This competing renewal requests funds to continue our research investigating auricular acupuncture as a treatment for cocaine addiction. In the previous grant period we conducted three clinical studies enrolling 211 patients. Each study compared auricular acupuncture to two control conditions - a needle insertion control using sites in the auricle helix, and a relaxation group - under a variety of conditions, with and without a widely used psychosocial treatment (Coping Skills Training - CST) as well as financial incentives for attendance. Findings supported the efficacy of acupuncture when provided in conjunction with CST and without financial incentives. However, these studies were not designed to definitively examine the interaction between acupuncture and CST, or to determine whether acupuncture is more effective than CST delivered alone. The proposed study builds upon our previous research and will investigate two widely used treatments and their interactions - acupuncture and CST - in a clinical context in which each treatment is provided by substance abuse counselors, employing a research design consistent with the need to bring research findings to clinical practice, and in which relative cost of each treatment is also considered. We propose to conduct a """"""""Phase III"""""""" clinical trial in which 200 cocaine-abusing methadone maintained patients, all receiving standard methadone maintenance treatment, will be randomly assigned to 4 treatment conditions, each of 12 weeks duration, in a 2 (acupuncture/no acupuncture) by 2 (weekly coping skills training group/no coping skills training) factorial design. The four groups are: (a) acupuncture only (ACU); (b) coping skills training only (CST); (c) acupuncture plus coping skills training (ACU+CST); (d) standard methadone maintenance only (MM). In a second phase of the study, in order to explore the effectiveness of these treatments in preventing relapse, patients who initiate abstinence in the 12-week trial will be invited to continue their assigned treatment for 6 months. Both clinical efficacy, cost, as well as treatment/patient matching variables, will be examined.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA008513-08
Application #
6523239
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Riddle, Melissa
Project Start
1994-09-15
Project End
2005-06-30
Budget Start
2002-09-01
Budget End
2003-06-30
Support Year
8
Fiscal Year
2002
Total Cost
$308,975
Indirect Cost
Name
Yale University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Margolin, Arthur (2003) Acupuncture for substance abuse. Curr Psychiatry Rep 5:333-9
Margolin, Arthur; Kleber, Herbert D; Avants, S Kelly et al. (2002) Acupuncture for the treatment of cocaine addiction: a randomized controlled trial. JAMA 287:55-63
Margolin, Arthur; Avants, S Kelly; Holford, Theodore R (2002) Interpreting conflicting findings from clinical trials of auricular acupuncture for cocaine addiction: does treatment context influence outcome? J Altern Complement Med 8:111-21
Avants, S K; Margolin, A; Holford, T R et al. (2000) A randomized controlled trial of auricular acupuncture for cocaine dependence. Arch Intern Med 160:2305-12
Falk, C X; Birch, S; Avants, S K et al. (2000) Preliminary results of a new method for locating auricular acupuncture points. Acupunct Electrother Res 25:165-77
Margolin, A; Avants, S K (1999) Should cocaine-abusing, buprenorphine-maintained patients receive auricular acupuncture? Findings from an acute effects study. J Altern Complement Med 5:567-74
Margolin, A; Avants, S K; Kleber, H D (1998) Rationale and design of the Cocaine Alternative Treatments Study (CATS): a randomized, controlled trial of acupuncture. J Altern Complement Med 4:405-18
Margolin, A; Avants, S K; Kleber, H D (1998) Investigating alternative medicine therapies in randomized controlled trials. JAMA 280:1626-8
Avants, S K; Margolin, A; McMahon, T J et al. (1997) Association between self-report of cognitive impairment, HIV status, and cocaine use in a sample of cocaine-dependent methadone-maintained patients. Addict Behav 22:599-611
Margolin, A; Avants, S K; Birch, S et al. (1996) Methodological investigations for a multisite trial of auricular acupuncture for cocaine addiction: a study of active and control auricular zones. J Subst Abuse Treat 13:471-81

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