Is Acupuncture Safe?
By Brian B. Carter, MS, LAc, Thu Dec 8th

Acupuncture is much safer than most western medical treatments.

To support that statement, I will cite such phenomenallycredible sources as:

The National Institutes of Health (NIH) The Journal of theAmerican Medical Association (JAMA) - several places The Foodand Drug Administration (FDA)'s Center for Drug Evaluation andResearch (CDER) The British Medical Journal (BMJ) The AmericanSociety of Health-System Pharmacists 7 peer-reviewed medicaljournals found on the National Library of Medicine's MedLineStudies of data from malpractice claims Retrospective studies(from America and the U.K.) of more than 100,000 acupuncturetreatments

First I will discuss issues of acupuncture safety.

Then, I will bring out some issues in western medicine safety...just to give you a sense of the comparison between the two.

The National Institutes of Health Consensus Statement onAcupuncture In 1997, the National Institutes of Health issued aconsensus statement on acupuncture which said, among otherthings:

"One of the advantages of acupuncture is that the incidence ofadverse effects is substantially lower than that of many drugsor other accepted medical procedures used for the sameconditions. As an example, musculoskeletal conditions, such asfibromyalgia, myofascial pain, and tennis elbow, orepicondylitis, are conditions for which acupuncture may bebeneficial.

"These painful conditions are often treated with, among otherthings, anti-inflammatory medications (aspirin, ibuprofen, etc.)or with steroid injections. Both medical interventions have apotential for deleterious side effects but are still widely usedand are considered acceptable treatments. The evidencesupporting these therapies is no better than that foracupuncture." - National Institutes of Health ConsensusStatement on Acupuncture, 1997

Did you get that? They said that aspirin, anti-inflammatories,and steroids have not been supported by scientific evidence anybetter than acupuncture.

The Safety of Acupuncture in terms of Malpractice InsuranceClaims "In an analysis of data from malpractice insurers from1990 through 1996, Studdert and colleagues18 found that claimsagainst chiropractors, massage therapists, and acupuncturistsgenerally occurred less frequently and usually involved lesssevere injury than claims against medical doctors." - Phil B.Fontanarosa, MD; George D. Lundberg, MD - JAMA 1998

Retrospective Studies of Acupuncture Treatment Safety: TheFrequency and Types of Adverse Events in 55,291 AcupunctureTreatments

99.8% of acupuncture is performed with no significant minoradverse events; "During these 5 years, a total of 76acupuncturists (13 preceptors and 63 interns) participated inthe study, and the total number of acupuncture treatments was55291. A total of 64 adverse events were reported and included11 types of events... The most frequent adverse event wasfailure to remove needles after treatment; no sequelae(problems) occurred after removal of the needles. The secondmost common adverse event was dizziness, discomfort, orperspiration probably due to transient hypotension (low bloodpressure) associated with the acupuncture treatment.... We may,therefore, reasonably conclude that serious adverse events inacupuncture treatment are uncommon in the practice of adequatelytrained acupuncturists... ." - Hitoshi Yamashita, Bac, HiroshiTsukayama, BA, Yasuo Tanno, MD, PhD, Kazushi Nishijo, PhD, JAMA

Two September 2001 Studies of Acupuncture Safety in BritishMedical Journal discuss the details of just 43 minor adverseevents in 34,407 acupuncture treatments; and only 91 minorevents in another 31,822 acupuncture treatments. If combinedwith the other study above, that equals a total of 121,520treatments with 198 minor adverse events (only 0.16% incidence),and no pnemuothoraxes (collapsing of the lung- this wasconcluded to be extremely rare). - The British Medical Journal(BMJ) 2001

What's the worst that can happen from acupuncture - and did it?

The most serious adverse events possible with acupuncture arepneumothorax (collapsing the lung due to puncture) andsepticemia (systemic infection of the blood by bacteria);"Instruction is given by both lectures and practical trainingand includes information about anatomically risky depth ofinsertion and use of aseptic procedure for puncturing... Mostimportant, no serious events such as pneumothorax, spinallesion, or infection were reported." - JAMA November 1998

...Zero out of 55,291! But even just one would have meant only a0.002% chance of these occurring.

The Safety of Acupuncture compared with that of Biomedicine:

Antibiotic overuse leads to resistant super-bacteria. "Theprevalence of antibiotic-resistant bacteria in Taiwan is due tothe heavy use of antimicrobial agents in both animal husbandryand clinical practice over the past decades" - Int J AntimicrobAgents 2001 Sep) as well as intestinal flora imbalance(diarrhea, vaginal candidiasis).

"Antibiotic use is a short-term risk factor for symptomaticvulvovaginal candidiasis, either as a first episode or in theform of recurrence. Increasing duration of antibiotic use isdirectly related with an increased prevalence of Candida vaginalinfection." - Am J Obstet Gynecol 1999 Jan

"The spectrum of diarrheal disease associated with antibiotictherapy ranges from antibiotic associated diarrhea and colitis,to the more severe pseudomembranous colitis, which is alwaysassociated with Clostridium difficile (CD)." - ActaGastroenterol Latinoam 1996

The FDA approves unsafe drugs if they are effective enough.

"No drug product is "perfectly" safe. Every single drug thataffects the body will have some side effects. Since the FDAconsiders both the benefits and risks of all medications beforeapproval, side effects are generally not serious. For every drugFDA approves, the benefits are balanced against its risks. Inaddition, FDA makes sure the labeling (package insert) outlinesthe benefits and risks reported in the tested population. Youand your health-care provider should decide together if thebenefits outweigh the risks for YOU. Talking about yourmedicines with your health-care provider is just as importantand good for your health as a complete check-up and taking yourmedicine as directed." - Frequently asked questions from theCenter for Drug Evaluation and Research (CDER) at the FDA

"The benefit-risk ratio weighs the benefits provided by a drug,versus risks or safety problems that may be associated with useof the drug. No drug can be considered to be totally safe. Drugsthat are associated with more significant safety problems areexpected to have sufficiently greater benefits to justify theincreased risk." - Questions and Answers from CDER'sOver-the-Counter Drug Products Public Hearing (FDA)

What does benefit-risk mean to us?

"There are categories that, from my perspective, clearly fallout where the benefits unequivocally outweigh the risks... Ithink physicians very frequently discuss risk-benefit ratios forall sorts of treatments, and it ultimately comes down to adecision between the patient and the doctor." - Questions andAnswers from CDER's Over-the-Counter Drug Products PublicHearing (FDA)

Adverse drug reactions (ADRs):

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen"Gastrointestinal (GI) Adverse Drug Reactions (ADRs) from the+NSAIDs are a major cause of morbidity and mortality inarthritic patients taking these drugs... Clearly, the need todevelop newer NSAIDs with lower risks of ulcers and bleeding aswell as symptomatic ADRs is still representing a majorchallenge." - J Physiol Paris 2001

High dosage Steroid use (e.g. in Asthma or COPD) "High dose ofinhaled steroids may lead to adrenocortical suppression andhence estrogen deficiency in postmenopausal women" - J AllergyClin Immunol 1989 Feb

"the daily dose, but not the duration, of inhaled steroidtherapy may adversely affect bone density" (osteoporosis) - JAllergy Clin Immunol 1995 Aug

"The potential risks of antiasthmatic inhaled steroid therapyare essentially dose-related and include oropharyngealcomplications such as:

thrush and dysphonia, and systemic complications such ashyperactivity behavioural change hypothalamic-pituitary-adrenalaxis suppression facial and weight changes characteristic ofhypercortisonism cataracts increased intraocular pressure dermalatrophy causing steroid purpura retarded growth in children andosteoporosis. A few cases of fracture or acute adrenocorticalinsufficiency have been reported." - Can Respir J 1998

This last article is subtitled "First do no harm" after theHippocratic Oath taken by most MD's.

Drug Misadventures: "Still, we know from studies published todate that drug misadventures account for: 8-10% of admissions ofpatients to hospitals 25% of admissions to hospitals by personsage 65 years of age or older 10-15% of visits to emergency roomsin some urban settings 4.5 drug order errors per 1000 drugorders in hospitals Significant decreases in the quality of life(due to inappropriate prescribing, e.g., of hypnotics for theelderly) 2 in 1000 deaths in hospitals, and Deterioration ordestruction of specific organs." - from "Toward defining andapplying a higher standard of quality for medication use in theUnited States" from the American Society of Health-SystemPharmacists

So in summary, it's clear that no medicine is totally safe.Except perhaps prayer!

Hopefully the comparison above is telling- the risks of mostwestern medical interventions are greater than in acupuncture.

So, I ask you- if it works and it's safer, why is it an"alternative"?

About the author:Acupuncturist, herbalist, and medical professor Brian B. Carterfounded the alternative health megasite The Pulse of OrientalMedicine (http://www.PulseMed.org/). He is the author of thebook "Powerful Body, Peaceful Mind: How to Heal Yourself withFoods, Herbs, and Acupressure" (November, 2004). Brian speaks onradio across the country, and has been quoted and interviewed byReal Simple, Glamour, and ESPN magazines.