Clinicians who practice auricular and traditional acupuncture may find this book challenging. Instead of providing the mechanisms, methodology and practice of ear acupuncture for addiction as the title suggests, this book focuses heavily on neuroscience and critically dissects the theoretical underpinnings of acupuncture.
While a person seeking a practical guide to understanding ear acupuncture and its optimisation in drug and alcohol treatment settings may therefore be disappointed, this book does have several things to commend it including an introduction to neurophysiology, concepts of addiction and information about drugs of abuse.
The authors provide a comprehensive review of alternative theories to explain the mechanisms of acupuncture, for example bio-electronics, Piezo electricity, streaming potentials and the Qion theory of quantum oscillations. They settle on quantum electrodynamics (QED) or electromagnetism as the ultimate explanation for Qi. The chapter ‘A new model for Qi energy’ explores the concept of Qi on an atomic and cellular level and proceeds to explain different types of Qi (Zhen, Gu, Kong, Yuan and Jing) using a biochemical framework. The authors’ rationale for dismantling ‘outdated concepts’ such as Qi and channel theory is driven by a stated desire to save acupuncture from ‘ridicule’ and better position it to be integrated with western medicine.
The book is heavily weighted towards these theoretical discussions with only one of the sixteen chapters dedicated to auricular acupuncture mechanisms. The widely accepted reflexology model: that the ear reflects an inverted foetus and points on the ear correspond to internal organs and anatomical areas of the body, is rejected. Having earlier stated that acupuncture channels do not exist, the authors reiterate that the effects of acupuncture, both auricular and somatic, are attributed to ‘humoral mediation, whereby the circulation of neurotransmitters and hormones carry the effects of sensory information to more widespread areas of the body’. The authors claim to subscribe to the neurophysiological paradigm because it ‘has some basis in reality and evidence-based practice’. This is likely to also be influenced by one of the author’s current MSc studies in neuroscience.
Another chapter evaluates a single study, where auricular acupuncture is used with high security, substance-using male prisoners. However the value of this to a general audience may be limited, as findings from research conducted in settings where subjects are incarcerated may be difficult to apply in private practice and community health settings. The final chapter has four testimonials and shared anecdotes from clinicians currently using ear acupuncture in their drug and alcohol and/or mental health services.
There are numerous benefits to using ear acupuncture in drug and alcohol settings, for example cost savings, clinical efficacy and safety, enhanced patient outcomes, engagement with difficult to reach clients, non-pharmaceutical interventions and reduction in the need for prescribed medication, improved sleep hygiene and alternative treatment for stimulant users. It is disappointing these are not addressed in this book, as further research into these findings may also promote the use of auricular acupuncture within public health services.
The ideal readership for this book is hard to define. On the one hand, an acupuncturist interested in learning more about addiction will benefit from the ten chapters dedicated to the neurology and psychology of addiction and the introduction to common drugs of abuse. However other chapters may be confronting. Broad-minded clinicians working in the field of addiction may glean some interesting information about auricular acupuncture though they may find that it is not substantial enough to motivate them to explore its application further. Existing auricular acupuncture clinicians and trainees may question their instruction and feel disappointed the book lacks practical application. And students of traditional Chinese medicine may find it disillusioning.
Whilst the book did not meet my own expectations, it did challenge many of the concepts I have accepted and adopted in practice, research and teaching. Because Qi, channel theory, acupuncture points and Yin Yang theory are thoroughly explored and superimposed on to a Western medical model in such an in-depth, clear and logical way, the authors go some way to achieving their goal of integrating Chinese medical theory with modern biomedical concepts. Whether describing acupuncture within a neurophysiological framework is really the way to achieve integration is open to question, however. And is it really ‘integration’ if one paradigm is favoured and the other dispelled?
‘Pluralistic Medicine’ where both eastern and western medical paradigms sit alongside each other and accept their different conceptual underpinnings seems a preferable route to blending the two systems.
It is nevertheless refreshing to read a book that inspires these sorts of questions. I thoroughly enjoyed being philosophically stretched and ideologically challenged. It is through texts like these the research and practice of Chinese medicine will continue to evolve and ultimately our shared goal as clinicians will be achieved. That is to improve the health of the community through the provision of acupuncture.
List of contributors.
1. The brain - target organ of addictive substances.
2. How nerves work.
3. Neurotransmitter typology.
5. Emotion: addiction is an emotion.
6. The limbic (emotional) system.
7. The physiology of relapse, bingeing and the permanency of addiction.
8. How does the brain exert influence on the rest of the body?
9. Addiction and genetics.
10. The drugs of misuse.
11. Qi, the story so far.
12. The new model for Qi energy.
13. Yin-Yang theory.
14. Auricular acupuncture mechanisms.
15. An evaluation of auricular acupuncture with high security substance misusing male prisoners.
16. Diversity in practice. Index.