The patient waits for Wu Jing-Nuan in a sparsely furnished room at the Green Cross clinic at 15th and U streets NW. His meticulously tailored suit bespeaks a certain prosperity. Right now, he is out of work. This is the third time in the last 10 years that Wu has used acupuncture to treat him for cocaine abuse. He is run down. He has a cold. "I'm just looking to get back on my feet right now," he says. "I don't have any money."
"I feel I know the down side and the good side," he says. "The good side is an instant pleasurable sensation and the down side being everything else."
The first two times he went to Wu, he stayed straight for 18 months.
"People are obviously going to be skeptical," he says. "It definitely works. But he's not a magician. He can only do so much. Whoever is being cured has to take that extra step."
Green Cross of the Americas offers treatment for all sorts of addictions: food, tobacco, and other, illegal, substances. The clinic also offers the community conventional health care. D.C. law requires a physician to be on the premises to offer diagnosis and treatment at all times.
The ancient Chinese medical books say nothing about treating addiction with acupuncture. Research began in Hong Kong about 13 years ago when Wu was studying there. He began planning the Green Cross clinic 18 months ago, after watching the addiction of a friend's 18-year-old son tear the family apart. "An addiction is like everything else, a disbalance of the body's functions," he says. "In Chinese medicine, you can be sick from an excess of joy. An addiction is an excess."
Lincoln Hospital in New York was the first clinic in the United States to offer the treatment beginning in 1979. There are now clinics in Brooklyn, Minneapolis and New Mexico, and others planned in Boston, Chicago, Colorado and California. A national acupuncture detoxification conference is scheduled for Washington in April.
"The reality is staggering," says Dr. Michael O. Smith, a psychiatrist and medical director of the Lincoln Hospital acupuncture clinic. "People line up and parade in."
Smith says his clinic treats 200 detox patients a day (Green Cross ultimately will be able to treat 50 a day). He estimates that "90 percent get symptom relief after treatment." In testimony last spring before the Senate Mental Hygiene and Addiction Control Committee, Smith reported that 80 to 90 percent of their clients return for a second visit and that more than 60 percent attend daily for one to two weeks as recommended for short-term detoxification.
"Fifty percent of the people who do what we suggest have a substantial period of sobriety of several months," he says.
No one is clear exactly how or why acupuncture eases the symptoms of withdrawal. The explanations vary depending on the vocabulary. One western explanation is that the process releases endorphins, natural opiates, in the brain. The Chinese explanation is that the vital jing energy, the seed energy, is depleted by addiction. The treatment allows the body to replenish that energy and regain its natural balance.
"Unlike western methods which intervene in localized processes, acupuncture works by enhancing the body's own healing mechanisms," says Dr. Bernard Bihari, director of the Kings County Hospital Substance Abuse Program at Down State Medical Center in Brooklyn, N.Y.
"It eases the symptoms of withdrawal -- anxiety, depression, insomnia, cravings -- and balances the body energy so there is less desire for self-medication," says Green Cross director Gayle Hamilton, a psychologist who specializes in drug and alchohol treatment. "The most dangerous thing is people who misunderstand it."
"Or expect too much," Wu says. "This is not a cure."
Acupuncture is a system of ethics and philosophy as well as health care. It is based on the belief that energy flows through the body, maintaining both health and harmony with the outside world. Acupuncturists believe the energy flows along 14 meridians. When the flow is disrupted, acupuncturists rely on the stimulation of the needles at specific points along those meridians to restore it.
Wu generally uses four or five needles in each ear, one at the base of each thumb and one at the top of the head in detox treatment. The shen men point in the ear is "called the spirit door and is a point that is used over and over to balance the emotions," Wu says. "It relates to functions of the heart. Two of the others are related to the general nervous system and one relates to the lungs and liver. The ones in the hands relate to the lungs and large intestine. The one on the top of the head, bai hui, or 100 meetings, is again for emotional control."
The treatment is said to produce a sensation of well-being, which lasts up to 24 hours. Frequency of treatment depends on the drug involved. Heroin and alcohol patients are asked to come in every day for three weeks. Cocaine abusers are treated once or twice a week. The cost of treatment varies from $15 to $60 a session depending on the patient's ability to pay (treatment is covered by insurance). One advantage of acupuncture dextoxification is that it can be provided cheaply on an outpatient basis.
The statistics on drug rehabilitation are sobering. "The recovery rate across the board, regardless of the treatment, over long periods is under 50 percent," Hamilton says. "We're still on the losing end of the battle. For heroin, the recovery rate is probably under 10 percent."