Addiction — Scientific Evidence

Based on scientific evidence the following approaches have shown to be effective. To review the supporting scientific evidence, select a treatment option.

In order to help interpret the strength of the scientific evidence (the level of proof) provided, descriptions of the different types of studies, reviews and guidelines are available in the glossary. Please click on each term for a discussion of the topic: Case review, consensus statement, controlled clinical trial, guidelines and recommendations, literature review, meta-analysis, multi-center study, outcome study, systematic review.

Acupuncture
Author(s):
Karst M, Passie T, Friedrich S, et al.
Institution:
Department of Anesthesiology, Pain Clinic, Medical School of Hannover, Germany
Title:
Acupuncture in the treatment of alcohol withdrawal symptoms: a randomized, placebo-controlled inpatient study
Source:
Addiction Biology. 7(4):415-9, 2002.
Type of study:
Randomized controlled clinical trial
Control/comparison:
standard medication with carbamazepine
Sample characteristics:
Thirty-four alcoholics
Type of intervention:
acupuncture to the ear and the body over 14 days in additin to standard medication with carbamazepine
Primary outcome measure(s):
the Clinical Institute Withdrawal Assessment (CIWA-Ar-scale) assessed on days 1-6, 9 and 14. Also used were the Beck Depression Inventory, State-Trait Anxiety Inventory, and Eigenschaftswoerterliste (EWL S60).
Outcome:
Patients assigned to acupuncture had a general tendency towards better outcome results and significantly fewer withdrawal symptoms on day 14. No significant differences were found in the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI X1 and X2) and Eigenschaftswoerterliste (EWL S60). It was concluded that acupuncture as an adjunctive treatment to carbamazepine medication shows promise for the treatment of alcohol withdrawal symptoms. Further investigation of this treatment modality appears to be warranted.

Author(s):
Margolin A.
Institution:
Department of Psychiatry, Yale University School of Medicine, New Haven, CT
Title:
Acupuncture for substance abuse
Source:
Current Psychiatry Reports. 5(5):333-9, 2003.
Type of study:
Review (54 refs)
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
Acupuncture, in the form of insertion of needles bilaterally in the outer ears, is widely used for the treatment of addiction in the US. However, support for this form of treatment from controlled studies has not been consistent. This article examines recent clinical trials of acupuncture for addiction treatment, with a goal of conveying to the reader some of the complex issues involved in conducting studies in this area. Acupuncture trials in addictions frequently have been conducted without preliminary dose-ranging studies to establish efficacious doses of the experimental treatment, use needle insertion controls of unknown degrees of activity, and present no rationale for the type or intensity of concurrently offered psychotherapy. At the present time, it is premature to put forth recommendations for or against acupuncture for the treatment of addiction based on evidence from existing studies.

Author(s):
Trumpler F, Oez S, Stahli P, et al.
Institution:
Psychiatric Hospital Munsingen, 3110 Munsingen, Switzerland
Title:
Acupuncture for alcohol withdrawal: a randomized controlled trial
Source:
Alcohol & Alcoholism. 38(4):369-75, 2003.
Type of study:
Randomized controlled clinical trial
Control/comparison:
sham laser stimulation
Sample characteristics:
Inpatients undergoing alcohol withdrawal were randomly allocated to laser acupuncture (n = 17), needle acupuncture (n = 15) or sham laser stimulation (n = 16).
Type of intervention:
compared auricular laser and needle acupuncture
Primary outcome measure(s):
The duration of withdrawal symptoms (as assessed using a nurse-rated scale) was the primary outcome; the duration of sedative prescription was the secondary outcome.
Outcome:
Patients randomized to laser and sham laser had identical withdrawal symptom durations (median 4 days). Patients randomized to needle stimulation had a shorter duration of withdrawal symptoms (median 3 days), and tended to have a shorter duration of sedative use, but these differences diminished after adjustment for baseline differences. The data from this pilot trial do not suggest a relevant benefit of auricular laser acupuncture for alcohol withdrawal. A larger trial including adequate sham interventions is needed, however, to reliably determine the effectiveness of any type of auricular acupuncture in this condition.

Author(s):
Bier ID, Wilson J, Studt P, et al.
Institution:
I. B. Scientific, LLC, 1 Griffith Drive, Durham, NH
Title:
Auricular acupuncture, education, and smoking cessation: a randomized, sham-controlled trial
Source:
American Journal of Public Health. 92(10):1642-7, 2002.
Type of study:
Randomized controlled clinical trial
Control/comparison:
sham acupuncture and smoking cessation educatonal program
Sample characteristics:
141 adults
Type of intervention:
acupuncture alone and acupuncture in combination with education
Primary outcome measure(s):
Beck Depression Inventory, Zung Self-Rating Anxiety Scale, Visual Analogue Scale to rate levels of craving
Outcome:
All groups showed significant reductions in smoking and posttreatment cigarette consumption, with the combined acupuncture-education group showing the greatest effect from treatment. The trend continued in follow-up, but significant differences were not maintained. Greater pack-year history negatively correlated with treatment effect. Trend analysis suggested 20 pack-years as the cutoff point for this correlation. Acupuncture and education, alone and in combination, significantly reduced smoking; however, combined they show a significantly greater effect, as seen in subjects with a greater pack-year history.

Author(s):
Killeen TK, Haight B, Brady K, et al.
Institution:
Department of Psychiatric and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
Title:
The effect of auricular acupuncture on psychophysiological measures of cocaine craving
Source:
Issues in Mental Health Nursing. 23(5):445-59, 2002.
Type of study:
Randomized controlled clinical trial
Control/comparison:
sham or placebo auricular acupuncture, insertion of needles into ear point locations not targeted for any specific therapeutic benefit
Sample characteristics:
30 treatment-seeking cocaine-dependent patients.
Type of intervention:
real auricular acupuncture intervention, insertion of needles into ear point locations specifically targeted for drug withdrawal.
Primary outcome measure(s):
Psychological (Cocaine Craving Questionnaire - Now) and physiological (skin conductance activity) changes associated with cocaine craving were measured
Outcome:
Results showed no differences between the control and the experimental group in diminishing psychological and physiological measures associated with craving. There were differences from pre- to posttest on measures of psychological but not physiological craving for the combined experimental and control groups.

Author(s):
White AR, Rampes H, Ernst E.
Institution:
Department of Complementary Medicine, University of Exeter, Exeter, UK
Title:
Acupuncture for smoking cessation.[update of Cochrane Database Syst Rev. 2000;(2):CD000009.
Source:
Cochrane Database of Systematic Reviews. (2):CD000009, 2002
Type of study:
Review (49 references)
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
The objective of this review is to determine the effectiveness of acupuncture and the allied therapies of acupressure, laser therapy and electrostimulation, in smoking cessation in comparison with: a) sham treatment, b) other interventions, or c) no intervention. Randomised trials comparing a form of acupuncture, acupressure, laser therapy or electrostimulation with either sham treatment, another intervention or no intervention for smoking cessation were included. Twenty two studies were identified that met the criteria for inclusion. Acupuncture was not superior to sham acupuncture in smoking cessation at any time point. Similarly, when acupuncture was compared with other anti-smoking interventions, there were no differences in outcome at any time point. Acupuncture appeared to be superior to no intervention in the early results, but this difference was not sustained. The results with different acupuncture techniques do not show any one particular method (i.e. auricular acupuncture or non-auricular acupuncture) to be superior to control intervention. Based on the results of single studies, acupressure was found to be superior to advice; laser therapy and electrostimulation were not superior to sham forms of these therapies. Thus, there is no clear evidence that acupuncture, acupressure, laser therapy or electrostimulation are effective for smoking cessation.

Author(s):
Courbasson CM. de Sorkin AA. Dullerud B. Van Wyk L.
Institution:
Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Title:
Acupuncture treatment for women with concurrent substance use and anxiety/depression: an effective alternative therapy?
Source:
Family & Community Health. 30(2):112-20, 2007
Type of study:
Controlled clinical trial
Control/comparison:
21-day outpatient structured psychoeducational treatment program
Sample characteristics:
286 women with concurrent substance use problems, anxiety, and depression
Type of intervention:
auricular acupuncture
Primary outcome measure(s):
self report of craving, anxiety, feelings of depression
Outcome:
Women receiving acupuncture reported fewer physiological cravings for substances, felt significantly less depressed, less anxious, and were better able to reflect on and resolve difficulties than women in the control group. It was found that auricular acupuncture, as an adjunct therapy to a comprehensive psychoeducational treatment program for women with addictions, shows promise in being an effective, more viable treatment alternative to anti-anxiety medication.

Author(s):
Liu TT. Shi J. Epstein DH. Bao YP. Lu L.
Institution:
National Institute on Drug Dependence, Peking University, Beijing, China.
Title:
A meta-analysis of acupuncture combined with opioid receptor agonists for treatment of opiate-withdrawal symptoms.
Source:
Cellular & Molecular Neurobiology. 29(4):449-54, 2009.
Type of study:
Meta-analysis
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Withdrawal-symptom scores were lower in combined treatment trials than in opioid agonist-alone trials on withdrawal days 1, 7, 9, and 10. Combined treatment also produced lower reported rates of side effects and appeared to lower the required dose of opioid agonist. There was no significant difference on relapse rate after 6 months. This meta-analysis suggests that acupuncture combined with opioid agonists can effectively be used to manage withdrawal symptoms. High-quality studies are needed to confirm findings regarding the side effects and medication dosage.

Author(s):
Bearn J, Swami A, Stewart D, et al.
Institution:
Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, UK.
Title:
Auricular acupuncture as an adjunct to opiate detoxification treatment: effects on withdrawal symptoms.
Source:
Journal of Substance Abuse Treatment. 36(3):345-9, 2009.
Type of study:
Randomized Controlled Trial
Control/comparison:
standard methadone detoxification treatment.
Sample characteristics:
83 drug users with opiate dependence
Type of intervention:
standard methadone detoxification treatment plus auricular acupuncture
Primary outcome measure(s):
Daily measures of withdrawal severity and craving were taken using the Short Opiate Withdrawal Scale and an eight-item craving questionnaire. Urine screening was used as an objective assessment of treatment adherence.
Outcome:
Auricular acupuncture had no effect upon withdrawal severity or craving when provided as an adjunct to a standard methadone detoxification treatment.

Author(s):
Cho, SH, Whang, WW.
Institution:
Department of Neuropsychiatry, Hospital of Korean Medicine, Kyung Hee University Medical Center, Korea.
Title:
Acupuncture for Alcohol Dependence: A Systematic Review
Source:
Alcoholism: Clinical and Experimental Research. 33(8): 1305–1313, August 2009
Type of study:
Review
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
In the 11 studies reviewed, acupuncture was not found to be an effective treatment for alcohol dependence.
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Aromatherapy
Author(s):
Kunz, S., Schulz, M., Lewitzky, M., et al.
Institution:
Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany.
Title:
Ear acupuncture for alcohol withdrawal in comparison with aromatherapy: a randomized-controlled trial.
Source:
Alcohol Clinical and Experimental Research. 31(3):436-42, 2007.
Type of study:
randomized controlled comparative study
Control/comparison:
Aromatherapy
Sample characteristics:
74 patients undergoing alcohol withdrawal
Type of intervention:
ear acupuncture was administered daily for 5 consecutive days
Primary outcome measure(s):
rating scale for the assessment of the alcohol-withdrawal syndrome was used to measure symptoms during the first 5 days of withdrawal
Outcome:
Both aromatherapy and ear acupuncture appear to be effective treatments for patients undergoing alcohol withdrawal.Craving and withdrawal symptoms were not found to be different between the two groups over the course of the study.
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Biofeedback
Author(s):
Trudeau DL.
Institution:
University of Minnesota, Academic Health Center, Department of Family Practice and Community Health and Minneapolis Veterans Affairs Medical Center, USA
Title:
The treatment of addictive disorders by brain wave biofeedback: a review and suggestions for future research
Source:
Clinical Electroencephalography. 31(1):13-22, 2000.
Type of study:
Review (75 references)
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
 

Author(s):
Scott WC. Kaiser D. Othmer S. Sideroff SI.
Institution:
Neuropsychiatric Institute, University of California, Los Angeles, CA
Title:
Effects of an EEG biofeedback protocol on a mixed substance abusing population.
Source:
American Journal of Drug & Alcohol Abuse. 31(3):455-69, 2005.
Type of study:
Randomized Controlled Trial
Control/comparison:
control group received additional time in treatment equivalent to experimental procedure time
Sample characteristics:
One hundred twenty-one volunteers undergoing an inpatient substance abuse program
Type of intervention:
40 to 50 biofeedback sessions
Primary outcome measure(s):
Treatment retention and abstinence rates as well as psychometric and cognitive measures were compared.
Outcome:
People receiving biofeedback remained in treatment significantly longer than the control group. Of the experimental subjects completing the protocol, 77% were abstinent at 12 months compared to 44% for the controls. This protocol enhanced treatment retention, variables of attention, and abstinence rates one year following treatment.
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Cognitive Behavioral Therapy
Author(s):
Voshaar RC, Gorgels WJ, Mol AJ, et al.
Institution:
University Medical Centre, Nijmegen, The Netherlands
Title:
Tapering off long-term benzodiazepine use with or without group cognitive-behavioural therapy: three-condition, randomised controlled trial
Source:
British Journal of Psychiatry. 182:498-504, 2003.
Type of study:
Randomized controlled clinical trial
Control/comparison:
tapering off alone or usual care
Sample characteristics:
180 people attempting to discontinue long-term benzodiazepine use
Type of intervention:
tapering off plus group CBT
Primary outcome measure(s):
not known
Outcome:
Tapering off led to a significantly higher proportion of successful discontinuations than usual care (62% v. 21%). Adding group CBT did not increase the success rate (58% v. 62%). Neither successful discontinuation nor intervention type affected psychological functioning. Both tapering strategies showed good feasibility in general practice. Tapering off is a feasible and effective way of discontinuing long-term benzodiazepine use in general practice. The addition of group CBT is of limited value.

Author(s):
McCaul ME, Petry NM.
Institution:
Johns Hopkins University School of Medicine, Baltimore, MD
Title:
The role of psychosocial treatments in pharmacotherapy for alcoholism
Source:
American Journal on Addictions. 12 Suppl 1:S41-52, 2003
Type of study:
Review. (70 refs)
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
Medication treatment for alcohol use disorders often includes a psychotherapy component. The most appropriate psychotherapy to use may depend upon characteristics of the patient, the medication, the setting, and the experiences of the provider. To date, little empirical research has investigated these issues with respect to outcomes in clinical trials that combine pharmacotherapy and psychotherapy. This paper reviews seven major types of psychotherapy for treatment of alcohol use disorders: brief interventions, motivational enhancement therapy, cognitive-behavioral therapy, cue exposure therapy, behavioral treatments, behavioral marital therapy, and twelve-step therapy. The theoretical basis for and empirical evidence supporting the efficacy of the therapies are reviewed, with an emphasis on studies that provided pharmacotherapy in conjunction with psychotherapy.

Author(s):
Witkiewitz K, Marlatt GA.
Institution:
Addiction Behaviors Research Center, University of Washington, Seattle, WA
Title:
Relapse prevention for alcohol and drug problems: that was Zen, this is Tao
Source:
American Psychologist. 59(4):224-35, 2004.
Type of study:
Review (138 references )
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
Relapse prevention, based on the cognitive-behavioral model of relapse, has become an adjunct to the treatment of numerous psychological problems, including substance abuse, depression, sexual offending, and schizophrenia. This article provides an overview of the efficacy and effectiveness of relapse prevention in the treatment of addictive disorders, an update on recent empirical support for the elements of the cognitive-behavioral model of relapse, and a review of the criticisms of relapse prevention. In response to the criticisms, a reconceptualized cognitive-behavioral model of relapse that focuses on the dynamic interactions between multiple risk factors and situational determinants is proposed. Empirical support for this reconceptuali- zation of relapse, the future of relapse prevention, and the limitations of the new model are discussed.

Author(s):
Carroll KM, Fenton LR, Ball SA, et al.
Institution:
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
Title:
Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients: a randomized placebo-controlled trial
Source:
Archives of General Psychiatry. 61(3):264-72, 2004.
Type of study:
Randomized Controlled Clinical Trial
Control/comparison:
placebo plus cognitive behavioral therapy (CBT), and placebo plus interpersonal psychotherapy (IPT)
Sample characteristics:
121 individuals meeting the criteria for current cocaine dependence.
Type of intervention:
disulfiram plus CBT and disulfiram plus IPT
Primary outcome measure(s):
Random regression analyses of self-reported frequency of cocaine use and results of urine toxicology screens
Outcome:
Participants assigned to disulfiram reduced their cocaine use significantly more than those assigned to placebo, and those assigned to CBT reduced their cocaine use significantly more than those assigned to IPT. Findings were consistent across all study samples. Benefits of disulfiram use and CBT were most pronounced for participants who were not alcohol dependent at baseline or who fully abstained from drinking alcohol during treatment. Adverse effects experienced by participants who received disulfiram were mild and were not considerably different from those experienced by participants who received placebo. Disulfiram and CBT were shown to be effective therapies for general populations of cocaine-dependent individuals. Disulfiram seems to exert a direct effect on cocaine use rather than through reducing concurrent alcohol use.

Author(s):
Tavares H, Zilberman ML, el-Guebaly N.
Institution:
University of Calgary, Calgary, AB
Title:
Are there cognitive and behavioural approaches specific to the treatment of pathological gambling?
Source:
Canadian Journal of Psychiatry - Revue Canadienne de Psychiatrie. 48(1):22-7, 2003 Feb.
Type of study:
Review (63 references)
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
This paper reviews cognitive-behavioural models in a search for original insights that are specific to gambling treatment. New cognitive-behavioural approaches to the treatment of pathological gambling provide 3 original additions to the traditional multimodal treatment of addictions: cognitive restructuring, in vivo exposure, and imaginal desensitization. Other cognitive-behavioural techniques, such as relapse prevention, problem solving, and social skill training, are shared by gambling treatment and addictions treatment. When treating pathological gamblers, clinicians should consider introducing techniques to address cognitive distortions related to gambling. Also, cue exposure--whether in vivo or imaginal--may help deal with urges prompted by such cues. The blending of these new techniques provides a multimodal addiction treatment apporach.

Author(s):
Galanter M, Dermatis H, Keller D, et al.
Institution:
Department of Psychiatry, NYU School of Medicine, New York City, NY
Title:
Network therapy for cocaine abuse: use of family and peer supports
Source:
American Journal on Addictions. 11(2):161-6, 2002.
Type of study:
Clinical trial
Control/comparison:
none
Sample characteristics:
47 cocaine-dependent subjects
Type of intervention:
a 24-week sequence of Network Therapy, a cognitive-behavioral orientation in sessions with family and peers as well as in individual sessions
Primary outcome measure(s):
weekly urines and toxicologies
Outcome:
Of 47 subjects, 73% of all observed weekly urines were negative for cocaine, and 20 (45%) of the subjects had negative toxicologies in the last 3 scheduled samples. A positive outcome was associated with the number of network (but not individual) sessions attended and completion of the full treatment sequence. Results suggest the utility of Network Therapy.

Author(s):
Reus VI. Smith BJ.
Institution:
University of California School of Medicine, Langley Porter Neuropsychiatric Institute, San Francisco, CA
Title:
Multimodal techniques for smoking cessation: a review of their efficacy and utilisation and clinical practice guidelines.[
Source:
International Journal of Clinical Practice. 62(11):1753-68, 2008
Type of study:
Review (108 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Abstinence rates for pharmacotherapies range from approximately 16% to approximately 30% at 1-year follow-up. Behavior modification therapies have achieved quit rates of between 8% and 43% for up to 1 year. No direct comparisons have been made between pharmacotherapy alone and psychological behavior strategies alone. However, combining physiological approaches with counselling significantly increases the odds of quitting compared with either technique alone.

Author(s):
Hoppes K.
Institution:
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
Title:
The application of mindfulness-based cognitive interventions in the treatment of co-occurring addictive and mood disorders.
Source:
Cns Spectrums. 11(11):829-51, 2006.
Type of study:
Review (61 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
This article reviews the theory, clinical application, and empirical findings on mindfulness-based cognitive therapy (MBCT) for mental health and addictive disorders. Expanding upon the research demonstrating the efficacy of cognitive-behavioral therapy (CBT) for addiction, this article explores the rationale for combining mindfulness-based interventions with evidence-based CBTs in treating addictive disorders, with an emphasis on substance use disorders with co-occurring mood disorders. Summarizing magnetic resonance imaging and positron emission tomography findings on the effects of MBCT and the neurobiology of drug addiction, this article outlines directions for further research on potential benefits of MBCT for the recovering individual. Finally, this article describes a structured protocol, developed at the Mount Sinai School of Medicine, which combines CBT with mindfulness-based intervention, for the treatment of co-occurring addictive and mood disorders.
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General
Author(s):
Breslin KT, Reed MR, Malone SB.
Institution:
Drug Dependency Treatment Program, Veterans Administration, Maryland Health Care System, Baltimore, Maryland
Title:
An holistic approach to substance abuse treatment
Source:
Journal of Psychoactive Drugs. 35(2):247-51, 2003 Apr-Jun.
Type of study:
Review (8 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
The purpose of this article is to describe a model outpatient substance abuse treatment program. This program is designed to provide patients with not only traditional modalities of treatment such as individual, group, and family therapy, but also to provide an opportunity for patients to express thoughts and feelings through holistic modalities. These modalities include dance/movement therapy, Tai Chi, art therapy, leisure and recreational skills, spiritual growth and development, cultural awareness and appreciation, vocational services, psychiatric care and physical health. The authors describe features of this program that they believe to be unique and that focus on ways to help patients develop a stronger sense of self-identity, self-esteem and self-confidence.
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Herbal Medicine
Author(s):
Kampman K, Majewska MD, Tourian K, et al.
Institution:
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA
Title:
A pilot trial of piracetam and ginkgo biloba for the treatment of cocaine dependence
Source:
Addictive Behaviors. 28(3):437-48, 2003.
Type of study:
Randomized controlled clinical trial
Control/comparison:
placebo
Sample characteristics:
44 cocaine-dependent subjects
Type of intervention:
piracetam (4.8 g/day) or ginkgo biloba (120 mg/day)
Primary outcome measure(s):
treatment retention, urine toxicology screens, Clinical Global Impression (CGI) scores, and results from the Addiction Severity Index (ASI)
Outcome:
Ginkgo biloba was not superior to placebo in any outcome measure. Piracetam was associated with more cocaine use and lower CGI scores compared to placebo. Neither piracetam nor ginkgo biloba appears to be a promising medication for the treatment of cocaine dependence.

Author(s):
Poyares DR, Guilleminault C, Ohayon MM, et al.
Institution:
Sleep Laboratory of the Department of Psychobiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
Title:
Can valerian improve the sleep of insomniacs after benzodiazepine withdrawal?
Source:
Progress in Neuro-Psychopharmacology & Biological Psychiatry. 26(3):539-45, 2002 Apr.
Type of study:
Randomized Controlled Clinical Trial
Control/comparison:
placebo
Sample characteristics:
19 patients (mean age 43.3+/-10.6 years) with primary insomnia (DSM-IV), who had taken benzodiazepines (BZDs) nightly, for 7.1+/-5.4 years and a control group of 18 healthy individuals (mean age 37+/-8 years)
Type of intervention:
valerian
Primary outcome measure(s):
Sleep electroencephalogram (EEG) of the patients was analyzed with period amplitude analysis (PAA) and associated algorithms, during chronic BZD use (Night 1), and after 15 days of a valerian placebo trial (initiated after washout of BZD, Night 2). Sleep of control subjects was monitored in parallel.
Outcome:
Valerian subjects reported significantly better subjective sleep quality than placebo ones, after BZD withdrawal, despite the presence of a few side effects. However, some of the differences found in sleep structure between Night 1 and Night 2 in both the valerian and placebo groups may be due to the sleep recovery process after BZD washout. There was a significant decrease in wake time after sleep onset (WASO) in valerian subjects when compared to placebo subjects; results were similar to normal controls. Nonetheless, valerian-treated patients also presented longer sleep latency and increased alpha count in SWS than control subjects. The decrease in WASO associated with the mild anti-anxiety effect of valerian appeared to be the major contributor to subjective sleep quality improvement found after 2-week of treatment in insomniacs who had withdrawn from BDZs. Despite subjective improvement, sleep data showed that valerian did not produce faster sleep onset; the increase in alpha count compared with normal controls may point to residual hyperarousabilty, which is known to play a role in insomnia. Nonetheless, we lack data on the extent to which a sedative drug can improve alpha sleep EEG. Thus, the authors suggest that valerian had a positive effect on withdrawal from BDZ use.

Author(s):
Akhondzadeh S, Kashani L, Mobaseri M, et al.
Institution:
Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, South Kargar Avenue, Tehran, Iran
Title:
Passionflower in the treatment of opiates withdrawal: a double-blind randomized controlled trial
Source:
Journal of Clinical Pharmacy & Therapeutics. 26(5):369-73, 2001.
Type of study:
Randomized controlled clinical trial
Control/comparison:
clonidine plus placebo
Sample characteristics:
A total of 65 opiates addicts were assigned randomly to treatment with passiflora extract plus clonidine tablet or clonidine tablet plus placebo drop during a 14-day double-blind clinical trial
Type of intervention:
60 drops of passiflora extract and a maximum daily dose of 0.8 mg of clonidine administered in three divided doses
Primary outcome measure(s):
The severity of the opiate withdrawal syndrome was measured on days 0, 1, 2, 3, 4, 7 and 14 using the Short Opiate Withdrawal Scale (SOWS)
Outcome:
Both protocols were equally effective in treating the physical aspects of withdrawal syndromes. However, the passiflora plus clonidine group showed a significant superiority over clonidine alone in the management of mental symptoms. These results suggested that passiflora extract may be an effective additional agent in the management of opiate withdrawal. However, a larger study to confirm our results is warranted.

Author(s):
Carai MA, Agabio R, Bombardelli E, et al.
Institution:
Bernard B. Brodie Department of Neuroscience, University of Cagliari, Cagliari, Italy
Title:
Potential use of medicinal plants in the treatment of alcoholism
Source:
Fitoterapia. 71 Suppl 1:S38-42, 2000.
Type of study:
Review (12 references)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
The present paper briefly reviews the most relevant experimental data on the reducing effect of some medicinal herbs on voluntary alcohol intake in animal models of alcoholism. Pueraria lobata, Tabernanthe iboga, Panax ginseng, Salvia miltiorrhiza and Hypericum perforatum proved to be effective in decreasing alcohol consumption. Reduction of alcohol absorption from the gastrointestinal system appears to be a common feature among most of the above plants. These data suggest that medicinal plants may constitute novel and effective pharmacotherapies for alcoholism.

Author(s):
Hao W, Zhao M.
Institution:
Mental Health Institute, Hunan Medical University, Changsha, Hunan, China
Title:
A comparative clinical study of the effect of WeiniCom, a Chinese herbal compound, on alleviation of withdrawal symptoms and craving for heroin in detoxification treatment
Source:
Journal of Psychoactive Drugs. 32(3):277-84, 2000.
Type of study:
Randomized controlled clinical trial
Control/comparison:
a buprenorphine group (21 cases)
Sample characteristics:
Forty-two heroin addicts meeting the criteria of dependence in DSM-IV
Type of intervention:
a WeiniCom group (21 cases)
Primary outcome measure(s):
The Withdrawal Symptom Rating Scale and the Craving Rating Scale were employed to assess acute withdrawal symptoms and craving for heroin, and the Side Effects Rating Scale was used to measure side effects in the 14-treatment period
Outcome:
Both the WeiniCom and buprenorphine treatments are well-tolerated and safe. Overall, the relief from opioid withdrawal symptoms and craving was better in the WeiniCom group than in the buprenorphine group. The rate of reduction in the severity of the withdrawal symptoms was faster in the WeiniCom group than in the buprenorphine group. By day nine to 10, the WeiniCom group showed very few withdrawal symptoms. In contrast, from day five on, the buprenorphine group continued to report relatively high scores for withdrawal symptoms and craving. WeiniCom demonstrated positive effects quickly, and required a shorter treatment period to achieve a desired degree of elimination of acute withdrawal symptoms and craving.

Author(s):
Shebek J, Rindone JP.
Institution:
Veteran Affairs Medical Center 316, Prescott, Arizona
Title:
A pilot study exploring the effect of kudzu root on the drinking habits of patients with chronic alcoholism
Source:
Journal of Alternative & Complementary Medicine. 6(1):45-8, 2000.
Type of study:
Prospoective randomized controlled clinical trial
Control/comparison:
a matching placebo
Sample characteristics:
Thirty-eight alcoholic patients completed 1 month of the study; 21 randomly assigned kudzu, 17 to placebo
Type of intervention:
kudzu root extract 1.2 g twice daily
Primary outcome measure(s):
Sobriety level and craving for ethanol were assessed on a visual analogue scale from 0 to 10
Outcome:
No statistically significance difference in craving and sobriety scores were noted after 1 month between kudzu and placebo, or at later stages with smaller numbers (15-19) of patients. In this small patient population, kudzu root appeared to be no better than placebo in reducing the craving for alcohol or promoting sobriety.

Author(s):
Parsons A, Ingram J, Inglis J, et al.
Institution:
University of Birmingham, Edgbaston, Birmingham, UK
Title:
A proof of concept randomised placebo controlled factorial trial to examine the efficacy of St John's wort for smoking cessation and chromium to prevent weight gain on smoking cessation.
Source:
Drug & Alcohol Dependence. 102(1-3):116-22, 2009.
Type of study:
Randomized Controlled Trial
Control/comparison:
placebo treatment started 2 weeks prior to quit day and continued for 14 weeks. All participants received weekly behavioural support.
Sample characteristics:
143 smokers
Type of intervention:
900 mg St John's wort (SJW) and 400 microm chromium a day. Treatment started 2 weeks prior to quit day and continued for 14 weeks. All participants received weekly behavioural support.
Primary outcome measure(s):
biochemically confirmed prolonged abstinence and mean weight gain in abstinent smokers 4 weeks after quitting.
Outcome:
Six out of 71 (8.5%) participants on active St Johns wort and 9 out of 72 (12.5%) on placebo achieved prolonged abstinence at 4 weeks. At 6 months, 3 (4.2%) on active St. Johns wort and 6 (8.3%) placebo participants were still abstinent. The small difference between active and placebo and the lack of effects on withdrawal shows that St Johns wort is ineffective for smoking cessation.

Author(s):
Lu L, Liu Y, Zhu W, et al.
Institution:
National Institute on Drug Dependence, Peking University, Beijing, China.
Title:
Traditional medicine in the treatment of drug addiction.
Source:
American Journal of Drug & Alcohol Abuse. 35(1):1-11, 2009.
Type of study:
Review (146 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Clinical trials were rare for herbal remedies. Radix Puerariae showed the most promising efficacy for alcoholism. Ginseng and Kava lack efficacy data in addictions, and Kava can have a toxic effect on the liver. Thunbergia laurifolia can protect against alcoholic liver toxicity. Withania somnifera and Salvia miltiorrhiza have no efficacy data, but can reduce morphine tolerance and alcohol intake, respectively, in animal models. Traditional herbal treatments can compliment pharmacotherapies for drug withdrawal and possibly relapse prevention with less expense and perhaps fewer side effects with notable exceptions. Both acupuncture and herbal treatments need testing as adjuncts to reduce doses and durations of standard pharmacotherapies.

Author(s):
Rambaldi A. Jacobs BP. Gluud C.
Institution:
Cochrane Hepato-Biliary Group, Rigshospitalet, Copenhagen, Denmark
Title:
Milk thistle for alcoholic and/or hepatitis B or C virus liver diseases.
Source:
Cochrane Database of Systematic Reviews. (4):CD003620, 2007.
Type of study:
Review (145 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Eighteen randomised clinical trials assessed milk thistle in 1088 patients with alcoholic and/or hepatitis B or C virus liver diseases. The methodological quality was low: only 28.6% of the trials reported high methodological quality characteristics. Milk thistle versus placebo or no intervention had no significant effect on mortality, complications of liver disease, or liver histology. Milk thistle was not associated with a significantly increased risk of adverse events. Results question the beneficial effects of milk thistle for patients with alcoholic and/or hepatitis B or C virus liver diseases and highlight the lack of high-quality evidence to support this intervention. Adequately conducted and reported randomised clinical trials on milk thistle versus placebo are needed.
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Hypnosis
Author(s):
Abbot NC, Stead LF, White AR, et al.
Institution:
Dept of Epidemiology and Public Health, University of Leicester, Leicester, UK
Title:
Hypnotherapy for smoking cessation
Source:
Cochrane Database of Systematic Reviews. (2):CD001008, 2000
Type of study:
Review. (10 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
The objective of this review was to evaluate the effects of hypnotherapy for smoking cessation. Randomised trials of hypnotherapy which reported smoking cessation rates at least six months after the beginning of treatment were considered. The main outcome measure was abstinence from smoking after at least six months follow-up in patients smoking at baseline. The most rigorous definition of abstinence in each trial were used, and biochemically validated rates where available. Nine studies compared hypnotherapy with 14 different control interventions. There was significant heterogeneity between the results of the individual studies, with conflicting results for the effectiveness of hypnotherapy compared to no treatment or to advice. There was no evidence of an effect of hypnotherapy compared to rapid smoking or psychological treatment. We have not shown that hypnotherapy has a greater effect on six month quit rates than other interventions or no treatment. The effects of hypnotherapy on smoking cessation claimed by uncontrolled studies were not confirmed by analysis of randomised controlled trials.

Author(s):
Carmody TP, Duncan C, Simon JA, et al.
Institution:
San Francisco Veterans Affairs Medical Center, University of California, San Francisco, CA
Title:
Hypnosis for Smoking Cessation
Source:
Nicotine & Tobacco Research. 10(5):811-8, 2008.
Type of study:
Randomized controlled trial
Control/comparison:
Standardized behavioral counseling combined with nicotine patches
Sample characteristics:
286 current smokers
Type of intervention:
Active hypnosis with nicotine patch use
Primary outcome measure(s):
No smoking at all in a 7 day period with confirmation from blood, urine or slavia tests or by confirmation from spouse or significant other.
Outcome:
At 6 months, 29% of the hypnosis group reported a 7 day abstinence as compared with 23% of the behavioral counseling group. At six months 26% of the participants in the hypnosis group were abstinent compared with 18% in the behavioral group. At 12 months, 20% of the participants in the hypnosis group were abstinent as compared with 14% in the behavioral group. It was concluded that hypnosis combined with nicotine patches compares favorably with standard behavioral counseling in generating long-term quit rates.
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Meditation/Relaxation
Author(s):
Lichstein KL, Peterson BA, Riedel BW, et al.
Institution:
Department of Psychology, University of Memphis, TN
Title:
Relaxation to assist sleep medication withdrawal.
Source:
Behavior Modification. 23(3):379-402, 1999.
Type of study:
clinical trial
Control/comparison:
none
Sample characteristics:
40 volunteers from the community who had insomnia, half of whom were chronic users of hypnotics while the other half were nonmedicated.
Type of intervention:
Half of all participants (10 medicated and 10 nonmedicated) received progressive relaxation. All medicated participants received a standard gradual drug withdrawal program.
Primary outcome measure(s):
not known
Outcome:
Medicated participants reduced sleep medication consumption by nearly 80%. Participants who received relaxation obtained additional benefits in sleep efficiency, rated quality of sleep, and reduced withdrawal symptoms. Medicated and nonmedicated participants attained comparable, improved sleep by posttreatment and follow-up. Hypnotic withdrawal was accompanied by serious worsening of insomnia, but this dissipated by the end of the withdrawal period. The psychological treatment of hypnotic-dependent insomnia has high potential for making an important clinical contribution.

Author(s):
Cropley M, Ussher M, Charitou E.
Institution:
University of Surrey, Guildford, Surrey, UK
Title:
Acute effects of a guided relaxation routine (body scan) on tobacco withdrawal symptoms and cravings in abstinent smokers
Source:
Addiction. 102(6):989-93, 2007
Type of study:
randomized controlled trial
Control/comparison:
listened to a 10 minute audio recording of a natural history text
Sample characteristics:
30 participants reporting to smoke 10 or more cigarettes daily for at least 3 years
Type of intervention:
10 minute guided relaxation body scan
Primary outcome measure(s):
Ratings of strength of desire to smoke and smoking withdrawal symptoms were assessed at the start of the study, immediately after the interventions, and 5, 10 and 15 minutes post-intervention.
Outcome:
The desire to smoke was significantly lower in the body scan group than in the control group immediately after the intervention, and 5 minutes post-intervention. The body scan group also reported lower ratings of irritability, tension and restlessness. It was concluded that a brief body scan relaxation exercise reduces the strength of desire to smoke and some tobacco withdrawal symptoms in current smokers who abstained from smoking for a 12 hour period.

Author(s):
Simpson TL, Kaysen D, Bowen S, et al.
Institution:
VA Puget Sound Health Care System and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
Title:
PTSD symptoms, substance use, and vipassana meditation among incarcerated individuals.
Source:
Journal of Traumatic Stress. 20(3):239-49, 2007.
Type of study:
Controlled clinical trial
Control/comparison:
treatment as usual
Sample characteristics:
incarcerated individuals with post-traumatic stress disorder and substance abuse problems
Type of intervention:
a Vipassana meditation course
Primary outcome measure(s):
degree of substance use
Outcome:
Participation in the Vipassana course was associated with significantly greater reductions in substance use than treatment as usual, regardless of PTSD symptom severity levels. These results suggest that Vipassana meditation is worthy of further study for those with comorbid PTSD and substance use problems.

Author(s):
Kochupillai V, Kumar P, Singh D, et al.
Institution:
Department of Medical Oncology, Institute Rotary Cancer Hospital, New Dehli, India.
Title:
Effect of rhythmic breathing (Sudarshan Kriya and Pranayam) on immune functions and tobacco addiction.
Source:
Annals of the New York Academy of Sciences. 1056:242-52, 2005.
Type of study:
Review (52 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Stress affects cellular processes of body and immune functions, and can lead to disease states and substance abuse. Sudarshan Kriya (SK) and Pranayam (P), rhythmic breathing processes, are known to reduce stress and improve immune functions. Cancer patients who had completed their standard therapy were studied. SK and P increased natural killer (NK) cells significantly at 12 and 24 weeks of the practice compared to baseline. Increase in NK cells at 24 weeks was significant compared to controls. There was no effect on T-cell subsets after SK and P either in the study group or among controls. SK and P helped to control the tobacco habit in 21% of individuals who were followed up to 6 months of practice. The inexpensive and easy to learn and practice breathing processes (SK and P) in this study demonstrated an increase in NK cells and a reduction in tobacco consumption.
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Music Therapy
Author(s):
Winkelman M.
Institution:
Department of Anthropology, Arizona State University, Tempe, AZ
Title:
Complementary therapy for addiction: "drumming out drugs"
Source:
American Journal of Public Health. 93(4):647-51, 2003.
Type of study:
Review (43 references)
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
This article examines drumming activities as complementary addiction treatments and discusses their reported effects. Research reviews indicate that drumming enhances recovery through inducing relaxation and enhancing theta-wave production and brain-wave synchronization. Drumming produces pleasurable experiences, enhanced awareness of preconscious dynamics, release of emotional trauma, and reintegration of self. Drumming alleviates self-centeredness, isolation, and alienation, creating a sense of connectedness with self and others. Drumming provides a secular approach to accessing a higher power and applying spiritual perspectives. Drumming circles have applications as complementary addiction therapy, particularly for repeated relapse and when other counseling modalities have failed.

Author(s):
Mays KL. Clark DL. Gordon AJ.
Institution:
VA Pittsburgh Healthcare System, Pittsburgh, PA
Title:
Treating addiction with tunes: a systematic review of music therapy for the treatment of patients with addictions.
Source:
Substance Abuse. 29(4):51-9, 2008.
Type of study:
Review (27 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
This systematic review describes and compares the types of music therapy demonstrated in the literature and evaluates the evidence that music therapy improves outcomes of patients with addictions. Few studies assess the use of music therapy in the treatment of patients with addictions. Music listening provided by music therapists is commonly studied. Music therapy sessions reported were additive, not independent, treatment modalities. No consensus exists regarding the efficacy of music therapy as treatment for patients with addictions.
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Nutrition/Supplementation
Author(s):
Sher L
Institution:
not known
Title:
Role of selenium depletion in the etiopathogenesis of depression in patients with alcoholism
Source:
Medical Hypotheses. 59(3):330-3, 2002.
Type of study:
Review (42 references)
Control/comparison:
not applicable
Sample characteristics:
not applicable
Type of intervention:
not applicable
Primary outcome measure(s):
not applicable
Outcome:
Chronic heavy alcohol consumption adversely affects both macronutrients and micronutrients. Alcohol use affects selenium status. Considerable evidence suggests that selenium status may modify mental function. The author suggests that the effects of alcohol intake on mood, behavior, and cognition may be partly mediated by biological changes related to selenium deficiency.It has been observed that there is a trend towards the normalization of selenium levels in patients with alcoholism after a relatively short period of abstinence from alcohol. It has also been observed that when depression develops in persons with alcoholism, they are likely to improve fairly rapidly after a relatively short period of abstinence from alcohol without therapy aimed at the depressive symptoms. The author suggests that improvement in depressed patients after a period of abstinence from alcohol might be in part related to the normalization of selenium status. Future studies of the etiology and pathogenesis of mood disorders in patients with alcoholism are merited.

Author(s):
Gueguen S, Pirollet P, Leroy P, et al.
Institution:
INSERM U525 and Centre de Medecine Preventive, Vandoeuvre-les-Nancy, France
Title:
Changes in serum retinol, alpha-tocopherol, vitamin C, carotenoids, xinc and selenium after micronutrient supplementation during alcohol rehabilitation
Source:
Journal of the American College of Nutrition. 22(4):303-10, 2003.
Type of study:
Randomized controlled clinical trial
Control/comparison:
placebo
Sample characteristics:
106 alcohol-dependent patients 20 to 60 years of age without severe liver disease, hospitalized for a 21-day rehabilitation program
Type of intervention:
daily combination of micronutrients (beta-carotene: 6 mg, vitamin C: 120 mg, vitamin E: 30 mg, zinc: 20 mg, selenium: 100 micro g)
Primary outcome measure(s):
Vitamin C, retinol, alpha-tocopherol, zeaxanthin/lutein, beta-cryptoxanthin, lycopene, alpha- and beta-carotene, zinc and selenium were measured in serum, initially and after supplementation
Outcome:
In the placebo group, after 21 days of rehabilitation, serum concentrations of vitamin C and all five carotenoids significantly increased, whereas retinol and alpha-tocopherol concentrations decreased; zinc and selenium levels were unaffected. At the end of the hospital stay, serum indicators were significantly improved in the supplement group as compared to the placebo group for vitamin C, alpha-tocopherol, beta-carotene, zinc and selenium; conversely, lycopene changes were higher in the placebo group than in supplement group. Of the serum antioxidants measured at entrance, only vitamin C was significantly depleted in heavy smokers, and, after the supplementation period, vitamin C was efficiently repleted in this later group. Our results indicate that a short-term supplementation with physiological doses of antioxidant vitamins, carotenoids and trace elements during alcohol rehabilitation clearly improves micronutrient status indicators. Heavy smokers in particular seem to respond to vitamin C supplementation.

Author(s):
Evangelou A, Kalfakakou V, Georgakas P, et al.
Institution:
Laboratory of Experimental Physiology, Faculty of Medicine, University of Ioannina
Title:
Ascorbic acid (vitamin C) effects on withdrawal syndrome of heroin abusers
Source:
In Vivo. 14(2):363-6, 2000.
Type of study:
Clinical trial
Control/comparison:
a third group of heroin addict in-patients (group C, 30 males-control group), treated only by conventional medication.
Sample characteristics:
two groups of heroin addicts consisting of in-patients (Group A, 30 males) and one of out-patients(Group B, 10 males)
Type of intervention:
Ascorbic acid at doses of 300 mg/kg b.w/day, supplemented with vitamin E (5 mg/kg b.w/day), was orally administered in two groups of heroin addict for a minimum of 4 weeks. The group A in-patients were also administered the conventional (diazepam + analgesic) medication.
Primary outcome measure(s):
 
Outcome:
The patients of the vitamin C-treated groups (in-patients and out-patients) experienced mild withdrawal symptoms (in 46.6% to 50% of the subjects) in contrast to the control group patients, who experienced mild withdrawal symptoms in 6.6% of the cases. The vitamin C-treated subjects expressed major withdrawal symptoms ranging from 10% to 16.6%, in contrast to the untreated subjects (control group), who expressed a major withdrawal symptoms in 56.6% of the cases. The results indicate that high doses of ascorbic acid administered orally may ease the withdrawal syndrome of heroin addicts. Further studies are needed in order to estimate the dose- and time-dependent effects of ascorbic acid treatment, and to clarify its mechanisms of action in the withdrawal syndrome.

Author(s):
Griffith CM. Schenker S.
Institution:
University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Title:
The role of nutritional therapy in alcoholic liver disease.
Source:
Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse & Alcoholism. 29(4):296-306, 2006.
Type of study:
Review (42 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Alcoholic liver disease (ALD) evolves through various stages, and malnutrition correlates with its severity. Poor nutrition is caused both by substituting calories from alcohol for calories from food, and by the malabsorption and maldigestion of various nutrients in alcoholic liver disease (ALD). The only established therapy for ALD consists of abstinence from alcohol. Sufficient nutritional repletion coupled with appropriate supportive treatment modalities may be effective in reducing complications associated with ALD---particularly infection. Nutrition makes a significant positive contribution in the treatment of ALD, especially in selected malnourished patients.
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Prayer
Author(s):
Miller WR. Bogenschutz MP.
Institution:
Center on Alcoholism, Substance Abuse and Addictions and the Department of Psychology, University of New Mexico, Albuquerque, NM.
Title:
Spirituality and addiction
Source:
Southern Medical Journal. 100(4):433-6, 2007.
Type of study:
Review (27 refs)
Control/comparison:
Not applicable
Sample characteristics:
Not applicable
Type of intervention:
Not applicable
Primary outcome measure(s):
Not applicable
Outcome:
Research on spirituality and addiction remains at an early stage, with recent developments in methodology. Correlational evidence supports an inverse relationship of substance use both with religiousness and with certain spiritual practices. Post-treatment abstinence has been associated with Alcoholics Anonymous attendance, Twelve-Step counseling, and training in mindfulness meditation. Emerging and future research on spirituality and addiction may yield important new knowledge useful in prevention and treatment.
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Qigong
Author(s):
Li M, Chen K, Mo Z.
Institution:
Institute of Qigong Research, Guangzhou University, People's Republic of China
Title:
Use of qigong therapy in the detoxification of heroin addicts
Source:
Alternative Therapies in Health & Medicine. 8(1):50-4, 56-9, 2002 Jan-Feb.
Type of study:
Randomized controlled clinical trial
Control/comparison:
no-treatment control group (n = 26)
Sample characteristics:
Eighty-six male heroin addicts, aged 18 to 52 years, who met the substance-dependence criteria of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised, with a history of heroin use from .5 to 11 years
Type of intervention:
qigong treatment group (n = 34), medication group (n = 26)
Primary outcome measure(s):
Urine morphine test, electrocardiogram, Hamilton Anxiety Scale, and a withdrawal-symptom evaluation scale were applied before and during the 10-day intervention
Outcome:
The qigong group practiced Pan Gu qigong and received qi adjustments from a qigong master daily. The medication group received the detoxification drug lofexidine-HCl by a 10-day gradual reduction method. The control group received only basic care and medications to treat severe withdrawal symptoms. Reduction of withdrawal symptoms in the qigong group occurred more rapidly than in the other groups. From day 1, the qigong group had significantly lower mean symptom scores than did the other groups. Both the qigong and medication groups had much lower anxiety scores than did the control group, and the qigong group had significantly lower anxiety scores than did the medication group. All subjects had a positive response to the urine morphine test before treatment. Fifty percent of the qigong group had negative urine tests on day 3, compared to 23% in the control group and 8% in the medication group. By day 5 of treatment, all subjects in the qigong group had negative urine tests, compared to day 9 for the medication group and day 11 for the control group. Results suggest that qigong may be an effective alternative for heroin detoxification without side effects, though we cannot completely eliminate the possibility of the placebo effect from the current study.
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