Development of the NADA Protocol
The use of acupuncture for the treatment of drug and alcohol dependency is a recent development in the history of this ancient art. For centuries Asian cultures have placed needles in precise locations on the body to relieve pain and treat disease. Only since 1972, when a Hong Kong neurosurgeon, H.L Wen M.D., discovered that acupuncture could alleviate the symptoms of drug withdrawal, has this method been used for detoxification and relapse prevention.
The Lincoln Memorial Hospital
In the USA, the NADA protocol was first introduced on an outpatient basis in 1974 at the Lincoln Memorial Hospital, a city facility in the South Bronx area of New York City. By the mid 1980’s the success of this unique procedure had become so evident that treatment facilities across the USA began incorporating acupuncture into their treatment programmes.
NADA: The National Acupuncture Detoxification Association, USA
In 1985, the National Acupuncture Detoxification Association (NADA) was established to promote education and training of clinicians in the use of the NADA protocol through the NADA five-point ear acupuncture protocol. In 1987, Bullock, Culliton and Olander published research on its effectiveness in treating people with chronic drug dependency problems. Acupuncture detoxification evolved rapidly and is now used
effectively for acute and prolonged withdrawal as well as relapse prevention. Yale University, school of internal medicine, published a research report in the August 2000 (Archives of Internal Medicine) that showed the effectiveness of the NADA protocol in the treatment of cocaine, heroin and methadone addiction. Currently, over one thousand treatment programmes in the USA now use acupuncture and NADA US has trained over 5000 clinicians in the USA and worldwide.
NADA In Europe
Over 45 European countries now utilise the NADA protocol and have their own national independent NADA Associations and hold annual national conferences on a yearly basis. NADA European National Conferences are held every two years.
The Lincoln Story
Lincoln Recovery Centre
349 East 140th Street
Bronx, New York, 10454
Dr Michael O Smith. Director
Lincoln Recovery Centre, formerly Lincoln Hospital Substance Abuse Division, which is housed in a grey painted brick building on a dead end street in the Mott Haven section of New York city’s south Bronx, is the grandfather to thousands of programs worldwide now using auricular acupuncture detoxification in some fashion. Originally Lincoln Detox was primarily a methadone programme established in response to strong community action.Most of the pressure for an alternative to methadone came from the clients themselves as well as many of the staff who was discouraged about the use of addictive drugs to treat substance misuse.
In 1973, Dr H L Wen, a neurosurgeon in Hong Kong serendipitously discovered opiate addicted patients had no withdrawal symptoms when he use electroacupuncture on the lung ear point for their post surgical pain. These initial findings were published in “Drugs and Society” and The Asian Journal of Medicine, Subsequently Dr Wen went on to conduct many formalised studies.
Learning of Dr Wen’s research and success, dedicated staff including counsellors and physicians both paid and volunteers began experimenting with auricular acupuncture detoxification. After the death of Dr Richard Taft, Dr Michael Smith was hired as director of the Substance Abuse Division. Utilizing the expertise of local acupuncturists, in 1974 Lincoln Detox began applying electro stimulation to the Lung point on the ear.
This new auricular electro-acupuncture treatment was used as an adjunctive treatment for the prolonged methadone withdrawal symptoms after the 10 day detoxification cycle. Patients reported less malaise and better relaxation in symptoms surveyed. Subsequently twice daily acupuncture was used concurrently with tapering methadone doses. Reduction in opiate withdrawal symptoms and prolonged program retention were noted. It was accidentally discovered that when electro acupuncture equipment malfunctioned or broke down and money was not available for repairs, that electro stimulation was not necessary to produce symptomatic relief. In fact simple manual needling produced a more prolonged effect, it was easier to administer and was less expensive. Patients were able to use acupuncture only once a day and still experience a suppression of their withdrawal symptoms.
By 1975, acupuncture had become a permanent feature at the Lincoln Detox programme, for opiate dependence and later on for alcoholic patients. Initial official city and state acceptance of auricular acupuncture detox was limited. Acceptance, however, was not automatic.
Lincoln Detox was producing notable advances in addiction treatment with collected data of how well acupuncture detox worked. However, as is often the case when new ideas are brought to the pubic service, the work its self was the easy part. It was the dedicated perseverance of Dr Smith and the Lincoln detox team giving countless public testimonies, presentations to professional groups here and abroad, journal articles, press interviews and even congressional hearings that brought the use of acupuncture detox into the addiction treatment community.
In 1978 some political turmoil within the city and the city hospital system forced Lincoln detox to move to their current location on East 140th Street. Now it was required for the clinic to stop using methadone. These transitions in the long run solidified a base of acupuncture detox both physically and practically.
The late 70’s brought many gratifying accomplishments, following a presentation at the 1977 World Congress of Acupuncture in Montreal, Lincoln detox was awarded six scholarships for clinicians. Five workers went on to earn the Doctor of Acupuncture (D.Ac.) and one a level two diploma. By 1982 the clinic had clearly defined its acupuncture detox method and treatment plan.
The `crack` cocaine epidemic reached New York in the mid-80’s and it was discovered that the same treatment was effective in addressing the craving, anxiety and dysphasia accompanying `crack` withdrawal. Details of their protocol were published in an issue of The American Journal of Acupuncture. Drug programme specialists came from all over the world to learn to apply the Lincoln detox method. As the message spread of the effectiveness of acupuncture detox in chemical dependency treatment, demand for training grew.
In 1985 a group consisting Lincoln detox staff, chemical dependence professionals, and acupuncturists from many parts of the U.S formed NADA, The National Acupuncture Detoxification Association. Nada established a standard for training a new type of health care worker, the `Acupuncture Detoxification Specialist` one who is trained only in this specialised form of acupuncture and has a working knowledge of chemical dependency.
After much time consuming political lobbying and exhaustion of court ordered limited treatment personnel, in 1988 the then governor Mario Cuomo signed new legislation authorising the training of chemical dependency counsellors in acupuncture detox, and The Acupuncture Detoxification Training Institute at Lincoln Hospital was established.
The arena into which acupuncture detox has entered continues to expand. Many Criminal Justice systems throughout the country have established Drug Courts, which include acupuncture detox at various levels within the system.
Large collaborative programmes with community service agencies exist in hundreds of metropolitan areas, approximately 1000 world wide. About 75% of Lincoln detox clients are referred from court related agencies.
Lincoln operates a treatment programme that if funded to include prenatal and drug abuse treatment in the same setting. Pre- and Postnatal treatment is provided to about 1500 women per year. Acupuncture detox is the initial treatment modality for all clients, Lincoln detox clinic treats some 250 clients a day.
By 1992, the Lincoln detox clinic had treated more than 3000 crack patients per year since 1987. This is more than any other programme in the U.S. 60% of new patients dependent on crack give a series of clean urine tests within several weeks after entering treatment.
More than 65% of criminal justice clients have achieved drug free status (as measured by daily urine testing) for 2 months or more.
90% of pregnant women enrolled in our maternal substance abuse programme are drug free at delivery. The birth weight of their babies approaches the average for the general population.