By Dr. med. Gabriel Stux, Professor Bruce Pomeranz MD, Ph.D (auth.)
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The "garbage-in, garbage-out" criticism which was raised previously for meta-analysis of chronic pain studies applies here as well. Should 20 bad studies negate the two good studies? Why were factors such as combined acupuncture plus intense psychotherapy not used as a prerequisite for inclusion in the meta-analysis? More work is needed. Since this meta-analysis was performed there has been intense interest by National Institute of Drug Abuse (NIDA) in the USA to fund controlled clinical trials of acupuncture for addiction.
Naloxone. Since these early papers there have been numerous studies in which systemically administered endorphin antagonists have been used to test the endorphin-AA hypothesis. Although most researchers reported naloxone antagonism [17, 21, 25, 26c, 29-31, 39, 53, 63, 75, 88, 91 b, 92, 136, 138, 148, 149, 152, 166, 172, 173, 176, 177, 180a, 181, 189, 194, 210, 213, 224, 225], a few did not find any effects of naloxone [1, 23, 24, 140, 187, 198, 214]. Three of these seven failures were obtained with high-frequency, low-intensity stimulation, which is probably not endorphinergic [1, 198, 214].
By including papers in which negative results were obtained from improper acupuncture, the positive results of other studies were cancelled out [187 b]. In conclusion, we see that AA works better than placebo (class C) for most pains (except neuralgias or migraines) [44, 97] and helps 55%-85% of patients, which is a remarkable efficacy rate; morphine only helps 70% of patients with chronic pain . If AA is better than or equal to conventional methods, and if AA is safer than drugs, then AA should become the method of choice for treating certain chronic pains.