Abstract
Objectives To assess the efficacy of acupuncture in treating opioid use disorder (OUD). Design Systematic review and meta-analysis. Methods PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, ProQuest Dissertation and Theses, Allied and Complementary Medicine Database (AMED), Clinicaltrials.gov, and who.int/trialsearch were searched from inception to 23 December 2017. The methodological quality of selected studies and the quality of evidence for outcomes were assessed, respectively, by the Cochrane risk of bias assessment tool and the GRADE approach. Statistical analyses were conducted by RevMan 5.3. Results A total of nine studies involving 1063 participants fulfilled the inclusion criteria. The results showed that acupuncture could be more beneficial than no treatment/sham acupuncture in terms of changes in craving for opioid (MD -2.18, 95% CI -3.10 to -1.26), insomnia (MD 2.31, 95% CI 1.97 to 2.65), and depression (SMD -1.50, 95% CI -1.85 to -1.15). In addition, these findings showed that, compared to sham electroacupuncture (EA), EA had differences in alleviating symptoms of craving (SMD -0.50, 95% CI -0.94 to -0.05) and depression (SMD -1.07, 95% CI -1.88 to -0.25) and compared to sham transcutaneous acupoint electrical stimulation (TEAS), TEAS had differences in alleviating symptoms of insomnia (MD 2.31, 95% CI 1.97 to 2.65) and anxiety (MD -1.26, 95% CI -1.60 to -0.92) compared to no treatment/sham TEAS. Conclusions Acupuncture could be effective in treating OUD. Moreover, EA could effectively alleviate symptoms of craving for opioid and depression, and TEAS could be beneficial in improving symptoms of insomnia and anxiety. Nevertheless, the conclusions were limited due to the low-quality and small number of included studies. PROSPERO registration number is CRD42018085063.
Highlights
Opioid use disorder (OUD) is a serious substance-related disorder resulting from abuse or misuse of opioids [1]
Previous studies have shown that patients with OUD have a high risk of death and high rates of infectious diseases, for instance, human immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS), and hepatitis B and C [5,6,7,8,9]
Manual acupuncture (MA) was used in 1 study [24], electroacupuncture (EA) was used in 4 studies [22, 23, 34,35,36], auricular acupuncture (AA) was used in 2 studies [21, 37], and transcutaneous acupoint electrical stimulation (TEAS) was used in 2 studies [33, 38]
Summary
Opioid use disorder (OUD) is a serious substance-related disorder resulting from abuse or misuse of opioids [1]. With the increases in the prevalence of drug use disorders and the size of population, the disability-adjusted life-years (DALYs) attributed to drug use disorders increased by 24 percent from 2005 to 2015 [3, 4]. Opioids remain the most harmful drug type in health terms, which cause 70 percent of the global burden of disease attributable to drug use disorders [2, 4]. OUD is a worldwide health problem that seriously aggravates the burden on the individuals, family, and society [10, 11]
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