July 30, 2009

Characteristics of Substance Abuse Treatment Facilities Offering Acupuncture

Acupuncture is one of the oldest healing practices in the world, and it has been used to treat a wide spectrum of medical conditions and diseases. Recently, acupuncture was identified as one of the fastest growing complementary or alternative therapies covered by private insurance companies in the United States.^1,2

Acupuncture was introduced into alcohol and drug abuse treatment in the 1970s. Clinical trials of acupuncture to treat chemical dependency have been conducted and focused on different substances of abuse (e.g., opiates and cocaine), within different therapeutic settings, and among different populations.^3,4 The results of these clinical trials are mixed and often hindered by small sample sizes, lack of study controls, and inability to control for placebo effects.⁵ Anecdotal evidence suggests that acupuncture can relieve the physical symptoms of withdrawal during detoxification, increase feelings of relaxation during therapeutic rehabilitation, and relieve or prevent cravings during relapse prevention. Acupuncture proponents point out that it is a low-risk, low-cost therapy that does not require medication, produces no side effects, and causes little to no discomfort.

Using data from the 2007 National Survey of Substance Abuse Treatment Services (N-SSATS), the primary objective of this report is to examine general characteristics of the 587 facilities (4 percent of all facilities nationwide) that offered acupuncture as a part of substance abuse treatment. Selected comparisons are made between facilities that offered acupuncture and all substance abuse treatment facilities in general.

The majority of substance abuse treatment facilities that offered acupuncture were privately owned and operated (77 percent), either by a for-profit entity (25 percent) or a non-profit organization (52 percent). In addition, 11 percent of facilities offering acupuncture were operated by local governments, 6 percent by State governments, and 6 percent by Federal or tribal governments. When compared to all substance abuse treatment facilities nationally, a smaller proportion of facilities offering acupuncture services were privately owned and operated, but a higher proportion were operated by local, State, and Federal or tribal governments.

N-SSATS categorizes substance abuse treatment offered by facilities into three main types of settings—hospital inpatient, residential, and outpatient. Some facilities provide one type of care only while others provide a combination. Of the facilities offering acupuncture, 56 percent offered outpatient treatment only, and 21 percent offered residential treatment only (Figure 1). Approximately 13 percent of facilities that offered acupuncture offered opioid treatment programs (OTPs), a slightly higher percentage than all substance abuse treatment facilities (8 percent).

More than a third (38 percent) of facilities that offered acupuncture also offered detoxification services. Most facilities that offered both acupuncture and detoxification services reported detoxifying clients from opiates (95 percent), and the majority reported detoxifying clients from alcohol (87 percent) or cocaine (81 percent).

Facilities that offered acupuncture services most commonly accepted cash or self-payments (85 percent), private health insurance (63 percent), or Medicaid payments (56 percent) (Figure 2). Over a third of these facilities also accepted State-financed health insurance (40 percent) or Medicare payments (38 percent). A smaller percentage accepted Federal military insurance such as TRICARE or Champ VA (31 percent). Substance abuse treatment facilities offering acupuncture were more likely than facilities in general to accept Access to Recovery (ATR) vouchers (26 versus 10 percent) and slightly more likely to accept other State-financed health insurance (40 versus 34 percent).

Overall, N-SSATS data show that substance abuse treatment facilities that offered acupuncture provided traditional assessment and treatment services to clients. Specifically, screening for substance abuse (95 percent) and comprehensive substance abuse assessment and diagnosis (92 percent) were provided by most facilities that offered acupuncture. Almost three-quarters provided screening for mental health disorders (72 percent), and more than half provided comprehensive mental health assessment or diagnosis (53 percent) or community outreach (53 percent). A smaller percentage offered interim services when admission was not possible (44 percent).

The majority of facilities that offered acupuncture also provided the four main types of counseling services. Among facilities that offered acupuncture, most offered individual counseling (98 percent) and group counseling (93 percent), and a majority offered family (77 percent) and marital/couples (56 percent) counseling. A similar proportion of all substance abuse treatment facilities provided individual counseling (96 percent), group counseling (89 percent), and family counseling (72 percent). However, facilities that offered acupuncture were more likely than all substance abuse treatment facilities nationally to provide marital/couples counseling (56 versus 45 percent).

The most common types of testing provided by facilities that offered acupuncture included drug or alcohol urine screening (92 percent), breathalyzer or other alcohol blood testing (75 percent), and tuberculosis (TB) and Human Immunodeficiency Virus (HIV) testing (56 and 54 percent, respectively). Less than half of the facilities offered sexually transmitted disease (STD) (42 percent) or Hepatitis B or C (43 and 46 percent) testing services.

Most facilities that offered acupuncture also offered other ancillary or transitional services, which are services central to and supportive of the needs of clients. Such services included substance abuse education (98 percent), discharge planning (96 percent), case management (87 percent), and aftercare or continuing care (82 percent) (Table 1). The majority also provided social skills development, HIV or Acquired Immunodeficiency Syndrome (AIDS) education, counseling, or support, other health education, mental health services, assistance obtaining social services, self-help groups, mentoring/peer support, assistance locating housing, and transportation assistance to treatment.

Overall, 82 percent of facilities that offered acupuncture also offered at least one special program or group to serve a specific client type. The majority offered a specially designed program or group for adolescents (64 percent), adult women (55 percent), and clients with co-occurring disorders (52 percent) (Table 2). Substance abuse treatment facilities offering acupuncture were more likely than substance abuse treatment facilities in general to offer specially designed programs or groups for various client types. Most notably, facilities that offered acupuncture were twice as likely as all substance abuse treatment facilities to offer programs for adolescents (64 vs. 31 percent) and persons with HIV/AIDS (20 vs. 10 percent).

Acupuncture is offered by a very small percentage of substance abuse treatment facilities nationwide. However, facilities that offer acupuncture tended to offer many other types of services that are designed to support recovery and address the needs of specific clients. Thus, although acupuncture may be viewed as an “alternative” therapy, facilities that offer acupuncture do so in the context of a broad range of traditional approaches to treatment.

¹ Burke, A., Upchurch, D. M., Dye, C., & Chyu, L. (2006). Acupuncture use in the United States: Findings from the National Health Interview Survey. The Journal of Alternative and Complementary Medicine, 12 (7), 639-648.
² Henry J. Kaiser Family Foundation and Health Research and Educational Trust. (2004). Employer Health Benefits 2004 Annual Survey. Menlo Park, California.
³ Jordan, J. B. (2006). Acupuncture treatment for opiate addiction: A systematic review. Journal of Substance Abuse Treatment, 30, 309-314.
⁴ Moner, S. E. (1996). Acupuncture and addiction treatment. Journal of Addictive Diseases, 15, 79-100.
⁵ Otto, K. C. (2003). Acupuncture and substance abuse: A synopsis, with indications for further research. The American Journal on Addictions, 12, 43-51.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (July 30, 2009). The N-SSATS Report: Characteristics of Substance Abuse Treatment Facilities Offering Acupuncture. Rockville, MD.

This page was last updated on .

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.    Site Map | Contact Us | Accessibility | Privacy Policy | Freedom of Information Act  Disclaimer | Department of Health and Human Services | SAMHSA | White House | USA.gov * PDF formatted files require that Adobe Acrobat Reader® program is installed on your computer. Click here to download this FREE software now from Adobe. What's New Highlights Topics Data Drugs Pubs Short Reports Treatment Help Mail OAS