Months ago, I shared specific examples of how the 5-Needle Protocol (5NP) was offered in communities affected by gun violence. That post wasn’t so much about violence reduction; it was more about supporting community trauma in the aftermath of violent mass shootings.

I mentioned then that we can’t measure violence that didn’t happen. But as it turns out, that’s not entirely true.

According to the National Acupuncture Detoxification Association (NADA) manual, the Penn North Recovery Center in Baltimore managed to track exactly that back in 2000. Out of 552 initial intakes that year, 436 people chose to stay and enroll, receiving an average of 21 AcuDetox sessions each—totaling over 9,000 treatments in a single year.

Here is the takeaway: Of the 206 Penn North clients with criminal records, 97% were not arrested within their first 5 months in the program. Prior to treatment, the group averaged 4.3 arrests per person; after treatment at Penn North, that rate plummeted to an estimated 0.37 arrests per person.

Penn North’s approach mirrors the pioneering work of the Lincoln Hospital Program in the South Bronx, where ear acupuncture was central to community-based recovery, treatment, harm reduction, and prevention.

In a previous post, I looked at similar data from jails and prisons, where staff noted far fewer violent outbreaks between inmates when AcuDetox/5NP was integrated into daily care. But applying this care in practice often brings us face-to-face with difficult subjects.

During a supervision meeting here in New Hampshire, an AcuDetox Specialist (ADS) who works as a practicing nurse shared that she provides ear acupuncture to patients at the medical practice where she works. None of us in the room were quite prepared when she mentioned that some of the patients she treated were sex offenders. Later, another ADS confided in me that she felt deeply uncomfortable by that conversation—which is entirely understandable.

The only perspective I could offer was that of the late NADA trainer Laura Cooley. As someone who was open about her own lived experience as a sexual abuse survivor, Laura held a deep conviction that therapy and treatment are just as vital for perpetrators of violence as they are for victims—sexual or otherwise.

In our phone conversations, she would often say: “The ones who have been harmed are the ones who seek therapy. The people who commit the harm are the ones who need therapy and are less likely to get it.”

Laura’s conviction wasn’t just theoretical; other outcome data in the NADA manual reflect that exact same pattern.

At a maximum-security prison in Oak Park Heights, Minnesota, acupuncturist Linda Leef surveyed incarcerated clients receiving ear acupuncture in the early 1990s. She recorded a marked drop in reported levels of anger, stress, intrusive sexual fantasies, and compulsive masturbation. Similarly, Ben Wharton ran a three-year sex offender program in Sweetwater, Texas, and found AcuDetox/5NP just as transformative for his clients as it was for addiction recovery—notably reporting that offenders admitted to their crimes much sooner and actively engaged in treatment.

The stats and clinical reports paint a clear picture, but watching this shift happen in real time is something else entirely.

Back in 2017, New Hampshire Public Radio ran a story after state lawmakers passed HB575, the bill creating Acupuncture Detoxification Specialists certification. It ended up being their third most shared story of the year. The journalist, Paige Sutherland, wanted to observe people receiving the 5-Needle Protocol and talk to them firsthand. My friend, Nikki Casey, opened the doors to a women’s group at Revive Recovery in Nashua so Paige could conduct interviews.

2017 NHPR Ear Acupuncture Story

Not all of the women interviewed made it into the final radio piece. One woman in particular was speaking to Sutherland when another group member interrupted her. She turned to her friend and said, “You interrupted me. You know how angry I get when I’m interrupted.”

She paused, a look of surprise washing over her face and a tear in her eye, before adding: “But I’m not even angry.”

Keep poking ears. Keep changing lives.

Earlier this week, I saw a social media video announcing that The Doorway in Manchester (run by Elliot Hospital)1 is hosting a public information meeting at the Manchester Police Station one week from today—Wednesday, September 2, at noon.

Coincidentally, I ran into Jay McLeod from Hope for NH Recovery and his friend Scott, a former Hope employee, at the gym the same morning I saw that video. They gave me their full encouragement to attend that meeting.

The Doorway program in New Hampshire is a entry point where people can seek services and treatment for substance misuse. Seeing the announcement felt like a full-circle moment: I remembered that I actually started this Substack months ago after a rather frustrating conversation when a Licensed Drug Councilor from The Doorway in Nashua (run by Southern New Hampshire Hospital) reached out to Manchester Acupuncture Studio about 5NP ear acupuncture services. She did not understand that she and her coworkers can get certified as Acupuncture Detoxification Specialists (ADS) and provide ear acupuncture to the clients they see at Nashua’s Doorway program.

The Doorway is the perfect setting for ear acupuncture. Psychiatrists Drs. Libby Stuyt and Ken Carter have explained, the 5-Needle Protocol significantly improves treatment retention whether someone is seeking help for substance misuse, behavioral health, or both. Not to mention, it’s recognized by SAMHSA in TIP 45 as a treatment for detoxification and withdrawal.

5NP/AcuDetox ear acupuncture may be relatively new to New Hampshire, but I want to keep reassuring the Granite State Acupuncture Detoxification Specialists (ADS): this practice has crisscrossed the globe many times over since its origins at the South Bronx-based Lincoln Hospital in 1970. It just took a (really) long time to come to fruition here in New Hampshire.

Last week, Dr. Libby Stuyt shared a newsletter filled with updates from around the world about people practicing and teaching the 5-Needle Protocol (5NP) from NADA International.

International News From Nada Summer 2026

7.74MB ∙ PDF file

Download

Download

Here is what stood out from that international report:

An Austrian physician, researcher, and professor, Dr. Thomas Ots shared that he and his colleagues in Austria are celebrating 20 years of bringing ear acupuncture into psychiatric hospitals, addiction treatment programs, and trauma counseling—with new expansions into prisons and palliative care.

Reading this was a balm to my soul. Back in 2017, hardly anyone in New Hampshire had heard of AcuDetox, 5NP, or the NADA Protocol.

While volunteering at Hope for New Hampshire Recovery, Sandy Pascucci—a retired nurse on the board—asked me about it with genuine curiosity. I explained the history and concept of AcuDetox for withdrawal, treatment, recovery, and prevention. She decided to try a treatment herself. She loved it.

The following week, while running a recovery meeting, Sandy noticed two participants who were struggling to settle down. She suggested they walk down the hall and see me for ear acupuncture. When they returned to the meeting, Sandy said they were like different people. She continued to recommend ear acupuncture to a lot of people spending time at Hope on Tuesday mornings. Because of Sandy, it wasn’t unusual for me to treat 15 to 20 people in two hours.

There were even mornings where I treated people who turned up at Hope before being escorted to the precursor of The Doorway—Safe Station at the Manchester Fire Station on Central Street. I remember a mother and her adult daughter came to Hope for NH Recovery looking for treatment. One of Hope’s founders, Melissa Cruz, suggested that they try ear acupuncture while she made phone calls for them. They were hesitant but willing to try it. Within minutes, the mother mentioned that she felt relief from the withdrawal symptoms. I wasn’t ready for what happened next. She opened up about the history of abuse that was happening in her family. No one else was around, so I sat with her and her daughter and listened. About 20 minutes later, their ride to the Safe Station came. I took their pins out and wished them well.

Another morning, I arrived at Hope and a man named Craig sat by himself at a table. He asked if I worked there. I explained that I was a volunteer, and I offered him an ear acupuncture treatment. He was willing to try it. I sat with him while he explained that he had used heroin the night before and he had more heroin in his apartment, but he didn’t want to go home and use it. His journey with substance misuse started with a back injury in 2001 that led to losing his business, his marriage, his home, and everything he knew. He gave me permission to share his story at the State House later that week at a hearing to approve the administrative rules of the Acupuncture Detoxification Specialists certification law.

This is my letter with Craig’s story:

Comments on Administrative Rules for ADS

59.7KB ∙ PDF file

Download

Download

Months later, I ran into Craig at Hope for NH Recovery. He greeted me with a big smile and thanked me for the treatment I gave him. He was doing well with his recovery.

Last year, ADS Sharna Steinhart, who runs Hope for New Hampshire’s Wellness Clinic, described to me a similar experience of treating someone experiencing withdrawal before he headed to The Doorway. She told me that when she offered him an ear acupuncture treatment, he said he was willing to try anything. He calmed down and he even fell asleep for 30 minutes. Months later he came back to see her and he thank her.

On the flip side, I can share another story about someone I know who dropped her son off at a treatment program because he said he was ready to get help. By the time she got back to Manchester, he was already calling her and asking her to come back and get him. Since she was certified as an Acupuncture Detoxification Specialist (ADS), she could have given him ear acupuncture right before he was admitted into the program. I regret that I didn’t suggest it at the time—I wasn’t a trainer yet and I wasn’t sure if my advice about her son would be welcome. She got back in her car and drove an hour back to Dublin, NH, to get her son. I don’t know what happened after that.

I’ve gotten really comfortable behind my keyboard writing to all of you every week. Thank you for reading—even if you don’t comment, I see the numbers, and it means the world to me. But now it’s time push myself into a face-to-face conversation with people who might not have heard about ear acupuncture as an adjunct modality for treatment, recovery, and prevention. The Manchester Doorway, like the Nashua Doorway, is probably not aware of Acupuncture Detoxification Specialist certification.

If any ADSes in the Manchester area wants to join me at the Wednesday, September 2 meeting at 12 noon at the Manchester Police Department, please let me know! Leave a comment or send me a direct reply.

Maybe in 11 more years, we can celebrate ear acupuncture’s integration in New Hampshire in substance misuse treatment, psychiatric treatment settings, jails and prisons, palliative care, and anywhere people need help to calm and regulate their nervous systems.

Keep poking ears, keep changing lives.

In my recent interview with Dr. Libby Stuyt, she emphasized that the 5-Needle (ear acupuncture) Protocol, 5NP, significantly improves client retention in substance misuse treatment.

This week, I am sharing a transcript of Dr. Ken (Khensu) Carter’s 2015 speech at a conference in Oslo, Norway. Dr. Carter is a Florida-based emergency department psychiatrist and currently serves as the president of the National Acupuncture Detoxification Association (NADA). Thank you to Rita Nilsen and the Norwegian foundation Stiftelsen Retretten for sharing Dr. Carter’s speech freely on YouTube.

The Stiftelsen Retretten is a program and resource center in Norway focused on the treatment of substance misuse. Notably, they are known for offering support programs, conversation groups, and NADA/5NP ear acupuncture services.

In his presentation, Carter states plainly that the 5-Needle Protocol keeps clients engaged in mental health treatment, just as it does in addiction treatment. He illustrates this through a case study from early in his career, involving a psychotic patient he treated with the simple 5-point ear acupuncture protocol.

Back in 2016, when I first connected with NADA trainer Laura Cooley to create a legal pathway for certifying Acupuncture Detoxification Specialists (ADS) here in New Hampshire, she was clear on one point: she would only work on a bill that allowed ADSes to utilize 5NP for mental and behavioral health treatment as well as addiction treatment and recovery. There are states where ADSes can be certified, but can only provide the 5-Needle Protocol for the purposes of treating addiction. The State of New York, where AcuDetox was pioneered, is one of the states with that restriction.

Many acupuncturists only know the National Acupuncture Detoxification Association (NADA) as an organization that trains practitioners of a variety of backgrounds in an ear acupuncture protocol used for addiction. I was one of those acupuncturists until I met Laura Cooley. In reality, NADA expanded its mission nearly twenty years ago to include education and advocacy for broader behavioral health. Unfortunately, acupuncture organizations often operate in silos and remain unaware of the decades of evidence supporting the effectiveness of 5NP/AcuDetox for mental health and general well-being.

I encourage everyone to listen to Dr. Carter’s speech—it’s only 20 minutes long. I tried writing about his talk over the last few weeks, but I realized that providing a full transcript would be far more valuable. Special thanks to my dad (Paul Ropp) for helping edit the transcript. It’s great to have an archival enthusiast in my family.

Transcript: Dr. Ken (Khensu) Carter (Oslo, 2015)

(Transcribed and edited for clarity)

I wish I knew what Rita just said. I didn’t have my ear phones on. But I am thinking about the first time we met and I heard her story and just how remarkable it is. It’s a real honor to be invited here. It’s a wonderful program. I am hoping that in this home of the Nobel Peace Prize that our proceedings and what we say and what I might say might have a little to do with bringing more inner peace to the world. I am going to be talking today from my clinical experience. Feet on the ground in an emergency room, in the trenches, what do you do when a patient comes through the door, psychotic and with drugs in their urine. You know they’ve been using drugs. I am wondering by a show of hands how many of you have treated someone who has been psychotic before?

(Hands raise)

Oh, lots of hands, okay, already. So, I see a number have not. Can you raise your hands if you have not treated anyone who has been psychotic before?

So, it’s a good mix of both. I’m going to be speaking from my clinical experience as an emergency psychiatrist. I’ve been doing it for about 10 years. It is fitting my yearning more and more because I simply have difficulty sitting still for eight hours a day in a chair seeing people in an outpatient setting. I have set up acupuncture/Acudetox programs on inpatient units where I work. We have now close to 60 in-patient beds in the psychiatry until, a general psychiatry unit that treats a whole spectrum of psychiatric patients. And the emergency room, of course, we treat whatever comes in the door. And often you don’t know what that is coming through the door.

Of course, the extremities of depression can turn into psychosis. The extremities of anxiety can also look very psychotic, in addition to the psychiatric disorders per se such as schizophrenia and schizoaffective disorders where psychosis is of part and parcel with the diagnosis itself. Lars mentioned one of the primary research articles that I’ve published. I’ve had a couple other endeavors at using (ear acupressure) beads in our psychiatric partial hospitalization program for children and adolescents. We’re very excited about it. We had our pediatric psychiatrist that came on board as an investigator. I know that people whom I’ve been speaking with are eagerly awaiting to get something more formal with regard to trial. Much of what I am going to say you’ve already heard, but I can bring a summary conclusion to try to put it all together in terms of just putting words to how AcuDetox, the NADA protocol, helps with relapse prevention for those who are psychotic.

I am going to do this by way of talking about a case study. The case study is illustrative of what has propelled me as a psychiatrist to hold so tightly to the NADA protocol. Two years after college, I decided I would take a break from medical school to travel around the country to see if alternative medicine helped really sick people. I ended up spending six months at the clinic in Lincoln (Hospital’s Detox/Recovery Program, South Bronx). I liked to think of it as the “Wild, Wild, West” in those days. Because we treated anyone who came in the door with anything, it was just such a wonderful experience. Everything from psychosis to strokes to broken bones, back pain, and anxiety, in addition to addiction. I am going to talk (about) a patient by way of a case study. I will then use the patient as an example of the many ways in which NADA can help with relapse prevention in terms of psychosis. It is quite parallel with the way in which it is used for relapse prevention in addiction. The parallels are striking. If you are familiar with how you’ve been using it in addiction for those who have not treated psychotic patients, it is extremely parallel of other aspects of behavioral health. In fact, the NADA organization, the NADA board decided, I guess seven or eight years ago that we would change our mission. NADA went from education and advocacy for addiction to education and advocacy for behavioral health, including addiction. All we are doing again is putting words to what the patients, the many patients, whom have been treated have taught us through the years. Mike (Dr. Mike Smith) is certainly very articulate about how none of this arrived on his desk or in his brain de nouveau.

It was really learning from the patients as we went along. Here I am, an eager medical student who is taking a leave of absence to see if alternative medicine really works. I walk in to the clinic and I’m ready to start reading and stuff, “what can you tell me? What can I read? Where are the articles and stuff?” At that time Carlos (Alvarez) was in the clinic. I don’t know how many of you have met Carlos? They made it very clear that this is not that kind of party. This is something that has to take place from the inside out. We want you to have an experience first. So, I had my experience and a couple weeks later after I went through the slow, organic trainings that they did--lots of hands on stuff--I remember after the second day or so Mike directed me to treat a patient who came in. This was a patient who was having command auditory hallucinations to kill himself. He had been out smoking crack all night long. He’s sitting there, he’s wide eyed and bug-like, and he’s twitching, tremulous in the chair. I could get enough of a history once I went through an experience similar, I think, to what Sheila (Judge Murphy of Illinois) had described. Again, I’m a medical student coming into this setting for the first time, and thinking “is he going to let me treat him?” “ What am I going to do?” He could barely put two words together. Of course, I treat this gentleman and he sits back. I am sitting there staring at him the whole time. Gradually he calms down and goes to sleep, and I just continue staring. Waiting and anticipating that he might jump up and do anything at any time.

So, a little over a half an hour later, he wakes up. Generally after we treat patients, we don’t want to do a treatment autopsy and have them talk about what happened. But this was a learning experience, so I’m not encouraging you to do this with every client, but I did this with him. He said that he was still hearing the voices. We had talked about half an hour or so about other aspects of his history. The voices were intermittent, which means that they weren’t there as constantly or incessantly as they were before. And they were not telling him to kill himself. Now, he if had come into the Emergency Room, where I work now ,and virtually any clinical mainstream setting, what would we have done with him?

Shots. Shots of what? Haldol, yes. Yes, yes, to all of that.

We would have given him anti-psychotics and Ativan. It’s our “go-to. Sometimes we vary it if indicated but usually it’s Haldol 10 and Ativan 2 and that will basically take down the most difficult person that comes into the clinic. The remarkable part--one of the most remarkable parts about this gentleman--is that he did not come in as an involuntary commitment. And this is somebody who’s psychotic. He’s been smoking crack all night. He can barely put two words together. And what he thinks about doing as these voices are getting so strong telling him to kill himself is to come to Lincoln to get a treatment. That is relapse prevention.

Generally, it’s difficult to have this sort of conversation with folks. That says is a lot. And what I hope to do is put words to what we know about the NADA protocol. The first step to really looking at manifesting hope and a hopeful outcome is engagement and retention. You can’t have a better vote for engagement and retention than somebody who keeps coming back. Even with the most psychotic of patients, this approach still works, just like it does with an addiction. As a matter of fact, again on Mike’s recommendation, I have the honor of being a co-author for guidelines for best practices in addiction treatment in the United States through the National Institutes of Health (NIH). First time in US history, it endorsed an alternative medicine as a best practice. NIH hung its hat on the idea of engagement and retention. I’ve been talking to many folks who’ve been telling me they’ve had difficulty moving AcuDetox over into the behavioral health side of the equation, in addition to addiction. If we think about the way it works for basically any drug of any persuasion at any stage in the intoxication withdrawal process is just a no brainer. It’s a no brainer that it should work for everything we do and treat in psychiatry. This first issue was insuring that people continue coming back. That’s what I saw in this first patient. One of the bedrocks of engagement and retention and the spirit of NADA will do that.

Secondly, one of the things that patient also learned in the nonverbal way was that he could feel better without the use of the Haldol or the Ativan. Or whatever he was withdrawing from or looking for some other street drug to offset that. That’s a message that you can use 1,000 words trying to talk about and you cannot convince somebody that that’s so.

Think about the first treatment that we had and if someone had told you that putting stainless steel needles in your ear would help you feel better. What would have said to them? Have a treatment in a setting, a group with easy access--virtually barrier free on any given day--and let patients see that. To experience without the 1,000 words that they can feel so much better and (in) a half an hour or so is a very powerful message to give. That is really relapse prevention.

We think about why the Ativan? NADA cut its teeth on the opioid epidemic in New York back in the 60’s and 70’s, but quickly learned again through the patients that it worked for the alcoholic, it worked for the crack addict, it worked for the person using hallucinogens, and PCP. So, virtually any drug of abuse that you would never think of even having a medication to really support (them) through the process, NADA protocol can do that. But, again, why is Ativan and the idea of benzodiazepines such an attractive medicine for so much that we do in psychiatry? We know that the element of anxiety and the element of stress make anything worse. If it’s pain, pain is very subjective. We heard Libby (Dr. Stuyt) talking this morning about those looking for marijuana, looking (to address) severe pain….

Pain is more than just a physical symptom. It has an emotional component; it has a cognitive component. Sedatives work within that setting. We give Ativan to folks who are psychotic and abusing drugs. We’ll combine Ativan and Haldol. If they come in with a panic attack, we reach for Ativan to give to them to calm down. If somebody comes in depressed and they’re wailing and hysterical, we reach for Ativan or something similar. If they come in with dementia and are extremely paranoid or can’t be calmed we reach for benzodiazepines or potentially (an) anti-psychotic.

These categories are diagnostic categories that we find. The latest one on the psychiatric side is the DSM-5. They are not based or correlated strongly with treatment at all. The treatments that we use cross the diagnostic categories. Ativan is one of those medications that we can use for almost whatever ails you because it helps to decrease the element of distress. The NADA protocol for mild to moderate anxiety and depression, again is just as good as any medication that anyone can prescribe. If I had to use one tool of everything that I’ve ever been exposed to--that would help the most people most of the time with the least risk of side effects and liability--it would be the NADA protocol.

Everyone claps.

I’ll just let you know that I was doing something a couple years ago. Sara and some others assisted me in tracking down the liability claims against NADA practitioners in the United States over the (first) 40 years of its existence. Somebody guess some numbers and don’t give it away.

Zero.

Absolutely zero. We know that much of the reason why the NADA protocol is not more widely used, is not because of an evidence base. Lars (Wiinblad) just went through lots of the evidence. We have a strong evidence base. That’s my position, just as strong as many psychotropic medications that are used or cardiac medications that are used have tremendous liability. The years and the hundreds of thousands of patients that have been treated with the NADA protocol, it is not about the evidence base. It’s about getting the voice and the political presence to make this wonderful tool more available.

What about sleep? What about sleep. Sleep is important in everything, as well. We know that there are certain stages of sleep that patients are supposed to have for it to be restorative, assist with their resilience, and to help to restore wholeness. Virtually all of the anti-depressants we prescribe, the benzodiazepines, the anti psychotics, mess up your stages of sleep. NADA protocol helps to restore that.

We didn’t need the diagnosis to have this as an upfront barrier-free tool for folks who may not be ready to talk. You have to have something that is homeostatic, something that will help to balance them no matter where they are. That way you don’t have to be there to put on the diagnostic hat and figure out what’s going. The diagnoses are in front of you, trying to get somebody to tell you how they were bad, how bad they’d been, how much they enjoyed being bad while they were being bad and think you are going to get the truth about all of that. We need a tool to help them balance no matter what they say: if they lie, if they tell the truth, if you get the diagnosis right or wrong. So again, for this first patient whom I saw, I didn’t have a diagnosis. I was told he was schizophrenic, but we know what that can look like: the schizophrenia is the drug abuse. Was he severely depressed? Was there an organic problem? This helps to clear the static. And so even for someone who wants to wear that diagnostic hat, it is good to have something that can clear the static. So, you can really see what’s in front of you to get the best history possible from someone who can actually talk to you. The NADA protocol does that as well.

I will end before Rita gets the hook and pulls me offstage with the idea that one of the things that was so impressive to me with the Lincoln program was (when it was ) thriving was the use of peers and peer counselors. We know that for Axis II and most people who are using drugs have some sort of an Axis II component from the acting out to the lying to the antisocial behaviors. Psychiatry has nothing to treat that. As a matter of fact, in my early days of psychiatry residency I was even more driven that when I read that for the major problems affecting us in the United States in terms of the addiction, the high crime rates, the prison rates, psychiatry has basically zero to offer that population in terms of addressing the Axis II component. Even for those who are using drugs, or (are) psychotic. For those who have all sorts of behavioral problems, everything that you have learned about addiction is parallel to what you find with psychosis. They often go together. You have a wonderful tool in our hands. And again, my observations are not unique either. They are shared by many of you and thank you for the opportunity for me to sing my song.

Keep poking ears, keep changing lives.

A few weeks ago, staff members from Hope for New Hampshire Recovery took a field trip to Manchester Acupuncture Studio for full acupuncture treatments with Andy Wegman. Because Hope for NH Recovery hosts our 5NP ear acupuncture trainings, it was a special treat to welcome them into our clinic space.

(Speaking of training: our next 5NP training is coming up on September 18th and 19th. If you know anyone who might be interested, please share this post or send them our way!)

Registration details are here:

5NP Registration

Hosting the team from Hope felt like a true full-circle moment. This quote from Lisa Rohleder’s Substack, Acupuncture Can Change the World, sums up the lineage beautifully:

“5NP or Acudetox is where the core of community acupuncture came from. There would have been no Working Class Acupuncture and no POCA Cooperative and no POCA Tech if there had been no Lincoln Acupuncture Detox Collective in the Bronx fifty years ago. It’s a remarkable story, and fortunately there are books, documentaries, and podcasts to tell it. You can find some of them on WCA’s ‘history of community acupuncture’ webpage.”

(Read Lisa’s full post here.

We talk about this history during our 5NP trainings, but the connection might not fully click for New Hampshire Acupuncture Detoxification Specialists (ADSes) if they’ve never spent time inside Manchester Acupuncture Studio.

Last week, I wrote about David Eisen, director of an outpatient substance misuse treatment and recovery program in Portland, Oregon. Nearly 30 years ago, acupuncturists Lisa Rohleder and Skip Van Meter worked at that program before starting their own acupuncture clinic. The clinic they started did not look like a typical acupuncture clinic. They wanted to offer acupuncture in a way that most people could afford. They filled a former TV repair shop with reclining chairs and ultimately named their new clinic Working Class Acupuncture (WCA). It is fondly referred to as “The Mother Ship” among Community “Acu-punks.”

Rohleder wrote articles about their affordable model for an acupuncture trade journal, Acupuncture Today. Practitioners across the country—including Andy Wegman—joined forces to establish what eventually became the People’s Organization of Community Acupuncture (POCA).

In 2012, Working Class Acupuncture in Portland and Philadelphia Community Acupuncture pooled their resources to produce a short documentary about this movement:

I moved to New Hampshire in 2010 to work with Andy at Manchester Acupuncture Studio. He doesn’t remember this, but during my job interview, he mentioned being interested in changing New Hampshire’s acupuncture law to allow certification for non-acupuncturist practitioners of AcuDetox/5NP.

That idea stuck with me for years.

Then in 2016, I met NADA trainer Laura Cooley for the first time. At the time, New Hampshire was widely considered “ground zero for the opioid epidemic”. Expanding access to ear acupuncture across the state felt necessary and urgent. POCA members in Rhode Island had worked on similar legal changes the year before, and community acupuncturists in other states were starting to follow suit.

Acupuncture Can Change the World

Remembering Laura Cooley, L.Ac.

Longtime 5NP advocate and trainer Laura Cooley, L.Ac, passed away on March 23. Laura was one of the Founding Subscribers of this newsletter and a generous supporter of POCA Tech. There’s nobody else like her — she was in a category all her own — and lots of people miss her already, in…

Read more

2 years ago · 8 likes · Lisa Rohleder

And that is the very short version of how we got to where we are today: from the Lincoln Detox movement in the Bronx, to community clinics in Oregon and New Hampshire, to 5NP training and legal certification in the Granite State.

NADA and POCA are like-minded organizations. Years ago, I hoped they would come together to build a coalition around our shared interests. That bridge is happening now—even if informally. Last year, Andy and I presented at a POCA conference in Milwaukee and met nurses from Oklahoma are long time trainers of the 5-Needle Protocol who used to train with NADA and had since joined POCA. They asked why community acupuncturists in POCA care so deeply about 5NP.

Over lunch, I gave them this exact same story about how we’ve come full circle.

Keep poking ears, keep changing lives.

Last week, I wrote about my conversation with psychiatrist and 5NP trainer Dr. Libby Stuyt regarding 5NP ear acupuncture research. This week, I want to keep leaning in that direction. I listened to a 2021 recorded conversation with Dr. David Eisen, Executive Director of the Portland-based Quest Center for Integrative Health, which provides detox, outpatient treatment, and recovery support.

Thank you to Sara Bursac, Tania Watts, and Mary Walle for recording this conversation, which you can listen to here.

Before getting into the research that Eisen holds up as some of the most significant for 5-Needle Protocol, it helps to understand his background.

Eisen joined the staff at Lincoln Recovery Center in the Bronx in 1977, six years after its founding. He worked alongside Dr. Mike Smith for many years and met Dr. Mutulu Shakur on his very first day. He also worked with nurse Nancy Smalls, who ran Lincoln’s Maternal Program—providing care for expecting and new mothers, including ear acupuncture.

Nancy Smalls attended that recorded 2021 meeting with Eisen and asked him directly: “Who discovered the 5-point protocol?”

Here is how Eisen remembered it:

“When I got to Lincoln, it was all over the place. One of you would tell me one thing, [Dr. Richard] Delaney would tell me another, Mike would tell me another, Tony would tell me another... Aponte would tell me another. I think it was in 1978 or ‘79 there was a coming together about that. And you were there, Nancy—I remember you being there. I think that you, me, Mike, [Naomi] Rabinowitz, and Jesse Morgan were there. And I do believe that was the solidification of the 5-Needle Protocol.”

He added: “Unless you remember it differently.”

It’s a perspective I hadn’t heard framed quite that way. Is it the complete origin story? Probably not—as Eisen noted, early Lincoln was dynamic and chaotic. But the takeaway is clear: the 5-Needle Protocol was not a solo discovery. It was an evolving collaboration shaped by clinicians, activists, counselors, and nurses.

Eisen wasn’t at Lincoln during the 1970 takeover, when the Young Lords, Black Panthers, and hospital staff staged a standoff with police demanding better healthcare and a Patients' Bill of Rights. But that legendary occupation jumpstarted the first outpatient program of its kind to offer ear acupuncture for detox, treatment, and recovery.

However, Eisen accompanied Mike Smith in 1999 to provide a training at the Pine Ridge Reservation in South Dakota after tornados had devastated the community. According to the NADA manual, the director of the Native American Advocacy Project (NAAP) convinced the Indian Health Services (IHS) that AcuDetox should be part of mental health crisis counseling. In 2016, the IHS officially recommended AcuDetox/5NP as a best practice for treatment and recovery.

The Landmark Lancet Study

While Eisen lamented what he feels is a scarcity of rigorous 5NP research, a different point of view from Dr. Libby Stuyt, he pointed to the seminal work of Patricia Bullock and Pat Culliton at Hennepin County Medical Center as essential reading for anyone practicing 5NP. After decades in public health, Eisen still highlights their 1989 paper:

“I mean, she (Culliton) was published in the fucking Lancet. That’s a big deal, people.”

The Lancet is a premier medical journal dedicated to publishing high-quality science.

That randomized controlled trial evaluated ear acupuncture for severe, chronic alcoholism published in The Lancet (Bullock et al., 1989).

Here are the key details of that study:

• Participants: 80 severe, recidivist alcoholics undergoing treatment.

• Treatment Group: 40 participants received 5NP ear acupuncture.

• Control Group: 40 participants received sham ear acupuncture (needles placed less than 5 millimeters away from designated 5NP points).

• Outcomes: 21 of the 40 people in the 5NP group successfully completed the treatment program, compared to only 1 person in the sham group.

• 6-Month Follow-Up: Participants in the sham group reported significantly higher cravings for alcohol and experienced twice as many relapses and re-admissions compared to the 5NP group.

One detail missing from the published abstract is treatment frequency. I would imagine that participants in that study would have been treated at least 3 to 5 times per week—or daily during acute withdrawal.

My longtime co-worker sent her son to an expensive treatment program in Florida after multiple failed attempts to stop drinking. The program included daily acupuncture. Although her son insisted the needles did nothing for him, he remains sober to this day. Regardless of which specific component gets the credit, the program as a whole—acupuncture included—achieved its goal.

5NP vs. GLP-1 Research Funding

Last year, I spoke with Eisen when New Hampshire lawmakers considered a Medicaid reimbursement bill for ear acupuncture in substance misuse treatment. Eisen was invaluable to consult because he helped secure Medicaid coverage for 5NP in Oregon. Medicaid and grant funding are how he has been able to keep The Quest Center going for so many years.

Eisen anticipated that New Hampshire’s bill wouldn’t pass. He advised that a more strategic next step would be proposing legislation for Medicaid to fund a pilot study measuring the cost-effectiveness of ear acupuncture in addiction treatment.

I was reminded of his advice when I noticed a local treatment program now offering GLP-1s, supported by growing, quality research on their potential for substance misuse. Nine years ago, when I discussed 5NP with Licensed Alcohol and Drug Counselors (LADCs) in Manchester, a few worried that tiny acupuncture needles might trigger clients with a history of intravenous drug use. Yet GLP-1s—which are primarily administered via self-injection and carry significant side effects—are readily embraced. The double standard surrounding acupuncture never ceases to amaze me.

This isn’t an argument against Medication-Assisted Treatment (MAT). If an intervention helps people recover, then it should be considered. But it highlights a stark reality: pharmaceutical companies have immense financial incentive to fund every conceivable application for their products. There are no profit motives for research on ear acupuncture, or for the practice of it.

5NP Research Beyond the US

Randy Stevens, director of Hope for NH Recovery, mentioned finding a lot of research on 5NP, much of it from Sweden while writing papers for his Master’s program. He plans to continue to look at 5NP research while pursuing his doctorate. I have been told that there are thousands of clinics offering 5NP throughout Sweden and Denmark. This is due in part to their different attitudes towards occupational licensing and a healthcare system that is not profit-driven. This is a reminder to myself to ask Randy to let me read his papers. Hopefully, he will let me share them on this Substack.

Keep poking ears, keep changing lives

This post was originally supposed to be my very first podcast episode. But as technology so often dictates, things didn’t go as planned. Technical issues got in the way, so I ended up calling Dr. Libby Stuyt on the phone, asking questions, and scribbling down her answers as fast as I could.

This conversation was long overdue. While I am confident in the effectiveness of ear acupuncture as an adjunct treatment for substance misuse, discussing research is not my personal strength. I am a practitioner, not a researcher. That is precisely why I reached out to Dr. Libby Stuyt.

Right at the beginning of our conversation, I explained to Libby that back in 2017, our colleague Laura Cooley and I sat down with Marty Boldin, who was serving as New Hampshire’s Drug Czar at the time. We explained to him that state lawmakers had just passed the Acupuncture Detoxification Specialists Law. Marty was gracious enough to give us a meeting in his Concord office. He even mentioned that he had been mentored in the 1980s by the founder of the National Acupuncture Detoxification Association (NADA), Dr. Mike Smith—the New York-based psychiatrist whose life’s work was integrating ear acupuncture into substance use and mental health treatment.

But then Marty dropped the hammer. He told us he had read all the literature on 5NP ear acupuncture, and in his view, “the results are inconclusive.”

Over the phone, I could practically feel Dr. Stuyt rolling her eyes.

“I don’t think that’s true at all,” she insisted.

Dr. Stuyt is not alone in this sentiment. Dr. Tom Corbin, a PhD researcher and acupuncturist who has collaborated on NIH studies, is on record stating that 5NP/AcuDetox is the most researched protocol in all of complementary and alternative medicine. I wrote about that here:

Before I move on to the rest of my conversation with Dr. Stuyt, I want to clarify what a state-level drug czar is supposed to do: bring stakeholders together to collaborate. When Marty Boldin asked about the purpose of our meeting, I requested two things: that he connect us with people running residential and outpatient treatment programs in New Hampshire, and that he help raise awareness about RSA 328-G:9-a. That law created the certification for practicing ear acupuncture as an adjunct treatment for substance misuse, mental health, behavioral health, disaster relief, and emotional trauma. His advice to me? “Pick your four corners.”

That was his way of saying, “You’re on your own, kid.”

After Marty Boldin was asked to resign in 2018, Manchester’s former Police Chief, David Mara, was appointed as the next drug czar. I tracked him down at a Safe Station Academy event at a fancy country club in Nashua and basically cornered him until he gave me a lead on who I could talk to about ear acupuncture. Chief/Czar Mara connected me with the Governor’s Commission on Addiction, Treatment and Recovery.

In early 2019, Laura and I, along with MLADC Jeff Davis and CRSW Ryan Fowler, presented to both the Treatment Task Force and the Recovery Task Force. Members of the Recovery Task Force ultimately voted to endorse the practice of ear acupuncture by peer counselors. I wrote previously about that endorsement here:

As I write this, I recall that because we met with the Recovery Task Force, Laura Cooley was asked to provide a NADA/AcuDetox training at one of the residential treatment programs in New Hampshire—it might have been Harbor Care, but I can’t say for sure. This was shortly before the pandemic hit.

Diving Into the Research with Dr. Libby Stuyt

Now, back to my conversation with Dr. Stuyt about ear acupuncture research. During our 45-minute phone call, she walked me through three specific studies in detail. I also highly recommend checking out Libby’s interview on The Mental Health Evolution Podcast, which captures so much of her brilliant perspective.

When you talk to Libby, it’s almost impossible to separate hard research from clinical practice—she lives directly at the intersection of both.

Libby isn’t someone operating on the fringes of medicine. She’s a board-certified psychiatrist and the retired medical director of a state-run addiction treatment facility in Pueblo, Colorado. She served for years as the president of NADA and now trains practitioners through the People’s Organization of Community Acupuncture (POCA).

Right before our call, she had been on another line with a pharmaceutical company, serving on an advisory board for a new cannabis withdrawal medication. Years ago, Pfizer even paid her to travel and present on Chantix for smoking cessation. What I am getting at is that she is a highly respected, mainstream medical professional—which made her reaction to my story about Marty Boldin all the more affirming.

Libby pointed out that Marty’s reaction represents a massive, common misunderstanding among doctors, administrators, and others in field of addiction treatment: they keep evaluating 5NP as if it’s supposed to be a standalone, silver-bullet cure for addiction.

On top of that, many acupuncture studies face a shared limitation: sample sizes are relatively small. Because of those modest sample sizes, researchers almost always include a standard boilerplate disclaimer at the end—something along the lines of, “while positive benefits were measured, more study is needed.”

That is one reason why the Marty Boldins of the world get hung up. They see a concluding phrase and dismiss an entire modality as “inconclusive,” completely ignoring the clear clinical benefits.

AcuDetox pioneers like Dr. Mike Smith never claimed 5NP cures addiction on its own. What the research actually shows is that 5NP dramatically improves client engagement and treatment retention.

As Libby put it to me: “Nothing else really does that.”

Libby has seen it transform clinical environments entirely. When ear acupuncture is offered, staff become more compassionate, clients become more receptive, and the hostile edge in a clinic softens. It directly smooths out therapeutic dynamics like transference and countertransference—phenomena that are difficult to measure in a lab setting, but instantly noticeable on the ground.

Her program offered 5NP/AcuDetox five days a week. She noted that routine ear acupuncture supports:

• Program participation and retention

• Receptivity to other therapeutic interventions

• Emotion and affect regulation, including anger, depression, and anxiety

The Power of Protocol: Smoking Cessation Studies

Take smoking cessation as an example. Libby explained that research shows ear acupuncture should be offered at least three times a week to effectively treat tobacco dependence. She successfully transitioned her own treatment program to a tobacco-free facility by offering ear acupuncture multiple times a day upon request, helping clients manage cravings and anger that they didn’t have cigarettes to self soothe.

She pointed to a landmark study by Dr. Ivker Bier that evaluated ear acupuncture combined with education and counseling.

• The group receiving 5NP/AcuDetox alongside counseling hit a 40% quit rate.

• The group receiving “sham” acupuncture (needles placed in non-NADA ear points) plus counseling dropped to 22%.

• The group getting ear acupuncture alone without counseling hit just 10%.

(You can find the link to that study here: PMC1447300)

That 40% success rate rivals Chantix, but without the laundry list of side effects. In fact, Libby told me Pfizer once offered to fund any study she wanted to design—until she proposed a head-to-head trial comparing Chantix directly against 5NP ear acupuncture. Pfizer ghosted her and never called back.

When Replication Goes Wrong: The 2002 Multi-Site Trial

I asked Libby to address the elephant in the room: a massive 2002 multi-site trial involving 620 participants that concluded ear acupuncture was no more effective than sham needles or relaxation for cocaine use. That single study sent shockwaves through the field and halted a lot of 5NP research funding for years.

Libby explained that the 2002 trial was an attempt to replicate a highly successful study previously conducted at Yale. At Yale, researchers offered 5NP to methadone-maintained patients who were to turning to cocaine as a way to stay awake and alert. The Yale trial showed a massive, statistically significant drop in cocaine use in the 5NP group compared to sham and control groups.

(You can find the link to the Yale University study here: PubMed 10927727)

So why did the 2002 replication study fail? Because the new researchers didn’t follow their colleagues at Yale. Instead of offering 5NP as a supportive tool inside existing, structured treatment programs, they recruited active cocaine users through newspaper ads and offered cash incentives. They treated 5NP as an isolated, standalone medication designed to cure cocaine dependence in a vacuum.

They set the study up to fail by ignoring the foundational truth of ear AcuDetox research: 5NP isn’t a standalone cure. It is an anchor that holds people steady while they do the real work of recovery. As Rachel Harrison, host of the Healthcare Evolution podcast, observed, 5NP/AcuDetox "expands the window of tolerance”.

(You can find that flawed 2002 study here: JAMA Article) and the study that analyzed the problems with the flawed study here: https://pubmed.ncbi.nlm.nih.gov/12006119/

Beyond Addiction: 5NP vs. Medical Acupuncture for Low Back Pain

The benefits of 5NP extend far beyond substance use disorders. Libby referenced a 2024 trial in Brain Sciences comparing NADA ear acupuncture directly to full-body medical acupuncture for chronic low back pain in older adults. The trial revealed that 5NP ear acupuncture offered pain relief that was just as effective as full-body acupuncture.

(You will find the link to that study here: PubMed 38539594)

That didn’t surprise me at all. At Hope for NH Recovery, several people that I treated with 5NP reported relief from neck pain, back pain, and migraines. While ADSes in New Hampshire aren’t legally credentialed to claim they treat physical pain, they can treat someone who is in pain to ease stress, anxiety, and depression because of the pain.

It reminds me of Mike Amato, an ADS here in Manchester, NH. Mike was skeptical of ear acupuncture for years. But during a Recovery Festival in Manchester’s Veterans Park, he finally sat down in the shade to try a treatment. He came back the following week to report a 90% reduction in his chronic back pain. Mike attended the very next ADS training at Hope for NH Recovery.

This is noteworthy because Mike will tell you himself that his chronic pain was the initial gateway into his substance misuse. His recovery required him to choose between sobriety or pain relief. Fortunately, ear acupuncture supports both—support being the key word.

In Salida, Colorado, where Libby lives, the ADSes she trained organize a free 5NP clinic twice a month. Many community members who attend are elderly residents seeking simple, accessible pain relief.

Moving Forward

As drug czar, Marty Boldin had the opportunity to build bridges and expand access. Instead, a fundamental misunderstanding of how ear acupuncture works in a clinical context led him to block an effective modality from reaching the people who needed it most.

I want to acknowledge that many people deeply respect Marty Boldin. ADS and CRSW Jason Snook speaks highly of Marty and remains thankful for his mentorship. Nikki Casey, my longtime friend and former director of Revive Recovery Center, has always sung his praises as well. Both things can be true at the same time.

Chief/Czar David Mara, on the other hand, didn’t overthink the research. He simply made the connection. Because of that open door, conversations happened, and more clinicians and peer recovery specialists were trained to deliver AcuDetox.

If anyone reading this is part of the Governor’s Commission on Alcohol and Other Drugs, we would love to connect with you again.

I suspect many people who took Laura’s Harbor Care training before the pandemic have since retired or changed jobs. But if you were in that cohort and wish to practice 5NP/AcuDetox again, I am happy to help you get recertified. Before Laura passed away, she gave me a list of the Certified Acupuncture Detoxification Specialists she supervised. The list was incomplete, and I know some ADSes fell through the cracks during the transition.

A huge thank you to Dr. Libby Stuyt for taking the time to speak with me and share her deep knowledge and clinical experience. As a new trainer, that kind of mentorship is invaluable.

Keep poking ears, keep changing lives.

This week, I’m sharing an interview from The Blinded Truth podcast featuring Virginia-based acupuncturist and 5NP trainer Katie Clifton1.

Katie and I reconnected in Rhode Island at a People’s Organization of Community Acupuncture (POCA) conference in 2023. I shouldn’t say “met,” because it was actually a reunion! We attended the same college at the same time. While we didn’t know each other back then, her name was familiar because we shared mutual friends. After graduating from Hollins College (now Hollins University) in Roanoke, VA—her in 1998 and me in 1999—we each found our own way to becoming acupuncturists and advocating for 5NP ear acupuncture certification in our respective home states.

In 2016, New Hampshire was often referred to as “Ground Zero” of the opioid epidemic. But we were trading that heavy title back and forth with West Virginia, Ohio, and Virginia, which were all hit incredibly hard by opioid overdose deaths. If you’ve read Beth Macy’s book Dopesick (or watched the Hulu series starring Michael Keaton), you’ll remember it tells the story of the devastation that the over-prescription of OxyContin brought to many communities in Central and Southwest Virginia. Beth Macy is also a Hollins alum, a candidate for Congress—and, as it turns out, a close friend of Katie’s family.

In this interview, Katie talks about founding the Wellness Wagon (now the Calm Clinic and Caravan), a mobile unit created to bring 5NP ear acupuncture directly to people in medically underserved areas, recovery events, and local agencies. Beyond just delivering 5NP ear acupuncture treatments, Katie use her mobile initiative to partner with other local community organizations, connecting people to essential resources—from Medicaid sign-ups and harm reduction supplies to maternal/child health support—all in one accessible space.

It’s a lot like an ongoing effort in Coconino County, Arizona. A 5NP-trained practitioner, Amanda Tso, offers ear acupuncture to her tribal community through an effort called The Justice Bus. Last December, a local Arizona news station ran a story about the Justice Bus bringing legal help, voter registration, healthcare screenings, Narcan, and ear acupuncture for mental health to rural communities that may not have access to transportation to get to nearby Flagstaff.

You can see that news story here:

Justice Bus on AZ news

New Hampshire has harm reduction teams and other mobile outreach. I can’t wait for the day when 5NP ear acupuncture will be incorporated into that work.

Keep poking ears, keep changing lives.

1

Katie is also on Substack under the name Sassy Queenpin Mama. Be sure to follow her.

Sassy Queenpin Mama

Blinded Truth Podcast with Me!

It’s been a minute, folks. I’ve been working hard to get a community acupuncture clinic open, and as a result, my writing has been put on hold. Every day, I ask myself, how do people make time to write? I actually know the answer, but right now, I’m not choosing to do it, and I’m letting that be okay…

Read more

4 months ago · 5 likes · MK Clifton

This week, I want to talk about supervision for Acupuncture Detoxification Specialists (ADSes) and 5-Needle Protocol (5NP) practitioners.

Each state that regulates or allows the practice of 5NP by non-acupuncturists has its own unique requirements. New Hampshire law requires ADSes to be under the general supervision of a Licensed Acupuncturist (L.Ac.) and to meet for a minimum of two site visits per year.

New Hampshire’s ADS/5NP regulations were originally modeled after Louisiana’s, which require general supervision by an L.Ac. with those same two annual site visits.

Back in 2017, this model was considered cutting-edge. Members of the New Hampshire Board of Acupuncture Licensing (NHBAL) and the New Hampshire Acupuncture and Asian Medicine Association (NHAAMA) pushed back hard, arguing instead for direct supervision. As we have seen in states like Georgia and South Carolina, direct supervision completely hinders the practice of 5NP. (I will get to that in a minute.)

At the time, the NHBAL didn’t seem to care that Louisiana and New Mexico had successfully implemented the exact general supervision requirements we were proposing. One board member, refusing to believe our data, repeatedly referenced an outdated document and essentially accused me of lying at every meeting. Fortunately, she retired during the pandemic.

Since 2017, however, the landscape has shifted. More states have adopted and expanded regulations for 5NP, and supervision is increasingly absent from modern ADS laws.

The Shift Away from Supervision

• Vermont (2019): Dropped supervision entirely when the state decided not to regulate ear acupuncture. To practice there, you simply need a certificate proving you completed a training course, and you cannot claim to be treating specific medical conditions.

• West Virginia (2019): Advocates successfully lobbied for an ADS/5NP certification law that requires no supervision whatsoever.

• Maine (Post-2017): Passed an ADS law shortly after New Hampshire. The local acupuncture association collaborated on a law requiring general supervision with twice-yearly meetings—but only during the practitioner’s first year of state certification.

• Colorado, Wyoming, Rhode Island, Virginia, Delaware, and Oregon: None of these states require supervision for ADSes or 5NP practitioners.

• Oklahoma does not require supervision for ADS/5NP practitioners because Oklahoma does not regulate the practice of acupuncture. The neat thing about that is that ADSes and Licensed Acupuncturists run a very collaborative state association with annual symposiums.

A current list of 5NP regulations by state lives on POCA’s website.

Where Did Supervision Come From?

The late NADA trainer Laura Cooley once explained to me that supervision was actually created in the 1980s by NADA founder Dr. Michael Smith. He did this as a compromise with local acupuncturists who had passed a highly restrictive acupuncture practice act in New York, which suddenly left Dr. Smith’s non-acupuncturist staff at the Lincoln Detox program unable to practice.

To keep the program alive, Dr. Smith set aside his other work as a psychiatrist and director of the hospital-based outpatient program to personally provide all the ear acupuncture himself—delivering up to 100 treatments a day. He did this until the law was finally amended to allow his staff and other substance use disorder treatment teams to return to practicing 5NP under a general supervision model.

Coincidentally, over 20 years ago in acupuncture school, I had a teacher who taught us about AcuDetox. She had spent her early years of practice in New York and worked with the head of a local acupuncture school (Mark Seem) to pass that very same restrictive practice act. Years prior, Dr. Smith had actually introduced her to acupuncture when she and her former husband, a medical doctor, toured the Lincoln Recovery program. She admitted she wouldn’t have become an acupuncturist if it weren’t for him. Yet, she went on to throw a wrench into his program by advocating for a law that restricted all acupuncture—including 5NP—strictly to licensed acupuncturists.

Laura also told me that Dr. Smith wasn’t particularly fond of acupuncturists. After all the trouble they put him through, I can’t say I blame him.

The Chilling Effect of Direct Supervision

When the NHBAL saw the overwhelming legislative support for our AcuDetox bill, they pivoted from total opposition to pushing for direct supervision. Direct supervision means a supervising L.Ac. must be physically onsite while the ADS provides 5NP treatments.

To understand why this is a structural dead end, we can look at Georgia and South Carolina. Both states certify non-acupuncturists to perform 5NP, but limit their practice to treatment programs with direct, onsite supervision.

In a 2018 paper1 co-authored by NADA/5NP trainers Dr. Libby Stuyt, Dr. Claudia Voyles, and former NADA Executive Director Sara Bursac, Georgia’s restrictive model was contrasted with Colorado’s supervision-free model:

In 2018, 70 substance use treatment programs offered 5NP/AcuDetox in Colorado, utilizing 160 certified ADSes. Meanwhile, in Georgia, only five treatment programs offered 5NP, with just 10 certified practitioners statewide.

You can read the full paper here.

In South Carolina, the story is similar. Prior to 2005, non-acupuncturist 5NP practitioners could offer barrier-free care. That ended when an acupuncture practice act passed requiring direct, onsite supervision for ADSes. This change derailed a promising pilot program spearheaded by a NADA-trained paramedic that would have brought 5NP into five South Carolina correctional facilities. (For more on this, see Ryan Bemis’s 2005 article, “Light and Dark in the Deep South”)

Lightdarksouthcomplete

357KB ∙ PDF file

Download

Download

Furthermore, a 2017 study by Dr. Kenneth Carter demonstrated highly positive outcomes when adding ear acupuncture to traditional therapies in substance use treatment programs. However, Dr. Carter noted that the study faced severe limitations due to South Carolina’s laws, pointing out that requiring an onsite supervising acupuncturist inherently caps the volume of care an ADS can provide.

Read Dr. Carter’s study here.

The Unexpected Benefits of General Supervision in New Hampshire

Just two weeks ago, the Governor of New Hampshire signed HB1269 into law2, which officially adds an ADS seat to the NH Board of Acupuncture Licensing.

Originally, the bill included language to cap general supervision to twice a year for only the first two years of practice—a compromise I negotiated with the licensing board in 2024. However, the New Hampshire Acupuncture and Asian Medicine Association (NHAAMA) opposed the change. During a 2025 annual meeting with NHAAMA, some members expressed that they wanted the opportunity to serve as general supervisors for ADSes. In response, Andy Wegman requested that the NHAAMA board compile and send a list of acupuncturists willing to be supervisors.

We never received that list.

Perhaps the topic of supervision is something we can revisit in a few years, especially as acupuncture schools continue to close and the profession at large shrinks. But until then, we are finding that New Hampshire’s semi-annual site visits have yielded some incredibly beautiful, unintended consequences.

Instead of acting as a bureaucratic hurdle, general supervision has become a powerful vehicle for collaboration, resource sharing, and professional networking.

Because of these mandatory touchpoints, we are seeing brilliant community connections spark across the state:

• Bridging Care: Bedford-based psychotherapist and ADS Nick Pigeon met Plymouth-based peer support specialist Cara LaPlante. Because of that connection, Nick could refer a student client at Plymouth State to Cara so they could continue receiving 5NP care.

• Creating Jobs: Nick Pigeon also went on to hire fellow ADS and MLDAC Jason Snook after Jason left a previous counseling practice that refused to let him utilize his 5NP skills. Jason is working remotely from Florida, where the law does not allow the practice if 5NP by non-acupuncturists. But he treats a lot of people with ear seeds at recovery meetings. He reported back during a supervision meeting that they love it.

• Fostering Community Support: Retired nurse and ADS Kathy Knight connected with Concord-based ADS Patricia Bedford, who works closely with local immigrant communities. Together, they teamed and now Kathy provides tutoring to nursing students within the agency where Patricia works.

These supervision check-ins also keep us plugged into the incredible volume of care being delivered on the ground. We get to celebrate and learn from ADSes who are offering 20-30 treatments per week: Randy Stevens; Trent Hill; Sharna Steinhart (Hope for NH Recovery); Brekke Best (Live Free Recovery); Dr. Patricia Keifner (Capital Recovery); Tia Elie (Acts of Kindness); Amy Cloutier (Sacred Moon); Adam Kellet (Process Recovery); and Amanda Liakas, who is providing vital access to the general public in underserved Belknap County. Meanwhile, Valerie Piper holds our regional record, delivering a staggering 70 treatments per week at her facility in central Vermont.

ADS Carol Ellis runs a 5NP clinic in Concord for the general public. She uses her knowledge of Chinese Medicine from studying and teaching tai chi to provide acupressure with ear seeds on body points3. I am eager to hear more about how her practice continues to develop.

Finding the Medicine in the Red Tape

When Dr. Mike Smith first conceived of supervision, it was a political shield—a necessary compromise to keep essential public health tools in the hands of the frontline workers who needed them most. It was never meant to be a permanent muzzle on the practice, nor was it meant to protect professional turf.

While the ultimate goal remains a barrier-free environment where 5NP can be integrated into any space without unnecessary red tape, New Hampshire’s current general supervision model has evolved into something Dr. Smith likely would have appreciated: a community-building tool.

By forcing us into the same rooms twice a year, supervision has stopped being a mere regulatory hoop. Instead, it has become a bridge—connecting peer support specialists, counselors, nurses, and acupuncturists. Until the day we can finally shed these regulatory training wheels, we will keep using these site visits to do what we do best: build a stronger, more connected, and deeply resilient network of care.

Keep poking ears, keep changing lives.

Before I dive into this week’s topic, I want to let everyone know that our application to present a panel on ear acupuncture at New Hampshire’s Behavioral Health Summit is currently on the waitlist. We are still in consideration in case any of the selected presenters drop out.

After I previously wrote about the application that ADS Cara LaPlante submitted for the panel, I heard from retired MD Patricia Keifner, who offered to step in as a panelist. Yes, a thousand times, yes! (if we ever get accepted) Dr. Keifner has been practicing 5NP ear acupuncture since 2019—first under her medical license and now as a certified ADS since retiring from full-time medical practice.

I got to know Dr. Keifner because she joined me at Hope for New Hampshire Recovery when I ran a weekly clinic on Tuesday mornings. She was trained by NADA trainer Laura Cooley, and she completed her 40 ears with me at Hope. That is where she told me her story. As a medical doctor, she felt that doctors needed to take responsibility for the over-prescription of opioids that led to New Hampshire’s and the country’s opioid epidemic. She got certified to prescribe Suboxone and she got trained in ear acupuncture. She fell in love with ear acupuncture in the process and has been promoting it around Concord ever since. She volunteers weekly at Capital Recovery and inspired someone else at Capital Recovery to take the 5NP training.

Expanding the Toolbox: Dr. Amy de la Garza

Dr. Keifner’s journey leads me to another medical doctor I want to highlight: Utah-based buprenorphine doctor, Amy de la Garza. Trained to practice 5NP by psychiatrist Libby Stuyt, Dr. de la Garza offered ear acupuncture at Odyssey House, which is the largest and most comprehensive treatment program in Utah.

During the pandemic, she provided ear acupuncture twice a week at Odyssey House1. Working in small cohorts, she managed to deliver an astounding 100 treatments a week in just eight hours. In an interview on The New Odyssey House Journals Podcast, both Dr. de la Garza and host Randall Carlisle noted that multiple individuals explicitly credited the ear acupuncture with helping them stay in the program during those incredibly stressful times.

It is a conversation well worth watching. If you tune into the episode, note that she doesn’t pivot to ear acupuncture until about 18 minutes into the 35-minute runtime. Prior to that, she spends a significant amount of time discussing experimental research on ketamine and psilocybin (magic mushrooms). I’ll admit, the first time I listened, my impatient, single-track mind—which mostly defaults to ear acupuncture—felt a bit irritated by how much time she spent on psychedelics.

However, by my third listen, I finally appreciated her perspective. As an MD, Dr. de la Garza simply has access to a much wider array of tools than an acupuncturist or a typical ADS. While she acknowledges the burgeoning research into these experimental approaches, she also warns that the medical community must proceed with extreme caution. I have one friend who has benefited immensely from ketamine therapy, and a patient who recommends it because it helped her when nothing else did. But as we collectively witnessed with the tragic passing of actor Matthew Perry, these substances carry real risks when not tightly controlled.

What resonated with me most happens in the final minutes of the podcast. Dr. de la Garza recalls testifying at the Utah State House in support of a bill (House Bill 0195) to expand 5NP certification to mental health workers, nurses, and case managers. During her brief testimony, she told lawmakers:

“This is a tool in my toolbox that I have never had before, and it works instantly in the moment to relieve suffering.”

For a medical doctor who has an entire arsenal of conventional (and experimental) pharmaceutical tools at her disposal to make a statement like that speaks volumes. I only wish more physicians and program directors could hear her message.

Dr. de la Garza became a 5NP trainer through the People’s Organization of Community Acupuncture (POCA). A few years ago, SAMHSA gave her a grant to cover the cost of 5NP ear acupuncture trainings. SAMHSA recognizes ear acupuncture in TIP 45 because of psychiatrist Dr. Kenneth “Khensu” Carter.

Introducing Ear Seeds to Major Medical Systems

Finally, I want to highlight a New Hampshire-based medical doctor who has become a true champion for ear seeds: Dr. Matt Hand, the Section Chief of Pediatric Nephrology and Director of the Pediatric Integrative Medicine Initiative at Dartmouth-Hitchcock. Dr. Hand is passionate about blending integrative modalities and remedies into conventional healthcare systems. He leads the Pediatric Integrative Medicine Initiative (PIMI), which meets weekly online to discuss a wide variety of conditions and the possible integrative therapies that can be beneficial for treatment. Physicians at the Cleveland Clinic have even asked if they can join the weekly sessions run by Dr. Hand and PIMI.

I had the privilege of introducing him to ear seeds and an online training course. This course was originally created through a Medical Reserve Corps grant by an organization called Public Health Acupuncture New Mexico.

Dr. Hand recently shared some incredible news with me: many of his medical colleagues at Dartmouth Hitchcock have since taken the online training. Some of them are now actively implementing the practice of auriculotherapy with ear seeds across a major medical system right here in New Hampshire.

Keep poking ears, keep changing lives.

Quick note from me: I am away on vacation this week, but I still wanted to keep the Substack going while I am away. Enjoy!

I wrote this right after getting back from Manchester’s Pride Festival last Saturday. I don’t think I have ever seen Veterans Park in downtown Manchester look more joyful. The entire block was a beautiful sea of rainbows, bubbles, stickers, puppies, and sheer happiness.

The team at Hope for New Hampshire Recovery had a booth set up offering bottled water, Narcan, and ear seed treatments. Yes, that’s right—ear seeds! I wrote about these in a previous post and discussed how surprisingly effective they can be.

I got treated by Hope staffer, Heidi Kincaid. Heidi just learned how to practice ear seeds the day of the festival from father/daughter ADS duo, Jeff Davis and Meg Slater.

Her quick start goes to show you just how accessible this tool is. You don’t need a three-to-four-year acupuncture education or even a 70-hour ADS training to learn how to place an acupressure bead or a seed on the most researched point on the ear to offer someone therapeutic benefit. It clearly works—by the time I left the festival, Heidi, Meg, and Jeff had already given over 200 treatments.

According to research compiled on the Manchester Acupuncture Studio website, single- and double-blind studies show that ear acupressure on the Ear Shen Men point can reduce:

• Fatigue

• Anxiety and stress

• Acute and chronic pain

• Heart rate and blood pressure

The studies found positive clinical outcomes across widely diverse populations, including behavioral healthcare providers, post-cesarean section patients, children with ADD/ADHD, patients being transported by ambulance, and elderly patients recovering from hip fractures.

The booth even caught the attention of NH gubernatorial candidate Jon Kiper, who stopped by to talk. Meg put some seeds and bling right on his Ear Shen Men point, making him the first known candidate for governor to try out ear seeds!

Below are some more photos from Manchester Pride.

Keep poking (and seeding) ears, and keep changing lives.

I recently sat down with Matt Bohannon from Brave Space New Hampshire and my fellow trainer Jeff Davis to talk about the radical simplicity, history, and community power of ear acupuncture. You can watch our full conversation right here:

I met Matt through LinkedIn almost two years ago, and he’s easily the best local connection I’ve made through that platform. I initially joined hoping to connect and share information about ear acupuncture with mental health and recovery professionals here in New Hampshire.

I’ll admit, I got a bit exasperated one day and decided to send him a direct message. I shared a link to a story I wrote about a treatment program in Baltimore that doesn’t just provide ear acupuncture—they make it a central focus of their entire program.

Matt wrote back and told me that he actually had ear acupuncture while he was in treatment himself and found it incredibly helpful. He immediately saw my point: why aren’t more programs adopting this, and why do the programs that do offer the 5-needle protocol (5NP) offer it on such a limited basis?

One of the reasons the historic Lincoln Detox model in the Bronx was so successful (for over forty years) is because ear acupuncture was offered every single day on a walk-in basis. It met people exactly where they were. That consistency meant 5NP could act as a fluid form of harm reduction, stabilization, withdrawal support, active treatment, and long-term recovery maintenance.

Our late mentor, Laura Cooley, once told me an incredible piece of oral history. She mentioned that New York City municipal workers who got treated at Lincoln Detox commented that the Bronx had far fewer cases of children entering foster care than any other borough in NYC at the time. I don’t believe that statistic was ever officially written down in a study, but I can certainly believe it. If parents can access simple, effective, low-barrier tools for their mental health, they can function better, stay grounded, and take care of their families.

To see this exact Lincoln Detox community model in action—and to hear directly from the people who built it—you can watch this archival documentary, Points to Change:

During our 5NP trainings, we teach about how this protocol needs to be as accessible as possible, and how the frequency of treatments—from early stabilization and withdrawal all the way to long-term maintenance—leads to much better results.:

Treatment Frequency For 5np

117KB ∙ PDF file

Download

Download

My fellow trainer, MLDAC Jeff Davis, has his own story of his first encounter with 5NP from back in the 1980s. He served as the clinical director of a substance misuse treatment program in Baton Rouge. The head of the program was a physician by the name of Dr. Struther Dixon. She offered ear acupuncture every morning to the people in her program and came back later in the day to offer ear acupuncture to anyone who wanted a second treatment later in the day.

Fast forward over thirty years later, I met Jeff at a meeting at the Makin’ It Happen Collaborative—a regional coalition of diverse stakeholders working to prevent substance misuse and improve mental health services in Greater Manchester. He nearly jumped out of his seat when I mentioned ear acupuncture certification is now available in New Hampshire. He knew how effective it was from his time as an early mental health professional. Dr. Dixon’s program had waitlists when other area programs did not.

Jeff knew how effective this modality is, and that is why he brought his clients from Manchester Mental Health to Hope for NH Recovery when I offered ear acupuncture every Tuesday morning for three years before the pandemic. That is why Jeff now offers ear acupuncture every Saturday at Hope and mentors other ADSes (Acupuncture Detoxification Specialists) who volunteer with him.

Keep poking ears, keep changing lives.

Many people who take the 5NP (5-Needle Protocol) training in New Hampshire ask about practicing ear acupuncture in other states, especially in Massachusetts.

Currently, 5NP can be practiced by non-acupuncturists in 31 states, though the regulations are unique to each one. The People’s Organization of Community Acupuncture (POCA) maintains a handy reference chart on their website to track these differences: POCA Ear Acupuncture Chart.

I also created a summary document covering New Hampshire’s ADS (Acupuncture Detoxification Specialist) regulations, neighboring states, and our closest Canadian provinces. Everyone who takes our 5NP training in New Hampshire gets access to this resource in our Google Classroom.

Nh Ads Law And Rules

117KB ∙ PDF file

Download

Download

The Waiting Game in Massachusetts

Massachusetts is on track to become the 32nd state to offer 5NP ear acupuncture certification. Lawmakers in Boston passed an ear acupuncture law back in December of 2024, and since then, my POCA colleagues have been waiting with bated breath to get trainings started.

However, the administrative rules—which spell out the law's details, set certification fees, and create a practitioner registry—haven't even been drafted yet. Regulators estimate it will take another 9 to 12 months just to write the initial proposals. But here is the important part: once those draft rules are released, public comment periods will open up. If you are interested in getting certified in Massachusetts, that will be your chance to weigh in and make your voice heard.

What we do know about Massachusetts is that they have a list of licensed and certified mental health and healthcare professionals who qualify for this certification. Not everyone who qualifies to practice 5NP in New Hampshire will qualify in Massachusetts.

A Lesson in State Legislatures

It took several years for the Massachusetts 5NP law to pass. In New Hampshire, our legislature ensures that every single bill filed gets a public hearing. I am learning in real time that not all states operate that way.

Like Massachusetts, our POCA colleagues in Illinois are currently fighting to reinstate the practice of 5NP. Before Illinois regulated the practice of acupuncture, 5NP ear acupuncture was offered in substance misuse treatment programs in the Chicago area by staff members.

The Vegetarian Times actually wrote a story in 1989:

Vegetarian Times

Former New Hampshire Drug Czar Marty Boldin told me in 2017 that he was originally mentored in Chicago by Dr. Mike Smith, the legendary founder of the National Acupuncture Detoxification Association (NADA).

The “Acupocalypse”

We have mentioned this briefly in several of our trainings: acupuncture schools are in serious jeopardy. Schools have been closing gradually since the 2000s, but since the pandemic, the collapse has accelerated to about two or three acupuncture schools shutting their doors every single year.

It comes down to a harsh reality: the astronomical cost of an acupuncture education does not lead to stable employment.

This is incredibly unfortunate because acupuncture is effective at treating so many conditions. Even the World Health Organization published a comprehensive list validating its clinical uses for over 100 conditions.

To make matters more complicated, the US Department of Education has proposed limiting student loan borrowing for Master’s programs. That’s the quick summary, but if you want to dive deep into the specific policy details, I can connect you with some brilliant people who know the ins and outs.

The bottom line? By the time the 5NP regulations are finally approved in Massachusetts in mid-to-late 2027, the remaining acupuncture schools may be plunged into the abyss.

Time to Straighten This Out (The “TMI” Part)

Laura Cooley often discouraged me from talking about regulations with ADSes. I completely understand why—it’s dry, bureaucratic stuff. But at the risk of boring you and giving you more information than you ever wanted, I have to ask: Would you like to help the acupuncture profession straighten its shit out?

All I am asking right now is that you take a quick straw poll by June 21.

In an effort to prevent more school closures, the acupuncture school accrediting body, ACAHM, has put out a straw poll asking for feedback on draft proposals that would change minimum educational requirements. Anyone can weigh in—you do not have to be a licensed acupuncturist. In fact, it would be a massive benefit if 5NP practitioners of all backgrounds shared their perspectives.

ACAHM is floating three primary proposals:

• Proposal 1: Shorten the length of the Master’s level acupuncture program. Right now, many of us go to school for 3.5 to 4 years for a Master’s “level” degree. It’s insane.

• Proposal 2: Shift the primary credential from a Master’s to a Bachelor’s degree. This would make the program significantly less expensive while maintaining better options for student loan borrowing.

• Proposal 3: Offer the vast majority of the training in a Bachelor’s program, followed by a very short Master’s add-on so graduates can still hold a Master’s “level” degree.

You can review the details and participate here: ACAHM Program Revision Proposals Straw Poll.

I agree with Lisa Rohleder, the Executive Director of the Oregon College of Community Acupuncture (formerly known as POCA Tech). All three of these proposals are than what we have now, even though some are better than others. You can read her excellent synopsis here: On Imperfect Futures.

My colleague Bex Groebner, a former faculty member from the now-defunct Oregon College of Oriental Medicine (OCOM), has proposed a fourth option centered on a robust Bachelor’s track. I copied and pasted her proposal into the comments for consideration, and you can read her breakdown here: Needling to Get to the Point: ACAHM Straw Poll.

Why We Need Apprenticeships Back

I left a comment on the poll arguing apprenticeship1 should be brought back as a viable route toward acupuncture licensure. New Hampshire actually offers a pathway for licensure via apprenticeship thanks to Laura Cooley. It is an option for a rural state with zero acupuncture schools.

However, the organization that administers our national certification exam no longer allows apprentice-trained students to sit for the boards. That needs to change. Apprenticeships need to come back.

I have a coworker who would love to train apprentices, and he would be phenomenal at it. This option could open doors for New Hampshire acupuncturists who wish to pass their decades of clinical experience down to their children. Instead of requiring the next generation to take on staggering amounts of student loan debt, practitioners could directly train their own family members to join and eventually inherit their practices. It would mean that established clinics can continue to serve their communities into the next generation.

I am sure this is a lot more than you bargained for when you signed up for a 5NP ear acupuncture training. You probably didn’t realize the broader acupuncture profession was facing a systemic collapse—and honestly, why would you?

But now you are here, actively bringing ear acupuncture to populations in New Hampshire who might otherwise never have access to it. The work you do makes a massive difference to the people sitting in your chairs. That makes you a stakeholder in this fight.

Take the poll, keep poking ears, and keep changing lives.

1

Read more about the realities of apprenticeship in the acupuncture profession here:

Acupuncture Can Change the World

On Acupuncture Apprenticeships

I keep saying that it’s hard to have an acupuncture school and in this post I want to spell out why. Technically this post is about acupuncture apprenticeships as an alternative to conventional schooling — it’s about the technicalities of apprenticeships — but the tl;dr version is…

Read more

5 months ago · 21 likes · 6 comments · Lisa Rohleder

Thank you to everyone who submitted testimony and signed in remote support for HB1269: relative to the qualifications to practice acupuncture. Our bill passed the Senate and is on its way to the New Hampshire Governor’s desk.

This would not be possible without the state lawmakers who sponsored HB1269. Many thanks to Representative Peter Schmitt (D-Dover) and Representative Mark Warden (R-Manchester). I also want to thank Representatives Mark Proulx (R-Manchester) and Pat Long (D-Manchester) for speaking at the House and Senate hearings.

I wrote about the House hearing and the Senate hearing in previous posts.

For Acupuncture Detoxification Specialists (ADSes) in New Hampshire, this means that there will be a seat on the NH Board of Acupuncture Licensing (NHBAL) for an ADS. The licensing board will drop one of the four seats currently occupied by a licensed acupuncturist in order to maintain an odd number of members. The fifth seat on the board is for a member of the public who does not practice acupuncture.

Licensing boards are not meant to promote their respective professions. That is what professional trade associations do. It’s really important that everyone understands that distinction. A licensing board is a regulatory body; its sole mandate is to protect the public by establishing minimum competency standards for entering a profession.

When a board forgets this distinction, it stops protecting the public and starts protecting its own turf, acting as an exclusive gatekeeper. That is exactly what we ran into in 2018. Instead of focusing on safe public access to the 5-Needle Protocol (5NP), the board wrote rules designed to heavily restrict who could practice it—treating a public health tool like a competitive threat.

In 2018, I watched the NH Board of Acupuncture Licensing write the administrative rules of the ADS law they didn’t want. It was excruciating. The rules are messy because of it. Getting the POCA Auricular Technician (AAT) training approved by the NHBAL was no small feat because of the long list of requirements that are written into the rules1. Current members of the NH Acupuncture Board are aware and are willing to make changes, but it is important for current ADSes to have representation on the licensing board weighing in on rules that affect them and future ADSes who will be practicing 5NP ear acupuncture in New Hampshire.

The former Executive Director for the National Acupuncture Detoxification Association (NADA), Sara Bursac, submitted a great letter in support of HB1269. In 2018, she was asked to give guidance to the NH Licensing Board (as the ED of NADA) while they wrote the administrative rules. I sat in on that meeting when she spoke to the board on a conference call from two time zones away in Wyoming. She advised them to keep the rules simple to honor the spirit of New Hampshire’s law, which makes ear acupuncture accessible for both the treatment of substance misuse and as a tool to support mental and behavioral health. They clutched their pearls and ignored her2.

You can read Sara’s letter for HB1269 here.

Sara Bursac Hb1269

89.3KB ∙ PDF file

Download

Download

The administrative rules desperately need revisions, and we have the opportunity to make them. Every ten years, licensing boards in New Hampshire are required to overhaul their administrative rules and fix outstanding problems. For the Acupuncture Licensing Board, that revision process started in 2024. One of the most restrictive rules left behind by the 2017 board requires that a licensed acupuncturist supervise 5NP trainings. This needs to change. Many 5NP trainers in POCA, NADA, or other state-approved programs are not licensed acupuncturists. For example, Sara Bursac is a Licensed Clinical Social Worker; she was a trainer with NADA for many years and served as the head of the organization, and she now runs her own Wyoming-approved training, AcuRecovery Wyoming.

We have been pushing to get this rule fixed, among others. I submitted a formal request for rule changes, as did Sara Bursac, while Jeff Davis and Randy Stevens submitted a joint letter. Laura Cooley also submitted a letter advocating for these changes shortly before she passed away in 2024. Having an ADS on the board ensures our voices can’t be ignored during this crucial revision cycle.

Applying to the Board

In a few months’ time, NH’s Office of Professional Licensure and Certification (OPLC) will solicit applications from ADSes who would like to apply to serve on the Licensing Board3. If you are interested—and I know some of you are—you will need to submit:

• A resume

• A cover letter

• Two letters of recommendation

The applications are put before the NH Governor, who will make her selection. After that, her choice for that board position will be put before the members of the New Hampshire Executive Council, who have to confirm the Governor’s nominee.

The licensing board meets quarterly at minimum, but it’s reasonable to expect a few additional meetings each year. They meet at the OPLC Office in Concord, across from the State House in Eagle Square, on alternating Friday mornings or afternoons. This is where I give credit to the board members. This work is unpaid and not particularly glamorous, but it’s crucial. If good people don’t serve on the board, self-interested people will.

Looking Under the Hood

The first bill I ever worked on was NH’s ADS bill. It was like looking under the hood of an old car. Once you fix one problem, you notice plenty more.

The licensing board did not have term limits until 2022. Two of the licensing board members who worked on the ADS rules in 2018 had served on the board since 1998, when they got the NH Acupuncture Practice Act passed. It wasn’t long before I rolled up my sleeves, and Laura Cooley and I went back to the State House to change that. But even that wasn’t enough. For a few years after that, the NHBAL refused to provide public notice when there was an opening on the board. Board member seats were being filled by people handpicked by current board members. I had to complain to lawmakers about that, too.

At this point, I can tell you that there are some lawmakers in Concord who are sick of seeing my face in their committee. And I no longer have Laura Cooley with me to work through all of the big and small hurdles. That is why I am writing this Substack.

I need company.

If you apply to the board and don’t get selected—like I did—remember that the meetings are public. Anyone can attend NHBAL meetings in person or remotely. I have been sitting in on most of their meetings since last year. It gives me a deeper appreciation for the work of my colleagues who serve as board members, but it also allows me to be a voice in the room to fill in knowledge gaps. No one goes to acupuncture school to learn how to be a regulator.

You can see Sara Bursac in this video getting an ear seed treatment from her son. This was a collaborative project made by NADA members during the pandemic.

1

New Hampshire ADSes who are trained through POCA are given extra NH-specific material that was written to satisfy the long list of requirements in our state's administrative rules. It was my spring and summer project in 2023, and that is how I created the book list for our NH 5NP trainings.

5np Book List And Other Resources

69.7KB ∙ PDF file

Download

Download

Last weekend, my longtime colleague Heather Finn shared a beautiful surprise with me: a New York Times gift article that explicitly highlights ear acupuncture. It truly felt like a gift.

In the May 31, 2026 edition of the Metropolitan Diary, a reader-submitted story captures a quirky, fleeting moment between two passing strangers. The author, Bonnie, sets the scene perfectly:

“I was returning from a free ear-acupuncture clinic on a balmy spring day a few years ago, leisurely walking along Fifth Street on my way to the East Village.”

Because Bonnie was feeling so profoundly relaxed, she made a point of connecting with a fellow human being to share a quick laugh. This is the subtle magic of the medicine: it drops us out of our hyper-vigilant minds and back into our bodies, creating immediate room for spontaneous human connection.

Tracking Down the “Free Clinic”

Curious about where Bonnie received her treatment, I reached out to two longtime 5NP (5-Needle Protocol) ear acupuncture trainers in NYC, Jo Ann Lenny and Wendy Henry.

As it turned out, Wendy knew the storyteller. Bonnie is a regular at the clinic Wendy runs at the Educational Alliance’s Center for Recovery and Wellness on Avenue D.

I always enjoy finding these connections. For instance, I know nurses in Providence, Rhode Island, who provide ear acupuncture to students at Brown University for stress reduction. Last year, Wendy texted me from New York because she had just treated a Brown alum who was already familiar with 5NP.

This kind of word-of-mouth momentum is exactly how the practice takes root. And we see that exact same ripple effect where I live in Manchester, NH.

The Ear Acupuncture “Beer Garden”

The first time we offered ear acupuncture at Hope for NH Recovery’s annual recovery rally in Veteran’s Park was in 2019. By that point, I had already been hosting a free weekly morning clinic at Hope for two years. While the regulars at Hope knew the practice deeply, many of the surrounding organizations tabling at the rally did not.

One staff member from WestBridge, a mental health and treatment center in Manchester’s North End, used to bring residents to our weekly clinic. At that first rally, several WestBridge clients spotted our banner and immediately swarmed us from all directions, eager for a treatment. It was beautiful, but chaotic.

Ever since, we’ve roped off the ear acupuncture tent and created a single, clear entrance. It’s a lot like a beer garden—but instead of IPAs, we’re offering ear acupuncture.

After a few years of showing up at the rally, people started coming up to us to share where they’d first encountered the ear acupuncture—whether at the former Farnum Center with ADS Jessica Wheeler, or with ADS Reggie Champigny at The Process Recovery.

I’ve even had new patients walk into Manchester Acupuncture Studio because they first tried ear acupuncture through Licensed Alcohol and Drug Counselor Rich Kania, or Nurse Thisvi McCormack, who used to offer semi-regular treatments out of her friend’s flower shop

The Ripple Effect in Real Time

Just before last month’s training, I was buying supplies at the Family Dollar and struck up a conversation about ear acupuncture with the cashier. She mentioned she’d heard about it through Hope for NH Recovery across the street but hadn’t tried it yet.

Moments later, another customer walked in and chimed right in: “I’ve had ear acupuncture! Sharna from Hope came to where I work and gave us all treatments.”

The only way to spread the word about ear acupuncture is to offer it. It only works when it’s available regularly and often. The same is true for all acupuncture.

During a 5NP training, a trainee once asked how we could better promote our work. Andy Wegman replied without missing a beat: The way to spread the word is through practice. Making sure that people have access to treatment.

Stepping Into Big Shoes

In 2024, an ADS who took the very first 5NP training back in 2017 reached out to express how upset she was with me. She didn’t think my mentor, Laura Cooley, and I were the best people to be promoting ear acupuncture. Her reasoning? She had told so many people about it, and yet none of them had ever heard of it.

Was she actively practicing ear acupuncture herself? Nope. Not at all.

Laura had passed away only a few months prior. I was still deeply grieving the loss of my friend while trying to wrap my mind around stepping into her shoes as a trainer. I was terrified of making a mistake that would cause future trainees to get upset with me.

In hindsight, that critical interaction was a gift. I learned that I can’t control who gets mad at me or why, so I might as well just start training1. I am incredibly grateful to every cohort since for giving me the opportunity to practice and improve.

Last week, during our online semi-annual supervision, one New Hampshire ADS shared that she treats her co-workers before staff meetings. One particular colleague was a total, vocal skeptic.

The punchline? The treatment left the skeptic so deeply relaxed that she literally had to leave work early. The next day, she asked when she could get another treatment.

It was hard to run the rest of the meeting because I couldn’t stop laughing.

The Grassroots Reality

Ultimately, that disgruntled ADS from 2024 was right about one thing: I am not the best person to promote ear acupuncture in New Hampshire.

But that’s because there is no “best person.” This is grassroots work, and it always has been—whether in the East Village of New York City, a campus in Providence, or a park in Manchester, New Hampshire. No one really understands ear acupuncture (or any acupuncture for that matter) until they have access to it. And they are more likely to try it if they know people who recommend it.

Wendy Henry has been running clinics all over NYC for decades. It is a testimony to her consistent work that someone she treated eventually wrote a love letter to the practice and landed it in the New York Times.

Thank you, Wendy. And thank you, Bonnie.

Keep poking ears, keep changing lives.

In 2025, many New Hampshire certified Acupuncture Detoxification Specialists (ADSes) weighed in on SB 123, a bill requiring the state Medicaid plan to cover ear acupuncture for the treatment of substance misuse. You all wrote great letters of support, signed in remotely, and attended a hearing before the Senate Committee on Health and Human Services (HHS).

The bill did not pass; however, it was the most joyous hearing at the NH State House I have ever attended. The Senate HHS Committee loved SB 123 and supported it unanimously. They passed it to the Senate Finance Committee, which decided—without giving us a hearing—that there was not enough evidence to prove the efficacy of ear acupuncture. These two committees played a game of “ping-pong” with the bill that lasted until early 2026. I have never seen anything like it. It was certainly entertaining, if nothing else.

I did not expect this bill to pass. I was shocked to learn that a Republican State Senator had filed it, and even more shocked when lawmakers from both sides of the aisle signed on as co-sponsors. I only told one State House Representative about the bill—simply to express my astonishment—and he kindly signed on as well.

To be clear, I never wanted to work on legislation for billing ear acupuncture (or acupuncture of any kind). Manchester Acupuncture Studio does not bill insurance because it would be a paperwork nightmare, forcing us to raise our rates. The same would be true for Medicaid. But there we were: the bill had been filed, and ADSes who work in treatment programs thought this was a great idea.

When the ADS certification bill passed in 2017, I was quickly hit with the reality that recovery and mental health services are a business. The first question professionals in these fields usually asked about ear acupuncture was, “How do you bill for it?” I wrote about that when I started this Substack:

Because I have no experience with billing, I didn’t feel like the best person to lead an effort on Medicaid. I reached out to more knowledgeable people, including Dr. Libby Stuyt in Pueblo, Colorado. She happily wrote a letter of support to the Senate committee, citing peer-reviewed papers she had authored. She also shared a pilot study led by a New York HMO that showed a significant difference between a group that received ear acupuncture five times a week during inpatient rehab and a non-acupuncture group. The acupuncture group recorded higher satisfaction and completed their training sooner, which saved $2,000 per participant.

Libby's Letter

56.2KB ∙ PDF file

Download

Download

I also reached out to an acupuncturist with a Master’s in Social Work, Dr. David Eisen, the Executive Director of the Quest Center for Integrative Health in Portland, Oregon1. Because of David’s work, the State of Oregon has covered acupuncture for the treatment of substance misuse treatment for over 30 years2. I believe the only reason he was willing to talk to me is because I introduced myself via email as Laura Cooley’s buddy in New Hampshire.

Before David ended up in Oregon, he established clinics in the Boston area offering acupuncture and other services for people living with HIV/AIDS or seeking treatment for substance misuse. MAS Executive Director and 5NP co-trainer Andy Wegman interned at some of these clinics when he was in acupuncture school. Many of my New England community acupuncture colleagues in POCA did the same. (In contrast, I attended acupuncture school in North Carolina, where opportunities to integrate acupuncture into public health work did not exist.)

From their website:

“Quest Center is committed to providing the best integrated behavioral and physical health services. More than 85% of our clients are low-income and/or medically uninsured or under-insured. The Oregon Health Plan, as well as other commercial insurance plans, are welcomed at Quest Center.”

David Eisen was very direct. He doubted SB 123 would pass. His recommendation was to ask lawmakers to sponsor a different bill requiring NH’s State Medicaid to run a pilot project3 to prove efficacy and cost savings. I thanked him for his time and advice. I also asked if he would be willing to write a letter for the Senate committee; I never saw the letter, but I trust he sent it.

But back to our Senate hearing. The sponsor of SB 123, Republican Senator Victoria Sullivan from Manchester, introduced the bill. She explained to her fellow senators that she runs a sober living facility and a temp agency that employs many people in recovery. She saw how many people on medication-assisted treatment struggle to stay awake during the day, but have a hard time sleeping at night because they’ve consumed coffee and energy drinks all day to stay awake, perpetuating a vicious cycle.

She also mentioned that someone she knows through her church has received significant benefit from getting regular ear acupuncture at Hope for NH Recovery. That is how she found out about it in the first place. This underscores the point that community acupuncturists have been making for decades: when more people get acupuncture, then more people will get acupuncture—which includes policymakers. Senator Sullivan admitted that she is actually terrified of needles, but she wants other people to have access to ear acupuncture because she has seen what it can do for those she knows personally.

I testified and shared all of the research that was available to me at the time4, focusing mostly on the NY HMO pilot. I also discussed the origin story of ear acupuncture at Lincoln Hospital in the Bronx—an outpatient program that ran for 40 years, offering harm reduction, stabilization, and recovery support on a walk-in basis.

A lawyer from New Hampshire’s Department of Health and Human Services (DHHS), Rob Berry, overestimated the costs of ear acupuncture. He used figures for full-body acupuncture and estimated each treatment would be billable at $90. I explained that ear acupuncture is entirely different, noting that Andy Wegman once contracted with the Farnum Center and was paid $15 per treatment. All the Senators nodded in support—it was almost like they were in a trance.

5NP trainer and Master Licensed Drug Counselor Jeff Davis spoke about his first experience with ear acupuncture while serving as the clinical director of a treatment program in Baton Rouge, Louisiana. The medical doctor overseeing the program offered ear acupuncture every morning and would return later in the day to offer a second treatment to anyone who needed it. It was a highly successful program with a waitlist at a time when other programs were struggling to fill spots.

Brekke Best, an ADS and nurse, gave powerful testimony about how weekly ear acupuncture helped her during early recovery after graduating from a treatment program, keeping her from relapsing. I had treated Brekke at the time when I ran a weekly clinic at Hope for NH Recovery every Tuesday morning. I had no idea until the hearing that she made a point to walk across town just for ear acupuncture; I’d simply assumed she was already there for meetings.

The Senators were sitting on the edge of their seats, jaws dropping, through all of this.

ADS Trina Serrecchia explained how ear acupuncture affects the Vagus nerve, creating a downregulation of the central nervous system. She then admitted she was a “closet smoker” and that ear acupuncture had helped her cut back.

Donlon Wade, a licensed drug counselor in the Upper Valley, shared that ear acupuncture and ear seeds have been beneficial for the teens and adults he works with—particularly in helping kids in his community stop vaping.

Last but not least, Daryl Lennon spoke. He read a letter of support from his wife, Michelle Lennon, the founder of Archways—a recovery program serving areas between Concord and the White Mountains. Reading testimony can often lose the attention of lawmakers, but Daryl pulled them back in by sharing his personal experience as someone who struggles with substance misuse resulting from chronic pain. Daryl isn’t a polished public speaker; he spoke earnestly and from the heart, which made his testimony so powerful. I remember the last thing he said very clearly: “This doesn’t take the pain away. But it gives me peace.”

No one attended the hearing to testify against the bill. I was left with the impression that the NH Acupuncture and Asian Medicine Association (NHAAMA) wasn’t taking a position. I found out much later that they had actually submitted a letter in opposition to SB123. The former Vice President of NHAAMA insisted the bill did not include licensed acupuncturists.

As I said, I am not a billing expert. However, nothing in SP123 specified who would be billing for the services; it merely required the State Medicaid program to reimburse for ear acupuncture. I assume that means anyone licensed or certified to practice 5NP in New Hampshire would qualify, which would have encouraged programs to bill Medicaid for services provided by either an ADS or a Licensed Acupuncturist.

NHAAMA was paying for a lobbyist at the time. The lobbyist did not testify, and while I can’t say for certain he wasn’t there, it’s possible he was in the back of the room and left before I noticed. It’s unfortunate that NHAAMA paid a lobbyist to oppose a bill that could have benefited acupuncturists. I believe that money would have been better spent on a consultant to explain how Medicaid works, allowing them to make an informed decision based on the best interests of the profession.

I wasn’t a member of NHAAMA at the time; I was simply doing what I thought would help the more people gain access to acupuncture. I don’t know if a Medicaid bill will come up again, and I do not plan on making requests myself. I believe that if programs feel that billing for ear acupuncture would serve their mission, the request should come from them, and they should take the time to testify at the hearings. I have explained to NHAAMA members more than once that nothing in the bill excluded them, and I believe their leadership is reasonable. My hope is that if this issue arises again, they might consider attending the hearing to have their concerns about inclusion addressed directly.

Keep poking ears, keep changing lives.

2

For decades, only licensed acupuncturists in Oregon could legally practice 5NP. Oregon now certifies 5NP practitioners because of the work of acupuncture students and staff from The Oregon College of Community Acupuncture, founded by The People’s Organization of Community Acupuncture (POCA).

Acupuncture Can Change the World

On Recognizing the Right Thing

Last week’s paywalled post was about making leadership decisions in relationship to big, ambitious projects with uncertain outcomes. I wrote…

Read more

3 months ago · 7 likes · 2 comments · Lisa Rohleder

3

If you are a program director who wants to do a pilot study on ear acupuncture to determine efficacy and cost effectiveness, I recommend duplicating this one:

Cost Effectiveness Of Nada (4)

2.11MB ∙ PDF file

Download

Download

4

Thanks to Tad Montgomery for organizing 5NP research into a single document.

Osf Grant Application Acup

248KB ∙ PDF file

Download

Download

First, I am excited (and humbled) that The Ear to the Granite Substack has reached over 100 subscribers in just two and a half short months. Thank you so much for joining. I still have a lot to cover, including last year’s attempt to get Medicaid coverage for ear acupuncture for substance misuse treatment in New Hampshire. I ran out of time this week to delve into that topic, and I want to do it justice. Instead, this week I am going to share some of the media coverage of 5NP ear acupuncture that I’ve seen in the last few weeks.

First Responders in West Virginia

A POCA-trained 5NP practitioner in Bluefield, West Virginia, was awarded a grant to provide ear acupuncture to first responders at Bluefield City Hall. The police chief said that 5NP was one of the most relaxing things he has ever done and he hopes he didn't snore too loudly!

You can watch the Local WVVA news story here:

West VA news story

A Recovery Center in Vermont

The Vermont News and Citizen covered a story about regular 5NP clinics offered at the North Central Vermont Recovery Center in Morrisville. I love many things about this story. Treatments are offered at this center by licensed acupuncturist Jaimie Long; one of the people she treats is peer counselor John Sherwood. Sherwood was introduced to ear acupuncture at a program in Boston 10 years ago and says it’s the only thing he has used consistently in his recovery for the last six years. He is now trained in 5NP himself and offers a weekly drop-in clinic at another Morrisville center that works to prevent domestic violence.

Tracy Brannstrom, the journalist who wrote the article, was NADA-trained by Laura Cooley in 2019. Tracy has joined us at many community events to share her 5NP skills.

Anxiety and Disaster Trauma in the Philippines

I come across many articles about 5NP ear acupuncture practice in the Philippines. There is a dedicated group of trainers affiliated with the National Acupuncture Detoxification Association (NADA) there. In this article, a Manila-based AcuDetox Specialist, Patricia Paredes, focused on the anxiety-relieving aspects of ear acupuncture and how it supports communities who have experienced a traumatic event.

“This kind of detox is really offered not only for addiction but also sometimes in grief-stricken areas or areas where there was calamity,” she said, recalling how NADA volunteers provided sessions in communities affected by disasters such as Typhoon Yolanda.

The Reality of the Need

Only one of these stories about 5NP is focused strictly on substance misuse; the others speak more broadly about ear acupuncture and mental health.

In 2017, while pushing for New Hampshire’s ADS law, I encountered opposition from the acupuncturists who served on the acupuncture licensing board and the acupuncturist trade association1. First, they were against the bill entirely. Then, they argued for amendments to restrict the practice of ear acupuncture solely to the treatment of addiction. They even tried to limit the practice of 5NP by AcuDetox Specialists to substance misuse treatment programs only. Unfortunately, these New Hampshire acupuncturists could not seem to understand the broader need for recovery support.

Instead of seeing practitioners of ear acupuncture as allies who promote the medicine, many acupuncturists fear they will lose work opportunities that never would have existed, or lose patients they probably would never meet.

I mentioned in my very first post that the acupuncture profession is facing an existential threat. The US Department of Education does not currently look favorably on degree programs that require high amounts of student loan borrowing with a low return on investment. Acupuncture and Naturopathic degree programs are at the top of that list. As a result, the remaining acupuncture schools in the US may face closures if they can’t figure out how to bring down the cost of education.

The benefit of having many 5NP practitioners is that acupuncture becomes accessible to more communities, even if it is just one specific aspect of the practice. The irony is that as more people are introduced to acupuncture and become curious about how else it can help them, they may have a hard time finding a licensed acupuncturist who has the room in their schedule to see them.

I treat a patient regularly who suffers from crippling anxiety. Sometimes he calls out sick from work because of it; instead, he comes to the community acupuncture clinic where I work to take a break from his anxiety. I want everyone who feels that level of anxiety to have a place to go for support, whether it’s ear acupuncture provided by an ADS or a licensed acupuncturist. There will never be enough acupuncturists to support everyone who feels paralyzing anxiety. Communities need 5NP practitioners.

NADA Conference In a few weeks, the National Acupuncture Detoxification Association is hosting a conference in Detroit. The focus is on trauma recovery and community healing. Several online news organizations posted NADA’s press release. Before I became a 5NP trainer with POCA, I took the NADA training with Laura Cooley. POCA and NADA are separate but like-minded organizations with similar goals. Both are needed equally. So, if you have any reason to be in Detroit in June, the NADA conference is happening!

Keep poking ears, keep changing lives.

Thanks to the efforts of AcuDetox Specialist Cara LaPlante, an application has been submitted to present on ear acupuncture at the annual NH Behavioral Health Summit in early December.

Please light some candles and keep your fingers crossed for us.

The New Hampshire Behavioral Health Summit is the exclusive statewide event in NH for behavioral healthcare providers and organizations, including mental health and substance use disorders.

In 2019, Laura Cooley, Jeff Davis, and I presented at the Summit. Thanks to ADS Jason Snook for sharing space at the Aware Recovery1 table, we were able to turn the lobby of Manchester’s Downtown Hotel into one large ear acupuncture clinic.

I still have photo evidence:

There was a lot of interest in our presentation. It went well despite a technical snafu that was entirely my fault: I neglected to request a sound system for the screening of Laura’s video, Unimagined Bridges. Laura turned the volume up as high as it would go on her laptop while the video was projected onto a big screen. To their credit, the attendees remained pin-drop quiet. A few attendees even told Laura it was the only presentation of the entire conference they didn’t walk out of.

It felt like ear acupuncture was finally poised to take off in New Hampshire.

Then, a few months later, the pandemic hit. Laura faced a number of hurdles2 and quit training in 2021.

Trainings resumed in September 2024, this time in partnership between Manchester Acupuncture Studio and Hope for New Hampshire Recovery.

Each year since 2019, I’ve received the emails reminding me to apply for the Behavioral Health Summit. It’s not because I didn’t want to, it just wasn’t the right time. To be honest, I didn’t even notice the emails this year. It was Cara who reached out and nudged me. Last Thursday, we sat down over Zoom and completed the application. We proposed a panel on ear acupuncture.

This time, I learned my lesson: we requested two long conference tables, 8–10 chairs, a minimum of two microphones, and—most importantly—a full sound system.

We submitted sources of research on ear acupuncture, including a summary report from the Bureau of Justice Assistance and a pilot study on ear acupuncture run by a New York HMO. That study showed that participants completed treatment sooner and reported higher overall satisfaction than the non-acupuncture group, resulting in a savings of over $2,000 per person. The third resource is SAMSHA’s recognition of ear acupuncture in TIP #45

Bja Summary Of Research Findings 2011

175KB ∙ PDF file

Download

Download

Cost Effectiveness Of Nada (3)

2.11MB ∙ PDF file

Download

Download

I don’t know yet if our application will be accepted. But if it is, there are so many incredible people practicing ear acupuncture in New Hampshire ready to fill an 8-10 person panel and share their stories.

Whenever I meet with groups of ADSes during the supervision meetings required twice a year by New Hampshire law—I hear remarkable things. I hear from Adam Kellett and Brekke Best, who brought ear acupuncture to the detox units at Process Recovery and Live Free Recovery. Adam reports that clients in detox often go right to sleep after treatment. Brekke says the protocol calms people down instantly when medication isn’t reaching them.

I hear from Kathy Knight, a retired nurse who applied ear seeds to all of her grandchildren during a family camping trip. She reported how quickly the kids settled down; when it was time to get in the car to go swimming, everyone followed directions without the usual drama or infighting.

Cara LaPlante works at Archways in Plymouth, bringing ear acupuncture to recovery groups for college students at Plymouth State University and NHTI. Sharna Steinhart offers regular ear acupuncture through Hope for NH Recovery’s Wellness clinic. She shared that she gave an ear acupuncture treatment to someone in a desperate state of withdrawal before he headed to Manchester’s Doorway program. He returned over a month later to hug her and thank her for making the transition into treatment so much easier.

Most profoundly, Tia Elie treated a distraught friend who later shared that she had originally “come to say goodbye,” but the treatment settled her mind enough to realize that taking her own life would be a huge mistake.

I want everyone who could be offering ear acupuncture in their professional capacity to hear these stories. I want the decision-makers to support this work—or, at the very least, to stop getting in the way.

A few of Laura’s first trainees never made it to certification because their organizations refused to let them practice. But the tide is turning. I know two ADSes who quit their jobs because their agencies blocked them from offering ear acupuncture. One of them, Valerie Piper, now commutes over an hour each way to central Vermont because a treatment program specifically hired her for her ear acupuncture training. She now provides 80 treatments per week. Her program director joined her at our January supervision meeting at Hope. He was already looking for ways to expand the program, asking if they were offering enough treatments and how to get more staff trained.

Last but not least, I took this fun video of Jason Snook at the end of the 2019 NH Behavioral Health Conference.

Keep poking ears, keep changing lives.

This past weekend, Manchester Acupuncture Studio and Hope for NH Recovery teamed up again for another Ear Acupuncture Detoxification Specialist (ADS) training. It is our sixth training since we partnered in September 2024.

Twenty-two people joined us from New Hampshire, Vermont, and Maine, representing organizations such as Revive Recovery in Nashua, Community Improvement Associates in Keene, the University of Southern Maine in Portland, the City of Manchester, and, of course, Hope for NH Recovery.

We had a small contingent from Vermont in attendance who are in the process of applying for opioid abatement funds to provide ear acupuncture in White River Junction and the surrounding areas. We were told that there is no acupuncture offered in White River Junction. Not to mention, services for substance misuse and behavioral health are critically needed in that area.

If you would like to support their efforts, please email a statement of support for funding these ear acupuncture to Tad Montgomery at eco@tadmontgomery.com.

Your statements can be addressed to:

Evaluation Committee and Select Board Opioid Settlement Fund Town of Hartford, VT 171 Bridge St. White River Junction, VT 05001

ADS graduates from previous trainings stopped by to share their experiences with the newest group. A huge shout-out to Robin Dunn and Acts of Kindness founder, Tia Elie. Acts of Kindness (AoK) is a Manchester-based non-profit organization that offers support to Manchester’s unhoused population. Tia is a hairdresser and the entrepreneur behind Salon U on Pearl Street. Every Thursday, she turns her hair salon into a food pantry. During the winter, she and her team are out on the street providing hand warmers and hot chocolate. During the warmer months, Tia offers pop-up acupuncture clinics in Manchester’s parks.

Tia shared stories about how ear acupuncture supports her family, her hair clients, and the people she works with through AoK. With ear acupuncture, she was able to provide soothing care to a grieving family after a funeral. She also provides regular treatments to her friend’s teenage daughter, who once struggled with anxiety so intense that she refused to go to school. Since Tia started providing treatments, the young girl feels better and has stopped skipping school.

This is not the first time I have heard this story. Tia’s partner, Fadz, shared this with me earlier in the year, and I still get teary when I think about it. I was once an anxious teenager and I skipped school because of my anxiety.

Tia’s work supporting youth mental health with ear acupuncture does not stop there. She has offered group treatments for some of Manchester’s unhoused young adults through an organization called WayPoint. When Tia had to miss a few weeks to attend to her hair clients (Tia is in high demand), the residents were anxious waiting for her return—that is how much the treatments helped them.

This is not the first time that an organization serving homeless youth has offered ear acupuncture in their shelters. The Reciprocity Organization in New York City serves homeless youth and has staff members trained to provide ear acupuncture when residents need it. You can read more about their work in this 2015 article from NADA’s Guidepoints newsletter*1.

NADA’s Guidepoints

On the second day of training, the trainees provided 67 treatments to those who showed up for our free clinic. Manchester Alderman Jason Bonilla, who represents Ward 5 joined us to try an ear acupuncture treatment. Other guests brought their adorable animal companions.

The busy clinic would not be possible if it weren’t for Hope for NH Recovery staff and volunteers who have great systems in place. They set up extra folding chairs and tables to accommodate a crowd of people. ADS (and Manchester Police Officer) Shannon Stevens had clip boards ready for everyone to sign in and give written consent to receive a treatment.

Four of the trainees completed the requirement of needling 40 ears under trainer supervision. We look forward to seeing the rest of the trainees over the next few weeks at our upcoming free clinics, held over the next two Tuesday evenings at the Manchester Acupuncture Studio and the next two Saturday afternoons at Hope for NH Recovery.

Keep poking ears, keep changing lives.

I have been meaning to write about how close we came to bringing auriculotherapy with ear seeds to the Valley Street Jail since I started this Substack. We had no idea how close we were to success before it fell apart. In this post, I’ll share that story and then highlight examples of other jails and prisons that have successfully integrated ear acupuncture into their facilities to reduce recidivism.

Ear acupuncture is offered in jails and prisons for two reasons:

• It helps to break the cycle of addiction before an inmate returns to society.

• It reduces violent outbreaks between inmates.

The Campaign and the Connection

Back in 2018, I ran for Register of Probate for Hillsborough County. I actually won. The funny thing about Registers of Probate in New Hampshire is that they don’t actually do anything; it’s a position in title only. However, it was worth the time and effort because I used it as a platform to talk about ear acupuncture for mental health and substance misuse.

During the campaign, I met Ward 10 Alderman Bill Barry. He joined me and Manchester-based MLDAC, Jeff Davis, at Hope for NH Recovery on a Tuesday morning and tried an ear acupuncture treatment for the first time. He then invited me and NADA trainer Laura Cooley to present to a special subcommittee of the Manchester Board of Aldermen, which resulted in Laura receiving an $8,000 grant to train more Acupuncture Detoxification Specialists (ADS) in Manchester. Hope’s Executive Director, Randy Stevens, was trained under that grant, as were CRSW Jessica Wheeler and Guardian Ad Litem Angela Delyani.

Meeting with Jail Leadership

When I was sworn into office with the other county officials in early 2019, I met then-Superintendent David Dionne from the Valley Street Jail. He gave me his card and offered a tour. I promptly followed up, and Laura Cooley and I met with him a week later.

After the tour, we had a sit-down with Superintendent Dionne and his second-in-command, Willy Scurry. We discussed ear acupuncture and gave them both treatments. Superintendent Dionne was willing to try ear acupuncture, while Willy Scurry opted for ear seeds. They liked the idea of ear seeds for the inmates and were willing to support finding the funds to pay a trained ADS to provide the service.

This is where I passed the torch to Laura Cooley and one of her ADS trainees, Leah Landry. Leah had previous experience working in correctional facilities. They presented at the next Hillsborough County Commissioners meeting. Laura told me that it looked favorable. The commissioners deferred to Superintendent Dionne, who supported the proposal; however, they told Laura they would formally vote on it at the following meeting.

Then, nothing happened.

The Aftermath

A year later, COVID-19 hit, which derailed Laura’s AcuDetox training programs. Many of the people she trained with the funds from the City of Manchester moved or retired. It felt like all of our work was being undone. I forgot about the Valley Street Jail, and Laura did too.

When the world opened up again, Jeff Davis ran into Willy Scurry, who was working a second job as a security guard at Catholic Medical Center. Jeff asked what happened with Valley Street and the ear seeds in 2019, especially since he and Superintendent Dionne were so supportive. Willy Scurry told Jeff that the funds were actually approved.

However, Laura was never contacted.1

What went wrong? I wish I could answer that. I think Laura assumed someone would notify her, but no one did. Hillsborough County administrators had her contact information; anyone who speaks at a public meeting must sign in and provide their details for the public record. We also signed in during our tour of the jail. Regardless, we could have contacted Superintendent Dionne after the meeting or reviewed the minutes to see the results of the vote. I regret that we did neither. If anything can be learned from this experience, it is the vital importance of following up. By the time we learned the funds had been approved, it was two years and a global pandemic later.

Dionne and Scurry are now both retired. I heard that Dionne moved to Arizona.

Ear Acupuncture in Corrections Globally

Now that I’ve got that off my chest, let’s talk about where ear acupuncture is successfully offered in jails and prisons.

In the UK, the practice of ear acupuncture in corrections facilities is more widespread than the US. Harvard Scholar Eana Meng interviewed Sue Cox, the director of SMART UK (Substance Misuse Acupuncture Register and Training), who shared the following points:

• Massive Adoption: SMART UK has brought ear acupuncture and acupressure into 128 of the 150 prisons in the United Kingdom.

• “Psychological First Aid”: Sue Cox teaches prison officers and staff that the treatment isn’t a “magic bullet” but a form of first aid that stimulates the vagus nerve and balances brain chemistry.

• Educating Inmates: A core part of the program involves teaching inmates the neurobiology of addiction. By understanding how the treatment helps “reset” the brain, inmates feel empowered to take control of their own recovery.

You can see the interview with Sue Cox in Eana Meng’s Video Series2 at the 17:22 mark:

Laura Cooley compiled data from various ear acupuncture-based programs and pilots, including those in jails and prisons. In her document, Beyond Detox, she shows that inmates at the Santa Clara Department of Corrections in Milpitas, California, who received AcuDetox reported less fear, paranoia, anger, resentment, depression, and anxiety. Additionally, inmates in the Denver County Jail in Colorado reported better overall health and attitude; notably, no Class I or Class II offenses (fighting and assault) were filed against those who received five or more AcuDetox treatments.

Beyond Detox Full Version

200KB ∙ PDF file

Download

Download

Other successful programs include:

• California: The Discovery Channel covered a story about ear acupuncture at the Biscailuz Recovery Program, at a minimum-security prison run by the Los Angeles Sheriff’s Department. According to the video, ninety percent of inmates participate in the acupuncture program, and the jail’s administrator even joins them for stress-reduction treatments.

• New Mexico: Ryan Bemis wrote in Mad in America (2024) about training corrections officers at the Carrizozo jail through the RISE program (Reach Intervention Support and Engage).

• Colorado: In 2023, the Summit County Sheriff brought 5NP (AcuDetox) and EMDR into their mental health program through the STARR program (Strategies to Avoid Relapse and Recidivism).

• Northern Ireland: 5NP/NADA trainer Trish Cathcart appears in a video produced by The John Marshall Law School Restorative Justice Project through the University of Illinois Chicago Law School. At the 9:17 mark, she discusses bringing ear acupuncture into the prison system. Cathcart explains that group ear acupuncture is the only time violent and non-violent offenders sit together.

Keep poking ears, keep changing lives.

During our 5NP (5-Point Protocol) trainings, we rarely have enough time to dive deep into ear acupressure with ear seeds and beads. The focus of the course is necessarily technical: ensuring everyone is needling safely and following New Hampshire law.

But I want to bring the conversation back to ear seeds today, especially following our recent training at Live Free Recovery. The staff and got trained to practice ear acupuncture, and it was a great success. However, until our 5NP trainees receive their official certification from the New Hampshire Office of Licensing and Certification (OPLC), they cannot legally practice with needles. In the meantime, our trainees can continue providing vital care using ear seeds and beads.

Beyond the Trend

Ear seeds are currently having a “moment.” If you had told me nine years ago that Vogue and Cosmopolitan would be publishing stories on the benefits of ear seeds, I wouldn’t have believed it. To be honest, I’m skeptical of the claims many fashion magazines make about “face sculpting” or “relieving cortisol face”—I’m not even sure what those terms are supposed to mean.

But I love that the word is spreading, primarily because you don’t need a license or certification to learn how to use ear seeds. Nine years ago, I had the opportunity to discover just how effective they actually are.

We sell ear seeds kits at the Manchester Acupuncture Studio and we include videos and research in a self-care section on our clinic’s website.

The Shelter on Lake Avenue

In 2017, my friend Ryan worked at a shelter on Lake Avenue, behind Kalivas Park in Manchester. The shelter provided a place for people to stay while they waited for open beds in treatment programs. Ryan actually testified in support of New Hampshire’s 5NP law, explaining to lawmakers that the shelter had nothing to offer residents for withdrawal except ibuprofen. Many people would leave and relapse before their recovery could even begin.

Ryan asked if I could come to the shelter and offer treatments. To be clear, Ryan was a peer counselor working overnight shifts, not a director. He was essentially sneaking me into the shelter after hours. I offered treatments with ear seeds and proposed teaching him and his fellow counselors how to use them.

I’ll admit: I wasn’t entirely confident the seeds would work. I only knew they wouldn’t cause harm. Anyone can learn to apply them in minutes.

“It’s Much Quieter at Night”

The residents were willing to give it a try. We lined up chairs next to the ping-pong table and I set out ear charts showing the 5NP points: Shen Men, Sympathetic, Kidney, Liver, and Lower Lung. I remember a young woman sitting down and pulling her long, blonde hair into a ponytail. I applied seeds to all five points on both ears. As I moved to the next person, the room began to transform. Some of the women gathered around the charts, reaching into their makeup bags for their own tweezers to help apply seeds to each other. Within half an hour, over twenty people had seeds on their ears, sitting together and gently pressing them.

I returned every Thursday for several months. Eventually, Ryan told me: “We can always tell when you’ve been here because it’s much quieter at night. Everyone is calmer, and they sleep better.”

A Tool for Every Toolkit

That experience sparked a chain reaction. I taught other friends who worked in recovery how to use beads and seeds. My friend Nikki took what she learned that night back to her job at Aware Recovery; a week later, she reported rave reviews from a coworker she had treated. My friend Tim still uses ear seeds to this day—he even treats his coworkers in the breakroom at the Concord Food Co-op.

The clinical results were often staggering. One evening at Serenity Place, I treated a woman in acute withdrawal who was moaning from stomach pain. A few minutes after I placed the seeds, she looked at me and asked, “My headache is gone. My body aches are gone. I’m not nauseous anymore. What did you just do?”

During COVID-19, ear seeds became an essential tool for me at the Manchester Acupuncture Studio. To help patients manage heightened anxiety, I modified treatments by placing seeds or metal beads on Ear Shen Men and Reverse Shen Men (on the back of the ear) before needling ear and body points.

Today, we offer our 5NP trainees with the same ear seed kits we make available for our patients at MAS. I introduced these kits to an integrative physician at Dartmouth-Hitchcock. He has since been advocating for the integration of beads and seeds within the Dartmouth-Hitchcock system, particularly for children experiencing stress and anxiety. As of last week, he is even building a registry of providers within their network who offer these treatments.

There are a number of online ear seed trainings available to those who want to go further into the practice. I highly recommend the AcuTherapy Course from Public Health Acupuncture New Mexico. The training is affordable, and their manual includes fascinating details about how they integrated ear seeds into public health programs within several of the Pueblos in New Mexico.

Keep poking (and seeding) ears, keep changing lives.