This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.The use of acupuncture for the treatment of withdrawal symptoms from drugs of abuse has been studied for greater than three decades. The mechanism by which the effect of acupuncture reduces withdrawal symptoms is believed to be mediated by endogenous opiate release in the brain. Nitric oxide (NO) research has shown that acupuncture points contain higher levels of NO locally and enhance neuronal NO synthase (nNOS) expression centrally, when stimulated. Elevated levels of nNOS in the brain have been shown to correlate with raised levels of central norepinephrine (NE). The purpose of this study is to examine the effects of acupuncture on methamphetamine withdrawal symptoms and to examine the hypothesis that improvement will be due to raised nNOS in the brain and consequent NE levels caused by the acupuncture treatment. Published research has examined cocaine, alcohol, and opiates with findings that generally support the effectiveness of acupuncture. There has been no investigation, however, evaluating the effect of acupuncture on methamphetamine (MA) withdrawal symptoms. Compared to cocaine, withdrawal syndrome from MA takes longer to resolve and therefore offers greater opportunity for elucidating acupuncture-induced NO changes. Placebo treatment will use acupuncture at ear and body locations not used for any traditional indication. Subjects will provide urine specimens for drug content after each acupuncture session and will receive 1-hour counseling 3 times a week. Once a week group therapy will also be provided. Plasma NE concentrations, nitrite, and nitrate will be taken before treatment on day 1 and after treatment on day 7 and 14. On day 1 and 14, skin NO levels will be measured before, during, and after acupuncture treatments. In addition, measures of methamphetamine withdrawal will be evaluated using the Beck Depression and Anxiety scales. Patients receiving sham and experimental acupuncture will receive these scales at baseline and before and after treatments (before counseling) on days 1, 3, 7 and 14. At 60 and 90 days post-treatment, subjects will also be tested for urine toxicology and be given the Addiction Severity Index.
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