title: Auricular acupuncture for substance use: a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services.
abstract: A common alternative treatment for substance abuse is auricular acupuncture. The aim of the study was to evaluate the short and long-term effect of auricular acupuncture on anxiety, sleep, drug use and addiction treatment utilization in adults with substance abuse.
  
  
  
  Of the patients included, 280 adults with substance abuse and psychiatric comorbidity, 80 were randomly assigned to auricular acupuncture according to the NADA protocol, 80 to auricular acupuncture according to a local protocol (LP), and 120 to relaxation (controls). The primary outcomes anxiety (Beck Anxiety Inventory; BAI) and insomnia (Insomnia Severity Index; ISI) were measured at baseline and at follow-ups 5 weeks and 3 months after the baseline assessment. Secondary outcomes were drug use and addiction service utilization. Complete datasets regarding BAI/ISI were obtained from 37/34 subjects in the NADA group, 28/28 in the LP group and 36/35 controls. Data were analyzed using Chi-square, Analysis of Variance, Kruskal Wallis, Repeated Measures Analysis of Variance, Eta square (η(2)), and Wilcoxon Signed Ranks tests.
  
  
  
  Participants in NADA, LP and control group improved significantly on the ISI and BAI. There was no significant difference in change over time between the three groups in any of the primary (effect size: BAI, η(2) = 0.03, ISI, η(2) = 0.05) or secondary outcomes. Neither of the two acupuncture treatments resulted in differences in sleep, anxiety or drug use from the control group at 5 weeks or 3 months.
  
  
  
  No evidence was found that acupuncture as delivered in this study is more effective than relaxation for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders. The substantial attrition at follow-up is a main limitation of the study.
  
  
  
  Clinical Trials NCT02604706 (retrospectively registered).
authors.affiliation: Faculty of Medicine and Health, University Health Care Research Center, Örebro University, P.O. Box 1613, SE-701 16, Örebro, Sweden.
authors.forename: Rickard
authors.initials: R
authors.lastname: Ahlberg
authors.affiliation: Addiction Center, Faculty of Medicine and Health, Örebro University, P.O. Box 1613, SE-701 16, Örebro, Sweden.
authors.forename: Kurt
authors.initials: K
authors.lastname: Skårberg
authors.affiliation: Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, P.O. Box 1613, SE-701 16, Örebro, Sweden.
authors.forename: Ole
authors.initials: O
authors.lastname: Brus
authors.affiliation: Faculty of Medicine and Health, University Health Care Research Center, Örebro University, P.O. Box 1613, SE-701 16, Örebro, Sweden. lars.kjellin@regionorebrolan.se.
authors.forename: Lars
authors.identifier: 0000-0002-4565-8864
authors.initials: L
authors.lastname: Kjellin
mesh_terms: D020831:Acupuncture, Ear; D000328:Adult; D001007:Anxiety / Q000150:complications / Q000628:therapy*; D016739:Behavior, Addictive / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000628:therapy*; D019966:Substance-Related Disorders / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Auricular acupuncture; Psychiatric comorbidity; Randomized controlled trial; Relaxation; Substance abuse treatment