Acupuncture for Substance Use Disorders
A Systematic Review and Meta-Analysis
Published in: Drug and Alcohol Dependence, 2016
Posted on RAND.org on March 09, 2016
BACKGROUND: This systematic review aims to estimate the effects of acupuncture for adults with substance use disorders (SUDs). METHODS: We searched 7 electronic databases and bibliographies of previous studies to identify eligible randomized trials. Two independent reviewers screened citations, extracted data, and assessed risks of bias. We performed random effects meta-analyses. We assessed quality of evidence using the GRADE approach. RESULTS: We included 41 studies with 5,227 participants. No significant differences were observed between acupuncture and comparators (passive controls, sham acupuncture, treatment as usual, and active interventions) at post-intervention for relapse (SMD −0.12; 95%CI −0.46 to 0.22; 10 RCTs), frequency of substance use (SMD −0.27; −2.67 to 2.13; 2 RCTs), quantity of substance use (SMD 0.01; −0.40 to 0.43; 3 RCTs), and treatment dropout (OR 0.82; 0.63 to 1.09; 22 RCTs). We identified a significant difference in favor of acupuncture versus comparators for withdrawal/craving at post-intervention (SMD −0.57, −0.93 to −0.20; 20 RCTs), but we identified evidence of publication bias. We also identified a significant difference in favor of acupuncture versus comparators for anxiety at post-intervention (SMD −0.74, −1.15 to −0.33; 6 RCTs). Results for withdrawal/craving and anxiety symptoms were not significant at longer follow-up. Safety data (12 RCTs) suggests little risk of serious adverse events, though participants may experience slight bleeding or pain at needle insertion sites. CONCLUSIONS: Available evidence suggests no consistent differences between acupuncture and comparators for substance use. Results in favor of acupuncture for withdrawal/craving and anxiety symptoms are limited by low quality bodies of evidence.