Acupuncture significantly lowers methadone doses for people undergoing treatment for opioid use disorder, while restoring antiviral immune responses and rebalancing gut microbiota and metabolism, according to a new study.
A randomized, placebo-controlled study shows that adding acupuncture to standard methadone maintenance can ease side effects of long-term opioid therapy and support safer, more effective addiction management.
Opioid use disorders affect tens of millions worldwide and carry risks of infection, metabolic disruption, and gut imbalance. Methadone maintenance helps curb illicit opioid use but can suppress immunity, alter metabolism, and disturb gut bacteria.
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This study, published in Research, provides evidence that acupuncture—a low-risk, non-pharmacological therapy recognized by the WHO—can reduce the required methadone doses, enhance antiviral defenses, and partially rebalance gut and metabolic disturbances. Findings could inform treatment guidelines for addiction specialists, public health policymakers, and patients seeking integrative care.
Non-drug therapy
“We felt encouraged to find that a non-drug therapy like acupuncture can safely lower methadone requirements while reawakening patients’ antiviral defenses and rebalancing their gut health,” says Prof. Fangfang Qi. “This opens a promising integrative path for addiction treatment that could dramatically improve patients’ long-term well-being.”
The study revealed several important outcomes:
- 84% of patients receiving real acupuncture cut their daily methadone dose by at least 20% over eight weeks, compared to 39% with sham treatment.
- Acupuncture triggered antiviral gene activity in classical monocytes and other immune cells, suggesting stronger defense against viral infections.
- Intercellular signaling via galectin-9 between monocytes and other immune cells increased after acupuncture, indicating enhanced coordination of immune responses.
- Gut bacteria shifts included higher levels of Bilophila species, which are associated with bile-acid processing and healthier gut barrier function.
- Blood metabolites showed reduced markers of bile acid overproduction and restored glutamine-glutamate pathways, indicating an improved metabolic balance.
In a patient-blinded trial, 48 individuals on stable methadone therapy were randomly assigned to real or sham acupuncture for eight weeks. Researchers collected blood, stool, and plasma before and after treatment. They applied single-cell RNA sequencing to blood immune cells, broad-spectrum metabolomics to plasma, and whole-metagenome sequencing to fecal samples.
Computational models linked changes at the cellular, microbial, and metabolic levels with clinical outcomes. Follow-up lab experiments in monocyte cultures tested how bile acids and galectin-9 affect immune signaling.
Holistic addiction care
This multi-omics study provides clinical and mechanistic proof that acupuncture can safely reduce methadone requirements and counteract opioid-induced immune and gut disturbances. Integrating acupuncture into methadone maintenance programs may improve patient outcomes and lower the burden of long-term opioid therapy.
Published in Research in June 2025 (https://doi.org/10.34133/research.0741), the research article was authored by researchers from the following institutions: Guangzhou University of Chinese Medicine, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Clinical Research Center for Cancer, Harvard Medical School, Jiangsu Medical College, State Key Laboratory of Traditional Chinese Medicine Syndrome, and Mayo Clinic.
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