Detoxes Turn to Alt-Therapy for Pain Relief
By marni norwich

http://www.straight.com/content.cfm?id=4672

Publish Date: 2-Sep-2004

Needles against needles: complementary therapists say acupuncture
can help addicts endure the agony of withdrawal. Mark Mushet photo.
The first time Les Moncrieff saw acupuncture being used to treat
addiction was in 1989, at a Portland facility called the David P.
Hooper Detoxification Center. "I went down there and walked into a
room and there were about 35 hard-core skid-row addict guys. But it
was like walking into a Buddhist monastery. They were just sitting
there, so tranquil and calm; I couldn't believe it. This was nothing
like any detox I'd ever seen before."

Moncrieff had an acupuncture treatment that afternoon, and the sense
of peace it brought him lasted all day and well into the next. "I
thought to myself, 'Any addict and alcoholic who's in pain and
suffering has to experience this,'" he recalls at the downtown detox
centre where he works in Vancouver.

The addictions specialist spent the next decade collaborating with
others to establish acupuncture as a viable treatment in the health
centres of East Vancouver. After much campaigning at the federal,
provincial, and local levels, their efforts met with success. In
1998, acupuncture became one of the first so-called complementary
therapies to be offered in B.C. government­funded health facilities,
where staff use it alongside drug therapy (methadone) and
counselling to treat people overcoming addictions.

Complementary therapists are the first to point out that, on their
own, the services they provide don't solve the puzzle of addiction.
At the same time, some in the scientific community believe the
benefits of these treatments are exaggerated. Proponents counter
that together with mainstream medicine, complementary therapy can
help alleviate the emotional and physical pain that addicts
frequently experience on the road to wellness.

Meanwhile, the Canadian public is becoming increasingly accepting of
complementary medicine, according to excerpts from an Ipsos-Reid
(formerly Angus Reid) "trend report". A 1997 Angus Reid poll of
1,200 adult Canadians showed that 42 percent of respondents had used
such treatments, an 81 percent increase from 1992. In a 2000 Angus
Reid survey of 1,500 Canadians, that number rose to 52 percent. In
2000, British Columbia had the highest rate of all provinces, at 65
percent.

And when it comes to integrating complementary therapies into the
health-care system, Vancouver is progressive, according to one local
expert. David Marsh is head of addiction medicine for Providence
Health Care--which owns and operates six Catholic health-care
facilities in Vancouver--and medical director of addiction, HIV
services, and aboriginal health at Vancouver Coastal Health
Authority. "Compared to the other places where I've worked in
Canada, it does seem to me that VCH is well-advanced in integrating
complementary therapies into the treatment for addictions," he says
in an interview at his office.

In the Downtown Eastside and beyond, complementary therapists have
gradually been taking their places beside local doctors, nurses,
social workers, and counsellors. As well as getting mainstream
treatment, people recovering from addiction can seek the services of
these acupuncturists and massage, music, and energy therapists. The
Georgia Straight spoke with four complementary-therapy practitioners
in the Downtown Eastside, to get their perspectives on the nature of
addiction and how they address this complex problem.



LES MONCRIEFF CONSIDERS himself a specialist in a "house of pain".
He calls acupuncture "the ultimate pain medicine".

"Pain and suffering are my life," he says with a laugh. "Working in
a place like this, one is exposed to an incredible array of
suffering." Moncrieff is referring to Vancouver Detox, a VCH­funded
residential facility where he is a registered acupuncturist with a
focus on addictions management.

The style of acupuncture he practises at the East 2nd Avenue
premises is called Acu Detox, whereby five tiny needles are inserted
into both outer ears at specific points. When stimulated by the
needles, Moncrieff says, the points help relieve physical pain and
improve liver and kidney function. According to him, they work with
the emotions, too, helping to relieve grief and anger and
strengthening willpower.

This form of acupuncture also helps people to relax, a benefit most
evident in the comfortable room where Moncrieff and his apprentice,
Benjamin Chang, are working this April afternoon. The two move with
an air of compassion and efficiency, needling peoples' ears and
addressing concerns as they arise. Needles in place, the half-dozen
patients move on to couches, where they sit back and listen to soft
music.

Moncrieff says he treats a lot of migraines, back and shoulder pain,
and arthritis. "You can just imagine some of the trauma that these
clients have experienced," he explains. "They come in very stressed
out with withdrawal pain, and in a very short time they become
tranquil. You see a reduction in anxiety and physical pain, they
sleep better, and their depression, their anxiety, seems to be
disappearing." He describes the more traditional style of detox
as "rough", and not a pleasant place for patients or staff.

If there's anyone who can do a comparison of the old style with the
new, it's Moncrieff. He's worked in addictions for two decades. "For
most of those years, it was a pretty harsh environment; it wasn't
very satisfying, and the relapse... It was a burnout job." He says
he didn't see much progress or real recovery and was always looking
for treatments that got better results.

Below the detox residence is Vancouver Daytox, where the
complementary therapies offered in addition to acupuncture include
healing touch, Bach flower remedies, and thought field therapy.
Patients are still medicated, but all these treatments are effective
in reducing their drug intake, Moncrieff claims. They are adjunct
therapies, he notes: not intended to stand alone, but used alongside
orthodox medicine to form a complete package.



VIKKI KING'S LIFE has been a tapestry of the holistic and the
traditional. When she was a child, her grandfather exposed her to
yoga, organic food, and homeopathy. King graduated from medical
school in 1985 and completed her specialty training in emergency
medicine four years later. In 1993, she took a year off to explore
other areas that held meaning for her. She lived in an ashram in New
York state, studied yoga intensively, and worked for Doctors Without
Borders in southern Sudan. When she returned to Canada, she chose to
apply her skills in the Downtown Eastside.

It seems natural that her role at the Downtown Community Health
Clinic on Powell Street--where she worked for four years--was that
of integrator between complementary and allopathic therapies. As a
clinical faculty member of UBC's family-practice department, she's
in a good position to build such bridges. She's also enrolled in the
two-year integrative-medicine program offered at the University of
Arizona by U.S. alternative-medicine guru and author Andrew Weil.

At the Downtown Community Health Clinic, King was responsible for
overseeing the complementary therapists and integrating them into
the clinic. "You can have somebody who comes in two days a week and
who works in isolation," she explains over a sushi lunch, "[or] the
doctor refers to the therapist, the therapist refers back to the
doctor, and they're working as a team." To achieve this outcome,
King made sure that doctors, medical residents, and other staff
became familiar with the nature of the therapies being introduced.

The character of addiction, with its host of underlying problems,
makes it no different than any other chronic disease, King says. And
although she describes emergency work as the area where Western
medicine really shines, she sees limits to its capacity to treat
chronic conditions.

"There can be a biological focus to addiction," she argues. "But you
can also look at it in a spiritual way, as a lack of meaning and
focus in life. You can look at it from [the perspective of] the
abuse that may have happened in the past....So you can't...treat
heroin addiction [solely] with methadone....By looking at it from
multiple levels, you're more likely to have a successful treatment."



SITTING IN A sunny café on Commercial Drive, music therapist Jeffrey
Hatcher shares his perception of the path that leads to drug
addiction.

"People very rarely grow up healthy and happy and well-adjusted and
content and safe," he says, "then suddenly become drug addicts. And
really desperate drug addicts. It's not as abrupt as that...it's a
long and tangled trail before then which has a certain logic to it."

As a staff music therapist at the Dr. Peter Centre and the Vancouver
Native Health Society, Hatcher estimates that more than 75 percent
of his clients are dealing with substance abuse. He says addiction
almost always indicates a history of neglect, physical and/or mental
abuse, or developmental delays.

"It [addiction] should teach us about abuse and trauma, really," he
adds. "Because when you scratch the surface of so many people with
addictions issues, there's somebody who's made it out of an abusive
situation in their life.

In treating people with addictions, Hatcher notes that typically,
it's people's emotional lives that are most present during a
session. "Sometimes it's not as obvious," he says. "But the
emotional life of the client is really what's being accessed at some
level, I think. Even if they're not comfortable at all with their
emotions...or confused by them. Music therapy is working on as deep
an emotional level as the client is comfortable with."

He says music therapy can take many forms: improvisation,
therapeutic songwriting, music and imagery for relaxation and pain
management, music education, jam sessions, and singing. Clients
don't need to have a musical background to participate.

According to Hatcher, the results can be dramatic. "I've seen people
increase their level of socialization with other people--people who
have been very reserved," he says. "I've seen First Nations clients
show more interest in family roots...exhibiting pride in their
cultural knowledge and being happy to share that knowledge with me."

Hatcher says addicts can teach us a lot: about public policy and how
it helps to create addiction, about society's tendency to make drug
use a moral instead of a health issue, and about compassion and
being non-judgmental.

"No one plans to become a drug addict. You just want to feel better.
All of us want to feel better sometimes, and almost all of us have
tried some kind of substance for stretching our consciousness."



AS AN ENERGY therapist, Jo-Ann Svensson spends a considerable amount
of time bringing people back into their bodies. She does this by
drawing energy away from their heads and down toward their
feet. "Often in our day-to-day life, energy accumulates around our
head area; we get very into our heads," she says. "Once people are
in their bodies, they can allow their truth to be spoken. And that
truth might just be 'I am really sad right now'....It's amazing the
amount of relief people feel just from that."

Complementary medicine explores the link between the emotional and
physical bodies in various ways. Svensson tells the story of a
client at Vancouver Detox who was coming off heroin. He was in a lot
of pain, which she was attempting to reduce with hands-on energetic
techniques. When that didn't work, she began to use a form of
dialoguing unique to ARC Bodywork. ARC (A Return to Consciousness)
is a form of therapy in which the practitioner works to balance and
charge the client's energy system while asking creative questions
that help them access their emotions and respond more directly from
the realm of feeling.

"He was able to express some stuff that was really bothering him,
and the pain released immediately," Svensson recalls. "Not to say
that it's [exclusively] emotional issues that lead to heroin
withdrawal pain, but they can really aggravate it."

In September 2000, Svensson initiated the pilot project that brought
energy work to several of Vancouver Coastal Health's downtown
clinics, where it is still practised. During her tenure with VCH,
she participated in two studies into the effect of energy therapy on
drug and alcohol addiction. The second study, which she conducted
independently, looked at the efficacy of ARC therapy for people in
early recovery from substance abuse. Results suggested that the work
helped people to develop an "internal witness". She says this kind
of self-awareness is vital for patients when they're responding to
the emotional triggers that lead to addictive behaviour.

As a demonstration of the development of such leadership, she gives
the example of an addicted client who felt that a physical condition
marred his appearance and thus controlled and inhibited his life.
Over the course of several sessions, Svensson helped him to separate
his sense of himself from his condition. The man began to see where
he was abdicating self-responsibility. He sought additional therapy
and eventually entered a 12­step program.



NOT ALL MEDICAL professionals are enthusiastic about the role of
complementary therapies in the treatment of addictions. Lloyd Oppel
is a Vancouver physician and the coordinator of Canadians for
Rational Health Policy, a group whose mission statement includes
advocating "the development of health policies and programs based on
the best available scientific evidence". Oppel says there is a lack
of proof to support the efficacy of complementary therapies. He adds
that addiction treatment has a large psychotherapeutic component.

"In an area like this where you're doing a behaviour-modification
program [to encourage people to quit a drug], a lot depends on the
faith of the person in the person [practitioner] they're going to,"
he claims. "You're going to get people experiencing positive results
no matter what you're doing for them."

Oppel says that when people choose complementary therapies, they are
almost always making their selection based on a prior belief, which
subjects them to the placebo effect. Another factor he cites is
the "norm of social reciprocity": in our society, it's considered
poor manners to suggest that services rendered weren't helpful.
Oppel disagrees with the argument that there's no difference between
a genuine and a placebo effect. The problem arises when people give
credit where it's not due, he says. Then there's the potential
for "disaster" when patients seek complementary remedies for
diseases that require mainstream medical treatment.



DURING HIS FIRST few years working in detox, Les Moncrieff wasn't
getting much satisfaction, understanding, or insight. "There was a
lot of burnout...in the old system, because of the difficulties,
anger, abuse, and lack of real healing happening," he remembers as
he sits in a small office at Vancouver Detox.

When he began to incorporate complementary medicine into his
practice, however, it was "an incredible transformation".

"It's a 24-hour-a-day job for me, but it's not work, it's not
stressful," Moncrieff insists. "I come in here every day and witness
miracle after miracle. I see people in extraordinary pain and all of
a sudden they have no pain," he says. "They'll wonder--they'll be
confused where the pain went."