Since its first mention in U.S. media in the early 1970s, the practice of acupuncture and Oriental medicine (AOM) has grown in stature from a fringe, counter-culture movement to a valid, evidenced-based treatment option for patients. In the last 40 years, AOM schools and colleges have been accredited by the U.S. Department of Education, offering both masters and doctoral degree programs. To date, forty-seven states and the District of Columbia license or certify acupuncturists based on competency proven through state examination or professional certification by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). As acceptance of AOM in the U.S. has increased through both the assurance of psychometrically sound certification and the education of the American public on this topic, many challenges have emerged. Problems such as the underemployment of AOM clinicians, methodological hurdles for the investigation of mechanisms, and efficacy of acupuncture and other AOM treatment techniques have been observed. Investigative challenges also include gaps in research training as well as a dearth of the basic resources needed to conduct randomized controlled trials (RCTs). As AOM research has sought integration into the Western research model, problems have been identified in the design of AOMRCTs, and strategies for their resolution through methods such as translational research have been examined. Incorporating these strategies as well as efficacy, effectiveness, and qualitative measures will strengthen the evidence base and thus provide clinical decision makers with more tools that can be used to design patient treatment regimens.
Acupuncture ; education ; Certification ; Cooperative Behavior ; Humans ; Medicine, East Asian Traditional ; Research ; United States

The United States (U.S.) is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public's opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture's cost-effectiveness can dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding addiction to opioids that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of commonly seen pain conditions. Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military, in some studies demonstrably decreasing the volume of opioids prescribed when included in care.