A New Era of the Five-Needle Protocol for Mental Health

During the 2023 Texas state legislative session, lawmakers voted unanimously to broadenthe use of a five-needle ear acupuncture protocol (5NP) to treat physical, emotional andpsychological stress, trauma, and addictions. The tool helps recipients reduce emotional distress,feel calmer physically, and experience a sense of confidence and capability. 5NP is a limitedacupuncture protocol that non-acupuncturists can be trained to use. Lawmakers saw 5NP as amuch-needed therapeutic resource to address increases in mental health diagnoses across Texas.

Background

Auricular acupuncture for behavioral health was developed in the early 1970s by LincolnHospital in the Bronx, New York, to combat a heroin epidemic. The procedure involves bilateral placement of acupuncture needles into five specific ear points. These ear points promote a sense of well-being, stillness, and emotional regulation helpful in mitigating symptoms of acute and post-acute withdrawal (Carter & Olshan-Permutter, 2015). The procedure’s origin was part of a community driven effort to assist its afflicted citizens to gain footing into recovery from addiction as well as easing participants into other treatment services (e.g.: group and individual counseling). The tool so effectively accomplished this, it was nicknamed ‘acudetox’ for its predictable and beneficial outcomes in substance abuse treatment. Lincoln Hospital became a center for training non-acupuncturists to learn the simple procedure and in 1985 a codified training regimen was established along with a training organization called the NationalAcupuncture Detoxification Association (NADA).

The tool gained significant attention when used in the aftermath of the September 11th attacks in 2001. Because of its proximity to ground zero, Lincoln-trained administrators of acudetox offered treatments to traumatized survivors and first responders. Acudetox became the preferred mode of treatment for trauma victims of 9/11, its non-verbal approach worked for. participants who simply did not have the ability nor the desire to verbalize their traumatic experience (Cooley, 2008). The Veterans Administration began to use acudetox after engagements in the Middle East treating the trauma of wounded veterans. The VA now uses ear acupuncture to address symptoms of PTSD, depression, pain, insomnia, addiction, and to promote general well-being.

Since its origin, the protocol has educated practitioners and recipients about its powerful effects beyond its limited use for addiction detoxification. In fact, acudetox works with or without an addiction diagnosis, or any diagnosis at all – a better name for the protocol is now simply, 5NP or the 5-needle protocol. At its core, 5NP helps establish balance and stability where lives are unstable. It reaches participants in a subjective manner, safely, non-verbally, non-pharmaceutically and with few known side effects. 5NP works in spite of doubts or resistance. The protocol has been used around the world to provide psychological first aid in conditions of natural and human disasters including earthquakes, civil unrest, hurricanes, and violence, treating those who have limited access to mental health resources.

In 1999 Texas passed its first ‘acudetox law’ with cautious regulations, allowing nonmedical professionals to use the tool under medical supervision, and only in the context of addiction recovery. The Texas Medical Board was appointed to issue permits to practitioners called Acudetox Specialist (ADS). After decades of successful use by ADSs, and years of advocacy to reduce regulation and the tie to an addiction diagnosis, the 88th legislative sessionHouse Bill 1106 passed the Texas House and Senate healthcare committees with unanimous and bipartisan support. The floor votes were overwhelmingly in support and the new law was signed by Governor Greg Abbott and enacted on September 1, 2023.

View the new law here

The most significant aspect of the new law is its provision to treat conditions beyond addiction. The law now allows the 5-needle protocol to treat conditions of trauma, physical, emotional and psychological stress, as well as addiction recovery. It expands the list of professionals allowed to use the protocol, and makes future additions to the acceptable practitioner list easier with Texas Medical Board approval. Additionally, HB 1106 eliminates unnecessary burdens of supervision requirements and too-frequent permit renewals placed on practitioners. Confidence to make these changes is a reflection of the data reporting that no injury claims have been filed over decades of safe use. The possibilities for this protocol are endless since no one is immune from the debilitating impact of trauma and stress on our everyday lives. We can now expand our thinking about 5NP’s therapeutic impact beyond drug detoxification to promote general health and well-being for all.