NADA Ear Acupuncture: An Adjunctive Therapy to Improve and Maintain Positive Outcomes in Substance Abuse Treatment

This randomized controlled trial investigated the efficacy of the NADA (National Acupuncture Detoxification Association) protocol as an adjunctive therapy in the treatment of substance use disorder. The NADA protocol is one of the most commonly used forms of acupuncture in the United States, involving bilateral needle insertion at five specific ear points: Shen Men, Sympathetic, Kidney, Liver, and Lung. The study was conducted at Keystone Substance Abuse Services in South Carolina between July 2015 and March 2016. One hundred patients diagnosed with substance use disorder were randomized into two groups: 50 received traditional treatment plus NADA, and 50 received traditional treatment only.

Traditional treatment included individual therapy, 12-step counseling, and various group therapies for both groups. NADA group patients received auricular acupuncture twice weekly in 45-minute sessions of up to 20 patients per group, for an average of 8.3 weeks. Needles remained in place for 30-45 minutes per session. Outcomes were assessed using standardized questionnaires administered at baseline and end of program, including the Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9) for depression, and the Quality of Life, Enjoyment, and Satisfaction Questionnaire (Q-LES).

Data were also collected on alcohol, drug, and tobacco use, as well as healthcare utilization at program completion and at 3- and 6-month follow-up. Main findings demonstrated significant benefits for the NADA group across multiple dimensions. With respect to quality of life, only the NADA group showed statistically significant improvement in Q-LES scores. NADA group patients reported feeling better about themselves and having more energy compared with the control group.

As for employment, 71% of unemployed NADA group patients obtained some type of work after discharge, compared with only 35% in the control group. Abstinence outcomes were particularly striking. At 3 months post-discharge, only 4% of the NADA group reported alcohol use versus 25% of the control group. At 6 months, this difference persisted, at 5% versus 50%, respectively.

For tobacco, at 6 months, only 7% of the NADA group continued smoking compared with 39% of the control group. Both groups showed similar improvements in anxiety and depression, but the NADA group demonstrated additional benefits on specific items such as energy and self-esteem. Interestingly, the study revealed that higher-risk populations (non-white, with criminal history, initial positive drug test) were more likely to complete the program when they participated in NADA treatment. The authors speculate that the observed benefits may be related to the physiological effects of acupuncture, including changes in neurotransmitter production and the body's regulatory system.

The NADA protocol induces a sense of "stillness" similar to the relaxation response experienced in mind-body therapies, but in a more passive way, which may be especially beneficial during early withdrawal when capacity for active participation may be impaired. Study limitations include the sample size without prior statistical calculation, high follow-up loss rate, and legal restrictions that limited the frequency of NADA treatments. Despite these limitations, the findings suggest that the NADA protocol may be a valuable addition to substance use treatment programs, offering unique benefits that complement traditional approaches.