An old practice is being put to a new use in West Virginia, thanks in part to the West Virginia School of Osteopathic Medicine (WVSOM).
The school is training members of approved health-related professions to use the National Acupuncture Detoxification Association (NADA), or acudetox, protocol, a form of acupuncture in which small needles are placed into specific areas on the exterior of the ear. The technique is being used to help battle the opioid epidemic.
Auricular therapies have existed for thousands of years, based on evidence from ancient Chinese and Egyptian literature. In modern times, clinical trials dating to 1958 have shown the effectiveness of ear acupuncture. The NADA protocol was developed in the 1970s, and currently about 25,000 people have been trained in the technique worldwide, according to the National Acupuncture Detoxification Association.
Deborah Schmidt, D.O., who chairs WVSOM’s Osteopathic Principles and Practice department, is a member of the West Virginia Board of Acupuncture and has used acupuncture in her own medical practice. She said the NADA protocol, when used in conjunction with other addiction treatments, can reduce cravings for drugs and minimize withdrawal symptoms. Schmidt said the procedure also can be used in non-addicted patients to improve sleep, decrease anxiety and ease symptoms of post-traumatic stress disorder, among other health benefits.
Schmidt pointed out that the World Health Organization has reviewed more than 4,000 articles demonstrating that acupuncture can ease symptoms of conditions such as fibromyalgia, carpal tunnel, asthma and nausea resulting from pregnancy or chemotherapy. But she emphasized the NADA protocol’s usefulness in treating people affected by the opioid epidemic.
“Many of West Virginia’s health care providers are completely burned out from treating people with addiction,” she said. “It can be very taxing. But this protocol is inexpensive, portable and easily learned, so providers are excited to have a new option.”
Gov. Jim Justice signed West Virginia House Bill 2324 into law in March 2019, allowing physician assistants, nurses, dentists, psychologists, professional counselors, occupational therapists, social workers, corrections medical providers and emergency medical service providers to be certified as acudetox specialists. To receive certification, the provider must complete a training program, attend a 12-step meeting, needle at least 40 ears under supervision and sign a pledge to use the treatment in an ethical manner.
WVSOM and West Virginia’s two other medical schools received funding in early 2019 through the State Opioid Response Grant to train health care providers in non-pharmacologic methods to aid in the treatment of opioid addiction. WVSOM’s portion of the funds allowed the school to train up to 100 people in the NADA acudetox protocol, and nationally registered trainer and acupuncturist Teal Beatty of Laurel, Md., was brought in to teach three-day courses on the WVSOM campus in Lewisburg.
The school offered its first course in July 2019 and continued with courses in August and September. WVSOM also hosted an “Introduction to NADA for Physicians” lecture and lab on Jan. 25 during the WVSOM Alumni Association’s Mid-Winter Osteopathic Seminar in Charleston, W.Va. Most recently, information on the NADA protocol was presented in a session titled “Non-Opioid Pharmacological Treatment and Other Tools” as part of the school’s 2020 opioid education series for students.
So far, the school has trained 86 people in the protocol, 12 of whom have gone on to complete the state requirements to become certified acudetox specialists.
To help trainees meet the post-training requirements, WVSOM hosted workshops in which volunteers were solicited to receive treatment using the NADA protocol. One workshop took place at the Healing Appalachia concert on Sept. 28 at the State Fair of West Virginia fairgrounds in Fairlea, W.Va., which was created to raise funds to benefit programs aimed at reducing addiction in greater Appalachia. Trainees provided NADA acudetox needling to 189 people at the concert.
The interest in NADA has been so great that WVSOM has a waitlist of providers who have asked to be trained when further opportunities become available. Many of the physicians whose ears were needled in a workshop during WVSOM’s Alumni Weekend in August 2019 expressed interest in receiving training.
One of those physicians is Neal Rehberg, a WVSOM Class of 1994 alumnus who practices emergency medicine in Madison, W.Va. He said ear acupuncture has an effect comparable to that of “tremoring,” a therapeutic technique that uses specific exercises to balance the sympathetic and parasympathetic nervous systems.
“I was surprised at the calming effect it had on me,” Rehberg said. “I’ve seen tremoring have remarkable results with veterans of the Iraq war who have PTSD, and this was similar. I think there are a lot of opportunities for NADA’s use beyond drug addiction. For example, it could be used for people with eating disorders or other addictive behaviors.”
Among those who have completed NADA training through WVSOM are the counselors and learning specialists in the school’s Academic Support and Intervention Resources (ASPIRE) department. ASPIRE employee Ginger Conley, M.A., LPC, said acudetox treatment aligns with the osteopathic medical philosophy that the person is a unit of mind, body and spirit and that the body is capable of self-healing.
“Counseling often deals with what’s going on in the mind and thoughts, but sometimes what’s happening to us emotionally is actually stored in the body,” she said. “Acupuncture is about the idea that people can heal and setting up the conditions that allow the body to do what it needs to do to make that happen.”