Firefighting

More than 42,000 Americans died from opioid overdoses in 2016. In 2009 at least 23.5 million people over the age of 12 needed treatment for illicit drug or alcohol use in the US. That number is growing dramatically.

People are dying.

LAcs are rightfully enthusiastic about the use of acupuncture to treat the physical and emotional pain that can lead to the use of and dependence on addictive medications and drugs. We have been proud of the history of auricular acupuncture helping those who struggle with addiction.

The development of a profession of Licensed Acupuncturists and the spread of acupuncture detox specialists happened comfortably, side-by-side, for a long while. Lincoln Recovery in the Bronx was treating addicts with acupuncture in 1974. In 1975 (More History ) the Traditional Acupuncture Institute was founded in Maryland. The AAAOM was incorporated in 1983, NADA in 1985. In many states, auricular acupuncture programs predated the regulation of acupuncture. Their safety and effectiveness was used promote acupuncture and lobby for Licensure.

In 2005 South Carolina (currently 123 LAcs, 658 deaths in 2016 related to prescription opioids and heroin) passed a licensure law with a dark side. Although 53 Acupuncture Detox Specialists (ADSes) had been working without incident in South Carolina, language was included that required an LAc be on site to supervise ADSes. With zero LAcs at the time the law passed, no ADS could continue to treat. (The force behind the legislation was Acupuncturist and then-president of the AAAOM, Martin Herbkersman, whose brother was and is SC state Representative Bill Herbkersman. Rep. Herbkersman also shut down a 2007 bill that would have removed the direct supervision requirement.)

Programs to provide the NADA protocol to addicts have been limited by the supervision requirement.

People are dying.

Unfortunately, South Carolina is not a fluke. The only voices against New Hampshire HB 575, allowing for the certification of acupuncture detox specialists, were the voices of LAcs. Luckily for New Hampshire (127 LAcs, almost 400 opioid related deaths in 2015, over 2000 opioid-related ED visits), the bill passed.

Connecticut (323 LAcs, 539 overdose deaths in the first six months of 2017) did pass a law expanding use of ADSes, but comments in response to the legislation from LAcs included gems like, “acupuncture should be left to the experts, the licensed acupuncturists” and ADSes “have absolutely no idea what it truly entails to safely provide acupuncture to others whether it be one needle or many.”

People are dying.

Remember, at least 42,000 opioid deaths in 2016. The number of Acupuncturists in the US? About 32,000 at best. Dealing with the epidemic is expensive, funding is limited.

It’s a crisis.

  • If you believe ADSes require in-person supervision, become a supervisor.
  • If you believe only LAcs should provide the NADA protocol, commit to weekly shifts at recovery centers, jails, and other programs, and take responsibility for daily staffing of those programs. Remember, funding will be minimal or nonexistent, and, unreliable.
  • If you believe that everyone deserves the benefits of full body treatment, commit to provide them to everyone – even if they can’t pay, don’t have reliable transportation, and aren’t as tidy as your typical clientele.
  • If you believe ADSes should work only within treatment programs available to those in active addiction, make sure your services are accessible to those struggling to maintain their recovery, whatever their circumstances.

Remember, some of the people most needing treatment won’t have insurance, housing, financial resources, steady employment, or reliable transportation. Where and how will you provide the services you think they should have?

If you don’t want to supervise, don’t want to treat everyone who walks through your door regardless of ability to pay, and don’t want to take regular shifts at treatment facilities, then, please, get out of the way of the people who do. Better yet, support them.

People are dying.

I’ve joined NADA, I’m making plans to receive training, and I’ll keep supporting efforts to increase access to NADA-trained providers in all states.

People are dying.

 

This post is in honor of Dr. Michael O. Smith. May his memory be for a blessing.

Copyright —

© Elaine Wolf Komarow and The Acupuncture Observer, 2013-2017. Unauthorized use and/or duplication of this material without express written permission from Elaine Wolf Komarow is prohibited. Excerpts and links are encouraged, provided that full and clear credit is given with specific direction to the original content.

11 thoughts on “Firefighting

  1. When I was in acupuncture school, I learned very little about NADA any kind of work for acupuncturists in recovery programs. I had 2 teachers who had briefly done that kind of work in NYC and Denver. However, there were no such jobs that I was aware of in my local area (Asheville, NC) despite the fact that there was a crystal meth epidemic. I had/have no idea where jobs are posted for acupuncturists to work in recovery program. I read Lisa Rholder’s book “Acupuncture Points are Holes” https://www.amazon.com/Acupuncture-Points-Are-Holes-Entrepreneurship/dp/0989254054 in which she describes the few jobs for acupuncturists at Central City Concern as unstable and constantly threatened by budget cuts. It seems like acupuncturists are fighting ADS laws because they are concerned about loosing jobs that scarcely exist or do not exist at all. Even if, theoretically, jobs in recovery centers for acupuncturists did come back because of the opioid epidemic, they would not lead to long term work or careers. It’s sad that acupuncturists hold on to turf like chinese finger cuffs. When we struggle and fight, the more we remain stuck, unable to make progress.

  2. Mike Smith passed on Dec 24th. Thank you Elaine for honoring him. He did in fact change the world. He designed the drug diversion courts, I have Judge Klein from Miami on tape saying so….. how Mike helped them understand the needs of the clients, so the program met their needs, instead of the bureaucratic needs. These courts do not follow the model he created closely, the way the early ones in Florida did, and they do not get the same incredible numbers… but still very effective in a good functional diversion court. This has changed the face of our court system, though I have never seen him receive credit, with the exception of the judges that brought him to Miami to do it. I have seen others claim they had a role…. Mike mentored so many, and opened up paths unknown to us…. he often paid with his own money to mentor folks, me included…He empowered his staff, so they could empower their clients…..”If your staff is not empowered, they can’t empower the clients”…He taught many powerful lessons to thousands….

  3. To those who want to know more about Dr. Smith — I heard from someone in NADA that he died the morning of December 25th. I haven’t been able to find an obit or learn anything more than that.

  4. I teach mindfulness meditation in two detox facilities in the metro DC area. At both facilities, I offered to come in and administer the NADA protocol for free ar one facility and for a very nominal fee at another. I developed a presentation citing evidence, etc. Both times I was pretty much shown the door rather quickly. I was shown the door by the doctors theortically in charge of the units. And I’ve come to believe I was shown the door by the medical profession and the health insurance companies — those entities that make money at/on addiction treatment facilities and units. I might try again now that the opiod crisis is growing and would appreciate any comments or suggestions.

    • I’ll give those facilities the (perhaps undeserved) benefit of the doubt — I’ll hold out hope that they aren’t interested in NADA because of the logistical and bureaucratic hurdles involved rather than actually wanting to make more money otherwise.

      The best advice I can give would be to connect with NADA, where people probably have lots of experience about how to overcome these hurdles. Have you tried getting their help?

    • The research for NADA is not that impressive, MDs often cite the research as being not convincing. That is a real barrier.I live with a graduate of Einstein School ofMedicine and Research…. the research does not meet the burden of proof by strict scientists.That is the most frequent reason MDs do not accept it. We think it looks good, but it is lacking to a schooled eye. Dont take it personally, they feel that they are doing the right thing. We have medicine based evidence, not amenable to being studied as if it is a chemical substance, which is frequently how the research is designed. Alan Trachtenberg, MD, would fund it when working for CSAT, based on the fact that it appears to keep people in treatment longer, and anything that keeps them there longer ups the success rates. It is rally hard to know where the resistance comes from, and it can come from many different places within a program.

  5. So many LAcs have zero experience with NADA settings. They think the protocols taught in schools makes them qualified to have an opinion about NDA and Michael and Carlos and the hundreds of ADS’ that worked for decades in the trenches long before they were born. Mark Seem cut his teeth alongside Matulu in the Bronx. I’ve spent almost 2 decades in homeless shelters treating the underserved. We are so fear-based.

    • One thing I wanted to include was that any LAc supervising ADSes should really have gone through the NADA training. But, at this point, I figured that the most important thing is that any ADS than needs supervision has someone available. Once that’s taken care of we can work on making sure that the supervision is actually helpful, and not just fulfilling a legal requirement.

    • Thank you for soldiering on and being part of the solution. “Ignorance cannot be dispelled if arrogance stands”, quote from Ken Burns series on Viet Nam war…..Mike Smith had his flaws, but he was brilliant and brought a whole lot of people committed to a much larger picture together…. His assessments of people he barely met were astounding and accurate just about 100% of the time. He guided hundreds, thousands into serving vulnerable folks in desperate need of attention. AMEN!

      • We all have flaws! If we’re lucky, the good we do outweighs them. I think it’s safe to say that was the case with Dr. Smith.

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