is this alternative medicine?

Is this ALTERNATIVE MEDICINE?

(AcuDetox Adapted for Stress Management)

Now, some 35 years later, AcuDetox (including two further points added by Dr. Smith) is well known throughout the Western world. Three major University of Toronto hospitals - The Toronto General Hospital, the Toronto Western Hospital and St. Joseph’s Hospital have OHIP-funded AcuDetox Units for the treatment of substance addiction.

The National Acupuncture Detoxification Association (N.A.D.A. ) was created by Dr. Smith in 1985 to train health care professionals to provide AcuDetox. NADA’s web site is HERE. NADA training allowed the above hospitals, and more lately others such as Ottawa’s Montfort Hospital and a number of Ontario Ministry of Health-sponsored Community Health Centres to be staffed with NADA-trained acupuncture technicians for several years, leading, finally, to their legislated accreditation their accreditation by Ontario Bill 50 in April 2013. NADA, prior Smith’s retirement in 2012 trained people at the Lincoln Hospital in New York City. At the time of the World Trade Centre disaster on September 11th 2001, our clinic had maintained a 6 year collegial to-and-fro interchange with Dr. Smith integrating our adapted stress management use of the NADA Protocol. Smith, seeing that New York’s mental health resources were overwhelmed in the aftermath opened the doors of the Lincoln Hospital to traumatized New Yorkers. They made a movie of the dramatic results, the trailer of which can be seen by CLICKING the Icon on the right/below.

The story of Michael O. Smith’s AcuDetox (and our add-on adaptation, AcuDestress) begins in 1972 when Hong Kong neurosurgeon, Dr. H.L. Wen, using three of the five AcuDetox points to provide anesthesia for operations, hears from an excited patient that his longstanding addiction to opium has suddenly and precipitously disappeared - after a single treatment.

If one practices acupuncture for long enough, such one-treatment wonders occur from time to time. Acupuncturists like Dr. Wen are appropriately alerted to the inherent possibilities, and Dr. Wen discovered that most people experience powerful relief from addiction, and that the time frame is more-or-less daily treatment for three weeks. Now, Dr. Wen’s discovery is used at 1500 sites around the world, thanks to the efforts of Dr. M.O. Smith, who brought it to the Lincoln Hospital in New York City in the 1970’s.

By CLICKING the icon above, one sees the NADA PROTOCOL administered in our clinic by NADA trainee, Maureen Fallis

Almost accidental beginnings...

championed by a true pioneer, Dr. Michael O. Smith!

Toronto General Hospital

Toronto Western Hospital

AcuDetox® NADA Dr. H.L. Wen M.D. Michael Smith

Protocol M.D., D. Ac.

St. Joseph’s Hospital

Smith, himself, had begun to realize AcuDetox’s greater potential, from studies showing that prison inmates successfully treated for substance addiction with 5-point ear acupuncture were much less likely to return to crime when released. He saw that his addicted patients, as they lost their addictions, were also losing undesirable personality traits which accompanied them. CLICK THE PICTURE ON THE RIGHT to see a short movie trailer that shows how, when the World Trade Centre disaster occurred in 2001, Smith, impelled to act, took occasion to test it out. The results were so successful, that efficacy of this unusual treatment is now widely known.

As a result of the 40,000 highly successful 5-point ear acupuncture treatments provided to the New York City victims of the massive trauma represented by the destruction of the World Trade Centre and the 3,000+ lives lost, the City of New York now funds a team called Acupuncturists Without Borders, who fly out to massive trauma events around the world to provide instant and effective treatment. The first successful mission was Hurricane Katrina in New Orleans. Since then they have flown dozens of effective missions.

So, is AcuDestress conventional medicine or a complementary and alternative approach?

While use in hospitals, especially university-based hospitals is usually a indicator that a treatment modality is conventional or mainstream the Ontario College of Physicians and Surgeons (CPSO) ultimately define (as seen on their web site) which treatment modalities are complementary and alternative in Ontario. Other jurisdictions have other definitions, so we are only talking here about using what applies here in Ontario. CPSO has created a definition of the difference between Conventional Medicine and Complementary / Alternative Medicine.

CPSO Terminology

Conventional Medicine: Refers to the type of treatment, diagnostic analysis and conceptualization of disease or ailment that is the primary focus of the curricula of university faculties of medicine. It is sometimes referred to as traditional medicine or science-based medicine and is the type of medicine that is generally provided in hospitals and in specialty or primary care practice.

Complementary/Alternative Medicine (CAM): Refers to a group of diverse medical practices and products that are not generally considered part of conventional medicine. They are also sometimes referred to by other terms, such as non-traditional, and non-conventional. The boundaries between CAM and conventional medicine are not absolute and some specific CAM practices may become incorporated into conventional medicine.

While in Ontario the identically-constituted use of ear acupuncture (AcuDetox) as is employed in AcuDestress is used to treat substance addiction in university hospital settings at the Toronto General Hospital, the Toronto Western Hospital and the St. Joseph’s Hospital, the Ottawa Montfort Hospital and perhaps more unknown to the author, and while the Toronto hospitals departments who use it have been funded by OHIP for several years as pilot projects, Smith’s 5-point ear acupuncture is still not widely known. Legislation (Ontario Bill 50 The Traditional Chinese Medicine Act) regulated acupuncture in Ontario in 2013 and specifically included this form.

Smith’s five-point ear acupuncture is offered by at least three Community Health Centres (CHC’s) run by the Province of Ontario Ministry of Health. Ours, South East Ottawa Community Health Centre is one of those CHC’s - and the practice was scrutinized by the Board of Governors before it was used, and was deemed both safe and appropriate, for stress management. Ontario hospitals hire and utilize physiotherapists who apply acupuncture. The Worker’s Compensation Board of Ontario includes acupuncture in its fee schedule, paying for such treatments.

McMaster University medical school sponsors a teaching program for physicians and others to teach acupuncture, and acupuncture is included in the physician fee schedule of the Ontario Workers Compensation Board. Does all of this constitute being part of conventional medicine? Not really, one might conclude, but it’s close. Currently acupuncture is seen as alternative medicine despite the fact that, in 2009, neuroscientists Richard Harris at the University of Michigan and Vitaly Napadow at Harvard University determined by neuroimaging the differing tangible effects of both true and sham on the brain’s µ-opioid receptor network (MOR’s). Interestingly enough, Harris and Napadow found the seat of acupuncture to be exactly located where the neuroimaging changes for Borderline Personality Disorder are also located.

The National Post in 2011 said:

”A proposal by Ontario’s medical regulator to take a more liberal approach to homeopathy, acupuncture and other alternative health care has drawn sharp criticism from some national doctors’ groups, who warn the draft rules mark a shift away from scientifically backed treatment.

Others are applauding the more inclusive tone adopted by the College of Physicians and Surgeons, whose suggested policy highlights a growing, if controversial, legitimacy around non-conventional health care in Canada.

The Ontario College, which licenses and disciplines physicians in the province, said it decided to revisit its policy partly because of the apparent increase in popularity of alternative care. The new document says doctors should respect patients’ wishes to try non-conventional care, avoid expressing personal judgments of alternative medicine and require “sound evidence” but not necessarily clinical trials to back up any alternative treatments they use.”

The Range of Neuromodulators in Use in Ontario by Physicians

Every treatment considered should be compared with alternatives available. It is estimated in various surveys that one third to 40% of those seeking treatment for longstanding mental health problems are refractory to traditional means of treatment. This has pushed the pharmacology industry to put forward new antidepressants such as Vortioxetine, but has sent treatment-oriented practitioners looking for non-medication solutions. Many of those who fail to respond to medication fail to respond to psychotherapy on account of being alexithymic i.e. - unable to feel their own or others’ emotions or to fashion creative responses to adversity. 30-40% of our patients are alexithymic, so it was natural to look for a neuromodulator to treat such an untreatable condition. in Toronto, Sunnybrook Hospital devotes a total department to neuromodulators such as those listed below - most of which would now be considered conventional medicine.

The use of acupuncture for mental emotional conditions which are not successfully treated by more traditional means - antidepressants like Prozac or psychotherapies like Cognitive Behavioural Therapy (CBT) are going up against a success rate of zero. So, if it has any efficacy at all, and it does, considerably, it is worth consideration. There are somewhat more conventional therapies which can do the same thing, the so-called neuromodular approaches, like ketamine for intractable depression, and MDMA for intractable PTSD but facilities which offer them are few and far between. and administration in terns of how they are best used is still experimental.

There are electronic means of treatment which have largely supplanted Electroconvulsive Therapy (ECT) repetitive Transcranial Magnetic Stimulation (rTMS), and transcranial Direct Current Stimulation tDCS, (tDCS) which are up-and-coming methods sometimes with costs involved. Finally, there is highly successful but highly expensive neuromodulator, Deep Brain Stimulation (DBS) which has a high success rate, but which would be hard for most to afford at $40,000 unless covered by insurance. Our web site area pointed towards referring clinicians has featured, since the outset, a web page Doctor-to-Doctor which explains, in context the science of neuromodulation, and AcuDestress in specific, to physicians and other clinicians.

Finally there is the highly-promising Portable Neuromodulation Stimulator (PoNS) which is investigative as yet, but which holds a great deal of promise. So let’s call AcuDestress Complementary and Alternative Medicine for now, at least until it’s better known and until we can produce a large enough study showing a reduction in our patients’ Hamilton Depression Index. Studies of this nature are in process as we speak. They may go a long way to settle the question.

Usage of 5-Point Ear Acupuncture With Less-Well-Known

but Conventional Psychotherapies

A significant addition we’ve made to Smith’s use of 5-point ear acupuncture is definitely considered conventional medicine, but remains little known - transpersonal psychotherapy - an approach initiated by psychoanalytic pioneer Roberto Assagioli - which is also used with other neuromodulators like ketamine and MDMA. You can read about mainstream transpersonal psychotherapy in article such as Joseph Nicholson’s article on Stanislaus Grof’s Holotropic Breathing.

The success of transpersonal psychotherapy, as Assagioli found, relies, at least to a degree in categorizing patients in terms of personality structures in contrast to diagnostic categories, like the DSM-IV and DSM-5. It looks at patients treatment needs as unique to them rather than being served by attempts at “one size fits all” methods. Just as Michael Stone has suggested in Personality-Disordered Patients - Treatable and Untreatable, those same patients who have intractable responses to medications or therapy are often suffering from personality disorders, even two or more co-morbidly occurring disorders, which are rendered even more difficult to treat when pigeon-holed.

As we now have several neuromodulators at our disposal or can refer patients for treatment with them (for instance, I refer refractory patients to the Royal Ottawa Hospital for ketamine treatment) one can readily see that naming the entity which is manifesting is not only the least helpful step in our treatment regime of trial-and-error, but may actually lead us astray. Many reasons exist today for moving beyond traditional diagnosis (DSM) usually for the same reason that we are now looking for means to treat the patients we now find untreatable. Professor G. Kenneth Bradford at John F. Kennedy University has authored a text book for psychotherapy students The I of The Other, which helps create diagnostic activity which goes beyond conventional labelling. We are moving in Bradford’s direction.

Suffice it to say that while our approach may be overarchingly “alternative” the tools we use to find means which will work for our alexithymic and otherwise challenged patients are always selected from evidence-based trials, more tried and true than say, a new antidepressant which has just come on the market.