Acupuncture Embraced as Aid for Addicts

For the last 24 years, Jose’s life traced a dizzying loop between jail and a drug habit he could never shake once he hit the streets of his East Los Angeles neighborhood. Downers and hallucinogens turned to PCP and a crippling combination of cocaine and heroin he wryly calls the “Belushi,” for comedian John Belushi, who died of an overdose.

But Jose has found hope--in a treatment most people associate with aching bones and mysticism rather than the torments of addiction and withdrawal. He gets it while relaxing on a ratty sofa at a Pasadena drug treatment facility, five needles in each ear, and one jutting from the top of his head. It is acupuncture.

Long denigrated by Western medicine, acupuncture has become a key element of a new proposal by prosecutors, judges and public defenders to give many Los Angeles County drug offenders the option of addiction treatment instead of jail.

Known as Drug Court, the program is the latest effort by a frustrated criminal justice system to break the spiral of addiction that shuffles people like 43-year-old Jose in and out of overstuffed jails, while a costly war on drugs continues to swallow taxpayer dollars.

The program, in the planning stage and without funding, is modeled after a highly lauded effort in Dade County, Fla., and would include the same elements: acupuncture together with conventional counseling, daily urinalysis, and, eventually, vocational training.

A pilot project is slated for Municipal Court in downtown Los Angeles, said Presiding Judge Rudolph Diaz, chairman of the Municipal Court Presiding Judges Assn.

The ancient needling treatment has been said to calm the nerves, reduce drug cravings and soften the acute discomforts of withdrawal, making addicts more receptive to conventional counseling. Treatments for addicts are also directed at the organs most battered by a life of drug abuse: the liver, lungs and kidneys.

From New York to Minnesota and Oregon, and as close to home as Oakland, Santa Maria and Santa Barbara, criminal justice officials are sending addicts for court-approved acupuncture treatments in a desperate effort to stem exploding jail populations, and save some of the money lost when addicts spin repeatedly through the system’s revolving door. In Los Angeles County jails, one of every four inmates is doing time for drug possession or sales, many more for other drug-related felonies.

The programs are bringing acupuncture its firmest stamp of approval. An Oregon law mandates that no addict enter methadone treatment unless he has tried acupuncture and counseling for a year--and failed.

Even Los Angeles County, which until now has resisted a systemwide acupuncture program, is dotted with pilot projects. In Biscailuz Center jail in East Los Angeles, South Pasadena acupuncturist Carol Taub first gave Jose and other inmates the needle treatments, and now also treats mentally ill addicts.

Since February, she has offered the treatments to pregnant and postnatal addicts at Crenshaw’s Asian American Drug Abuse Program. And in Santa Monica, a municipal judge is giving some addicts the choice of going to a walk-in acupuncture detoxification clinic as a term of probation.

“I haven’t heard anyone say it’s a bad idea yet, and the reason is obvious: You’ve nothing to lose by trying it,” said Santa Monica Presiding Municipal Judge David Finkel. “If you can detoxify somebody temporarily by acupuncture, that’s the cheapest method available.”

“The time is ripe,” said Los Angeles County Assistant Public Defender Michael Judge, who flew to Florida in February with other Los Angeles criminal justice officials to check out the acupuncture program.

The trip cemented the group’s interest in starting a similar program here.

A national association of county criminal justice planners last year gave an award to Dade County Judge Gerald Wetherington, who helped start the Drug Court with the support of Atty. Gen. Janet Reno, then Dade County’s chief prosecutor. Mark Cunniff, executive director of the Washington-based National Assn. of Criminal Justice Planners, said he has promoted drug court programs that feature acupuncture to association members.

Since the Dade County effort took off in 1989, about a dozen acupuncture-based drug courts modeled after it have started nationwide, he said. Scores of other programs not connected to the criminal justice system also offer acupuncture to addicts.

There is little strong criticism of acupuncture-assisted detoxification, but there is some ambivalence. Though officials in Dade County, where 700 court-referred addicts receive the treatments daily on a volunteer basis, say clients stay in recovery longer and produce more clean urine samples, there is no hard scientific evidence that the treatments work.

Now, supporters and skeptics are waiting for a Temple University study expected next month that will quantify Dade County’s results.

Proponents stress that acupuncture is not a treatment in itself, but say it primes addicts for counseling by reducing agitation and physical withdrawal symptoms.

“You can’t talk to a hungry man about food,” said Lianne Audette, director of the 2-year-old Santa Monica clinic she has dubbed Turnabout ASAP, for Alternative Substance Abuse Project. “We give them the physical relief they need, and the settling down of their mind.”

Though Santa Monica’s program--lurching along on volunteer efforts and dwindling funds--is nowhere near as systematic as a county-wide program would be, the brightly lit clinic offers a glimpse at the acupuncture techniques standardized over the years to help addicts.

On a recent morning, a handful of clients trickled into Audette’s clinic for the treatment session: five needles in each ear. Within minutes, all were asleep, lulled by what they say is a calming sensation.

“The acupuncture kills the craving and the withdrawal symptoms, and helps you to sleep better,” said Michael, 38, an alcoholic and former longtime heroin user who started treatments in January. Despite a monthlong relapse, he now comes six times weekly. Michael and Jose asked that their last names not be used.

Pulling out the treatment card he fills out after each visit, Michael tracks his progress: Next to an endless list of ailments, including sleeplessness, sweats, diarrhea, shakes, drug dreams and depression, are his entries from 1 (“very bad”) to 4 (“hardly noticeable”).

Since his treatments began in January, a litany of 1s and 2s that jammed the card’s columns have been steadily replaced by 3s and 4s.

“I noticed it after the first treatment,” Michael said. The acupuncture helps him concentrate on counseling and his group meetings with Alcoholics Anonymous, he added.

Turnabout has been welcoming walk-ins, many of them homeless, since Audette opened the doors two years ago. More recently, she has joined forces with Santa Monica’s court system to tailor her services to probationers.

“Since I’ve been here, I got a job, I have a lot more self-esteem, and I’m not as agoraphobic,” said a 26-year-old woman who received her first treatment Feb. 11. “I was sort of given a choice, of this or jail.”

The woman, who asked that her name not be used, was facing two counts of being under the influence of crack cocaine, and a 90-day jail sentence when Santa Monica Municipal Judge Laurence Rubin gave her the option of acupuncture and counseling.

“What’s really interesting is, compared to other substance abuse programs, after they’ve been in the program awhile, they really seem to like it,” said Rubin, who handles all Santa Monica Municipal Court drug cases. “I’m getting much more positive feedback from defendants.”

Acupuncture dates back at least 5,000 years in China, but the movement to integrate the ancient treatment into the bureaucratic halls of public health in the United States began at Lincoln Hospital in New York City’s South Bronx.

Initiated in 1974 by Dr. Michael Smith, the Lincoln Hospital acupuncture detoxification program became the model for more than 200 others worldwide. Recently, programs have sprouted in Hungary, Russia, France and Great Britain.

Smith founded the National Acupuncture Detoxification Assn. in 1985, drawing chemical dependency experts together with Oriental medicine specialists. The goal: to integrate acupuncture into a full treatment program for addicts, incorporating the most effective counseling methods as well.

Acupuncture approaches the body as a system of energy flows, or meridians, where certain points correspond to organs or regions of the body. According to Oriental medicine teachings, the ear is a microcosm of the body--conveniently for detoxification supporters, who can treat large groups of addicts at one time, without the need for private examining rooms.

The standardized NADA treatment--used from New York to Santa Monica--positions disposable needles at five ear points. Two correspond to the nervous system, and the other three relate to the organs most damaged by years of addiction: the kidneys, liver and lungs, said Taub, NADA’s Southern California regional coordinator.

Acupuncturist Karin Hillsdale--who administers the treatment to Jose and other addicts in residential treatment at Pasadena’s Impact Drug and Alcohol Treatment Center--pops an additional needle into the tops of their heads, a point believed to improve concentration.

The technique has a disjointed history in Los Angeles County.

Taub became involved with a Skid Row program in downtown Los Angeles about six years ago, which petered out when the building they were using suffered earthquake damage.

Between October, 1991, and May, 1992, Westwood acupuncturist Joseph Acquah ran a detoxification program for the state parole board, treating addicts in residential programs in Inglewood and El Monte, as well as out of the Van Nuys parole office.

The practical goal: to keep the urine of paroled drug offenders clean and prevent them from passing back into a costly and overcrowded jail system.

The program was effective, but the funding dried up, Acquah said.

Though state and county funding prospects are perhaps more dismal now than ever, the Los Angeles County criminal justice officials pushing for the countywide Drug Court are hoping for federal funding, Diaz said.

For Los Angeles County, a number of unresolved issues remain. Drug Court proponents are ironing out who will be eligible. The program may be open to second-time drug offenders and those committing drug-related crimes, Diaz said. Drug dealers, he stressed, will not be eligible.

The large number of Los Angeles courts and vast geography also make the program harder to design than Miami’s. And, it will somehow involve the myriad independent drug treatment providers who contract with the county.

But criminal justice officials are nevertheless hopeful.

“It’s a matter of finding out how we put all the pieces together,” said Bob Mimura, executive director of the countywide criminal justice coordination committee, made up of elected, criminal justice and law enforcement officials. “In the last six months to a year, the interest in the Drug Court has really grown. It’s really starting to gel.”

Those who have benefited from acupuncture treatments are among the biggest supporters. Jose is now on the staff at Pasadena’s Impact, helping to counsel others in the residential treatment program.

“They don’t have any gates where I’m at, and before, every time I got out of jail, I went to use,” Jose said recently. “I look forward to coming and getting this now.”