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Acupuncture for addicts
Rulemaking stalls access to acupuncture for withdrawal

12/14/17
By Ryan Lessard news@hippopress.com



 A bill that passed this summer allowed for addiction treatment and recovery staff to be trained and licensed to perform an acupuncture procedure that, for some, could help alleviate the symptoms of addiction withdrawal or post-disaster trauma. But, five months later, the procedure still can’t be done because the state licensing body has yet to set the rules. 

 
Quirk of the process
Elizabeth Ropp is an acupuncturist who has practiced for 10 years and currently works out of the community clinic in Manchester called Manchester Acupuncture Studio.
Right now, anyone already licensed to perform acupuncture, like Ropp, can provide ear acu-detox. But Ropp wants to make it available to the masses by allowing people like peer recovery coaches, counselors and other licensed health care professionals to perform the procedure so that people suffering from substance use disorder can get easier and less expensive access to it. 
Ropp and fellow advocates like Laura Cooley of Orford ushered the bill through the legislature with the help of Manchester state Rep. Bob Backus, a Democrat. 
But the acupuncture industry is divided on the issue.
“I knew, going into this, that I would have to fight my own profession,” Ropp said. 
In fact, the strongest opposition came from the state Board of Acupuncture Licensing, which she said tried to render the bill ineffective with an amendment proposed by an ally in the legislature. That amendment failed and the bill became law in July.
But, in a quirk of the process, the same board that opposed the law now has to write the rules, and they haven’t yet.  
“Here’s the crux that we’re in right now. Even though the bill was signed in July … the board of acupuncture licensing that never wanted the law to begin with gets to write the rules,” Ropp said. 
 
How it works
It involves putting needles in five points in each ear. The needles stay in for 20 minutes or more, Ropp said. After that, relief from symptoms like pounding headaches, body aches and nausea can be experienced for up to eight hours.
It’s most effective at treating the early stages of withdrawal after an individual stops taking the narcotic substance. Ideally, they’d receive the treatment daily, which Ropp said would decrease the chances of relapse.
She said many people seek help at Safe Station and Serenity Place and the like, but when they start detoxing, the serious discomfort and pain they go through drives many of them back to the streets for a fix.
Ropp said it’s also useful for latter stages of recovery.
Technically, people can get this treatment right now at the clinics like Manchester Acupuncture Studio, but the point of the legislation was to ensure access to this treatment in places where people suffering substance use disorder are and where they go to seek help. They typically don’t enter an acupuncture clinic, Ropp said, and even if they did, the clinic isn’t trained to provide counseling and other services.
To any detractors who think the ear acupuncture won’t work, Ropp said it’s not for everybody but everybody should be given the choice.
“It can’t hurt you. And … when it comes to recovery, everyone needs as many options as possible,” Ropp said.
The procedure is safe and no malpractice claims have ever been filed for the procedure in the country. Plus, she said, it’s a low-cost procedure. The needles alone cost about 50 cents per session. Then, a person just needs cotton balls, hand sanitizer and a sharps container.
 
The delay
It’s now December, and people who would be best positioned to give relief to individuals struggling through the detox process, like allied health professionals, peer recovery coaches, volunteers and paramedics, are still unable to render this form of care because the Board of Acupuncture Licensing hasn’t completed the rulemaking process.
Bob Lamberti, a lawyer who works with state licensing bodies, said in an email that the board started work on the rules before the bill became law and held an extra meeting in October, but the board usually only meets quarterly and doesn’t always have a quorum so they can vote. Sen. John Reagan, the chair of the joint rules committee, said it’s not uncommon for small licensing boards to be sluggish in writing even relatively simple rules. Unlike state agencies like the health department, they don’t have dedicated rules coordinators to help them.
The last meeting was held on Dec. 1. Ropp attended a few hours of it and said the board seemed to be acting in good faith, though she’s cautiously optimistic. 
Cooley saw an early draft of the rules.
“It looked pretty good to me,” Cooley said.
Still, she said the board hasn’t gotten to the stickier issue of how to deal with non-acupuncturists.
While no one in recovery and treatment centers is allowed to start offering this service aside from licensed acupuncturists, some in the recovery scene are already getting trained on how to do it.
Ryan Fowler, a recovery worker in Concord, was in an early group to get trained by the National Acupuncture Detoxification Association, as was Nikki Casey, the director of Revive Recovery Resource Center in Nashua. 
Casey said she was part of a group of about 10 people who did the training and she hopes to host regular NADA trainings at the Nashua facility in the future. 





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