In Memory of Dr Michael O Smith

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I have been fortunate to known Dr Michael Smith for many years; and have met on many occasions, in the UK and in lots of different countries at NADA conferences.

I would consider Dr Michael O Smith, the Grandfather of the National Acupuncture Detoxification Association (NADA). Dr Smith’s pioneering work with Auricular Acupuncture for the treatment of addiction and mental health span’s many decades, not only in the USA but, in many countries around the world.

From his early days in the New York Bronx, Dr Smith has helped spread the use of acupuncture to many countries around the world, in recent years he has helped set up NADA Philippines and NADA India to name but a few.

Dr Smith will be sadly missed but, he will be remembered by all as the true spirit of NADA.

Steve Pinnington

 

Dr. Michael O Smith, MD the NADA Five Point Acudetox Protocols Pioneer Passes Away.

By John Weeks

 

“Do you want to empower patients?”

 

The question was put to a small group who had chosen a breakout session with Dr. Michael O. Smith, MD, DAc and the founder of the National Acupuncture Detoxification Association (NADA) who passed away on December 24, 2017.

 

It was January of 2001. Perhaps 98 percent of those attending the American Hospital Association/Heath Forum conference on complementary and alternative medicine integration into hospitals seemed to be having a rousing time in a presentation next door. Meantime, while watching 8 or 10 others straggle into Dr. Smith’s session, I had been sizing up the dishevelled, bearded Dr. Smith. He apparently had no prepared slides, or handouts. I had clearly chosen the wrong session, I thought.

Yet Dr. Smith’s name had been at the top of my list among the conference presenters. As director of the Substance Abuse Division at Lincoln Hospital in the South Bronx since 1974 – a position he would hold until 2011 – Dr. Smith already had over a quarter century of offering and observing the dynamics of group visits, in a public health setting. He had first pioneered acupuncture in addiction treatment. Then, of necessity, he figured out how to train lay people in a five-point, ear acupuncture protocol. In the mid-1980s, he’d helped found NADA, the organization that has presently trained thousands counselors, social workers, nurses, medical doctors, psychologists, acupuncturists, chiropractors, outreach workers, drug court judges, corrections officers and others to use the protocol.

I held still in Dr. Smith’s session, despite my fear of missing out, thinking he likely had some wisdom to impart.

Dr. Smith did not disappoint. He had surmised correctly that those of us who had chosen to be there in his session had in common an interest in empowering people toward health. He surveyed our faces briefly and then answered his own question:

“If you want to empower patients, just put more patients than providers in the room.”

He supported his assertion with reference to the importance of breaking the web of transference in the one-on-one practitioner-patient relationship through which the patients often cede their initiative. He asked us to think of the kinds of things that practitioners can unconsciously do from their positions of authority that they “would absolutely not feel comfortable doing or saying if there was a witness in the room.” Smith re-counted stories of patients in groups gaining self-confidence as they experienced themselves as teachers of others.

He softly jabbed “integrative” practitioners who, while nominally patient-focused, remain in the power position, as the fount of knowledge. To a question about limitations of groups – how people may refrain from sharing – Dr. Smith asserted that we all might be surprised about what people are comfortable sharing, and will share, with their peers.

News of Dr. Smith’s death arrived via a brief announcement from NADA. A memorial service is being planned for later March or early April in New York City. The website of the Acupuncture Now Foundation, for which Smith served as an advisor, notes that the trained psychiatrist graduated from Wesleyan University and the from the University of California Medical School in San Francisco. More than 2,000 chemical dependency treatment programs worldwide use the Lincoln Hospital model he developed.  He has reportedly provided consultation to over 100 governmental and non-governmental agencies globally. The value of the five-point protocol led to Dr. Smith becoming the first person selected for the National Drug Court Hall of fame.

For Dr. Smith, the NADA acronym – “nada” is Spanish for nothing — was a sweet jab at the uber-professionalism that takes over many fields. Focus shifted to practitioner skills, specialization, tests and technology rather than staying with the individuals and communities where healing happens. Dr. Smith’s radical instincts birthed the field that in turn birthed the Community Acupuncture movement. Asked if his decision to educate lay people to deliver the treatment pushed regulatory boundaries, Dr. Smith responded: “This was the South Bronx in the Sixties. No one cared what we did.”

Now, all over the world, people care about and benefit from what he and his colleagues at Lincoln Hospital took radical risks to create. The organization for which Dr. Smith remained the honorary chair seeks to imbue in all those it trains something they call “The Spirit of NADA.”  The description on the website is an apt concluding comment on Smith’s contributions:

“Since the NADA Protocol works by mobilizing the existing internal resources of the patient, every aspect of a clinician’s interaction with persons in need is to help them help themselves. Opening access to the treatment itself comes first. This occurs through eliminating unnecessary bureaucratic, socio-economic and environmental barriers to starting a program of recovery. The next task is to create a zone of peace within which patients can begin to experience their own inner strengths. Finally, and in respect to the other aspects, keep it simple.”

To this I would add something a wise man once shared: “Remember, if you want to empower patients, put more patients than providers in the room”.

The History of the NADA 5-point Acupuncture Protocol

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                 The History of the NADA 5-point Acupuncture Protocol

The National Acupuncture Detoxification Association (NADA) is a not-for-profit training and advocacy organisation, encouraging community wellness through the use of a standardised auricular acupuncture protocol for behavioural health, including addictions, mental health and emotional trauma. We work to improve access and effectiveness of care through promoting policies and practice which integrate the NADA protocol with other western behavioural health modalities.

History of NADA

The use of acupuncture is a major component of the ancient traditional art of Chinese medicine. Chinese cultures have placed needles into precise locations on the body to relieve pain and treat disease for over 2000 years. Acupuncture for the treatment of addiction is a recent development in the history of this ancient art.

 

In 1973 a Chinese doctor, Dr H L Wen, a neurosurgeon working in Kwong Wah Hospital in Hong Kong was the first to report successful treatment of withdrawal symptoms and cravings of addiction with acupuncture.  Dr Wen observed that opiate users who had undergone surgery and received acupuncture for post-operative pain relief experienced fewer withdrawal symptoms and cravings.  He subsequently conducted clinical studies that established acupuncture as a valuable treatment for other forms of addiction, and published his findings in the “Asian Journal of Acupuncture”.

Meanwhile, over in mid-seventies USA, the New York Bronx had a growing epidemic of drug addiction and, in response to local outrage, the Lincoln Recovery Centre emerged.

Initially, the Lincoln was a methadone prescribing program but many of the staff had concerns about the use of addictive drugs to treat substance abuse.  Staff became interested in the acupuncture treatment method after learning of Dr Wen’s success with heroin addiction, and the addition of acupuncture for detox to the recovery program began in the late 1970s.

The staff, who donated their own time to this pioneering project, sought acupuncturists that would be willing to attend the Lincoln to demonstrate acupuncture; they started with the protocol used at Kwong Wah Hospital, which was to needle the Lung point on the Ear and add electro-stimulation, with the effect lasting for around six hours.

Because of a problem of the electro-stimulator boxes constantly breaking, staff discovered, much to their surprise, that the non-electrical potentiated treatment (Inserting needles by hand) had a more prolonged effect.

This development led to affect the proliferation of NADA’s acupuncture treatments.  They found that using plain needling (Without Stimulation) was more effective, more flexible and less expensive, thus making the treatment more accessible. The practice was easier to learn and easily replicated.

Once the efficacy of acupuncture was firmly established, many of the Lincoln staff, including Dr Mike Smith (pictured below), went on to study acupuncture and, over time and with much experimentation of various ear and body points, the current NADA 5-point protocol was embraced.

The protocol involves the gentle placement of up to five small sterilised disposable needles into specific sites on each ear; no electrical stimulation is used.  The recipients sit quietly in a groups setting for between 40–45 minutes, relaxing or meditating.

NADA Acudetox treatments have been shown to reduce the impact of withdrawal symptoms from alcohol, opiates, cocaine and amphetamines.  It also diminishes the cravings associated with some of the most commonly abused substances, including nicotine and prescription medication.

Incorporated in 1985 in the state of New York, the National Acupuncture Detoxification Association (NADA US) was established by Dr Michael Smith, Director of the Lincoln Recovery Centre, along with other like-minded people.  Their aim was to promote education and training of substance misuse counsellors in the NADA 5-point protocols.

Having determined the need to expand training capacity and awareness of auricular acupuncture as an effective tool for recovery, their work has gone on to help spread the use of standardised NADA acudetox protocols and practices both nationally and internationally.

 

NADA established membership enrolment, a collection of related reference materials, a codified training curriculum, and flexible systems for registering qualified trainers and methods for delivering training.

 

NADA has since trained thousands of health professionals, including counsellors, social workers, nurses, medical doctors, psychologists, acupuncturists, chiropractors, out-reach workers, drug court workers, corrections officers and many others, in the use the NADA 5-point Protocols.

Understanding the principles of both Chinese medicine and substance misuse is basic to NADA training and philosophy; the combined application of acupuncture alongside counselling and self-help groups enhances opportunities for success.

NADA in the UK

 

In 1991, the NADA 5-point Protocols were introduced and set-up in the UK by John Tindall at the Gateway Clinic, London.  John began to train health workers in the field of addiction and mental health in the NADA 5-point Protocol, including to prison officers and NHS staff.

In the mid-1990s NADA UK was established, in 2005 NADA UK became a registered charity with its own board of trustees.  Unfortunately, due to unforeseen problems with the board of trustees, in 2014, NADA UK had to take a different direction.

NADA was taken over by Steve Pinnington, who was for many years, a NADA trustee and integral part of the NADA UK board, as well as a NADA registered trainer.  He was trained by John Tindall in the early 1990s and went on to study full body Acupuncture and Pharmacology at The Beijing University of Chinese Medicine, London.

In 1998, Steve Pinnington established NADA Acudetox Training Workshops as the major NADA training body for the UK.  He also went on to introduce NADA Acudetox to Scotland and in 2014 established NADA Scotland.  NADA Acudetox and NADA Scotland have now become the major training body in the UK for NADA Acudetox 5-Point Protocols training.

NADA Worldwide

 

NADA protocols are now used in over 40 countries around the world as a legitimate tool for addiction and associated mental health problems.

NADA 5-point Protocols are being used in many countries around the world:

Austria       Denmark      Greece      India Foundation      South Africa      Norway      Japan

Finland      Germany      Philippines      Ireland      Sweden      Tunisia      Bermuda      Canada

Chile      Bhutan      Columbia      Guatemala      Croatia      Scotland      Greenland      Haiti

USA    Iran      Singapore      Italy      Israel      Russia      Kenya      Hungary      Nepal      Romania

Peru      Thailand      Trinidad & Tobago      Uzbekistan      Ecuador      United Kingdom

Mexico      Australia      New Zealand     Uganda

NADA Acudetox Protocols are also being used in some Asian countries to help people cope with the aftermath of natural disasters. NADA Acudetox Protocols were also used to treat New York Fire Fighters and Police Officers dealing with PTSD following the 9/11 attacks in the USA.

NADA Acudetox treatment programs are clinically effective, cost efficient, drug free and compatible across cultures.  Acudetox is also, non-verbal, non-threatening, and a first stop intervention that has a calming effect on clients.  As an initial form of substance misuse therapy, it has been shown to improve clients’ overall treatment response and retention in the program.

A 1999 CSAT-funded study showed that patients choosing outpatient programs with acupuncture were less likely to relapse in the 6 months following discharge.

(Shwartz et al. 1999)