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https://www.eventbrite.com/e/hill-briefing-acupuncture-a-powerful-tool-in-solving-the-opioid-crisis-tickets-38772019153

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The United States is facing a national opioid epidemic and regulatory agencies, patient advocacy groups, chronic care organizations and our medical systems are looking for non-pharmacologic strategies to join in the battle to decrease our country’s opioid dependence. Acupuncture is a powerful, evidence-based, safe, cost-effective and available treatment ready to step into this role. Licensed acupuncturists can be utilized throughout the current systems delivering first-line treatments for pain and can be employed for treatments of those suffering through the debilitative world of opioid addiction.

Join us November 8th as we discuss how acupuncture can be safely, easily and cost-effectively incorporated into hospital and rehabilitation settings across the country to help dramatically decrease health care expenditures while offering patients non-pharmacologic options for treating and preventing opioid addiction and pain.

We will begin with a complimentary session of acupuncture led by a team of experienced licensed acupuncturists. All attendees are invited to participate. There will be a Q&A session following the presentations and lunch will be served.

Speakers:

Dr. David Miller, MD, LAc

Dr. Jun Xu, MD, LAc

Dr. Arthur Yin Fan, CMD, PhD, LAc

Dr. Tracy Soltesz, DAc, LAc

Dr. Kallie Guimond, DOM, LAc

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Source: Just Published on Journal of Integrative Medicine: “Acupuncture’s Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management—White Paper 2017” (version 2.0)

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Today, White Paper version 2.0 was published online first at the Website of Journal of Integrative Medicine

http://www.jcimjournal.com/articles/publishArticles/pdf/S2095-4964(17)60378-9.pdf

Acupuncture’s Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management, White Paper 2017

Abstract by Arthur Yin Fan

The title of White Paper is “Acupuncture’s Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management, White Paper 2017”白皮书的题目是“针灸在解决阿片类药物危机中的作用:针灸作为一线非药物疗法治疗和控制疼痛的证据、花费和医疗服务的可行性”。

There were 6 organizations as the co-publishers-参加发表该白皮书的有6个合作单位:The American Society of Acupuncturists, ASA美国针灸师联合会 、The American Alliance for Professional Acupuncture Safety, AAPAS美国执业针灸安全联盟 ,  The Acupuncture Now Foundation, ANF针灸立刻行动基金会,  The American TCM Association, ATCMA全美中医药学会 ,  The American TCM Society, ATCMS)美国中医针灸学会和全美华裔中医药总会 National Federation of TCM Organizations, NFTCMO 。

White paper  was drafted and edited based on a letter, which original authors were(白皮书起草是在一封信的基础上起步的,信的原文作者是): The Joint Acupuncture Opioid Task Force (Chair: Bonnie M. Abel Bolash, MAc, LAc. Member organizations: The Acupuncture Now Foundation (ANF) ,The American Society of Acupuncturists (ASA) ;组员: Matthew Bauer, LAc ;Bonnie Bolash, LAc ; Lindy Camardella, LAc; Mel Hopper Koppelman, MSc ;John McDonald, PhD, FAACMA ;Lindsay Meade, LAc ;David W Miller, MD, LAc .

The first (revising) author 白皮书修改稿第一作者: Arthur Yin Fan, CMD, PhD, LAc (ATCMA) ;Correspondent author通讯作者: David W Miller, MD, LAc 。Other authors参与白皮书的其他作者: Sarah Faggert, DAc, LAc; Hongjian He, CMD, LAc;Mel Hopper Koppelman, MSc; Yong Ming Li, MD, PhD, LAc ; Amy Matecki, MD, LAc*;David W Miller, MD, LAc; John Pang, MD** , etc . *Division Chief, Dept. of Medicine, Highland Hospital, Alameda Health System; **Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California, San Diego School of Medicine.

Abstract

The United States is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public’s opioid dependence. Acupuncture has emerged as a powerful, evidence based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture’s cost-effectiveness could dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding the development of opioid addiction that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options, and acupuncture stands as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost -effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of pain seen commonly in hospitals.

Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military.

摘要

美国正处于整个国家的阿片类药物流行危机,医疗系统亟需非药物的疗法、用以治疗疼痛并减少公众对阿片类药物的依赖。针灸作为强有效的、循证的、安全的、具有成本效益的治疗方式,满足这一需求。众多针灸临床试验已经证明针灸对许多类型的疼痛治疗有效,针灸的作用机制已被阐明,并且可以从生物医学和生理学角度解释。同时,从治疗急性疼痛的角度来看,针灸的成本效益可能会大大降低医疗保健支出,并避免发生昂贵的阿片类药物成瘾、破坏生命质量、并导致致命的过量。许多联邦监管机构已经建议或强制医疗保健系统和提供者提供非药物治疗选项,而针灸是最具实证性的、并立即可以采用。针灸可以安全、便利、经济有效地纳入医院设置,如急诊部门、产房以及新生儿重症监护室等,用以治疗医院里普遍见到的各种疼痛。

退伍军人管理局和美国军方的各个部门已经成功地有针对性地采用针灸。

  1. Acupuncture is an effective, safe, and cost-effective treatment for numerous types of acute and chronic pain. Acupuncture should be recommended as a first line treatment for pain before opiates are prescribed, and may reduce opioid use.

针灸疗法安全有效、经济,治疗多种急慢性疼痛有效:理应作为疼痛的一线治疗,先于阿片类药物使用,针灸疗法可以显著减少阿片类药物用量(我们在以下各分项中归纳了众多证据)。

1.1 Effectiveness/Efficacy of acupuncture for different types of pain.

针灸疗法治疗多种疼痛有效。

1.2 Safety and feasibility of acupuncture for pain management.

针灸疗法治疗疼痛安全、易行。

1.3 Cost-effectiveness of acupuncture for pain management.

针灸疗法治疗疼痛可以减少支出。

1.4 Can adjunctive acupuncture treatment reduce the use of Opioid-like medications?

结合使用针灸疗法可以减少阿片的用量。 

  1. Acupuncture’s analgesic mechanisms have been extensively researched and acupuncture can increase the production and release of endogenous opioids in animals and humans.

针灸的镇痛机制已经有大量的研究,针灸增加动物和人类的内源性阿片肽并促其释放。

  1. Acupuncture is effective for the treatment of chronic pain involving maladaptive neuroplasticity.

针灸治疗慢性疼痛涉及改善其病态的神经塑形。

  1. Acupuncture is a useful adjunctive therapy in opiate dependency and rehabilitation.

针灸是有益的治疗阿片依赖并促其康复的辅助疗法。

  1. Acupuncture has been recommended as a first line non-pharmacologic therapy by the

FDA, as well as the National Academies of Sciences, Engineering, and Medicine in coping with the opioid crisis. The Joint Commission has also mandated that hospitals provide non-pharmacologic pain treatment modalities.

针灸已被FDA、以及美国国家科学院、国家工程院和国家医科院三院应对阿片类药物危机联合委员会推荐为一线非药物疗法。医院考核联合委员会也已经把非药物治痛疗法列为医院必须包括的项目。

  1. Among most non-pharmacologic al managements for pain relief now available, acupuncture therapy is the most effective and specific for opioid abuse and overuse.

迄今为止,可用的非药物治疗疼痛的疗法,针灸疗法最为有效并对于阿片类药物滥用和过用使用针对性最强。 

  1. Acupuncture is widely available from qualified practitioners nationally.

美国有足够的合格的针灸师

http://www.jcimjournal.com/articles/publishArticles/pdf/S2095-4964(17)60378-9.pdf

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Acupuncture’s Role in Solving the Opioid Epidemic

Part 1: Effective and Safe

Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management

http://www.pacificcollege.edu/news/blog/2017/09/29/acupuncture%E2%80%99s-role-solving-opioid-epidemic-part-1-effective-and-safe

 

September 26, 2017, the release of a comprehensive white paper, “Acupuncture’s Role in Solving the Opioid Epidemic”, credited to dozens of authors and a half-dozen different organizations of acupuncturists and TCM professionals. In this series, we’ll be looking at the different reasons why and the ways in which acupuncture can help alleviate the opioid abuse epidemic wreaking havoc in America.

Over the past 20 years, pain management has become nearly synonymous with opioids. Recent data has shown that opioid prescriptions vary widely and that most surgical patients are over-prescribed, with 70% of pills going unused, leaving opioids lying around in many households.(26) About 6% of all Americans prescribed opioids after surgery become dependent upon those opioids; in head and neck cancer patients, however, it’s as high as 40%.(28) Although they do manage pain, even for those who don’t become dependent, opioids lengthen patients’ recovery times through side effects like sedation, pneumonia, and delirium.

Acupuncture, on the other hand, is a safe, affordable, and readily available non-pharmacologic approach to decreasing opioid dependence that our healthcare systems badly need. It can be used in hospital settings from the emergency room to delivery room, and it’s already in use by the Veterans Administration and the US military.

Part 1: Acupuncture is an effective and safe treatment for both acute and chronic pain.

A growing body of research supports the effectiveness of acupuncture for the relief of pain, especially chronic pain, with the strongest evidence emerging for back, neck, and shoulder pain; chronic headaches; and osteoarthritis.

The Acupuncture Evidence Project(1), which we’ve previously covered, searched the literature with a focus on the highest form of evidence available to identify the conditions for which acupuncture has been found to be most effective. They also looked for evidence of acupuncture’s safety and cost-effectiveness and reported how the evidence for acupuncture’s effectiveness has changed over an eleven-year time-frame. Overall, the study found evidence for the effectiveness of acupuncture for 117 conditions, with stronger evidence for some conditions than others. Strong or moderate evidence supported the effectiveness of acupuncture for almost fifty conditions, including IBS, many varieties of musculoskeletal pain, post-operative nausea and vomiting, some types of headaches, PTSD, obesity, and stroke, as well as the aftereffects of stroke. It was found to be particularly safe and cost-effective compared to other potential treatments for allergic rhinitis and migraine.

In another study, the largest study of its kind to date, nearly half a million patients were treated with acupuncture for headache, low back pain, and/or osteoarthritis in an open pragmatic trial; treating physicians rated it as effective in 76% of all cases. Minor side effects were seen in 8% of patients, and major side effects in only 13 patients total.(3) Other studies found acupuncture, particularly electroacupuncture, equal or superior to standard care for sciatica, joint pain, post-surgical discomfort, and the infamously difficult-to-treat fibromyalgia.

Next time: acupuncture is affordable and reduces opioid use.

26: Hill MV, McMahon ML, Stucke RS, Barth RJ. Wide Variation and Excessive Dosage of Opioid Prescriptions for Common General Surgical Procedures. Annals of Surgery. 2017: 265(4), 709-714. doi:10.1097/sla.0000000000001993.

28: Pang J, Tringale KR, Tapia VJ, Moss WJ, et al (2017). Chronic Opioid Use Following Surgery for Oral Cavity Cancer. JAMA Otolaryngol Head Neck Surgery. 2017: doi:10.1001/jamaoto.2017.0582.

1: McDonald J, Janz S. The Acupuncture Evidence Project: A Comprehensive Literature Review. Australian Acupuncture & Chinese Medicine Association Limited, Dec 19, 2016.

3: Weidenhammer W, Streng A, Linde K, Hoppe A, Melchart D. Acupuncture for Chronic Pain within the Research Program of 10 German Health Insurance Funds–Basic Results from an Observational Study. Complementary Therapies in Medicine. 2007;15(4):238-46.

Read the original white paper

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Source: Acupuncture helpful in solving opioid epidemic: U.S. white paper

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http://news.xinhuanet.com/english/2017-09/27/c_136643493.htm

WASHINGTON, Sept. 26 (Xinhua) — In the wake of an opioid epidemic, acupuncturists in the United States issued a white paper on Tuesday, recommending acupuncture as a primary non-pharmacologic method for pain relief and management.

“The United States is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public’s opioid dependence,” said the 21-page white paper.

Official figures showed that opioid overdoses kill 91 Americans every single day and more than half of those deaths involve prescription opioids.

Titled “Acupuncture’s Role in Solving the Opioid Epidemic,” the white paper said “acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need.”

Organizations that contributed to this paper included the American Society of Acupuncturists, the American Alliance for Professional Acupuncture Safety, the Acupuncture Now Foundation, the American Traditional Chinese Medicine (TCM) Association, and the American TCM Society and National Federation of TCM Organizations.

The white paper said acupuncture has been shown to be effective for treating various types of pain, with the strongest evidence emerging for back pain, neck pain, shoulder pain, chronic headache, and osteoarthritis.

It said mechanisms of action for acupuncture have been extensively researched, which found the ancient Chinese practice increase the production and release of endogenous opioids in animals and humans.

“Acupuncture should be recommended as a first line treatment for pain before opiates are prescribed, and may reduce opioid use,” it wrote.

“Further, acupuncture’s cost-effectiveness could dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding the development of opioid addiction that requires costly care, destroys quality of life, and can lead to fatal overdose.”

The white paper came about a week after the U.S. National Association of Attorneys General sent a letter to America’s Health Insurance Plans, asking its insurance company members to review their payment and coverage policies in order to promote alternatives to opioids such as acupuncture.

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http://www.mdweekly.com.cn/m/view.php?aid=3452, accessed 071617

针刺联合西药治疗多囊卵巢综合征获得重要进展 ——吴效科团队研究成果刊发于国际顶级期刊《美国医学会杂志》

由国家中医临床研究基地妇儿病团队首席科学家、黑龙江中医药大学附属第一医院妇产科主任吴效科教授领衔完成的国家重大科技专项——“针刺联合西药克罗米芬治疗多囊卵巢综合征不孕症”研究成果,近日被全文刊发于国际顶级综合医学期刊《美国医学会杂志》(JAMA,影响因子44分)。该项课题基于我国PCOS疾病特征,规范评价中西医结合方法治疗多囊卵巢综合征的生殖和代谢临床疗效,这在中医临床研究上尚属开创之举。

多囊卵巢综合征(PCOS)是生育年龄妇女常见的一种复杂的内分泌及代谢异常所致的疾病,以慢性无排卵(排卵功能紊乱或丧失)和高雄激素血症(妇女体内男性激素产生过剩)为特征,主要临床表现为闭经、多毛、肥胖及不孕四大病症,患者可具备以上典型症状,也可以只有部分症状,治疗起来十分困难。吴效科团队的该项临床试验,采用的是被国际同行所高度认可的统计学上析因设计方案。课题组共筛选病例4645例,入组病例1000例,分布在国内25家医院,平均年龄28岁,不孕时间约2年,针刺和用药4个月,妊娠随访10个月。结果显示,试验受孕总数320例,妊娠总数达218例,活产人次205例,共出生婴儿数218名。

吴效科教授团队研究发现,针刺的两种方案联合西药一线促排卵药“克罗米芬”的“针药联合”方案,治疗多囊卵巢综合征(PCOS)不孕症妇女的4个月累积排卵率达93.2%,活产率约28.7%;针刺的两种方案联合西药安慰剂4个月排卵率达69.9%,活产率为15.4%;双胎妊娠率前者为9%,后者下降到3%。研究还发现,一线促排卵药克罗米芬会使PCOS女性妊娠晚期的腰背痛显著增加16.4%,而针刺干预能有效降低腰背痛发病率约6.6-14.3%。二次分析数据发现,克罗米芬的使用会加重PCOS妊娠女性的糖脂代谢异常,针刺则能明显改善这一代谢异常,并降低向心性肥胖参数。本项研究还首次在大样本量与严格的纳排标准的PCOS人群中,系统阐明了PCOS患者的痰湿、血瘀和肝郁等中医症候不同分类客观化特征。相关论文还在今年6月中旬在香港举办的第25届亚太妇产科学大会上被评为“最佳演讲论文”。

自2013年到现在,吴效科教授团队在系列研究中,规范评价了中西医多种方法医治PCOS的生殖和代谢临床疗效;利用模型动物和人体生物样本,系统而深入探讨了PCOS疾病病机和药效机制,首次发现PCOS综合中枢边缘系统(杏仁核与海马)GABA能神经元中5-羟色胺、r-氨基丁酸等改变情志、子宫内膜糖代谢障碍和胰岛素抵抗机理、卵巢亢进参数指标等。有关论文陆续发表于《美国科学院院刊》、《科学报道》、《人类生殖》等,并被《自然》系列杂志、《新英格兰医学杂志》、《英国医学会会刊》、《内分泌述评》等权威期刊多次引用。

另据介绍,本研究的运行模式是在国内外、中西医领域顶级团队合作的基础上,采用美国国立卫生研究院生殖医学协作网模式。功能委员会包括:方案优化委员会、项目执行委员会、数据协作委员会、数据与安全监测委员会、论文发表委员会,形成了重大研究的“图纸设计团队”、项目“施工团队”、质量“监管团队”、“受试者保护团队”、“成果产出团队”。以上临床试验中的专门机构设计和运行,为上述课题进行“全过程”和“纵深度”的国际合作,推进中医临床研究向国际化的大踏步迈进,提供了高度学术保障与组织运行保证。该项目成果的发表,凸显了国家中医临床研究基地的创新体系,在中医药“双一流”的学术发展中的带动作用。

(责任编辑:毕雪立)

这个报道刻意回避了针灸无效这个在JAMA上报道的结论

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