Consistency in the Face of Chaos

When new or returning clients come into the program they are usually "all tore up," physically and emotionally. Even if they haven't bottomed out to the streets, they may have a court case hanging over their heads. They may be living in a shelter or shuffling from relative to relative. They may owe drug dealers money. Generally, their life is chaos. Into this chaos I have to introduce, what for many, is new and unusual information. As part of a client's intake, my job is to impart information about the benefits of acupuncture, especially the detox aspect. I must make sure they understand all the risks, no matter how small, to satisfy Informed Consent, although I always leave that part until the end. Given the chaos that so much of their lives can be, I try my best to be consistent with the information I give.

I never embellish my skills or the reach of acupuncture. I acknowledge not everyone gets what they want from treatment and no one gets it every time but that those who say acupuncture doesn't work often have not complied with the criteria. I point out that it is not just a few needles for a few minutes a few times and that I cannot make Halle Berry or Denzel Washington call them, nor can I make them win the lottery. They usually laugh and I then point out that some people want me to perform miracles.

I tell them treatment is an ongoing process and good treatment lasts at least a half hour, but 45 minutes is better. Also, it is important to sit silently and let the treatment work; let the body/mind/spirit relearn to relax. I explain that acupuncture is a tool to help with recovery and the more you do it, the better. But its not like methadone; you do not have to do it the rest of your life to feel good. I also use this logic: before you came into the program, you used, tried to use or thought about using every day. When they agree, I suggest they do acupuncture as much as possible. We talk about consistency of treatment; groups, counseling, urine testing and acupuncture if they choose to use it. Acupuncture is a voluntary part of the program, which I have to sell them on trying at least once.

Inevitably most want to know if it hurts. I tell them everyone has a different response but, that in my 20 years experience, it is a positive event for most people. If you measure people's pain on a ruler, the first inch would be those who look up and say "You did it already?"; the last inch would be those who yell "Ow, Ow, Ow" as I wipe their ears with the alcohol swab. The rest fall somewhere in between. Many have tattoos and piercings that may be anywhere: neck, chest, head, hands, fingers, feet, toes, arms, legs, nose, lips, eyebrows and in places not generally visible. They may have a whole line of holes in both ears, often done with an ice cube to numb the ear and a sewing needle. Professional tattoos are one thing but jail tattoos are done by hand with a sharp object and heated shoe polish. To these people I say, "If you can do that, you can do acupuncture asleep," which may lead to a conversation about insomnia and an opening to treatment. To the ones with tongue piercings, I say with a smile, "I don't want to hear it. Compared to that, this is nothing."

There are those who come in with a sincere fear of acupuncture and needles. For some it is new, unusual and foreign. Some cannot equate the word "needle" with anything but drugs and feel treatment might be a "trigger" and cause them to use. I don't argue with them. I also don't stop trying to convince them. Many have seen acupuncture on TV or the movies but not experienced it. The "Pinhead" character in the "Hellraiser" books and movies has not helped.

Surprisingly, I still get people who actually have never heard of acupuncture. Then there are those who have an irrational terror. I have had people run out the door. Even when they understand they are not required to get treatment, some won't sit until I put away the sample needle that often leads to the statement, "Is that all it is?" I inform them that the needles are literally about the thickness of a human hair, but some will never be convinced. Some take a while. Some a long while.

Next, I tell them the needles are sterilized at the factory, used once and medically disposed so they do not have to worry about diseases. Often this is where many will disclose their HIV or hepatitis status and we talk about possible treatment.

Usually this is a good time for the "How Acupuncture Works" speech. I tell them that it was developed over thousands of years in Asia. That it is about balancing qi. Most people have heard of this concept, at least through phrases like tai chi or qi gong and once even through "qi pants."

This is also where I bring up the concept of pain and that withdrawal itself is a kind of pain. I usually get agreement with that last statement. I tell them some form of acupuncture has been discovered all over the world and talk about the Ice Age mummy unearthed in the Alps with tattoos relating to acupuncture points for disorders he was found to have. Or when NADA first went into the Native American reservations, an elderly man said that his great-grandfather had talked about using porcupine quills with the barb shaved off to do healing.

I have a three-page hand out turned to the ear chart from "The Essentials of Chinese Medicine." Once the fear of acupuncture needles conversation is over I discuss the role of acupuncture in recovery. I say, "This is a drawing of YOUR EAR (trying to get them used to the idea). The primary treatment for chemical dependency takes place in the outside part of YOUR EAR." I point to the highlighted ear points and say, "Actually, the treatment starts with a point in the forehead," indicating yintang. I was taught yintang not only calms the shen but expands the lungs and releases endorphins; all furthering relaxation. This fits perfectly into the NADA protocol, upon which this treatment is based.

After this, I go through the points highlighted on the ear chart and briefly explain their function. Ear shenmen, along with yintang, helps the body release endorphins, its own pain killers. I have learned to say that these are chemicals we are born with because some people have thought the treatment caused an unnatural chemical change.

I then point to Sympathetic Nerve, chosen because it helps calm your nervous system without using drugs or alcohol. Then on to the Balance or Zero Point. I say that drugs and alcohol throw the body "way out of balance." They usually also agree with that statement. I point to kidney, liver and lung and tell them they are the detox organs of the body and have enough to do removing toxins in the air we breathe, the water we drink and the food we eat. Adding drugs and alcohol, which are very strong poisons, overtaxes these organ systems.

Then I repeat the basic and somehow most frightening information: one needle in the forehead and three in each ear for a total of seven points. I end by again pointing out on the handout the words "sterile, disposable needles." I suggest they read a couple of articles I have included and what I call the "inspirational" back page, which might have a poem or a quote. I explain the detox tea, offer them a cup and ask if they are ready to try a treatment. If they won't try it this time, maybe they will the next time they are in treatment, if that happens.

People make it through without ever using acupuncture. I have run into graduates, years later, who often remark they wanted to try acupuncture but were afraid. I say that I am glad they are doing well but if life takes an unkind turn, come back into the program as quickly as possible and give acupuncture a try. The other part of my job: to offer consistency in the face of chaos.