1. Effect of Acupuncture for Methadone Reduction: A Randomized Clinical Trial.
- Author
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Lu, Liming, Chen, Chen, Chen, Yiming, Dong, Yu, Chen, Rouhao, Wei, Xiaojing, Tao, Chenyang, Li, Cui, Wang, Yuting, Fan, Baochao, Tang, Xiaorong, Xu, Shichao, He, Zhiqiu, Mo, Guodong, Liu, Yiliang, Gu, Hong, Li, Xiang, Cao, Fang, Xu, Hongxia, and Zhang, Yuqing
- Subjects
OPIOID abuse ,METHADONE treatment programs ,SUBSTANCE abuse ,CLINICAL trials ,PATIENT compliance ,DRUG withdrawal symptoms - Abstract
Methadone maintenance treatment is effective for managing opioid use disorder, but it can have many adverse effects that result in dose reduction. Patients often report persistent withdrawal symptoms after the dose reduction, which can decrease their adherence to treatment and increase the risk for relapse. Acupuncture has been recognized as an appropriate nonpharmacologic treatment for substance dependence. This multicenter, randomized, sham-controlled trial assessed the efficacy of acupuncture versus sham acupuncture on methadone dose reduction. Visual Abstract. Effect of Acupuncture for Methadone Reduction: Methadone maintenance treatment is effective for managing opioid use disorder, but it can have many adverse effects that result in dose reduction. Patients often report persistent withdrawal symptoms after the dose reduction, which can decrease their adherence to treatment and increase the risk for relapse. Acupuncture has been recognized as an appropriate nonpharmacologic treatment for substance dependence. This multicenter, randomized, sham-controlled trial assessed the efficacy of acupuncture versus sham acupuncture on methadone dose reduction. Background: Methadone maintenance treatment (MMT) is effective for managing opioid use disorder, but adverse effects mean that optimal therapy occurs with the lowest dose that controls opioid craving. Objective: To assess the efficacy of acupuncture versus sham acupuncture on methadone dose reduction. Design: Multicenter, 2-group, randomized, sham-controlled trial. (Chinese Clinical Trial Registry: ChiCTR2200058123) Setting: 6 MMT clinics in China. Participants: Adults aged 65 years or younger with opioid use disorder who attended clinic daily and had been using MMT for at least 6 weeks. Intervention: Acupuncture or sham acupuncture 3 times a week for 8 weeks. Measurements: The 2 primary outcomes were the proportion of participants who achieved a reduction in methadone dose of 20% or more compared with baseline and opioid craving, which was measured by the change from baseline on a 100-mm visual analogue scale (VAS). Results: Of 118 eligible participants, 60 were randomly assigned to acupuncture and 58 were randomly assigned to sham acupuncture (2 did not receive acupuncture). At week 8, more patients reduced their methadone dose 20% or more with acupuncture than with sham acupuncture (37 [62%] vs. 16 [29%]; risk difference, 32% [97.5% CI, 13% to 52%]; P < 0.001). In addition, acupuncture was more effective in decreasing opioid craving than sham acupuncture with a mean difference of −11.7 mm VAS (CI, −18.7 to −4.8 mm; P < 0.001). No serious adverse events occurred. There were no notable differences between study groups when participants were asked which type of acupuncture they received. Limitation: Fixed acupuncture protocol limited personalization and only 12 weeks of follow-up after stopping acupuncture. Conclusion: Eight weeks of acupuncture were superior to sham acupuncture in reducing methadone dose and decreasing opioid craving. Primary Funding Source: National Natural Science Foundation of China. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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