Acupuncture: Science behind the Miracles
Article featured in SCI Ontario’s Outspoken Magazine Spring 2018 Issue
I remember it clearly, as if it were yesterday. November 12, 1976, the Globe and Mail front page:
“Acupuncture chemical is effective in blocking pain, researcher says”.
To say I was gob-smacked is to understate the reality of my world at the time.
Less than two and a half years after I first marvelled at turning pain off by inserting very thin solid stainless-steel needles into specific body sites on long- suffering patients, there was finally a scientific hint of a possible mechanism of action of acupuncture for pain. And the researcher that the Globe and Mail’s medical reporter Joan Hollobon was referring to was a neurophysiology professor at my alma mater, the University of Toronto: Dr. Bruce Pomeranz.
The first researcher in the west to publish evidence that acupuncture causes the body to produce or increase production of the peptides we know generically as ‘endorphins’, Dr. Pomeranz published 66 papers on acupuncture analgesia. The first acupuncture experiments in his lab showed that electro-acupuncture produced a significant decrease in pain (analgesia) after about 30 minutes, much longer than one would expect when the nervous system is involved, so he did not publish the results. He was, after all, a neuroscientist. Nervous system effects are usually lightning fast.
However, in 1975, serendipity took him to the UK to the landmark meeting at which the exciting discovery of the first peptides that became known generically as ‘endorphins’ was announced. Pomeranz then realized that the results his lab had obtained with acupuncture could be related to a morphine-like molecule, so he presented his 1976 paper. To support this hypothesis at the same neuroscience meeting, Dr. David J. Meyer of the Medical College of Virginia reported that he had tested the effect of acupuncture on pain he created in human subjects by delivering an electric shock to a tooth. Acupuncture significantly reduced the amount of pain the subjects felt and that effect was blocked by giving them an injection of naloxone.
Naloxone has become a household word in our present-day world, unfortunately; it is the drug that can save the life of someone who has taken an overdose of fentanyl or other opioids. It binds to the special receptors that morphine, heroin, Oxycontin, fentanyl and other opiates attach to, blocking those drugs from attaching to the receptors and rendering them inactive. That is the way this drug is able to save many lives.
Researching acupuncture wasn’t always easy, given the reluctance of medical journals to publish non-pharmaceutical research, but Bruce Pomeranz unquestionably opened the door to a paradigm shift. Thanks to him and many international researchers, acupuncture and traditional Chinese medicine are now provided at major medical schools and hospitals around the world. Discovering a physiological underpinning for acupuncture lead to its acceptance by a far broader segment of the medical profession than would have otherwise not taken a second look at it.
The discovery that acupuncture could raise the body’s endorphins, its own “home-brewed narcotics”, as one writer described them, explained a lot about the effects we were seeing with acupuncture. For one thing, a pleasant side effect of acupuncture that was often described by our patients was a feeling of well-being or, occasionally, even euphoria. The “runner’s high” that exercise can produce has been attributed to a rise in endorphins.
Another very important effect of raising endorphins with acupuncture treatment is its role in the treatment of addiction. It makes sense that if you swallow or inject a drug that mimics something your body produces naturally, your own system for producing these “home-brewed narcotics” would shut down. After all, if you are shooting up heroin, why would your body think it needs to keep producing endorphins? The bad news is that when the drug wears off, you go into withdrawal and suffer severe symptoms of craving the drug, anxiety, diarrhea (remember that codeine and morphine are constipating), tremours, shivering, etc. Horrible symptoms; what heroin addicts call being “sick”. Acupuncture was found to quickly remove these symptoms back in the early 1970s in Hong Kong.¹
The story was told to a medical audience at a lecture I attended in Toronto General Hospital in 1975, by a neurosurgeon from HK, Dr. Wen. Dr. Wen had trained at TGH. He said that he didn’t believe in acupuncture when he heard about it being used in Mainland China, but he finally went to China and learned how to use it instead of anesthetic for performing his neurosurgery. It had many advantages.
He said, “I work in The World of Suzie Wong” (for those of you too young to understand the reference to a 1960 movie about a sex worker in Kowloon, Google it...). He said that it was common for his patients to be going through active withdrawal from heroin when they came to surgery.
One day he had a patient who was to have a lobotomy, a procedure that was used in the past for psychiatric patients in which a part of the brain that joins the two sides, the corpus callosum, is severed to make them manageable. The man was obviously in drug withdrawal, sniffing and twitching, when the acupuncture needles were inserted and hooked up to an electrical stimulation device. After about 20 minutes of waiting for the effect of the acupuncture to be strong enough to do surgery, the nursing staff said the man’s withdrawal symptoms were better. Dr. Wen was skeptical, but after another ten minutes or so it was obvious, so he decided to cancel the surgery and asked to be called when the effect wore off. About six hours later he was called back to the hospital and put the needles in again with the same result. That led him to search for the most effective points, which turned out to be in the external ear.
In the 1980s a protocol using five points in the ear without electrical stimulation was developed by the late Dr. Michael Smith, a psychiatrist at Lincoln Hospital in the south Bronx. It came to be known as the NADA (National Acupuncture Detox Association) protocol.²
Of interest is the fact that the NADA protocol has been shown to work for alcohol, opioids and cocaine which are all different; cocaine and alcohol do not bind to the same sites as the opioids. A possible explanation is that dopamine, the chemical messenger that is produced in response to pleasure, may be raised by all three.³
All acupuncture effects are not mediated by the endorphin system; there is more to learn about the science behind the needles. Stay tuned!
Note: there is an OHIP-covered clinic at Toronto Western Hospital where the NADA protocol is utilized in the treatment of addiction. Call 416-603- 5776 for a referral form to be filled out by your doctor.
Cui CL, Wu LZ, Li YJ. Acupuncture for the treatment of drug addiction. Int Rev Neurobiol. 2013;111:235-56. doi: 10.1016/B978-0-12-411545-3.00012-2.
Article on the National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives.
