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Ask an expert - general
Q: Please do you have a list of acupuncturists who specialise in addictions therapy - especially in relation to gambling addictions?
A: Sadly we are not aware of anyone who specialises in the treatment of gambling addiction, nor are we entirely sure that acupuncture as a therapeutic intervention would be sufficient in itself to deal with this problem. There is usually, to use the jargon, a multifactorial approach, in which acupuncture is but one component.
There is very little by way of research in this field. If you google 'acupuncture' and 'gambling addiction' you will find a report commissioned in Ontario which concluded that acupuncture could at best be described as having a small but relatively unimportant effect and probably no effect at all. The study is well designed, although from a Chinese Medicine perspective the variety of treatments seems a little spartan. CM is predicated on individual treatments tailored to the unique needs of the patient, and delivering the same treatments to an entire group would not always be appropriate. However, the points used were some of the more powerful on the body and if there were to be an effect, they would surely generate it.
You may find that some of the groups contained within the acupuncture microsystems group registered with the CNHC might extend their work in auricular acupuncture to gambling. This database can be found at www.macrwg.org. There are also two organisations, NADA UK and SMART UK which deal with alcohol and drug addiction, each having several thousand members using the five point protocol and similar techniques. You may also find that these have a number of people who have dealt with gambling addiction.
In general, we tend to believe that Chinese medicine, treating as it does the person as much as the condition they have, can achieve some fairly extraordinary changes in all manner of conditions. For problems such as addictions, however, we tend to be more cautious, especially since we are aware that it often requires a more experienced practitioner not to be outflanked by a patient who is often very skilled at avoidance and deception.
It is always worthwhile talking to a BAcC member local to you to see what advice they can offer directly, and they may be aware of local initiatives. There are also practitioners in various fields such as hypnotherapy who may be able to offer solutions, but these are notoriously difficult to sort out by virtue of qualification alone, and a personal recommendation would be extremely useful. This 'expert' rather likes the approach taken by people using Ericksonian hypnotherapy methods, but these are also used in business coaching and not everyone who claims to be using the technique will necessarily be able to deal with a problem like addiction.
A: We tend not to like words like 'heal' and 'cure', partly because the former lends itself to pejorative interpretations of what we actually do and the latter begs the question of what counts as a 'cure' anyway. However, that aside, traditional acupuncture came into prominence in the popular consciousness in the West after Nixon's visit to China in the 1970s mainly as a form of pain relief, but has a 2500 year history of being used to treat a huge range of conditions, many very successfully. The World Health Organisation, for example, publishes a list
of all the conditions for which evidence of acupuncture's benefits can be demonstrated.
One of the principal reasons that acupuncture treatment has not received the recognition we believe it deserves in the UK healthcare system is that the standard of evidence required, the randomised double blind control trial, is more suitable for testing drugs, not dynamic interactions like acupuncture. Setting up trials is both costly and difficult, and at the moment no-one is particularly interested in funding them. It is interesting, though, that the NICE guidelines for conditions like lower back pain and some forms of headache now recommend acupuncture as an option.
Of course, a fundamental difference between Chinese medicine and orthodox medicine is that CM treats the person, not simply the illness or disease which they have, and to that extent to say that it deals with conditions is to miss the point slightly. Every patient with a named western condition will probably receive a different treatment because the presentation will be unique to each patient and with that the combination of points used and the reasons for using them. There is quite a large amount of background material on our website which explains this more thoroughly.
Why the emphasis on pain relief? Well, one certainty in measuring the effects of acupuncture in pain relief is that there are some very specific chemicals whose levels can be determined exactly, and for the purposes of research this is a very exact outcome measure. When acupuncture was first tested scientifically it was an obvious choice, and because the results were good, pain relief became associated with acupuncture as a primary reason for its use. For some types of pain acupuncture is a good choice, although from a Chinese medicine perspective pain arises from specific changes in the system. If the treatment did no more than provide temporary relief, a master practitioner would be asking themselves what else they could do to effect lasting change, and if that did not happen, would be talking to the patient about whether the extent of the relief and the time it lasted were worthwhile and whether other options for treatment might be more advisable.
Q: Is there any evidence for the use of acupuncture in the treatment of Lupus? I have been told it is considered to be a contraindication by the Lupus organisation.
A: There is a small amount of evidence that acupuncture treatment may be of benefit for people suffering with lupus/SLE. Studies such as this:
seem to point to a worthwhile benefit, but it is a single study with a relatively small sample group, so we cannot really put too much emphasis on the results. A much larger study would need to be done, and also need to be replicated by other researchers for us to make any specific claims.
One problem, of course, is that SLE can manifest in dozens of different ways, and at various levels of severity. There are very likely to be cases at the less serious end of the spectrum which go undiagnosed, and some which are diagnosed where the symptoms are relatively few and possibly respond well to treatment. At the other end of the scale there are severe cases which do not respond at all, and many of us have find memories of a professional colleague who died from SLE many years ago for whom enormous amounts of acupuncture were of no benefit.
The best view to take is that from a Chinese medicine perspective we treat the person not the disease. This means that although twenty people may have a standard named western condition, each one of the twenty may be diagnosed differently in Chinese medicine. The theoretical basis of CM is underpinned by a concept of energy, called 'qi', and its correct flow, rhythm and balance, and by an understanding of the Organs as functional units which do more than the western correlates (hence the capital letters). A skilled practitioner would look at the unique presentation of symptoms and make sense of these in terms of changes or disruptions in the flow and changes in the function of the Organs. This could mean that some cases were more amenable to treatment than others, but in every case would mean that the treatment was unique and different just as each individual is unique and different.
Our best advice is to visit a BAcC member local to you and seek their advice. There is no substitute for a face to face assessment of what may be possible. From a western perspective there is no 'cure' for SLE, but from our practical experience this is just one of a number of auto-immune diseases where we have seen a considerable slowing down or halt in the disease process, and for many patients 'getting worse slower' is a viable and valuable treatment aim.
As far as contraindications are concerned we have looked at all of the lupus organisation websites and have not seen anything which seems to contraindicate the use of acupuncture. If you have seen one we would be grateful to be sent details. If there is actual evidence of potential detriment we need to see it, and if not, we may need to discuss with them why they are 'dis-recommending' acupuncture. In severe cases where the immune system is badly compromised, our members all have clear guidelines to ensure that they minimise the risk of opportunistic infections, but we have never heard of any cases of problems arising as a consequence of treatment.
Q: Is the British Acupuncture Council on the approved list for blood donors, and what is the time scale for giving blood after a treatment?
A: The most recent press release which we published on this subject was in June 2013. It said:
Blood donation current status June 2013
Date: Friday, 21 June 2013 12:42
The BAcC continues to receive calls and emails about the NHBTS policy that any patient who has had acupuncture treatment delivered by a practitioner who is not statutorily regulated has to wait four months before they can donate blood. This change to the NHSBT's donor criteria came into effect in late 2009,and with the statutory regulation of acupuncturists now unlikely in the foreseeable future, this could mean that someone having regular treatment with a BAcC member would never qualify to donate blood.
The BAcC has exemplary safety standards and campaigned vigorously to challenge this decision. We have since done our best to make sure that all of our members let their patients know that they must wait four months to donate blood or bone marrow products.
The official notification and rationale for the decision is available onhttp://www.transfusionguidelines.org/docs/pdfs/dl_change_note_2009_32.pdf andhttp://www.transfusionguidelines.org/docs/pdfs/dl_change_note_2009_33.pdf but some enquirers have found this difficult to locate on official sites.
The BAcC is fully committed to reversing this decision for the benefit of the patients of its members. The recent accreditation of the BAcC under the Professional Standards Authority Assured Voluntary Register scheme has given us hope that this new flagship scheme will provide the recognition of exemplary standards the BAcC needs for its members to be granted exemption from the deferral period for donation.
Since then, we have met senior officials in the NHBTS, and discussed with them how we might help to re-instate the donation of blood by non-statutorily regulated healthcare profesisonals, there having been no reported instances of blood borne virus transmission by acupuncture practitioners in the last decade. In order to change policy, however, there has to be evidence, and the NHBTS is proposing to conduct an analysis of previous screened donors to establish the level of risk. This study will take place later this year or early this year.
The wheels of bureaucracy turn slowly, and until that time anyone who has had acupuncture treatment from a BAcC member will have to wait four months until they are allowed to give blood.
We are sorry that many thousands of donors have been 'disenfranchised' by this change of policy and are working our hardest to bring them back within the list of eligible donors.
China is a very large country, and it would be difficult to offer a definitive view. However, as we understand it, the majority of acupuncture practice in China is offered through the state hospital system, and there are a variety of degree qualifications which mean that most practitioners are also trained in western medicine to a far greater extent than would be the case in the UK. This reflects the fact that acupuncture is in many areas of clinical specialty offered within the state system, and the training which people undertake can be as much as five to seven years long. There are shorter degree courses in China, but these tend to harness acupuncture to a western clinical skill. With the difficulty of making sense of the apparently infinite varieties of course available this means that we often have problems with determining the full extent of someone's competence when they apply through our external applicant route. What we can say with some confidence, though, is that it would be highly unlikely to find a course in China which replicated the form of UK courses, with the acupuncture skill being primary and sufficient western medicine included (about one third of course time) to ensure that practitioners can integrate their work with conventional medicine and be aware of red flag conditions requiring immediate referral.
That said, there is no doubt that there are more rural areas where acupuncture is still an apprentice-style system, often within families, which is roughly how it was pre-1945, and in these areas one assumes that if a practitioner was good enough they would be able to eke out a living. How the authorities might react to this is another matter, and we have not heard of any western Europeans who have taken their skills back to China in this way.
However, a number of the UK courses have close affiliations with Chinese hospitals and universities, and their students undertake six week or three month study programmes in China, and often undertake postgraduate training in China. Working within a specialist hospital department may give a practitioner a chance to see hundreds, if not thousands, of similar cases in a very short period of time, and this can provide invaluable clinical understanding.
There are also a number of short courses in cities like Nanjing and Beijing which offer three or six month training from scratch to westerners, and many of the senior figures in the profession undertook this training when UK training was in its infancy. We have a number of members who in the last decade have begun their training in this way and gone on to work successfully in Chinese hospital departments, but it has to be said that in each case they have had to meet our requirements in the UK and had to undertake a fair bit of additional training in clinical management and western medicine before we could admit them to membership.
The short answer, though, is that it would probably be unusual for a UK trained practitioner to be able to drop straight into mainstream acupuncture practice in China because of the way that this is offered as part of an integrated package of medicine through the state system.