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What it does 

The Acupuncture for Our Heroes Act (HR 2838) requires the Department of Veterans Affairs (VA) to provide acupuncturist services to veterans enrolled in the VA health care system. This bill specifies that this acupuncture program be carried out in at least one VA facility in each of the Veterans Integrated Service Networks, and that the program is accessible in both urban and rural areas.

Acupuncturist services available must be able to address, at minimum, the following:

HR 2838 requires this acupuncture program to be administered by qualified acupuncturists appointed as VA employees or by contract qualified acupuncturists. The bill defines “qualified acupuncturists” as those certified to practice acupuncture by the state government where they are practicing or who, in the absence of a state government certification program, meet criteria as specified by the VA. Additionally, the VA will provide training and materials to its primary care providers to promote awareness of the benefits of acupuncturist services.

The VA will additionally establish an advisory committee to provide the VA with assistance and advice in the development and implementation of the program. The Advisory Committee on Acupuncturist Services will consist of members appointed by the VA Secretary from the general public that include state licensed practicing acupuncturists, veterans from each of the Armed Forces, and representatives from veterans service organizations. The Advisory Committee, which will meet at least three times per year, will be tasked with:

  1. Reviewing and evaluating veterans’ access to VA acupuncturist facilities; and
  2. Advising the VA regarding direct access to acupuncture care, the scope of practice of acupuncture practitioners, and definitions of services to be provided, among other appropriate matters.

Once the VA has determined that the acupuncture program has been fully implemented, the Advisory Committee must submit to the VA a final report containing the evaluation of the program’s implementation. Following submission of this report, the VA Secretary will submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report including the following:

  • The original Advisory Committee report;
  • An explanation of the criteria and rationale the VA used to determine full implementation of this program; and
  • The Secretary’s opinions about future implementation of the program. 
Relevant Science 

Acupuncture is a technique that involves the insertion of thin needles through the skin to stimulate specific points of the body. While acupuncture has been a key component of traditional Chinese Medicine as a technique to balance the flow of energy known as chi, Western practitioners use acupuncture to stimulate nerves, muscles, and connective tissue. The later practice is believed to boost the body’s natural painkillers and increase blood flow. Scientists have recently begun exploring the connection between acupuncture and pain relief through a number of studies, including a large cohort study of patients with chronic pain conditions, such as back and neck pain, osteoarthritis, chronic headache, and shoulder pain. In this study, acupuncture was found to be an effective treatment of chronic pain.

Currently, patients seek acupuncture to relieve discomfort associated with a number of diseases and conditions, including:

  • Chemotherapy-induced and postoperative nausea and vomiting;
  • Dental pain;
  • Fibromyalgia;
  • Headaches, including tension and migraine headaches;
  • Labor pain;
  • Lower back pain;
  • Neck pain;
  • Osteoarthritis; and
  • Menstrual cramps.

While risks of acupuncture are low when administered by a certified acupuncture practitioner, possible side effects include soreness, organ injury, and infection.

Most recently, acupuncture has been investigated for its potential to act as an alternative to opioids for pain treatment. Due to the increased risk of addiction associated with opioid prescription, researchers are investigating alternative pain management treatments. The FDA has recommended that health care providers be knowledgeable about the range of available pain management therapies, including acupuncture as a nonpharmocologic therapy. Acupuncture has been found to lessen opioid side effects, such as pruritus, and to reduce dependency on opioids. While research has shown acupuncture to be effective in pain management, experts have recommended further research to be completed with more stringent experimental design to gain more conclusive scientific evidence.

Furthermore, acupuncture has been studied as a potential treatment for patients with post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI). Many groups have shown that acupuncture is effective in treating the symptoms of PTSD/TBI known as the trauma spectrum response, which includes chronic pain, headache, anxiety, depression, and sleep disturbance. But additional, future research may better determine the long-term potency of acupuncture so as to potentially establish this method as a treatment for PTSD/TBI.

Relevant Experts 

Jongbae Park, L. Ac., PhD is a clinician and researcher of acupuncture and Asian medicine and serves as the Director of Acupuncture and Asian Medicine for the Duke Center for Translational Pain Medicine.

Relevant publication:

  • Yin, Changshik, Thomas E. Buchheit, and Jongbae J Park. 2017. “Acupuncture for Chronic Pain: An Update and Critical Overview.” Current Opinion in Anesthesiology 30(5): 583 – 592. doi:10.1097/ACO.0000000000000501
Endorsements & Opposition 

Endorsements:

  • American Legion, email to NBC News, June 14, 2017: “We are urging Congress to improve pain management policies for the Department of Defense and the VA, and are pressing the VA to accelerate research efforts to properly diagnose and develop evidence-based CAM [complementary and alternative medicine] treatments.”
  • Korean Acupuncture and Asian Medicine Association, press release, June 8, 2017: no quotation given.
  • Council of Acupuncture and Oriental Medicine, press release, June 8, 2017: no quotation given.

Opposition:

  • At present, there has not been any publicly reported opposition to this bill.
Status 

HR 2838 was introduced in the House of Representatives on June 8, 2017, and referred to the Subcommittee on Health by the House Committee on Veterans’ Affairs.

Sponsors 

Sponsor: Representative Judy Chu (D-CA-27)

Primary Author 
Amy Hafez, PhD Candidate
Editor(s) 
Jacqueline Robinson-Hamm, PhD Candidate; Andrew Pericak, MEM
Recommended Citation 

Duke SciPol, “Acupuncture for Our Heroes Act (HR 2838, 115th Congress)” available at http://scipol.duke.edu/content/acupuncture-our-heroes-act-hr-2838-115th-congress (10/12/2017).

License 
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