Soothing instrumental music tinkles, as a medical staffer inserts hair-thin, steel needles into the ear of a recovering drug addict. Nearby, several people wait their turn.

It is a scene commonly found in thousands of substance abuse treatment centers across the United States and Europe. And now it is showing up in Maine.

ACCESS, Maine Medical Center's treatment program for mentally ill adults dealing with substance abuse, is running a yearlong study to see if auricular acupuncture, when used as an adjunct to counseling and medical care, helps to reduce cravings for alcohol and drugs and relieve tension. Proponents say acupuncture is integral to a well-balanced treatment program.

Every Monday, Wednesday and Friday, an acupuncturist spends 2 1/2 hours at the Portland ACCESS office, offering a modified form of the ancient Chinese therapy to a steady stream of clients, who also receive group and individual counseling.

While some of the state's 99 licensed acupuncturists and naturopathic doctors may serve recovering addicts in their private practices, experts believe that the ACCESS study is the first orchestrated attempt to bring free acupuncture services to that population in nearly a decade.

The state Office of Substance Abuse is funding the study through a $51,000 grant, a move its director, Kim Johnson, said speaks to the state's growing openness to new ideas and alternative treatments as drug problems in certain parts of the state grow more acute.

The study, which began in September, "is really our first experiment around how it works with that population," Johnson said. "If the outcomes are really positive, we could look at extending it."

There have been other attempts in Maine to provide free acupuncture services to recovering addicts in a group setting. In the mid-1990s, a substance abuse program called Crossroads for Women offered services at a residential facility in Windham for about a year. Then funding ran out, said Johnson, formerly with Crossroads.

Also during that period, the Westbrook Community Hospital, now Mercy Hospital's Recovery Center, unsuccessfully tried to start a pilot program that would enable patients to use Medicaid to pay for acupuncture.

In Maine and most other states, Medicaid still does not cover acupuncture treatments. Neither does the state's largest insurance company, Anthem Blue Cross Blue Shield of Maine, unless acupuncture is specifically written into one's policy.

"We're not saying acupuncture is good or bad, but right now the medical benefits are not supported by the science," said Bill Cohen, spokesman for Anthem, which stopped offering general coverage for acupuncture in October.

Some studies show that acupuncture benefits recovering addicts, while others show it has no effect.

Uncertainty about the efficacy of acupuncture in treating substance abuse may be why it has received little exposure and funding for that use in Maine, Johnson said.

"When money is relatively short, it's harder to do things that are experimental," she said. Johnson added that other states "have used acupuncture a lot for opiate abuse, which has only recently become a problem in Maine" - a reference to the rise in OxyContin abuse and heroin use.

Other states with severe drug and alcohol problems, such as New York, Connecticut and Florida, "were desperate and willing to try anything," said Sheldon Ganberg, the acupuncturist who helped develop both the Westbrook Community Hospital and ACCESS projects.

In Maine, state lawmakers "just weren't desperate enough. They weren't willing to give up the funds," said Ganberg, who moved his practice to Port St. Lucie this year, partly out of frustration.

ACCESS' Dr. Paul Ranucci, though, is optimistic that if acupuncture is shown to be effective in Maine, it may be more readily used to "enable (patients) to make more use of therapy to address personal matters that contribute to their substance abuse." As a result, he said, clients could stay in treatment longer and eventually become less dependent on community services.

In places such as New York City, acupuncture is often coupled with therapy to help substance abuse patients, said Dr. Michael Smith of Lincoln Hospital in the South Bronx, founder of the National Acupuncture Detoxification Association.

"We've been doing this 25 years," Smith said. "Almost every addict in the New York area has heard about this if they haven't tried it."

On a trip to Maine in the mid-1990s, Smith gave a presentation on acupuncture to the psychology staff at Maine Med. Ranucci, who attended, became determined to start a project that would use NADA protocol, which pairs counseling with a five-point acupuncture system.

The points on the outer ear represent the sympathetic nervous system, kidney, liver, lung and shenmen, or "spiritgate." Stimulation of the points is believed by some to establish normal neurochemical balance in the brain and to speed excretion of substances from the body.

Training in the NADA protocol takes just 70 hours, compared to the more than 1,000 hours required to become certified in acupuncture in most states. In New York alone, there are hundreds of NADA-certified health professionals. But in Maine, NADA certification is useless unless one is also certified to practice acupuncture.

Elizabeth Garnett, who was hired by ACCESS, is one of the handful of acupuncturists in Maine who is trained by NADA. With each of the study's 25 participants, she inserts needles into the same points on the ear. Then the patients sit silently on couches for about 45 minutes. Afterward, Garnett uses adhesive to stick a vaccaria seed on the ear of the patient who wants to be able to press on a particular point without her help.

Garnett used to offer acupuncture to recovering addicts in her own practice, but was unhappy that some clients failed to also seek counseling. She said the study at ACCESS - which stands for Adult Assertive Community Treatment - creates an ideal situation by providing one location for participants to get both services.

"Acupuncture does a great job in terms of helping deal with cravings and withdrawal symptoms, anxiety and issues that came up," she said. "But in terms of behavioral changes and long-term changes that one has to make, you really need to have the counseling piece, both individual and group."

Josie Huang can be contacted at 791-6364 or at:

From Mainetoday.com