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Acupuncture's Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management–White Paper 2017

Authors:
Arthur Yin Fan
Arthur Yin Fan
David Warren Miller at University Hospitals
David Warren Miller
Bonnie Bolash at Bonnie M. Abel Bolash, M.Ac., L.AC.
Bonnie Bolash
  • Bonnie M. Abel Bolash, M.Ac., L.AC.
Matthew Bauer
Matthew Bauer
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Abstract

The United States (U.S.) is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public's opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture's cost-effectiveness can dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding addiction to opioids that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of commonly seen pain conditions. Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military, in some studies demonstrably decreasing the volume of opioids prescribed when included in care.
Fan AY, Miller DW. Acupuncture’s Role in Solving the Opioid Epidemic, White Paper 20
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Fan AY, Miller DW. Acupuncture’s Role in Solving the Opioid Epidemic, White Paper 20
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... The outcomes of EA are contingent upon the frequency used, with different frequencies triggering the release of distinct endorphins [6]. Nevertheless, recurrent high-intensity EA could progressively diminish its analgesic effects [4][5][6][7]. Recent rat studies have indicated that repeated high-intensity sessions might lead to analgesic tolerance to EA [8,9]. ...
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Full-text available
  • Jan 2024
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... 14 Acupuncture has been recommended as a safe and effective therapy that can be incorporated in ED to treat acute pain. 15 Early-intervention acupuncture may provide timely effective analgesia for patients, and allow physicians to apply without the worry of risks. To date, there are no existing study about early-intervention acupuncture for analgesia on patients with suspected ARCUC. ...
Effect of Early-Intervention Acupuncture on Pain Relief Among Emergency Department Patients with Suspected Acute Renal Colic Due to Urinary Calculi: Study Protocol for a Randomized Clinical Trial
Article
Full-text available
  • Nov 2024
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Bilateral Sanyinjiao acupuncture reduces the dose of intravenous remifentanil in labor analgesia
Article
Full-text available
This study aims to evaluate the effects of intravenous analgesia using remifentanil combined with Sanyinjiao acupuncture in childbirth. A total of 150 women who delivered their babies naturally were selected. Among these, 100 women willing to undergo labor analgesia and were full-term and with single child, cephalic presentation, and without pregnancy complications were randomly divided into an intravenous injection group (IV) and a combined injection group (CI), while the remainder comprised the control group (C). After the patients entered the active phase of labor, remifentanil was intravenously infused. Patients in group CI were injected with 2 ml of 1% lidocaine into the bilateral Sanyinjiao acupoint. After analgesia began, pain score, mean arterial pressure, and heart rate in group IV and group CI were significantly lower than in group C (p < 0.05). The dose of remifentanil was significantly lower in group CI than in group IV (p < 0.05); however, there was no significant difference in the duration of labor and neonatal score among the three groups (p > 0.05). Neither excessive sedation nor respiratory depression occurred. Sanyinjiao acupoint injection combined with intravenous infusion of remifentanil reduced the amount of opioids and the risk for serious adverse reactions.
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RAVA® – Die Entwicklung der Ohrakupunktur seit den 1950er-Jahren bis heuteRAVA®—The development of ear acupuncture from the 1950s
Article
  • Mar 2025
Based on Dr. Nogier’s ear cartography from the 1950s, the practice of ear acupuncture (auriculotherapy) follows various protocols. National Acupuncture Detoxification Association (NADA), Battlefield Acupuncture (BFA), and balanced ear acupuncture according to Seeber® have become more and more common in the United States and in Germany. After more than 10 years of clinical use of and experience with the existing protocols at the Department of Complementary and Integrative Medicine, Evang. Kliniken Essen-Mitte, Germany, we developed a new method called RAVA® – Regulative and Vitalizing (Ear) Acupuncture. RAVA consists of three base points to regulate the triple heater (3E) and two individual ear acupuncture points. RAVA therefore combines the causal treatment of the triple heater (i.e., to affect the Qi flow and organ function) and a symptomatic approach, which can be individualized and adapted to the patient needs.
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Pharmacotherapeutic follow-up of opioid treated chronic pain patients within the Brazilian Unified Health System
Article
Full-text available
  • Feb 2025
Chronic pain remains challenging, as complete pain control is poorly achieved with pharmacological and non-pharmacological intervention. Opioid analgesics are prescribed to minimize chronic pain; however, in addition to little evidence of long-term effectiveness, critical adverse effects such as dependence, tolerance, respiratory depression and others may arise. This study involved the pharmacotherapeutic monitoring of 31 patients undergoing chronic pain treatment with opioids during the COVID-19 pandemic period. Three monthly pharmaceutical consultations were held for three months for medication review and guidance on their rational and safe use. Patients aged 41-60 years, treated chronic pain due to trauma or rheumatic diseases and presented a medium time of opioid treatment of approximately eight years, and 80,4% also used other analgesics. However, only 19,3% achieved complete pain relief. The most frequent comorbidities were depression (44,0%), systemic arterial hypertension (36,0%), insomnia (32,0%) and the main adverse effects included drowsiness (61,3%), concentration impairment (48,3%), nausea (45,1%), abdominal pain (48,3%) and constipation (41,9%). Pharmacotherapeutic monitoring increased the number of patients who achieved complete pain relief (19,3% to 32,3%) and reduced opioid dose (71,0% to 58,1%) from the first to the third consultation, contributing to improved opioid efficacy and safety.
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Early acupuncture intervention for pain relief in emergency department patients with suspected acute renal colic caused by urinary calculi: A randomized clinical trial
Article
  • Feb 2025
  • QJM-INT J MED
Background: Renal colic is one of the worst types of pain in acute renal colic caused by urinary calculi (ARCUC). We previously proved that acupuncture can alleviate the pain in ARCUC patients, but its effect on suspected ARCUC remains unclear. Objective: The objective was to evaluate the effectiveness and safety of acupuncture in patients with suspected ARCUC. Design: This prospective, double-blind, sham acupuncture-controlled, randomized clinical trial was conducted from July 2021 to June 2024 in an emergency department in China. Methods: The patients immediately received acupuncture treatment or sham acupuncture treatment after randomization.The primary outcome was the response rate at 10 minutes (pain relief rate) after needle manipulation.The secondary outcomes included the response rates at 0, 5, 15, 20, and 30 minutes, trends in the NRS score over time, patient satisfaction, the analgesic injection rate at 30 minutes, the surgical intervention rate, the revisit rate, and the occurrence of adverse events. Results: This trial enrolled 84 participants with suspected ARCUC patients, who immediately received acupuncture treatment or sham treatment after randomization. The pain response rates at 10 minutes were 64.3% and 16.7% in the acupuncture group and sham group, respectively, and the difference between the groups was 47.6% (95% CI, 29.3% to 66%; P < 0.01). The response rates of acupuncture were also significantly higher than those of sham acupuncture at 0, 5, 15, 20, and 30 minutes. Conclusions: These results suggest that acupuncture could alleviate the pain in patients with suspected ARCUC safely. Trial registration: Chinese Clinical Trial Registry: ChiCTR2100049069.
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Utilization of Reimbursed Acupuncture Therapy for Low Back Pain
Article
  • Aug 2024
Importance Treating low back pain (LBP) often involves a combination of pharmacologic, nonpharmacologic, and interventional treatments; one approach is acupuncture therapy, which is safe, effective, and cost-effective. How acupuncture is used within pain care regimens for LBP has not been widely studied. Objective To document trends in reimbursed acupuncture between 2010 and 2019 among a large sample of patients with LBP, focusing on demographic, socioeconomic, and clinical characteristics associated with acupuncture use and the nonpharmacologic, pharmacologic, and interventional treatments used by patients who utilize acupuncture. Design, Setting, and Participants This cross-sectional study included insurance claims of US adults in a deidentified database. The study sample included patients diagnosed with LBP between 2010 and 2019. Data were analyzed between September 2023 and June 2024. Main Outcomes and Measures Changes in rates of reimbursed acupuncture utilization between 2010 and 2019, including electroacupuncture use, which involves the electrical stimulation of acupuncture needles. Covariates included age, sex, race and ethnicity, income, educational attainment, region, and a chronic LBP indicator. Secondary analyses tracked other nonpharmacologic treatments (eg, physical therapy, chiropractic care), pharmacologic treatments (eg, opioids, gabapentinoids), and interventional treatments (eg, epidural steroid injections). Results The total sample included 6 840 497 adults with LBP (mean [SD] age, 54.6 [17.8] years; 3 916 766 female [57.3%]; 802 579 Hispanic [11.7%], 258 087 non-Hispanic Asian [3.8%], 804 975 non-Hispanic Black [11.8%], 4 974 856 non-Hispanic White [72.7%]). Overall, 106 485 (1.6%) had 1 or more acupuncture claim, while 61 503 (0.9%) had 1 or more electroacupuncture claim. The rate of acupuncture utilization increased consistently, from 0.9% in 2010 to 1.6% in 2019; electroacupuncture rates were relatively stable. Patients who were female (male: odds ratio [OR], 0.68; 99% CI, 0.67-0.70), Asian (OR, 3.26; 99% CI, 3.18-3.35), residing in the Pacific region (New England: OR, 0.26; 99% CI, 0.25-0.28), earning incomes of over 100000(incomeslessthan100 000 (incomes less than 40 000: OR, 0.59; 99% CI, 0.57-0.61), college educated (high school or less: OR, 0.32; 99% CI, 0.27-0.35), and with chronic LBP (OR, 2.39; 99% CI, 2.35-2.43) were more likely to utilize acupuncture. Acupuncture users were more likely to engage in other nonpharmacologic pain care like physical therapy (39.2%; 99% CI, 38.9%-39.5% vs 29.3%; 99% CI, 29.3%-29.3%) and less likely to utilize prescription drugs, including opioids (41.4%; 99% CI, 41.1%-41.8% vs 52.5%; 99% CI, 52.4%-52.5%), compared with nonusers. Conclusions and Relevance In this cross-sectional study, we found that acupuncture utilization among patients with LBP was rare but increased over time. Demographic, socioeconomic, and clinical characteristics were associated with acupuncture utilization, and acupuncture users were more likely to utilize other nonpharmacologic treatments and less likely to utilize pharmacologic treatments.
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Acupuncture for Aromatase Inhibitor-Induced Arthralgia in Breast Cancer: An Umbrella Review
Article
  • Aug 2024
Background: Acupuncture therapy shows promise in managing aromatase inhibitor-induced arthralgia (AIA) among breast cancer patients. An umbrella review synthesizes findings from systematic reviews and meta-analyses (SRs/MAs) to assess its effectiveness. Summary: This umbrella review aimed to evaluate the effectiveness of acupuncture therapy in treating AIA among breast cancer patients by analyzing existing evidence from SRs/MAs. Key messages: Six SRs/MAs were analyzed, revealing shortcomings in reporting quality, methodological quality, and evidence quality assessment. Comprehensive searches across eight electronic databases were conducted. PRISMA, AMSTAR 2, and GRADE were utilized to assess reporting, methodological quality, and evidence quality, respectively. Despite methodological shortcomings, a recent meta-subgroup analysis suggests the efficacy of acupuncture therapy for AIA patients, recommending a 10-session treatment course. Conclusion: Acupuncture is identified as a secure and effective remedy for AIA sufferers, yet further high-quality research is needed to strengthen the evidence base and endorse acupuncture as a viable treatment option.
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Distribution of licensed acupuncturists and educational institutions in the United States in early 2015
Article
Full-text available
  • Dec 2017
In recent decades, acupuncture has been used more widely and extensively in the United States (U.S.). However, there have been no national surveys or analyses reported in academic journals on the number of practicing or licensed acupuncturists. This study was conducted to identify the approximate number of licensed acupuncturists active in 2015. The Board of Acupuncture or Board of Medicine in each state or U.S. territory was contacted to collect data. Online license information searching was also performed in order to get accurate numbers of licensed acupuncturists for those states in which a board was unable to be contacted. The study found that the number of licensed acupuncturists in 2015 in the U.S. was 34 481. Of this, more than 50% were licensed in three states alone: California (32.39%), New York (11.89%) and Florida (7.06%). The number of licensed acupuncturists increased 23.30% and 52.09%, compared to the year 2009 (n = 27 965) and 2004 (n = 22 671), respectively; increasing about 1 266 per year. There were 62 and 10 accredited acupuncture institutions providing master and doctoral degrees, respectively. The West Coast comprised 51.39% of degree granting programs, while the East Coast comprised 29.17%; together the coastal states housed more than 80% of all programs, with the remainder sprinkled across the southern (9.72%), northern (8.33%), and the middle/central states (1.39%). Forty-four states and the District of Columbia regulated acupuncture practice by law at the time of data collection. Acupuncture continues to be a quickly growing profession in the U.S.
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Reduction in Pain Medication Prescriptions and Self-Reported Outcomes Associated with Acupuncture in a Military Patient Population
Article
Full-text available
  • Aug 2017
Background: Acupuncture is being offered to patients as part of routine medical care in selected military bases in the United States. There is little published information about the clinical outcomes associated with acupuncture in these clinical settings. Objective: The goal of this research was to assess clinical outcomes observed among adult patients who received acupuncture treatments at a United States Air Force medical center. Materials and Methods: This retrospective chart review was performed at the Nellis Family Medicine Residency in the Mike O'Callaghan Military Medical Center at Nellis Air Force Base in Las Vegas, NV. The charts were from 172 consecutive patients who had at least 4 acupuncture treatments within 1 year. The main outcome measures were prescriptions for opioid medications, muscle relaxants, benzodiazepines, and nonsteroidal anti-inflammatory drugs (NSAIDS) in the 60 days prior to the first acupuncture session and in the corresponding 60 days 1 year later; and Measure Yourself Medical Outcome Profile (MYMOP2) values for symptoms, ability to perform activities, and quality of life. Results: Opioid prescriptions decreased by 45%, muscle relaxants by 34%, NSAIDs by 42%, and benzodiazepines by 14%. MYMOP2 values decreased 3.50-3.11 (P < 0.002) for question 1, 4.18-3.46 (P < 0.00001) for question 3, and 2.73-2.43 (P < 0.006) for question 4. Conclusions: In this military patient population, the number of opioid prescriptions decreased and patients reported improved symptom control, ability to function, and sense of well-being after receiving courses of acupuncture by their primary care physicians.
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Meta-Analysis of Electroacupuncture in Cardiac Anesthesia and Intensive Care
Article
Full-text available
Background Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. Methods We searched 3 databases (Pubmed, Cochrane Library, and Web of Science—from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA. As primary outcomes, we investigated the association between GA + EA approach and the dosage of intraoperative anesthetic drugs administered, the duration of mechanical ventilation (MV), the postoperative dose of vasoactive drugs, the length of intensive care unit (ICU) and hospital stay, and the levels of troponin I and cytokines. Results The initial search yielded 477 citations, but only 7 prospective RCTs enrolling a total of 321 patients were included. The use of GA + EA reduced the dosage of intraoperative anesthetic drugs (P < .05), leading to shorter MV time (P < .01) and ICU stay (P < .05) as well as reduced postoperative dose of vasoactive drugs (P < .001). In addition, significantly lower levels of troponin I (P < .01) and tumor necrosis factor α (P < .01) were observed. Conclusion The complementary use of EA for open-heart surgery reduces the duration of MV and ICU stay, blunts the inflammatory response, and might have protective effects on the heart. Our findings stimulate future RCT to provide definitive recommendations.
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Medication-related patient harm in New Zealand hospitals
Article
  • Aug 2017
  • N Z Med J
Aim: The purpose of this study is to identify patterns of medication-related harm from a national perspective, and to use this information to inform decisions on where to focus medication safety efforts. This study updates a 2013 study using the same methodology. Method: District health boards (DHBs) still actively using either the Adverse Drug Event (ADE) Trigger Tool (TT) or the Global Trigger Tool (GTT), submitted two years of anonymised ADE data (1 July 2013-30 June 2015) to the Health Quality & Safety Commission (the Commission) using a standard template. Analyses were conducted using aggregated data only. Results: Of eight DHBs who submitted data, six datasets were included, representing a total of 2,659 chart reviews. From these reviews, 923 harms were identified in 751 patients, with 28% of patients experiencing one or more harms. Harms occurred at a rate of 34.7 per 100 admissions, 42.5 per 1,000 bed days and 28% of patients experienced one or more medication-related harms. Those harmed were more likely to be older, female and have an increased length of stay. Most harms (65%) occurred during an inpatient stay, however, a substantial number (29%) originated in the community and precipitated an admission. Across all levels of severity, the most common types of medication harm were constipation, hypotension and bleeding. In the more serious harm categories, bleeding, hypotension and delirium/confusion/over-sedation were most common. Six groups of medicines caused the greatest amount of harm: opioids (including tramadol), anticoagulants/antiplatelet agents, antibiotics, antianginals (beta-blockers, nitrates, calcium channel blockers and others), diuretics and other cardiovascular medicines (angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists (ARBs), centrally acting agents and statins). Opioids and anticoagulants/antiplatelet agents not only accounted for 40% of all harm, they were implicated in the most severe harm. Conclusion: This paper confirms earlier work that medication-related harms are common, occur both in hospitals and in the community, and are a substantial burden for patients and our healthcare system. Work is underway at local and national levels to decrease this harm, with a focus on the high-risk medicines most commonly implicated.
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Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review and Meta-analysis
Article
  • Aug 2017
Importance There is increased interest in nonpharmacological treatments to reduce pain after total knee arthroplasty. Yet, little consensus supports the effectiveness of these interventions. Objective To systematically review and meta-analyze evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. Data Sources Database searches of MEDLINE (PubMed), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Web of Science (ISI database), Physiotherapy Evidence (PEDRO) database, and ClinicalTrials.gov for the period between January 1946 and April 2016. Study Selection Randomized clinical trials comparing nonpharmacological interventions with other interventions in combination with standard care were included. Data Extraction and Synthesis Two reviewers independently extracted the data from selected articles using a standardized form and assessed the risk of bias. A random-effects model was used for the analyses. Main Outcomes and Measures Postoperative pain and consumption of opioids and analgesics. Results Of 5509 studies, 39 randomized clinical trials were included in the meta-analysis (2391 patients). The most commonly performed interventions included continuous passive motion, preoperative exercise, cryotherapy, electrotherapy, and acupuncture. Moderate-certainty evidence showed that electrotherapy reduced the use of opioids (mean difference, −3.50; 95% CI, −5.90 to −1.10 morphine equivalents in milligrams per kilogram per 48 hours; P = .004; I² = 17%) and that acupuncture delayed opioid use (mean difference, 46.17; 95% CI, 20.84 to 71.50 minutes to the first patient-controlled analgesia; P < .001; I² = 19%). There was low-certainty evidence that acupuncture improved pain (mean difference, −1.14; 95% CI, −1.90 to −0.38 on a visual analog scale at 2 days; P = .003; I² = 0%). Very low-certainty evidence showed that cryotherapy was associated with a reduction in opioid consumption (mean difference, −0.13; 95% CI, −0.26 to −0.01 morphine equivalents in milligrams per kilogram per 48 hours; P = .03; I² = 86%) and in pain improvement (mean difference, −0.51; 95% CI, −1.00 to −0.02 on the visual analog scale; P < .05; I² = 62%). Low-certainty or very low-certainty evidence showed that continuous passive motion and preoperative exercise had no pain improvement and reduction in opioid consumption: for continuous passive motion, the mean differences were −0.05 (95% CI, −0.35 to 0.25) on the visual analog scale (P = .74; I² = 52%) and 6.58 (95% CI, −6.33 to 19.49) opioid consumption at 1 and 2 weeks (P = .32, I² = 87%), and for preoperative exercise, the mean difference was −0.14 (95% CI, −1.11 to 0.84) on the Western Ontario and McMaster Universities Arthritis Index Scale (P = .78, I² = 65%). Conclusions and Relevance In this meta-analysis, electrotherapy and acupuncture after total knee arthroplasty were associated with reduced and delayed opioid consumption.
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Delirium and exposure to psychoactive medications in critically ill adults: A multi-centre observational study
Article
  • Aug 2017
  • J CRIT CARE
Purpose: Investigate the relationship between psychoactive drugs and delirium. Materials and methods: Prospective observational study of 520 critically ill adult patients admitted ≥24h to 6 intensive care units (ICUs). Data were collected on psychoactive drug exposure, use of sedation administration strategies, and incident delirium (Intensive Care Delirium Screening Checklist score≥4). Results: Delirium was detected in 260 (50%) patients, median (IQR) duration 2 (1-5) days, and time to onset 3 (2-5) days. Delirious patients received more low-potency anticholinergic (P<0.0001), antipsychotic (P<0.0001), benzodiazepine (P<0.0001) and non-benzodiazepine sedative (P<0.0001), and opioid (P=0.0008) drugs. Primary regression (24-hours preceding drug exposure) revealed no association between any psychoactive drug and delirium. Post-hoc analysis (extended 48-hour exposure) revealed an association between delirium and high-potency anticholinergic (HR 2.45, 95% CI 1.08-5.54) and benzodiazepine (HR 1.08 per 5mg midazolam-equivalent increment, 95% CI 1.04-1.12) drugs. Delirious patients had longer ICU (P<0.0001) and hospital (P<0.0001) length of stay, and higher ICU and hospital mortality (P=0.003 and P=0.007, respectively). Conclusions: The identification of psychoactive drugs as modifiable delirium risk factors plays an important role in the management of critically ill patients. This is particularly important given the burden of exposure and combinations of drugs used in this vulnerable patient population.
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Wide Variation and Overprescription of Opioids After Elective Surgery
Article
  • Jul 2017
Objective: We aimed to identify opioid prescribing practices across surgical specialties and institutions. Background: In an effort to minimize the contribution of prescription narcotics to the nationwide opioid epidemic, reductions in postoperative opioid prescribing have been proposed. It has been suggested that a maximum of 7 days, or 200 mg oral morphine equivalents (OME), should be prescribed at discharge in opioid-naïve patients. Methods: Adults undergoing 25 common elective procedures from 2013 to 2015 were identified from American College of Surgeons National Surgical Quality Improvement Program data from 3 academic centers in Minnesota, Arizona, and Florida. Opioids prescribed at discharge were abstracted from pharmacy data and converted into OME. Wilcoxon Rank-Sum and Kruskal-Wallis tests assessed variations. Results: Of 7651 patients, 93.9% received opioid prescriptions at discharge. Of 7181 patients who received opioid prescriptions, a median of 375 OME (interquartile range 225-750) were prescribed. Median OME varied by sex (375 men vs 390 women, P = 0.002) and increased with age (375 age 18-39 to 425 age 80+, P < 0.001). Patients with obesity and patients with non-cancer diagnoses received more opioids (both P < 0.001). Subset analysis of the 5756 (75.2%) opioid-naïve patients showed the majority received >200 OME (80.9%). Significant variations in opioid prescribing practices were seen within each procedure and between the 3 medical centers. Conclusions: The majority of patients were overprescribed opioids. Significant prescribing variation exists that was not explained by patient factors. These data will guide practices to optimize opioid prescribing after surgery.
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The Regulation of the Practice of Acupuncture by Physicians in the United States
Article
  • Jun 2017
Introduction: The landscape of acupuncture regulation has greatly evolved since the National Institutes of Health Consensus Statement in 1997. In recent decades, acupuncture treatment has become increasingly integrated with conventional medical care. Healthcare practitioners often utilize acupuncture as an adjunctive therapy to help alleviate symptoms of many conditions, such as nausea and pain. The popularity of this complementary and alternative modality has elevated the importance and urgency for states to regulate its practice and safety. Materials and Methods: The authors comprehensively examined the regulation of the practice of acupuncture by licensed physicians in the United States. Current statutes were evaluated with respect to those from past decades. Requirements were compared with the World Health Organization's recommendations for acupuncture basic training and safety. Results: Most physicians are permitted to practice acupuncture within the scope of their medical practices. Many states mandate that they complete additional education and training. Three states require that physicians obtain acupuncture licenses through the same process as non-physicians. Compared to prior decades, many states have changed their requirements. Conclusions: This article provides current, individual state regulations for the practice of acupuncture by physicians.
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