On the point of a breakthrough? : HEALTH

Mary Anne Fitzgerald discovers that acupuncture could make it easier fo r crack addicts to cope with the effects of withdrawal

"It's the sort of craving that can never be satisfied. You're always chasing that first buzz. Smoking crack, there's no tomorrow.''

Wayne, 29, spent three years free-basing crack cocaine. All the money from his £180-a-week job at a dry-cleaner's, plus much more, went into supporting his habit. Sometimes he would spend as much as £400 a day. He sold his car, jewellery and television just to get the next hit. When he had nothing left to sell, he turned to theft.

Wayne was a typical crack addict. The mother of one of his two sons refused to have anything more to do with him. When he told his new wife that he was heavily addicted, she agreed to help him to kick the habit. But she left him when it became obvious hewas unable to stop.

"There was no love for anyone, not even myself. The only love you have is for the drug,'' he recalls. "I tried to kick it but there's no way you can do it on your own. I was desperate."

That was when Wayne walked into Phoenix House, an independently funded drug rehabilitation centre in south London. Two months later he is still "clean". He has put on weight, regained his sex drive and is more positive about life.

Wayne believes the key to his recovery is acupuncture - when he was coming off crack it was used to help him to cope with the withdrawal symptoms. Now, like other Phoenix House residents, he has a one-hour acupuncture session each morning.

Acupuncture was first used to treat crack addicts about three years ago; until then, drug agencies had been stymied by the drug. Methadone, a drug substitute, can be prescribed legally to alleviate withdrawal from heroin, but doctors know of no similar substance to ease the pain of withdrawal from crack.

Crack is sold as small white or yellow rocks of cocaine powder that has been dissolved in water and heated to free the cocaine from the salt. It is smoked in a pipe or as a spliff (rolled in cigarette papers) or free-based: heated on tin foil and inhaled.

The euphoria it produces for a relatively low price - about £25 a rock - makes crack a favourite among drug users. The depression, anxiety, muscle fatigue and headaches of the "come-down" that users experience make it addictive.

"There's an aura of violence around crack," says Margaret Pennington, a psychotherapist at Phoenix House. "Heroin users can go on for 12 years without losing their mental stability, but crack provokes a crisis within two to three years because of the powerful effects of the drug.''

Crack is making a greater impact on society than other drugs do, she says, because of the arms-bearing crime and gang warfare that accompany it. Crack also destroys the personality, obliterating family love and social conscience.

The first NHS drug programme to use acupuncture to alleviate withdrawal symptoms was the Gateway Clinic in Brixton, south London. John Tindall, who runs the clinic, says: "If you can deal with the first 48 hours of intense physical and mental craving, then you're in a good position to change. Acupuncture reduces withdrawal symptoms by 60 per cent. Before, 90 per cent of clients would leave because of withdrawal symptoms. Now none leave because acupuncture helps them to deal with that.''

In the mid-Eighties, Mr Tindall was working as a physiotherapist at Tooting Bec Hospital. Some of his patients were in the hospital's drug dependency programme. He used shiatsu (Japanese massage), meditation and qi gong (Chinese self-healing exercises) to help calm them. He also became interested in auricular acupuncture.

According to Chinese medicine, there are five points in the ears that correspond to the nervous system, kidneys, lungs, liver and shen men, which calms the spirit. Hepatitis B and C, which damage the liver, are common side-effects among drug users. The lungs are in need of detoxification, while the kidney is considered to be the seat of energy. Acupuncture on the other two points helps to relax and heal body and mind.

According to Mike Smith, the clinic's director, there is a 60 per cent success rate after three months at the clinic, which increases to 90 per cent after a six- month period.

Unlike Britain, where doctors have been slow to recognise its benefits, auricular acupuncture has been incorporated into state-run programmes all over the United States. The Lincoln Clinic has trained 2,000 drug counsellors in its methods. In New York state alone, 75 drug programmes use the Lincoln Clinic technique.

While acupuncture undoubtedly assists drug users on the road to recovery, some experts in drug dependency remain sceptical: they point out that all the patients who attend rehabilitation programmes do so voluntarily and that techniques such as acupuncture fall far short of tackling the immense population of hardcore users.

"Only a tiny fraction of crack users want to detoxify. For those who do, any of the interventions are relevant,'' says Dr John Marks, a consultant psychiatrist for the Widnes drug dependency unit in Cheshire.

Mr Tindall acknowledges that acupuncture is not a cure-all and that crack users must have the willpower to stop.

Wayne recalls that he began to feel the benefits of acupuncture during the second week of withdrawal. "When I stopped for a while, the craving came back worse than ever,'' he says. "There are a lot of people caught up with crack who are desperate to comeoff. In here, you are given the tools which enable you to resist crack when you go back outside. Otherwise, you'd see the dealer you used to buy from and that would be it.''