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Electro-Acupuncture Combined Methadone for Withdrawal Symptoms of Opioid Addiction: A Protocol for Systematic Review and Meta-Analysis

Background Opioid addiction is a chronic brain disorder characterized by a series of withdrawal symptoms in behavioral, psychological, and neurobiological manifestations. Withdrawal symptoms are the main cause of relapse after periods of abstinence; thus, the treatment
 is focused on abstinence symptoms. Due to most of all types of opioid agonist drugs carry a potential for addiction and exacerbation of withdrawal symptoms, nondrug methods have great potentials in clinical applications. Electro-acupuncture (EA), as a novel nonpharmacological approach, combined
 with methadone has a long-term positive efficacy on treating addiction. Therefore, we designed a protocol to evaluate the adjuvant effect of EA for treating withdrawal symptoms of opioid addiction. Method To review reports of relevant clinical trials, we will search
 English language databases (EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials) and Chinese databases (Chinese Biomedical Literatures, China National Knowledge Infrastructure, Wanfang, and VIP). We will collect documents from the earliest possible date up to May 2020. We
 will also search online trial registries such as ClinicalTrials. gov (ClinicalTrials.gov/), the European Medicine Agency (www.ema.europa.eu/ema/), and WHO International Clinical Trials Registry Platform (www.who.int/ictrp). We will select randomized controlled trials (RCT) for withdrawal from
 opioid addiction involving EA-methadone and methadone alone treatment. We will use psychological assessment scales to evaluate treatment major outcomes which include numerous components such as OWS, VAS, HAMD, HAMA; then urinalysis and methadone dosage also will be measure as the additional
 outcomes. Finally, RevMan5 software will be used for literature quality evaluation and data analysis. Result: To evaluate the efficacy of EA in combination therapy by observing the outcomes of corresponding scale, urinalysis and decreasing methadone.
 Conclusion: This protocol will be used to evaluate the efficacy and safety of EA in combination with methadone in treatment of opioid addiction withdrawal symptoms. Abbreviations: Opioid dependence, OWS=Opiate Withdrawal Scale, VAS=Craving Visual Analog Scale,
 PWSS=Post-withdrawal symptoms Scale, HAMD=Hamilton Depression Scale, HAMA=Hamilton Anxiety Scale, RCTs=Randomized Controlled Trials, EA=Electrical Acupuncture, PRISMA=Preferred Reporting Items for Systematic Reviews and Meta-Analyses.