Military Medical Acupuncture and CAM: Next Steps

Abstract

Large-scale use of acupuncture and complementary and alternative medicine (CAM) therapies by civilian and military populations in recent decades has energized funding of acupuncture research, leading to advances in acupuncture investigation across multiple disciplines. Although significant questions and gaps in acupuncture research remain, current prospective controlled trials, meta-analyses and collaborative studies support the effectiveness of acupuncture in the treatment of many acute and chronic conditions and validate predictive models underlying the physiological effect of acupuncture. Side-effects and risks associated with polypharmacy approaches and inadequate relief from conventional therapies are reasons cited by many military members and civilians who seek holistic approaches and greater personal involvement in health maintenance and prevention. Military leaders and health care experts presently advocate an integrative approach to the treatment of mental and physical injuries affecting large numbers of returning combatants. Recent initiatives include funded training of military medical acupuncturists and hiring of full-time civilian acupuncturists in several military facilities. Increased patient demand for acupuncture in military treatment facilities and operational settings suggest that continued training of military medical acupuncturists and hiring of additional full-time civilian medical acupuncturists is needed to meet the demand for acupuncture services by military beneficiaries. Barriers to access to these services include: poor education of physicians and medical executives in the evidence relating to acupuncture; preconceived ideas concerning the role of complementary and alternative therapies in health care; and lack of acceptance of acupuncture as a Tricare Benefit. Future steps in military medical acupuncture and CAM therapies include: ongoing support for training; standardization of credentialing and peer-review processes; outcome research showing effectiveness of acupuncture in the treatment of mental and physical impairments in military populations; and demonstration of the effectiveness of acupuncture and other evidence-based CAM modalities in improving health-related quality of life and decreasing the burden of chronic conditions.