Once, at an acupuncture conference, someone asked about my practice. When I answered his question he said, "Oh you do that easy acupuncture." Easy compared to what, I thought, but it wasn't the first time a private practice acupuncturist had taken a disparaging tone due to their perception of the ease of detox/recovery acupuncture.Of course, I knew what he meant. "Easy" was in reference to the repetitious nature of the NADA protocol: insertion into the same few points. From a purely uninformed point of view it does seem easy; limited diagnostic criteria leading to a few needles in the same points over and over. So easy that in many states, non-acupuncturists can do treatments under the supervision of a licensed acupuncturist.
The "purely uninformed" part of the above statement refers to all that happens before and after the insertion of needles into the same few points; of the struggle, not with all but with many, to get them to try that first treatment. Then the ongoing effort to keep them coming back.
The chemically dependent have short memories when they are lost in their addiction. Case in point; the multitude of times I have heard "Wow, that feels great. I will be back every day." Some do just that, but others don't come with any regularity without constant reminding, cajoling and on occasion, a little good natured "tough love." The pull of the need to obliterate psychic, emotional, spiritual, mental, or even physical pain with any number of substances becomes too strong. There is a word for this process: Recalcitrant. The dictionary defines this as: "obstinately defiant; difficult to manage; not responsive to treatment; resistant." While this word is accurate, it also can be judgmental in light of the obstacles many clients have to overcome.
The judgmental aspect of the word is that it implies choice. Even though it is true the choice to get clean has to be made by the client, the parameters around the choice can be overwhelming, not the least of which is the uninformed attitudes of the larger society towards addiction. Many still see it as simply a moral failure. Or, the fact that those same childhood traumas - psychic, emotional, spiritual and mental - have to be revisited to be cleansed. And we all want to avoid pain.
If you have read any of my other articles, you know that obstacles can include: poverty, lack of educational opportunities, few chances to pull themselves out of the ghetto and a culture of addiction. There are even simple transportation issues such as having to take two, sometimes even three, buses with their children just to get to the program.
However, I think the biggest obstacle to change for the chemically dependent population cuts across socio-economic levels. I have never worked in a clinic funded at a "Betty Ford" level, and I don't know any acupuncturists who have (if you are such a person, I would like to hear from you; my e-mail is at the end of the article). Certainly, the poverty and other issues would not be an immediate problem in a "Betty Ford" setting.
From a Medline search and my own searching on the Internet, it appears that upward of 70 percent of the chemically dependent population suffers from childhood abuse: physical, sexual or emotional, and sometimes all three. Only one study included physical neglect and witnessing violence as forms of childhood trauma. Here is a breakdown of that study:113 adult opioid-addicted subjects reported: 20.4 percent sexual abuse; 39.8 percent physical abuse; 60.2 percent emotional abuse; 23 percent physical neglect; 65.5 percent witnessed violence; 19.5 percent denied any trauma; 60.2 percent reported one to three forms of trauma; 13.3 percent reported four forms and 7.1 percent reported all five.1
Most studies, if they gave numbers of clients who experienced abuse or trauma were in the 50 percent to 70 percent range. Researchers lamented the lack of studies and the even more rare studies that included men. Almost all studies were done with clients of public programs, since it appears private programs were not willing to ask clients to participate in such studies. Unofficially, anecdotally, I would say that the program I work in averages in the 50 percent to 70 percent range of clients who have been abused or neglected.
So yes, it is "easy acupuncture"; just a few needles in the same points. But that, if you are lucky, is a beginning of long-term treatment. Those few needles in the same points is the easy part.
I decided to end this column with a poem because it seemed fitting. I should note that I fall into the other 30 percent to 50 percent with other motivations and other pains to obliterate. I was never molested or abused as a child.
Green Tea Detox
"But, I don't know anyone like that," she says.
Smiling deeply into her eyes, I say, "You know me."
But she still doesn't believe:
needing to be removed from the people she serves;
needing an accomplice to her invention of superiority.
"But you were never like them," she says with a gasp.
The meaning clear: she holds herself separate
from the people she treats and I, another acupuncturist,
must be like her,
"Addiction is subject to degrees," I say.
We all have a void.
We all crave redemption.
We all need.
"But, you didn't steal and lie and..."
She is unable to say more.
Looking deeply into her eyes,
I employ a visceral knowledge:
"Can you stop drinking tea?"
"But tea is good for you," she murmurs.
Nodding in agreement,
I turn to put needles in the ears of
The seekers of perfection never found.
Those attempting redemption.
Those who need and know they need.
- Sansone RA, Whitecar P, Wiederman MW. The prevalence of childhood trauma among those seeking buprenorphine treatment. J Addict Dis 2009;28(1):64-7.
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