Understanding Cocaine Addiction According to Chinese Medicine Theory
On this page
- Abstract
- Introduction
- Cycle one: Lung, Heart, Spleen
- Cycle two: Lung, Kidney, Liver
- Six mechanisms that deplete Kidney Yin
- The spirit aspect — po dominating the shen
- Treatment strategies
- Conclusions
Abstract
Introduction: Cocaine is the most commonly used illicit stimulant drug in Europe. Auricular acupuncture has been used as a form of treatment for drug addiction since the early 1970s.
Discussion: Cocaine addiction affects all the solid (zang, Yin) organs — Lung, Liver, Heart, Spleen and Kidney — causing a complete Zangfu disharmony. The five patterns can be grouped into two cycles: Lung-Heart-Spleen, and Lung-Kidney-Liver.
Spirit aspect: Cocaine addiction is rooted in artificially inflating the po for it to dominate over the Heart, creating a false generation in the Lung which temporarily increases the mother-son relationship between Lung and Kidney. An addict is reminded of the empty high by the zhi and relayed across the mind by the yi.
Treatment strategies: The NADA protocol is a ‘cookbook’ strategy and acupuncture points located on the body should be used as well.
Conclusions: The use of Chinese medicine therapy can decrease the number of patients being admitted to hospital with drug-related illnesses, benefit society in reduced crime rates and benefit the addicts themselves.
Introduction
Cocaine is the most commonly used illicit stimulant drug in Europe (EMCDDA 2014). Cocaine was cited as the primary drug for 14% of all reported clients entering specialised drug treatment in 2012 (55,000), and 18% of those entering treatment for the first time (26,000). In 2012, 2,300 first-time treatment entrants in Europe reported primary crack cocaine use, with the United Kingdom accounting for around two-thirds of these.
Auricular acupuncture has been used as a form of treatment for drug addiction since the early 1970s, when Wen and Cheung (1973) found it to be effective in the treatment of opiate addiction. During the 1980s Michael Smith and his partner Walter Bosque developed an auricular acupuncture protocol at the Lincoln hospital in New York’s South Bronx area. This later developed into the auricular acupuncture system, the National Acupuncture Detoxification Association (NADA) protocol — a ‘cookbook’ approach made up of five auricular points: shen men, Sympathetic, Kidney, Liver and Lung.
A number of randomised controlled trials have tested the NADA protocol on cocaine addicts but have concluded with mixed results. A systematic critique of these studies (D’Alberto 2004) could not conclude with a definite answer as to the effectiveness of the NADA protocol on cocaine addiction, but did note a number of study design failures.
It is important that researchers and practitioners understand the mechanisms of cocaine addiction within the theories of Chinese medicine. There is little or no mention of addiction within the four major classics of Chinese medicine (Nei Jing, Shang Han Lun, Wen Bing Xue, Jin Kui Yao Lue). In Chinese medicine theory, cocaine addiction affects all the solid (zang, Yin) organs causing a complete Zangfu disharmony. It leads to five distinctive patterns:
- Lung Qi deficiency
- Heart Yin deficiency
- Spleen Qi deficiency
- Kidney Yin deficiency
- Liver Yin deficiency
Cycle one: Lung, Heart, Spleen
As cocaine is snorted through the nose, it enters the Lung where it impairs the Lung’s dispersing and descending function. Symptoms manifest instantly with nasal obstruction or rhinorrhoea with thin watery mucus and sneezing. The Lung Qi is damaged with symptoms of peripheral vascular collapse, tachypnoea and tachycardia. As Lung Qi is deficient, wei Qi will be weakened, causing the pores to open with spontaneous sweating and making the body susceptible to colds with flu-like symptoms. Together, the Lung and Heart distribute cocaine to the entire body. The pattern moves from the Lung to the Heart via the insulting sequence of five phase theory.
Cocaine then proceeds to damage Heart Yin, creating an Empty Fire pattern with symptoms of insomnia, vertigo and sweating. Heart Qi is also damaged, with symptoms of anxiety, peripheral vascular collapse, tachycardia and excitement. As the abuse of cocaine depletes Heart Yin, Heart Fire is allowed to rise. The excessive Heart Fire requires more Yin to regulate it, leading to a further deficiency of Kidney Yin — this is the ‘mutual assistance of Fire and Water’ mechanism.
Heart (Fire) is the mother of Spleen (Earth). A deficiency of the Heart will lead to a weakened Spleen. The deficient Spleen cannot produce enough post-heaven Qi to satisfy the body’s requirements, and additional Qi is sourced from pre-heaven Qi or essence housed in the Kidney — thus depleting Kidney Yin. A weakened Spleen will in turn lead to a weakened Lung (the son of Spleen). The cycle reverts back to the Lung, perpetuating the deficiency.
Cycle two: Lung, Kidney, Liver
A deficiency of the Lung (Metal) inhibits its ability to generate the Kidney (Water), leading to a deficiency of Kidney Yin. Coupled with this, many addicts are involved in excessive sexual activity that drains jing (Essence), which further exacerbates the empty heat pattern. Symptoms manifest as night sweats, paranoia, fear, and in severe cases renal infarction, atherosclerosis of the kidney and renal failure.
The abuse of sex that results from the empty heat pattern increases the Yin and jing deficiency. With some abusers, the addiction to drug-induced sex is a primary motivation for the abuse of cocaine; the empty heat pattern causes exuberant Yang which increases erectile function in men and a heightened sense of feeling in women. These people may be addicted to the empty heat pattern itself.
A deficiency of Water leads to a weakness of Wood, causing a deficiency of Liver Yin. Yin is unable to regulate Yang, allowing Yang to rise and become disruptive. This causes the pattern Liver Yang rising and displays all the classic drug abuse symptoms: irritability, euphoria, anger, depression, restlessness, tremors, hypotension, hypertension, exophthalmia and mydriasis. Mydriasis (dilation of the pupil) is termed ‘Wind orbiculus’ in TCM and illustrates the Liver’s involvement — a useful means of diagnosing current cocaine addiction.
The Liver imbalance leads in turn to a disharmony between the Liver, Spleen and Stomach. An overactive Liver exploits the Spleen, causing loss of appetite, abdominal cramping, loose stools and sweating in the day. As the Liver exploits the Stomach, it causes nausea and vomiting. Excessive loss of bodily fluids from sweating, vomiting and loose stools worsens the Yin deficiency.
Six mechanisms that deplete Kidney Yin
- Lung Qi deficiency: affects its ability to nourish and generate Water (Kidney) and insults the Heart.
- Heart Yin deficiency: requires additional Yin from the Kidney to regulate Fire via the controlling sequence of five phase theory and the mutual assistance of Fire and Water.
- Excessive sex: drains essence and Yin housed in the Kidney.
- Fluid loss: vomiting, sweating and loose stools deplete the body’s Yin.
- Liver Yang rising: drains Water from the Kidney as Water nourishes Wood (son ruins the mother), whilst also draining essence and insulting the Lung.
- Spleen Qi deficiency: causes a lack of post-heaven Qi, depleting pre-heaven Qi housed as Essence in the Kidney, and is unable to nourish the Lung (son of the Spleen).
The spirit aspect — po dominating the shen
At the root of addiction lies a reason, a pattern for it to exist in the first place. Some commentators have suggested the source of drug addiction is the shen as it is the mind and the commander of the other Zangfu. It is more complicated than that.
From a Zangfu spirit perspective, the initial inhalation of cocaine through the nose into the Lungs elevates the po. The Chinese character for po (魄) is made up of the character gui (鬼). Gui relates to spirits of the Earth, whilst the character for shen (神) relates to spirits of Heaven. The po is the Yin spirits attached to Earth, to form and to substance. The in-breath is the physical self, the ‘I’, our quest for life and presence on Earth connected through the inhalation of breath into the Lung, whilst the out-breath is surrender to the now, Heaven, via the Heart.
Cocaine addiction is rooted in artificially inflating the po for it to dominate over the Heart. The Heart is shen, Heaven and self-love. The artificial inflation and dominance by po is due to a disconnect from the Heart, shen and Heaven. This Heart disconnect from Heaven creates fear, and it’s this fear that propels the abuser to seek alternative protection in the disillusion that Heaven has forsaken them. This is done through artificially inflating the po by the inhalation of cocaine. This creates a false generation in the Lung, which temporarily increases the mother-son relationship between the Lung and Kidney — in that the Lung is powerful enough to nourish the Kidney and reduce fear, thereby quelling a lack of self-confidence and self-love born from the addict rejecting their connection to Heaven and shen. However, once the effects of the drug have worn off, the real pattern of Kidney deficiency and fear becomes prominent.
As the Kidney deficiency is the end cause of cocaine addiction, the zhi will be affected. The character for zhi (志) is made up of the Heart/Mind (心) with a small shoot above it. This shoot represents something that can form a base from which it is possible to grow and develop in the right way. If zhi is weakened then the person does not develop and mature and is stuck, in an addictive cycle of stagnation.
Yi (意) also contains the character of the Heart/Mind (心) but is the mouth piece of the shen: what is moving across the Mind at any one time can be voiced. The yi gives form to an image, a thought or intention, and then the zhi fixes that in the mind. An addict is reminded of the artificial high introduced by the abuse of cocaine by the zhi. The empty high is then fixed in the Mind by the zhi and relayed across the Mind by the yi. It is this that makes it an addiction rather than abuse, as it creates a Spirit imbalance.
From a shamanic point of view, every plant has a spirit and requires Qi. The cocaine plant gives the abuser a high in exchange for some of their Qi, which eventually drains the Kidney. This rule of Qi exchange is the same in all addictions.
Treatment strategies
The NADA protocol is a ‘cookbook’ strategy that treats the organ at a generic level — one point for one Zangfu. It doesn’t address the spirit or jing aspects of addiction. Therefore acupuncture points located on the body should be used in conjunction with auricular therapy to provide a correct treatment programme based upon a clear pattern analysis.
When using the NADA protocol, it is important to use electrical stimulation on the Lung point. This mimics the original research conducted by Wen and Cheung (1973) where only the Lung point was stimulated using electrical acupuncture to reduce cravings for illicit drugs. It is also a more natural way of stimulating the Lung to nourish the Kidney. The Lung point lies in the concha of the ear, which is the place of greatest density of vagal innervation (vagus nerve). Stimulating the vagus nerve causes the release of dopamine and therefore reduces drug cravings.
The use of acupuncture, herbs and dietary advice can help addicts rebuild their essence and strength so they can break the stagnant cycle of zhi and po addiction and re-establish a connection to shen as well as hun.
Conclusions
The NADA protocol, in addition to body points and herbs, provides a wide range of interventions available to oriental medicine practitioners. Acupuncture is highly cost-effective, with few overheads, and has no reported side effects. Herbs are equally cheap and offer an effective way of rebalancing withdrawal cravings for substances such as cocaine, assisting in detoxifying the body and rebuilding Yin and jing. The use of Chinese medicine therapy can decrease the number of patients being admitted to hospital with drug-related illnesses, benefit society in reduced crime rates and benefit the addicts themselves.
See also the related research paper: Auricular acupuncture in the treatment of cocaine/crack abuse (D’Alberto, JACM 2004, cited 102+ times).
