Acupuncture for illicit drug withdrawal syndrome: A systematic review and meta-analysis

Illicit drug addiction remains a significant problem around the world. Acupuncture has been promoted as a treatment for drug withdrawal syndrome, but its effect remains controversial. The aim of this meta-analysis was to evaluate the efficacy and safety of acupuncture for illicit drug withdrawal syndrome. We searched four English databases and three Chinese databases from their inception to June 2019. The RCTs involving acupuncture for drug withdrawal syndrome were included in our study. The Cochrane assessment tool and the GRADE approach were used to assess the risk of bias and the quality of evidence. RevMan 5.3 software was used to analyse the data. Thirty trials with 2391 participants were included in this study. The overall pooled results showed that compared to the control group, acupuncture could have a beneficial effect in the outcomes of withdrawal symptoms (n = 1160, SMD: -1.20, 95 % CI: -1.71 to -0.69, I2: 93 %), drug craving (n = 928, SMD: -0.80, 95 % CI: -1.38 to -0.23, I2: 94 %), anxiety (n = 1144, SMD: -2.32, 95 % CI: -3.00 to -1.64, I2: 95 %), depression (n = 489, SMD: -3.29, 95 % CI: -4.36 to -2.22, I2: 93 %), sleep (n = 649, SMD: -1.50, 95 % CI: -2.24 to -0.76, I2: 94 %). In total, 3 trials were assessed as low risk of bias. The quality of evidence assessed by GRADE was low or very low. Only 4 studies described adverse events. Acupuncture may alleviate illicit drug withdrawal syndrome. However, given the low or very low quality of evidence, more rigorous research is needed.