No, Wounded Soldiers Should Not Be Given Acupuncture

Is using acupuncture to treat pain in soldiers, even in combat, a good idea? No, it's not, for reasons that I will explain below. But first, in case you're in the mood for some propaganda that is worthy of Pravda then take a look at an article in Health.mil, which recommends that acupuncture should be used to "help" injured soldiers, even during combat. 

It should come as no surprise that the article features Dr. Richard Niemtzow, who is the editor in chief of Medical Acupuncture and the inventor of BFA (battlefield acupuncture) and also runs a weekend clinic, (2) which specializes in:

COMPLEX PAIN, DRY MOUTH, DRY EYES, LOW VISION, ERECTILE DYSFUNCION, [but apparently not spelling] HOT FLASHES, FATIGUE

OBESITY, SMOKING CESSATION, OTHER HEALTH PROBLEMS

Ain't that something! This list of ailments that can be treated by needles in the ear is nothing short of astounding since it takes cares of pretty much anything that you might suffer from. And, by no coincidence, Niemtzow is not a big fan of real pain medicine.

“Sometimes increased use of pain medication has been shown to have diminished effects and require additional medication." (1)

Dr. Richard Niemtzow. Air Force Medical Service

Let's sidetrack for a moment. Am I the only one who finds this resemblance vaguely disturbing?

Here's another opinion on acupuncture, this time from Dr. Paul Offit, a professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and the director of the Vaccine Education Center at The Children's Hospital of Philadelphia. Dr. Offit, was formerly a trustee of the American Council.

 "[A]cupuncture is the product of second‑century BC China... The Chinese believed that there were 365 different parts of the body because there were 365 days of the year. They believed that there should be twelve meridians, the longitudinal arcs ranging from head to toe into which one inserted needles, because there are twelve great rivers in China. If you believe that human anatomy has nothing to do with rivers in China or days of the year, then there's nothing accurate about acupuncture"

Paul Offit, M.D.

Now that that nonsense is out of the way, here are five reasons why I believe that battlefield acupuncture is a terrible idea.

1. IT GIVES CREDENCE JUNK SCIENCE

To paraphrase Eisenhower, we are the victims of a media-organic complex, which has been remarkably (and pathetically) effective in convincing people that if they live a chemical-free life, eat fresh organic food (3), avoid prescription drugs because of side effects, and keep their minds open to "alternative" therapies then they are going to live to be 150, at which time we will succumb to a heart attack playing the 5th set of singles, up 6-3, 6-4, 5-1... dead.

Of course, this sounds ridiculous, but it isn't as far-fetched as it seems. People are more than happy to have coffee injected into their anus, wear magnets to treat cancer and diabetes, have their blood pumped full of EDTA (chelation therapy) to get rid of toxic heavy metals that aren't there, or swallow colloidal silver to prevent infection. It doesn't, but there could be a benefit to the stuff, especially if you envision a career in theater.

(Left) Argyria caused by consumption of colloidal silver. Photo: Medscape.  (Right) These guys did OK for themselves. Photo: CBS News.

2. IF IT WORKS WHY NOT USE IT?

This is just fine, but it doesn't necessarily work. Since it is well accepted that benefits from acupuncture are due entirely to the placebo effect and that roughly one-third of people given placebo will respond to it, that means that two-thirds won't. Can anyone seriously tell me that it is a good idea to stick needles in the ear of a soldier with a compound fracture (3)? 

3. IT PROMOTES THE FALSE NARRATIVE THAT OPIOIDS ADDICT PAIN PATIENTS

It is a bad time to be a Vicodin pill.In the past few years, it has become very fashionable to hate the poor pill because it is a useless, evil medicine. But the Anti-vicodites are either ignorant or have an agenda. Medicines are neither good nor evil. They either work well or poorly and have side effects that are acceptable or are not. The comparison of the upside and downside of any drug is what determines whether a given drug should be used to treat any condition. Opioids, as imperfect as they may be are still the best option for treating severe pain. It would seem that Niemtzow is using the current anti-opioid hysteria to further his own cause. 

4. SAFETY

At least acupuncture can't harm you, right? No, not right. A 2010 BMJ paper entitled "Acupuncture transmitted infections" discusses infections caused by the procedure, although the number of infections is low.

A new clinical syndrome has emerged in the 21st century—acupuncture mycobacteriosis—which is mainly caused by rapidly growing mycobacteria.9 These mycobacteria are thought to be transmitted from the environment to patients via contaminated equipment used in acupuncture, such as cottonwool swabs, towels, hot pack covers, and boiling tanks/

P.Woo, et. al, BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c1268

5. "MISSION CREEP"

There is nothing inherently wrong with trying acupuncture on soldiers who have moderate pain. However, "suggestions" tend to become mandates. Look no further than the ghastly CDC Guideline for Prescribing Opioids for Chronic Pain. Guess what? The guidelines were nothing of the sort. Otherwise, we would not be seeing mandatory tapering of opioid doses in pain patients or the DEA going after doctors who have the audacity to care for pain patients. While the idea of trying acupuncture first may seem harmless enough don't believe for a second that it's going to stop there. Our veterans who have sustained serious and painful injuries are already being tortured by the VA by being denied sufficient pain medications. Will the same thing happen with injured soldiers? Don't take that bet. This is not a door that we want opened. 

So, no - acupuncture for soldiers, while it may have a "feelgood" aura to it, should not become common practice. Our military should not be promoting junk science. 

NOTES:

(1) This is nothing but a cheap trick. Yes, when people have been on pain meds for a long time they may need higher doses to control their pain. Welcome to life. 

(2) I called and asked prices. A pain session costs $250. Treatment for dry mouth runs $800. Neither is covered by insurance. 

(3) Whole Foods and Stoneyfield would happily have you believe that no pesticides or herbicides are used in their products. This is a load of crap. Organic farming uses plenty of chemicals, just a different collection of them, which are no better or worse than those used in conventional farming. 

(4) A compound fracture results from a broken bone puncturing the skin. It is very painful.