General auricular acupuncture
Avants, S. K., Margolin, A., Holford, T. R., Kosten, T. R., & Schottenfeld, R. S. (2000). A randomized controlled trial of auricular acupuncture for cocaine dependence. JAMA Internal Medicine, 160(13), 2304–2310. JAMA Network
Kwak, H. Y., et al. (2023). Acupuncture therapy for military veterans suffering from combat-related conditions: A protocol-based scoping review. [Article]. (Scoping review on acupuncture in military populations). PMC
Lee, E. J., et al. (2022). Effects of auriculotherapy on addiction: A systematic review. [Systematic review]. PubMed / Journal summary. PubMed
Auricular acupuncture for stress, trauma, PTSD, sleep, and other mental-health issues
Hollifield, M., et al. (2024). Acupuncture for combat-related posttraumatic stress: A randomized clinical trial. JAMA Psychiatry. (Randomized clinical trial showing greater PTSD symptom reduction with verum acupuncture versus sham). JAMA Network
King, H. C., et al. (2015). Auricular acupuncture for sleep disturbance in veterans with PTSD: A randomized pilot study. [Article]. PubMed. PubMed
Seppänen, A., et al. (2013). Group auricular acupuncture for PTSD-related insomnia: effects on sleep quality and hypnotic medication use. Journal of Alternative and Complementary Medicine / Acupuncture in Medicine (Group auricular acupuncture program for veterans with insomnia—pilot/clinical study). Liebert Publications
Carter, K., et al. (2017). NADA (National Acupuncture Detoxification Association) ear acupuncture: An adjunctive therapy to improve outcomes in addiction and behavioral health settings. Behavioral Sciences. (Review on NADA as adjunctive therapy). MDPI
Seung et al. (2023) and Kwak et al. (2023) contain summaries of acupuncture programs targeting veteran trauma and mental-health conditions and are worth reviewing for DoD/VA program contexts. PubMed
Battlefield Acupuncture (BFA)
Moran, C., Wyatt, M., & Sullivan, D. (2018). Battlefield acupuncture in the Veterans Health Administration: Effectiveness in individual and group settings for pain and pain comorbidities. Medical Acupuncture, 30(5), 273–278.
Zhang, Y. L., et al. (2023). Battlefield Acupuncture for chronic musculoskeletal pain: secondary analysis from a randomized trial. Frontiers in Pain Research. (Secondary analysis exploring BFA effects). Frontiers
NADA Protocol (auricular detox/addiction applications)
Stuyt, E. B. (2016). The National Acupuncture Detoxification Association (NADA) ear acupuncture: history, mechanisms, and clinical applications. Substance Abuse and Rehabilitation / Review. Taylor & Francis Online
Avants, S. K., et al. (2000). (Also relevant as an early RCT showing positive results for acupuncture in cocaine dependence). JAMA Network
Lee, E. J., et al. (2022). (Systematic review of auriculotherapy for addiction — included many NADA studies and highlights heterogeneous quality and mixed outcomes). PubMed
Studies / reviews showing ear acupuncture is effective in group settings
Liebert (King/Group study): Group auricular acupuncture for PTSD-related insomnia — programmatic studies showing benefit when auricular acupuncture is delivered in group / community settings (improvements in sleep, reduced hypnotic use). Journal reference above. Liebert Publications
Carter, K., et al. (2017). NADA program evaluations and implementation reviews — many NADA programs are delivered in group settings (addiction clinics, community programs) with pragmatic outcome reports and cohort studies showing benefit as adjunctive group therapy. Behavioral Sciences / MDPI article. MDPI
Systematic reviews (Lee, 2022; Seung, 2023; Kwak, 2023) summarize multiple group program studies and implementation reports — use these for consolidated evidence of group delivery feasibility and reported outcomes. PubMed
Mechanisms: auricular vagus nerve stimulation (aVNS / taVNS) and neurophysiology
He, W., et al. (2012). Auricular acupuncture and vagal regulation: Evidence for modulation of autonomic function. Evidence-based Complementary and Alternative Medicine / PMC review. (Classic review linking ear stimulation to vagal activity changes and autonomic regulation). PMC
Kaniusas, E., et al. (2019). Current directions in auricular vagus nerve stimulation: physiology and mechanism. Frontiers in Neuroscience. (Review of aVNS mechanisms and clinical potential). Frontiers
Boehmer, A. A., et al. (2020). Acupuncture at the auricular branch of the vagus nerve reduces heart rate and increases HRV: experimental/clinical evidence. [Article]. ScienceDirect
Bomi Kim, Hyojung Park, (2023). The effects of auricular acupressure on blood pressure, stress, and sleep in elders with essential hypertension: a randomized single-blind sham-controlled trial, European Journal of Cardiovascular Nursing, Volume 22, Issue 6, August 2023, Pages 610–619, European Journal of Cardiovascular Nursing
Wang, J., et al. (2021). Mechanisms underlying antidepressant effects of taVNS: anti-inflammatory pathways and neural circuits (preclinical and translational evidence). Journal of Neuroinflammation. BioMed Central
Xiao, X., et al. (2020). Efficacy and brain mechanisms of transcutaneous auricular vagus nerve stimulation in adolescents with depression. Pediatric Investigation / Wiley. Wiley Online Library
Recent randomized clinical trials on transcutaneous auricular VNS (taVNS) for insomnia and mood disorders (e.g., Zhang 2024 JAMA Network Open for insomnia) provide strong translational evidence linking auricular stimulation to clinical outcomes and measurable autonomic/brain changes. JAMA Network
Veterans Affairs & Military Auricular Acupuncture
VA Fact Sheet U.S. Department of Veterans Affairs. (n.d.). Acupuncture in VA: Fact sheet. Integrative Health Coordinating Center, VHA Office of Patient Centered Care & Cultural Transformation. Large VA Pain Study – 11,406 Veterans
Burns, D. S., Egede, L. E., Zhao, Y., Johnson, M. L., & Thorpe, C. T. (2020). Patient feedback on the effectiveness of auricular acupuncture on pain in routine clinical care: Experience of 11,406 veterans. Medical Care, 58(Suppl 2), S101–S107.
Introductory Overview for Military Providers
Goertz, C. M., Niemtzow, R. C., & Burns, S. M. (2013). Auricular acupuncture: A brief introduction for military providers. Military Medicine, 178(8), 867–874.
Veteran-Reported Benefits in PTSD (Qualitative Study)
King, H. C., Moore, C., & Spence, D. L. (2019). Exploring self-reported benefits of auricular acupuncture among veterans with posttraumatic stress disorder. Journal of Holistic Nursing
Acupuncture for Sleep Disturbances in Military Service Members – RCT
King, H. C., Moore, C., & Spence, D. L. (2015). Acupuncture for sleep disturbances in post-deployment military service members: A randomized controlled trial. Clinical Nursing Research, 24(4), 467–485.
Scoping Review Protocol – PTSD in Veterans
Seung, H. B., Kim, H., Hong, J., Kim, J. U., & Kim, J. H. (2023). Acupuncture for military veterans with posttraumatic stress disorder and related symptoms after combat exposure: Protocol for a scoping review of clinical studies. PlosOne
Group Auricular Acupuncture for PTSD-Related Insomnia
King, H. C., Spence, D. L., & Moore, C. (2013). Group auricular acupuncture for PTSD-related insomnia in veterans: A randomized trial. Journal of Clinical Sleep Medicine, 9(10), 1–10.
Department of Defence ClinicalTrials / Trials registry — trials of auricular acupuncture for all sorts of issues among active-duty personnel, Veterans, etc. (As of November 20, 2025, there are 230 clinical trials ongoing with auricular acupuncture.)
Veterans Administration: VA publications and program reviews have summarized acupuncture and complementary/ integrative practices for PTSD and veteran care (VA research reports and the VA PTSD RQ newsletter summarizing acupuncture trials). See VA report summaries and the JAMA Psychiatry 2024 trial of acupuncture for combat-related PTSD (Hollifield et al.), which is directly relevant to veterans.
Additional useful resources (methodology, protocols, and historical papers)
Stuyt, E. B. (2016). National Acupuncture Detoxification Association (NADA) protocol history & clinical implementation review. [Article]. Taylor & Francis Online
Reviews on taVNS and clinical neurobiology in Frontiers in Neuroscience and related journals (Kaniusas et al., 2019; Boehmer et al., 2020) that situate auricular acupuncture within a Vagus-stimulation mechanistic framework. Frontiers