title: Acupuncture as an intervention to reduce alcohol dependency: a systematic review and meta-analysis.
abstract: BACKGROUND
  Acupuncture has been widely used as a treatment for alcohol dependence. An updated and rigorously conducted systematic review is needed to establish the extent and quality of the evidence on the effectiveness of acupuncture as an intervention for reducing alcohol dependence. This review aimed to ascertain the effectiveness of acupuncture for reducing alcohol dependence as assessed by changes in either craving or withdrawal symptoms.
  
  
  METHODS
  In this systematic review, a search strategy was designed to identify randomised controlled trials (RCTs) published in either the English or Chinese literature, with a priori eligibility criteria. The following English language databases were searched from inception until June 2015: AMED, Cochrane Library, EMBASE, MEDLINE, PsycINFO, and PubMed; and the following Chinese language databases were similarly searched: CNKI, Sino-med, VIP, and WanFang. Methodological quality of identified RCTs was assessed using the Jadad Scale and the Cochrane Risk of Bias tool.
  
  
  RESULTS
  Fifteen RCTs were included in this review, comprising 1378 participants. The majority of the RCTs were rated as having poor methodological rigour. A statistically significant effect was found in the two primary analyses: acupuncture reduced alcohol craving compared with all controls (SMD = -1.24, 95% CI = -1.96 to -0.51); and acupuncture reduced alcohol withdrawal symptoms compared with all controls (SMD = -0.50, 95% CI = -0.83 to -0.17). In secondary analyses: acupuncture reduced craving compared with sham acupuncture (SMD = -1.00, 95% CI = -1.79 to -0.21); acupuncture reduced craving compared with controls in RCTs conducted in Western countries (SMD = -1.15, 95% CI = -2.12 to -0.18); and acupuncture reduced craving compared with controls in RCTs with only male participants (SMD = -1.68, 95% CI = -2.62 to -0.75).
  
  
  CONCLUSIONS
  This study showed that acupuncture was potentially effective in reducing alcohol craving and withdrawal symptoms and could be considered as an additional treatment choice and/or referral option within national healthcare systems.
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Southern
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Charlie
authors.initials: C
authors.lastname: Lloyd
authors.affiliation: Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Liu
authors.affiliation: Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
authors.forename: Congcong
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Tingting
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Bland
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Hugh
authors.identifier: 0000-0003-4255-4768
authors.initials: H
authors.lastname: MacPherson