Decision No. 5467/2003/QD-BYT Issuing "Guidelines on Applying Electroacupuncture Method for Supporting Drug Detoxification Treatment"

 

Pursuant to …;

REGARDING THE ISSUE OF ISSUING "GUIDELINES FOR APPLYING ACUPUNCTURE METHOD IN SUPPORTIVE DRUG DEPENDENCY TREATMENT"

THE MINISTER OF HEALTH

Pursuant to Decree No. 49/CP dated May 15, 2003 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;
Pursuant to Decision No. 2102/QĐ-BKHCNMT signed by the Minister of Science, Technology and Environment on October 5, 2001 regarding the establishment of the Scientific and Technological Council for the acceptance of state-level scientific research projects;
Considering the minutes of the specialized council's review of "Guidelines for applying acupuncture method in supportive drug dependency treatment," dated September 19, 2003;
At the proposal of the Director of the Department of Traditional Medicine and the Director of the Treatment Department, Ministry of Health;

Pursuant to …;

Article 1. Now hereby issuing with this Decision the "Guidelines for applying acupuncture method in supportive drug dependency treatment."

Article 2. The "Guidelines for applying acupuncture method in supportive drug dependency treatment" shall be applied in all state-owned, semi-state-owned, private healthcare facilities, and drug rehabilitation centers that meet the requirements set forth in these guidelines.

Article 3. Entrust the Acupuncture Hospital to organize training on "Acupuncture Method in Supportive Drug Dependency Treatment." Other units will organize training upon designation by the Ministry of Health.

Article 4. This Decision shall take effect fifteen days from the date of publication in the Official Gazette.

Article 5. The following officials are responsible for implementing this decision: Heads of the Office, Inspectorate, Department of Organization and Cadres, Department of Traditional Medicine, Department of Science and Technology, and Department of Treatment of the Ministry of Health; Directors of Provincial Health Departments under central cities; Directors of hospitals directly under the Ministry of Health; and Heads of health sectors.

GUIDELINES FOR APPLYING

ACUPUNCTURE METHOD IN SUPPORTIVE DRUG DEPENDENCY TREATMENT.
(Issued together with Decision No. 5467/2003/QĐ-BYT dated October 21, 2003 of the Minister of Health)

A. ACUPUNCTURE METHOD IN SUPPORTIVE DRUG DEPENDENCY TREATMENT

I. EFFECTS OF ACUPUNCTURE METHOD IN SUPPORTIVE DRUG DEPENDENCY TREATMENT:

Acupuncture in supportive drug dependency treatment, for individuals experiencing drug cravings, is a non-pharmacological method of traditional medicine (TM) that enhances vital energy, harmonizes the five organs, and promotes blood circulation, thereby helping patients overcome drug cravings.

Acupuncture increases beta-endorphin levels: if performed correctly (at the right time, according to the protocol, and stimulating appropriate acupoints), the beta-endorphin level in the patient's blood will increase significantly compared to the pre-craving stage and approach normal levels, indicating an increase in endogenous morphine in the body of the addict, thus supporting the alleviation of drug cravings.

II. INDICATIONS:

Patients addicted to drugs (such as heroin, opium, morphine, etc., through smoking, inhaling, injecting), who are willing to voluntarily quit and accept acupuncture-assisted drug dependency treatment.

III. CONTRAINDICATIONS:

Patients with prolonged bleeding.

1. Schizophrenia.

2. Severe acute infectious diseases.

3. Severe heart failure (Stage III, Stage IV).

4. Severe edema due to malnutrition.

5. Liver and kidney failure.

IV. TECHNICAL PROCEDURE FOR ACUPUNCTURE IN SUPPORTIVE DRUG DEPENDENCY TREATMENT:

1. Healthcare staff: Doctors, medical technicians, and licensed acupuncturists who have been trained and instructed in acupuncture and electroacupuncture for drug dependency treatment.

2. Equipment and tools:

2.1 Electroacupuncture machine.

2.2 Tray, cotton balls, antiseptic alcohol, sterilized medical instruments.

2.3 Sterile acupuncture needles of various types: needle diameter 0.2-0.3 mm, length 5-10 cm

(each patient requires 200-400 needles for the entire treatment process).

3. Patient:

3.1 Medical records are established:

- If at a general healthcare facility, using the standard medical record form issued by the Ministry of Health

- If at a drug rehabilitation center or community-based drug rehabilitation program: using the medical record form issued together with Circular Joint No. 01/2003/TTLT/BLĐTBXH-BYT-BCA dated January 24, 2003 of the Ministry of Labor, Invalids and Social Affairs, Ministry of Health, and Ministry of Public Security guiding the implementation of certain provisions of Decree No. 56/2002/NĐ-CP dated May 15, 2002 of the Government on organizing drug rehabilitation at home and in the community.

3.2 Patients are clearly informed about the electroacupuncture method for drug dependency treatment and the requirements during the treatment process to cooperate effectively with the healthcare providers.

4. Treatment room:

Each patient must have a separate room during the treatment period.

5. Steps to follow:

5.1 Timing of electroacupuncture: perform electroacupuncture 15-20 minutes before the onset of craving symptoms (to prevent cravings).

5.2 Patient position: the patient should lie in a position that facilitates access to the acupoints.

5.3 Disinfect the area where the needles will be inserted.

5.4 Insert needles and stimulate acupoints according to the protocol outlined in Section V. Used needles should be discarded after each insertion.

5.5 Electroacupuncture technique:

- Pulse frequency from 1-20 Hz

A (microamps) suitable for each patient (reaching the maximum intensity the patient can tolerate without pain).

- Duration of electroacupuncture: leave the needles in place for 25-30 minutes per session.

5.6 Turn off the machine, remove the needles, and disinfect the area where the needles were inserted.

6. Supportive treatment for withdrawal:

6.1 Average treatment duration is 7 days.

6.2 The number of electroacupuncture sessions in the first three days depends on the frequency of craving symptoms. From the fourth day onwards, electroacupuncture is performed three times daily (morning, noon, evening).

7. Complications and management: Commonly encountered is fainting

7.1 Mild degree:

a. Symptoms: patient feels fatigued, nauseous, dizzy, pale complexion, sweating forehead.

b. Management: Immediately close the patient's eyes, remove the needles, allow the patient to rest, and massage the Renzhong acupoint.

7.2 Severe degree:

a. Symptoms: patient loses consciousness, profuse sweating, dizziness, rapid weak pulse difficult to palpate.

b. Management: Immediately turn off the machine, remove the needles, place the patient in a well-ventilated area, loosen the collar, and insert needles at the Renzhong and Shixuan acupoints; when the patient regains consciousness, give them hot sweet tea.

8. Monitoring:

As with other patients treated with electroacupuncture.

9. Maintenance treatment: To maintain treatment effectiveness, continue electroacupuncture for 2 to 3 months, three times weekly, and possibly longer depending on the patient's condition.

V. TREATMENT PROTOCOL:

1. Liver-Gallbladder Syndrome:

a. Symptoms: patient craves drugs, easily irritated, restless, headache, insomnia, red tongue, thick yellow coating, yellow urine, thirst.

đầu昏厥，失眠，舌红，舌苔黄厚，小便黄，口渴。

b. Pulse: Deep, rapid.

c. Treatment Principle: Soothe the liver, reduce fire, unblock meridians and collaterals.

d. Techniques - Acupoints: Needling to reduce: Hegu (LI 4), Fengchi (GB 20), Taiyang (EX-HN 5). Needling to tonify: Taixi (KI 3), Shenshu (BL 23).

2. Syndrome of Spleen-Stomach:

a. Symptoms: Patient craves drugs, increased salivation, abdominal pain with diarrhea (sometimes with blood), vomiting or hematemesis, bitter mouth or numbness in limbs, yawning, excessive tearing, thin white coating on tongue.

b. Pulse: Deficient and weak.

c. Treatment Principle: Strengthen the spleen, harmonize the stomach.

d. Techniques - Acupoints: Needling to reduce: He Gu (LI 4), Tianku (ST 3), Zhongwan (CV 12), Neiguan (PC 6).

Needling to tonify: Sanyinjiao (SP 6), Zusanli (ST 36).

3. Syndrome of Heart-Pericardium-Small Intestine-Triple Burner:

a. Symptoms: Patient craves drugs, abdominal pain, chest tightness, palpitations, restlessness, cold shivers, insomnia, red tongue, thick coating on tongue.

b. Pulse: Reddish, rapid.

c. Treatment Principle: Clear heart heat, calm spirit.

d. Techniques - Acupoints: Needling to reduce: He Gu (LI 4), Neiguan (PC 6), Quchi (LI 11). Needling to tonify: Taixi (KI 3) or Shenmen (HT 7), Guanyuan (CV 4), Qihai (CV 6).

4. Syndrome of Kidney-Bladder:

a. Symptoms: Patient craves drugs, back pain, joint pain, leg pain, spinal pain (with abnormal sensations), nocturnal emission, erectile dysfunction (male), leukorrhea, menstrual disorders, amenorrhea (female), pale tongue, thin white coating on tongue.

b. Pulse: Deep, weak.

c. Treatment Principle: Tonify kidney, relieve pain.

d. Techniques - Acupoints:

Needling to reduce: Jiaji L2-L3 (Kidney point), Quchi (LI 11), Zhishi (BL 52). Needling to tonify: Shenshu (BL 23), Sanyinjiao (SP 6).

5. Syndrome of Lung-Large Intestine:

a. Symptoms: Patient craves drugs, shortness of breath, chest tightness, irritability, feeling of constriction in throat, abdominal pain, constipation; red tongue, yellow thick coating on tongue, fissures.

b. Pulse: Excess, rapid.

c. Treatment Principle: Clear heat, ventilate lung qi, unblock meridians and collaterals.

d. Techniques - Acupoints:

Needling to reduce: He Gu (LI 4), Quchi (LI 11), Qixue (ST 41), Zulinqi (GB 41). Needling to tonify: Xichang (SP 10), Zusanli (ST 36).

B. GUIDELINES FOR APPLYING ELECTROACUPUNCTURE TO SUPPORT DRUG DEPENDENCY TREATMENT

I. GENERAL PROVISIONS:

1. The electroacupuncture method for supporting drug dependency treatment is applied at medical facilities and drug rehabilitation centers that meet the conditions stipulated in Section II of Part B of this guideline.

2. When applying the electroacupuncture method for supporting drug dependency treatment, it must be carried out in accordance with the provisions in Section A of this guideline and other professional technical regulations and hospital rules issued by the Ministry of Health.

II. CONDITIONS FOR FACILITIES TO IMPLEMENT THE ELECTROACUPUNCTURE METHOD FOR SUPPORTING DRUG DEPENDENCY TREATMENT:

1. The treatment location must ensure that patients cannot come into contact with addictive substances (collectively referred to as drugs); ensure living and health training conditions for patients.

2. Must have complete equipment for electroacupuncture treatment for drug dependency support and emergency medical supplies as prescribed.

3. Must have doctors trained in electroacupuncture methods for supporting drug dependency treatment; capable of handling common emergencies and implementing according to professional technical regulations and hospital rules issued by the Ministry of Health.

4. Must have the necessary conditions to conduct or coordinate with other healthcare facilities to perform required tests for diagnosis and treatment.

III. PROCEDURES AND REQUIREMENTS FOR PATIENTS TREATED WITH ELECTROACUPUNCTURE FOR DRUG DEPENDENCY SUPPORT:

1. Procedures:

1.1 Patients must submit a voluntary application form to undergo electroacupuncture treatment for drug dependency support.

1.2 For underage patients, there must be a consent form from their father or mother or guardian as stipulated by law.

1.3 Patients must be fully informed about the treatment process and actions they need to take during treatment to cooperate effectively with the doctor.

2.1 Patients must meet the diagnostic criteria for addiction status and withdrawal syndrome according to the International Classification of Diseases (ICD-10) with at least 3 out of 13 symptoms (including a strong desire to use drugs).

2. The remaining 60% shall be used to supplement the operating funds of units directly responsible for public debt management at the Ministry of Finance (outside the regular state budget allocation for ongoing operations as currently provided) for the purposes specified in Article 4 of this Decision.

Withdrawal syndrome includes:

- Craving for drugs;

- Watery eyes and nose;

- Yawning;

- Muscle and joint pain;

- Nausea, vomiting;

- Dilated pupils;

- Goosebumps, sweating;

- Insomnia;

- Abdominal pain, diarrhea;

- Abnormal sensations;

- Increased body temperature;

- Rapid pulse;

- Weight loss.

2.2 The patient's urine must be tested positive for drugs using a rapid test.

2.3 Both the patient and their family must be persistent and closely cooperate with healthcare staff throughout the treatment process.

3. Cases not eligible for treatment:

3.1 Not meeting the diagnostic criteria for addiction status and withdrawal syndrome.

3.2 Non-compliance with facility rules.

3.3 Cases with contraindications.

3.2 Không tuân thủ nội quy của cơ sở điều trị.

3.3 Các trường hợp có chống chỉ định.”