of Bioethics. 3 http://w ww.dcscience.net/Wang-acupunc-A&A-2013.pdf Wang, SM. (2013). Acupuncture in 21st Century Anesthesia: Is There a Needle in the Haystack? Anesthesia and Analgesia. 1 July/August 2018 | drinkanddrugsnews | 9