• Liming Lu, Chen Chen, Yiming Chen, Yu Dong, Rouhao Chen, Xiaojing Wei, Chenyang Tao, Cui Li, Yuting Wang, Baochao Fan, Xiaorong Tang, Shichao Xu, Zhiqiu He, Guodong Mo, Yiliang Liu, Hong Gu, Xiang Li, Fang Cao, Hongxia Xu, Yuqing Zhang, Guowei Li, Xinxia Liu, Jingchun Zeng, Chunzhi Tang, and Nenggui Xu.
• Clinical Research and Big Data Laboratory, South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China (L.L., Y.C., Y.D., C.Tao, C.L., Y.W., B.F.).
• Ann. Intern. Med. 2024 Aug 1; 177 (8): 103910471039-1047.

BackgroundMethadone maintenance treatment (MMT) is effective for managing opioid use disorder, but adverse effects mean that optimal therapy occurs with the lowest dose that controls opioid craving.ObjectiveTo assess the efficacy of acupuncture versus sham acupuncture on methadone dose reduction.DesignMulticenter, 2-group, randomized, sham-controlled trial. (Chinese Clinical Trial Registry: ChiCTR2200058123).Setting6 MMT clinics in China.ParticipantsAdults aged 65 years or younger with opioid use disorder who attended clinic daily and had been using MMT for at least 6 weeks.InterventionAcupuncture or sham acupuncture 3 times a week for 8 weeks.MeasurementsThe 2 primary outcomes were the proportion of participants who achieved a reduction in methadone dose of 20% or more compared with baseline and opioid craving, which was measured by the change from baseline on a 100-mm visual analogue scale (VAS).ResultsOf 118 eligible participants, 60 were randomly assigned to acupuncture and 58 were randomly assigned to sham acupuncture (2 did not receive acupuncture). At week 8, more patients reduced their methadone dose 20% or more with acupuncture than with sham acupuncture (37 [62%] vs. 16 [29%]; risk difference, 32% [97.5% CI, 13% to 52%]; P < 0.001). In addition, acupuncture was more effective in decreasing opioid craving than sham acupuncture with a mean difference of -11.7 mm VAS (CI, -18.7 to -4.8 mm; P < 0.001). No serious adverse events occurred. There were no notable differences between study groups when participants were asked which type of acupuncture they received.LimitationFixed acupuncture protocol limited personalization and only 12 weeks of follow-up after stopping acupuncture.ConclusionEight weeks of acupuncture were superior to sham acupuncture in reducing methadone dose and decreasing opioid craving.Primary Funding SourceNational Natural Science Foundation of China.

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