Table 1: Summary of studies included in the review.

Author (year)Jadad scoreNo. of subjects (acup/control)Mean age (male%)Inclusion criteriaIntervention typeTreatment frequency (duration)Treated acupointsType of
control group
Outcome measureResults
reported
Adverse events

Washburn et al. (1993), [43] USA1100 (55/45)(1) Standard treatment group: 40.5 (63%)
(2) Sham treatment group: 40.4 (73%)
Self-reported with history of intravenous use of heroin confirmed by physical examination for signs of recent needle useAADaily
(21 days)
Sympathetic
Shenmen
Kidney
Lung
Nonspecific points(1) Attendance rate
(2) Self reports of frequency of heroin use
(3) Urinalysis
(1)
(2)
(3) NS
(1) Slight bleeding
(2) Mild nausea
(3) Mild dizziness

Wells et al. (1995), [44] USA360/(31/29)(1) Specific group: — (54.8%)
(2) Nonspecific group: — (48.3%)
Only subjects for whom opiates were determined to be the primary drug and who met federal requirements for entry into methadone treatmentAAPhase I: 5 days per week
(2 weeks)
Phase II: available on a daily basis
(6 months)
Sympathetic
Shenmen
Kidney
Lung
Liver
Nonspecific points(1) Attendance and retention rate
(2) Self-reported symptoms
(3) Cravings
(4) Methadone dose
(5) Urinalysis
(1) NS
(2) NS
(3) NS
(4) NS
(5) NS
NR

Zhang et al. (2000), [45] China1181 (121/60)(1) Specific group: 27.1 (—)
(2) Control group: 25.4 (—)
(1) DSM III for opiate dependence
(2) Positive morphine in urine
HANS (The frequency was 2/100 HZ; the intensities were 12–16 mA on arms and 16–26 mA on legs)Phase I: 4 times per day
(3 days)
Phase II: Twice a day
(3 days)
Phase III: Once a day
(7 days)
Hegu (LI4)
Laogone (PC8)
Neiguan (PC6)
Waiguan (SJ5)
Zusanli (ST36)
Sanyinjiao (SP6)
Electrodes were placed at the acupoints without any electrical stimulation(1) Heart rate
(2) Body weight
(3) Sleeping time
(4) Chilling
(5) Pain
(6) Anxiety
(7) Catarrh
(8) Craving
All 8 indices improved significantly ( )NR

Montazeri et al. (2002), [46] Iran240 (20/20)(1) Specific group: 32 (100%)
(2) Control group: 31 (100%)
Self-reported with history of heroin or opium addiction less than 6 monthsBody acupuncture with manual stimulationOnce per day for 3 daysHegu (LI4)
Neiguan (PC6)
Zusanli (ST36)
Shenmen (HT7)
Taichong (LR3)
Dazhui (DU14)
Baihui (DU20)
ROD by naloxoneCINAThe acupuncture group had smaller increase in CINA score compared to control group ( )No adverse events

Wu et al. (2003), [47] China1120 (30/30/30/30)(1) Acupuncture group: — (—%)
(2) Acupuncture plus opium group: — (—%)
(3) Opium plus buprenorphine group: — (—%)
(4) Opium plus HANS group:
— (—%)
(1) CCMD II-R and DSM III-R for: opiate dependence
(2) Positive morphine in urine
Body acupuncture with manual stimulationPhase I: Twice a day (3 days)
Phase II: Once a day (7 days)
Sishencong (EX-HN1)
Neiguan (PC6)
Hegu (LI4)
Zusanli (ST36)
Sanyinjiao (SP6)
(1) Opium plus buprenorphine therapies
(2) Opium plus Han’s therapies
(1) Opiate withdrawal scale
(2) Craving degree with VAS
(1) Acupuncture group showed significant improvement in withdrawal syndrome after the 6th day ( )
(2) Acupuncture group showed significant improvement in craving degree after the 8th day ( )
Mild dry mouth

Wen et al. (2005), [48] China2220 (111/109)(1) Acupuncture group:
33.9 (77.5%)
(2) Control group:
33.8 (78.0%)
(1) DSM IV for opiate dependence
(2) Positive morphine in urine
Body acupuncture with manual stimulationOnce a day (10 days)Hegu (LI4)
Neiguan (PC6)
Zusanli (ST36)
Waiguan (SJ5)
Shenmen (HT7)
Sanyinjiao (SP6)
Oral administration of lofexidine hydrochloride(1) Withdrawal symptom
(2) Self-Hamilton anxiety scale
(1) Acupuncture group showed significant improvements in withdrawal syndrome before and after treatment ( )
(2) Acupuncture group showed significant improvement in the score of the self-Hamilton anxiety scale after the 4th day ( )
NR

Margolin et al. (2005), [49] USA140 (20/20)(1) Five-needle NADA protocol group: 43.1 (65%)
(2) Modified NADA protocol group: 42.6 (55%)
HIV-positive methadone-maintained patientsAA5 days per week
(8 weeks)
Sympathetic
Shenmen
Kidney
Lung
Liver
Month 1:
Shenmen
Month 2:
Sympathetic
Shenmen
Lung
(1) Retention rate
(2) Attendance rate
(3) Drug use
(4) Changes in depression and anxiety
(1) NS
(2) NS
(3) NS
(4) NS
NR

Zeng et al. (2005), [50] China170 (35/35)(1) Treatment group:
33.1 (83.9%)
(2) Control group:
34.2 (80.8%)
(1) DSM III-R for opiate dependence
(2) Positive morphine in urine
(3) Had opioid withdrawal syndrome
Body acupuncture with manual stimulationOnce a day (10 days)Baihui (GV20)
Dazhui (GV 14)
Shendao (GV11)
Lingtai (GV10)
Zhiyang (GV9)
Mingmen (GV4) of the Du channel
Methadone 10-day decrescendo therapyScores of daily withdrawal symptomsAcupuncture group showed significant improvement in withdrawal symptoms on the 1st, 2nd, 4th, 6th, 7th, 8th, 9th, and 10th days ( or )NR

Mu et al. (2005), [51] China2120 (30/30/30/30)(1) Acupuncture group I:
29.5 (40%)
(2) Acupuncture group II:
29.7 (43.3%)
(3) Simulation group:
28.6 (33.3%)
(4) Control group:
31.7 (43.3%)
(1) ICD-10 for opiate dependence
(2) Negative morphine in urine
(3) Had opioid withdrawal syndrome
Body acupuncture with electrical stimulation (The frequency was 5 Hz; the intensity was 5 mA)3 times a week (10 weeks)(1) Acupuncture group I: Jiaji (EX-B2)
Shenshu (BL23)
(2) Acupuncture group II:
Neiguan (PC6)
Zusanli (ST36)
Shenmen (HT7)
Sanyinjiao (SP6)
(1) Simulation group: ST36, SP6 without electrical stimulation
(2) Control group: no treatment
(1) Withdrawal symptom
(2) Hamilton anxiety scale (HAMA)
(3) Self-rating depression scale (SDS)
In the treatment of 4, 8, 10 weeks, acupuncture groups I and II showed significantly decreased withdrawal syndrome, HAMA, and SDS ( )NR

Bearn et al. (2009), [52] UK383 (48/34)(1) Acupuncture group: 36.2 (73%)
(2) Control group: 35.7 (79%)
DSM IV for opiate dependenceAAOnce a day on weekdays
(14 days)
Five points in the ear cartilage ridge area (acupoints not mentioned)Application of oil to the ear followed by the attachment of 5 metal clips(1) Withdrawal symptoms
(2) Craving
(1) NS
(2) NS
NR

Note. Code. NR: not reported; NS: not significant; AA: auricular acupuncture; HANS: Han’s acupoint nerve stimulator; ROD: rapid opiate detoxification; CINA: clinical institute narcotic assessment; CCMD: Chinese Classification of Mental Disorders; DSM: The Diagnostic and Statistical Manual of Mental Disorders; ICD: International Statistical Classification of Diseases and Related Health Problems; VAS: visual analogue scale.