by Cris Monteiro

This article comes from Guidepoints News from NADA Summer 2021 Issue. Sign-up to receive Guidepoints in your inbox quartlery. The Guidepoints newsletter is the only publication devoted to the sharing and dissemination of our NADA work on an international scale. Become a member to opt-in for a print copy. Check-out past issues.

A black background with a white line on itIn late June, Rhode Island signed H5154/S0047 into law which now makes it possible not just for chemical dependency professionals to use the NADA protocol, but also social workers, peer recovery counselors, mental health counselors and nurses.

Cris Monteiro tells about the journey to get here which started back in 2014.

In this tiniest of the New England states, Providence, the capital, is no more than an hour from anywhere in the state. I think this makes it easier to “do legislation†– which is helpful because doing legislation is hard. In Rhode Island, everyone knows someone who can usually help or at least point you in the right direction. The process has been empowering, confusing, seemingly arbitrary and even punitive at times. There were moments that really challenged common sense – and moments of grace. It’s taken a long time to get to the point where we’re finally celebrating.

Over the past seven years, I have been part of a small group working on the passage of ear acupuncture legislation here. Our local, grassroots legislative coalition is made up of people in healthcare, harm reduction and long-term recovery. It also includes community acu-punks, such as myself, who “use what we’ve got and … do what it takes†(from Lisa Rohleder’s Punking book). Some of our group are in recovery, but all of us have experienced the benefits of the 5 Needle Protocol (5NP) personally.

Our work on the first law really began in 2014 when a 2-year pilot project offering free ear acupuncture was coordinated with one of CODAC Behavioral Healthcare’s medication-assisted treatment programs (see Fall 2016 issue of Guidepoints.) In 2016, we got a bill introduced that would let licensed chemical dependency professionals use 5NP, and the bill passed on the first try. The law, passed this June 2021, makes an exemption in the acupuncture statute and allows social workers, mental health counselors, drug and alcohol counselors, peer recovery coaches and nurses to use the 5NP once they are trained in the protocol.

Not all acupuncturists like acudetox specialist (ADS) laws. But many of us think that more people should be able to access care, and that 5NP is both safe and effective in the hands of non-acupuncturists. Back in acupuncture school in San Francisco in the ‘90s, only two of my teachers would even discuss NADA or 5NP, and mostly the conversations were vaguely constrained. It was as if the school was worried that we might get the idea that we didn’t need to go to acupuncture school in order to help people with filiform needles, and they didn’t want anyone to present us with evidence supporting this idea.

Acupuncture is extremely safe, and adverse reactions are rare. This is even more true when using 10 or fewer points in the ears. Can someone please help me to understand why then acupuncturists try to block the passage of ADS laws by saying how unsafe acupuncture needles are?! I never understood why anyone would stand up in front of a room of legislators, who are largely uninformed about the practices of acupuncture, and say that it’s soooo dangerous.

Rhode Island is a small state – there is a high likelihood that in less than two degrees of separation there is a link to one of the almost 400 overdose deaths that happened just last year. Both legislators who supported our amended law experienced losses due to overdoses in the three years between when our bill was introduced and when it passed. We need to get past spurious safety arguments and turf battles that have nothing to do with helping people.

For the past decade, the People’s Organization of Community Acupuncture (POCA) has supported acupuncturists who want to focus on creating access and affordability. Their idea of serving communities includes asking those communities what would be helpful. POCA clinics collectively deliver hundreds of thousands of treatments in the United States each year (some years well above a half million!).

With years of relationship-building, both with individuals and other organizations, we have been able to see success in the introduction, addition or expansion of ADS laws in RI, NH, ME, MA (pending) and AZ. We have worked with NADA folks in areas where there are NADA trainers and members, and have devised a comparable competency-based training that has been offered in WI, RI, AZ and Puerto Rico in just the past few years.

NADA’s half-century of work and organizing has been a foundation from which we have been able to draw on to do legislative work. NADA’s staff and its members have been strong supporters of our various efforts, and its advocacy resources have been something we’ve relied on to help shape opinion and inform legislators. The recent Full Circle history series has felt like a part of the celebration too – it’s been so amazing to hear the history of Lincoln Detox from folks who were there. Thank you, NADA, for all of your support with this work and for your ongoing work as well.

POCA is also indebted to the long history of radical healthcare and social justice activism of the Black Panther Party and the Young Lords. Though most have learned in acupuncture school that acupuncture came to the U.S. via James Reston’s appendix, it was here long before that, brought here and practiced by Asian immigrant communities for at least a century. We are grateful to the many people who learned, practiced and taught acupuncture and 5NP to one another so as to better care for their communities. Part of that care is to relieve day-to-day suffering, and our bigger work is to continue to challenge and change the economic and social causes of that suffering.