Intro + Acupuncture
***Disclaimer: This blog is not meant to be used as legal or medical
advice. It is written as my person perspective on how medical
professionals could blend western medicine with other modalities***
I’m interested in personalized medicine. I think a big part of what I can do as a pharmacist to personalize someone’s experience with health is to become a source of knowledge in complementary medicine. When a patient is not getting what they need from traditional western medicine, I can help guide them to other modalities that can enhance their health in cooperation with what they’re getting from their primary care physician (PCP).
For these posts, I’m going to discuss one modality at a time and explore potentials for its complementary position with western medicine. I’ll begin with Acupuncture.
Acupuncture is a modality originating from China. It is considered a
branch of Traditional Chinese Medicine (TCM). It focuses on 1000s of
points that lie on 12 meridians. These meridians (discovered to
actually exist using microdissection) are microtubule lines that run
through the whole body and intersect with organ systems. There appears
to be some communication that happens in both directions on each
meridian. The French researcher Pierre de Vernejoul demonstrated this
by injecting the microtubules with radioactive isotopes and tracking it
with a gamma imaging camera. The acupuncturist uses points along these
meridians to manipulate qi (or chi) to flow or pool in a way that
balances the patient. If you think of it like a mobile, touching one
point on one side of the mobile can cause the whole thing to change and
reorient itself to that touch. This is how an acupuncturist sees the
patient. The practitioner may not even need to insert the needle to
affect a change. They have other tools at their disposal including
moxibustion (the use of burning mugwort to heat an acupoint) and Gua Sha
(rubbing acupoints).
So where does this fit in with western medicine? Acupuncture is most effective when used for pain, addiction, mental disorders, and AIDS (note, acupuncture does not cure AIDS, it is used in the relief of complications due to disease and treatment). One example of this combination of eastern and western styles comes in a double-blind, sham-controlled study. Sixty patients undergoing chemotherapy for the treatment of multiple myeloma underwent either acupuncture or sham acupuncture for 5 days directly after their chemo treatment. Although the patients and clinical evaluators were blinded, the acupuncturists were not. The trial demonstrated that those receiving true acupuncture experienced less nausea, loss of appetite, and drowsiness, and they required less pain medication than those in the sham arm (see reference below).
Perhaps for patients who have pain or mental complications or addiction for whom standard drug therapy is not working, acupuncture could be an option. If a patient is experiencing side effects that have become intolerable, acupuncture sounds like a great modifying therapy. The research is still not strong enough to use acupuncture as a stand-alone therapy. I do not suggest that acupuncture replace any therapy prescribed by a physician. However, acupuncture does seem like a good direction for patients who experience difficulty with their circumstances even after being treated with other modalities.
Challenges acupuncture presents include lack of uniformity and
regulation. It was once described to me that there are almost as many
styles of acupuncture as their are acupuncturists. On top of that, you
may live in a state that doesn’t require any kind of license to
practice. In some states, practitioners must be licensed under some
other modality. These issues make it difficult to find an acupuncturist
that you can trust. You can start by looking at different associations
such as the American Association of Acupuncture and Oriental Medicine https://www.aaaomonline.org/
However, it may still come down to trying different practitioners in
your area and finding one you like. That could get expensive as you
move from one to the next. Often, first-time visits are over $100 and
usually not covered by insurance.
For western practitioners who are looking for alternatives to support their patients, it may be useful to get to know a few acupuncturists in your area that you can refer to when patients remain poorly managed in pain, mental disorders, addiction, and other complex therapy management. As patients come back with their experiences, you can get a better feeling on which ones to refer future patients.
References:
Deng G, Giralt S, Chung DJ, et al. Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation: a randomized sham-controlled trial. Support Care Cancer. 2018;26(2):657–665. doi:10.1007/s00520-017-3881-7.
I’m interested in personalized medicine. I think a big part of what I can do as a pharmacist to personalize someone’s experience with health is to become a source of knowledge in complementary medicine. When a patient is not getting what they need from traditional western medicine, I can help guide them to other modalities that can enhance their health in cooperation with what they’re getting from their primary care physician (PCP).
For these posts, I’m going to discuss one modality at a time and explore potentials for its complementary position with western medicine. I’ll begin with Acupuncture.
So where does this fit in with western medicine? Acupuncture is most effective when used for pain, addiction, mental disorders, and AIDS (note, acupuncture does not cure AIDS, it is used in the relief of complications due to disease and treatment). One example of this combination of eastern and western styles comes in a double-blind, sham-controlled study. Sixty patients undergoing chemotherapy for the treatment of multiple myeloma underwent either acupuncture or sham acupuncture for 5 days directly after their chemo treatment. Although the patients and clinical evaluators were blinded, the acupuncturists were not. The trial demonstrated that those receiving true acupuncture experienced less nausea, loss of appetite, and drowsiness, and they required less pain medication than those in the sham arm (see reference below).
Perhaps for patients who have pain or mental complications or addiction for whom standard drug therapy is not working, acupuncture could be an option. If a patient is experiencing side effects that have become intolerable, acupuncture sounds like a great modifying therapy. The research is still not strong enough to use acupuncture as a stand-alone therapy. I do not suggest that acupuncture replace any therapy prescribed by a physician. However, acupuncture does seem like a good direction for patients who experience difficulty with their circumstances even after being treated with other modalities.
For western practitioners who are looking for alternatives to support their patients, it may be useful to get to know a few acupuncturists in your area that you can refer to when patients remain poorly managed in pain, mental disorders, addiction, and other complex therapy management. As patients come back with their experiences, you can get a better feeling on which ones to refer future patients.
References:
Deng G, Giralt S, Chung DJ, et al. Acupuncture for reduction of symptom burden in multiple myeloma patients undergoing autologous hematopoietic stem cell transplantation: a randomized sham-controlled trial. Support Care Cancer. 2018;26(2):657–665. doi:10.1007/s00520-017-3881-7.
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