By Dr Ananya Mandal, MD
The World Health Organization has in its list enumerated around forty different conditions where acupuncture may be effective. These include:
acute and chronic pain
rheumatoid and osteoarthritis
headaches like migraine
irritable bowel disorders
drug dependence etc.
The legal status of acupuncture depends on these claims that have been proven scientifically when administered by trained acupuncture specialists.
All states in the United States of America permit acupuncture to be performed by trained physicians only. Some permit them to be performed by lay acupuncturists under medical supervision.
In 1990 the National Accreditation Commission for Schools and Colleges of Acupuncture and Oriental Medicine was recognized by the U.S. Secretary of Education as an accrediting agency.
In addition some insurance companies also cover acupuncture treatment if performed by a licensed physician. Medicare and Medicaid generally do not cover acupuncture. Acupuncture needles are considered investigational devices by the U.S. Food and Drug Administration and are thus unapproved.
Under the Californian laws acupuncture may be advertised for hypertension, obesity, heart failure, arthritis, and smoking and drug withdrawal but cannot be promoted in cancer. Cancer treatment with acupuncture is prohibited by the California Cancer Law.
The National Council Against Health Fraud recommendations
The NCAHF believes that after more than twenty years of safety and efficacy trials acupuncture has not been demonstrated effective for any condition. NCAHF thus recommends to the physicians that scientific literature provides no evidence that acupuncture can perform consistently better than a placebo in relieving pain or other symptoms.
They advise that acupuncture should not be offered without full informed consent that the treatment is experimental, may cause complications and has not been proven more effective than a placebo.
The organization advises legislators that acupuncture licensing should be abolished. In addition, public display of unaccredited degrees by individuals should be banned. Insurance companies, HMOs and government insurance programs should not be compelled to cover acupuncture.
Section 355 of the Federal Food, Drug, and Cosmetic Act covers labelling of medicines and devices, including acupuncture needles and equipment.
The FDA in 1973, declared acupuncture to be a method of treatment for investigational use by licensed practitioners only until “substantial scientific evidence is obtained by valid research studies supporting the safety and therapeutic usefulness of acupuncture devices”. They called for a label on such devices, “Caution: experimental device limited to investigational use by or under the direct supervision of a medical or dental practitioner”.
Licence to practice acupuncture
In New York, legislation was passed in 1974 on the recommendation of the State Commission on Acupuncture. In 1981, non-allopathic physicians were permitted to practise acupuncture under various conditions in at least 15 states.
The regulations stated certain rules need to be followed by all state boards responsible for medicine and dentistry practices to establish licensing procedures in New York.
The main prerequisites for a licence include that the applicant had practised acupuncture for at least 10 years and had a valid license as “a doctor of acupuncture, herb physician, or doctor of traditional Chinese medicine duly issued by the licensing board of any foreign country”.
This was modified in a 1991 statute by substituting licensing rules. A board was created consisting of acupuncturists, licensed allopathic physicians, and members of the public to decide on licensing.
To qualify for a licence to practice acupuncture, the applicants had to:-
Complete a pre-professional education requirement of at least 60 hours in an approved university or college - this would include a minimum of nine hours in the biosciences.
Complete a professional programme, lasting a minimum of 450 hours, which involves classroom instruction in the biosciences and acupuncture and supervised clinical acupuncture experience.
Pass a licensing exam set by the National Commission for the Certification of Acupuncturists or other approved body.
Be of at least 21 years of age - in California the applicants must be at least 18 years of age.
Under the Californian law the length of the internship depends on the applicant's examination results and prior clinical training. For candidates who have previously completed 800 hours of clinical training, internship is waived.
30 hours of continuing education every two years is required for renewal of the annual practising licence under the Californian law.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)
Last Updated: Feb 13, 2013