Abstract
Discussion
Author: Margaret A. PATTERSON,
Pages: 55 to 62
Creation Date: 1976/01/01
An interim report is presented of an in-depth study of the effects of neuro-electric therapy in the treatment of drug addiction. It prevents withdrawal symptoms and appears to remove the craving for the drug of addiction. The long-term results are significantly better in those who receive even a short period of in-patient therapy, than in those who receive out-patient therapy only.
The treatment of drug addiction be electro-acupuncture was described by Dr. Wen,1in Hong Kong in 1973, following on a visit to China in 1972 to study the techniques used there. He had started investigating electro-acupuncture in order to use it a sanalgesia in his operations, when some of the patients on whom he was experimenting volunteered the fact that after 40 minutes of electro-acupuncture, they lost their desire for heroin. (Hong Kong has a massive drug problem and it is estimated that an average of 15 per cent of the hospital's surgical patients were opiate addicts.)
The author had been involved with drug addicts on a personal level for several years, because her husband was investigating, filming and writing about the drug problem in the Far East on a political and sociological level. The author was therefore able to help Dr. Wen find addicts who were willing to be treated for their drug dependency, and it was established that:
A 40-minute treatment with electro-acupuncture consistently stopped all withdrawal symptoms for a period of time;
repeated treatments over a 10-day period, according to the addicts, completely removed the desire of the addicts to take their drug of addiction.
Dr. Wen reported on the first 40 cases in the Asian Journal of Medicine[1] ; a single case was also described in detail by Dr. Sainsbury in the Medical Journal of Australia[2] and his results were witnessed by independent psychiatrists.
It is significant that over 100 cases treated in Hong Kong before the author left there to return to the United Kingdom in July 1973, received no counselling whatsoever, no social support, no psychotherapy. In fact, their presence in the surgical wards (no other hospital beds being available) was deeply resented by the overworked surgical nurses; also the doctors treating them, all surgeons, were frequently unavailable. In spite of this, there was complete success in taking them off their drugs without any medication. When some patients developed acute withdrawal symptoms while no doctor was available, the symptoms ceased within 15 to 20 minutes of the commencement of a treatment. No follow-up of these patients has been published so far, nor of patients who are being treated by the same method in other centres in Australia, the United States of America and the Far East [3] .
1The author was Head of Surgery in the 850-bed Chinese Hospital in Hong Kong, of which Dr. Wen was neuro-surgical consultant.
The purpose of this preliminary report is to provide information on follow-up of 23 cases treated in London.2In addition, no cases who came to the author were refused treatment, and all were very hard-core addicts, except for cases 5 and 6 in the out-patient series. Two cases who were registered addicts had been pronounced by several psychiatrists as being "hopeless" cases who could never be taken off drugs. Another three cases, illegal users, were described by friend and foe alike as being "evil" in their drug-use and the author was warned not to treat them. These five cases were all treated as in-patients and have progressed well.
The technique, which the author is currently researching and developing, has been described in detail elsewhere [4] , [5] ; it is a modification of Dr. Wen's original technique using acupuncture needles. The author now uses only blunt electrodes, incorporated in a comfortable headset, so that the patient is free to move around during treatment, and especially to sleep all night with the electrodes in situ. By using only blunt electrodes, there is no danger of infection or hepatitis [6] , [7] , and the pain of repeated needling is avoided.
The electrodes make contact in the concha of each ear, and a small electric current in the 1-2 mAmp range is passed through them from a portable stimulator with varied wave-forms and pulse-widths, and with a range of frequencies from 5 to 2,000 cps. The frequency is the most significant factor in the choice of parameters of current.
The immediate effect of this current-application in preventing or stopping withdrawal symptoms in drug dependency without the use of any substitute drug at all has already been demonstrated to be at least partly neuro-chemical [8] , [9] , but the long-term effects in removing the craving for the drug of addiction may eventually be shown to be due to actual reconditioning of certain brain-circuits [10] .
Laboratory research has been conducted into the electro-chemical effects of the currents used in order to determine the modus operandi, and to establish accurate parameters of current for treatment. The results of the first year's research in alcohol studies have shown to be of potential significance for clinical application in alcoholism, and similar studies are planned for other drugs such as heroin, methadone and barbiturates.
Two series of consecutive, unselected cases are summarized in tables 1 and 2. The first series were given in-patient treatment; the second series were treated as out-patients because of lack of appropriate residential facilities, and their drugs were therefore easily obtainable at any time during the course of treatment. The follow-up reports refer to mid-December 1975, and are based on personal interview and the reports of family and close friends.
It is obvious from these brief records that a short initial period of in-patient therapy is preferable, because the addict under drugs lacks the wi power not to take what is readily available to him.
The follow-up in this brief outline is confined to [1] drug recidivism and [2] improvement in attitude and behaviour as estimated by the doctor and by relatives or close friends of the drug addict.
Also, intensive "flooding" techniques can be used effectively only in an inpatient setting. This method has been employed, particularly in bereavement, to compel the patient to face up to the specific problems of his or her loss. Dr. Ramsay of the University of Amsterdam, for example, would give intensive psychotherapy over a period of 2 to 3 weeks, instead of allowing the bereaved to accommodate gradually over the months to new and difficult situations. It is claimed that this method diminishes both the suffering and the apathy. It is particularly applicable to drug addicts, who frequently describe their separation from heroin as resembling, but being more agonizing than losing husband or wife.
It must be strongly emphasised that, in order to prevent recidivism, this neuro-electric therapy is only part of the total treatment of an addict; of equal importance is the intensive counselling on the rebuilding of their lives, during the therapy period. However, evidence is emerging that the addict is significantly more receptive to such counselling or to psychotherapy when receiving simultaneous N.E.T., than in any other method of withdrawal from drugs.
All the cases described received some counselling during the therapy period, usually insufficient because of lack of time and personnel. None received any structured rehabilitation, and the long-term results have been remarkably successful notwithstanding this deficiency. It is hoped that adequate rehabilitation will be available in the future.
An important side-effect of the N.E.T. was regularly observed, viz. that the sleep pattern returned to normal far more rapidly than is usual in withdrawal of narcotics. This is a major problem to the addict in other methods of withdrawal, the sleep pattern taking 40 to 60 days to return to normal, with a consequent risk of addiction to sedatives. There is also a consistent increase in optimism, in contra-distinction to the usual depression.
Addiction to barbiturates, alcohol and nicotine will be reported in a later series, as will dependency on tranquillizers and sedatives among the middle-aged.
H.L. Wen and S.Y.C. Cheung. "Treatment of Drug Addiction by Acupuncture and Electrical Stimulation", Asian Journal of Medicine, 9, 138-141, 1973.
002M.J. Sainsbury. "Acupuncture in Heroin Withdrawal", Medical Journal of Australia, 2, 102-105, 1974.
003Peter G. Bourne. "Acupuncture in the Treatment of Narcotic Addiction", Paper presented at 31st International Congress on Alcoholism and Drug Dependence, Bangkok, Thailand, February, 1975.
004Margaret A. Patterson. "Electro-Acupuncture in Alcohol and Drug Addictions", Clinical Medicine, 81 (1), 9-13, 1974.
005Margaret A. Patterson. "Acupuncture and Neuro-Electric Therapy in Treatment of Drug and Alcohol Addictions", Australian Journal of Alcoholism and Drug Dependence, 2 (3), 90-95, August, 1975.
006K.F. Hussain. "Serum Hepatitis Associated with Repeated Acupuncture", Letter to British Medical Journal, 1974 (Vol. 3), 41-42, July 6, 1975.
007P. Alexander, G. Hamilton Fairley and D.W. Smither. "Repeated Acupuncture and Serum Hepatitis", Letter to British Medical Journal, (Vol. 3), 466, 1974.
008Peking Medical College, Research Group of Acupuncture Anaesthesia. "The Role of Some Neurotransmitters of Brain in Finger Acupuncture Analgesia", Scientia Sinica , 17 (1), 112-130, 1974.
009D.J. Mayer. "Pain Inhibition by Electrical Brain Stimulation: Comparison to Morphia", Neuro-Sciences Research Progress Bulletin , 13 (1), 94-100, 1975.
010Margaret A. Patterson. " Addictions Can Be Cured ", Berkhamsted, England: Lion Publishing, 1975.
