Last Updated: May 2026 | Written by Jessica Eden LCSW, LAC, ADS-RT – Licensed Therapist & NADA Registered Trainer
What Is Acudetox?
Acudetox is commonly known as the NADA protocol, the 5-Needle Protocol (5NP), or auricular acupuncture detoxification and it involves the bilateral insertion of five fine-gauge, sterile needles into specific points on the outer ear: Sympathetic, Shen Men, Kidney, Liver, and Lung. Needles remain in place for 30–45 minutes, typically in a group setting with clients seated in chairs, fully clothed.
Originally developed at Lincoln Hospital in the Bronx and formalized in 1985 by the National Acupuncture Detoxification Association (NADA), the protocol was designed to support addiction recovery. Today it is widely used in behavioral health, trauma recovery, mental health, and disaster relief settings worldwide; with or without an addiction diagnosis.
As a licensed therapist and NADA Registered Trainer, I created this guide to help behavioral health professionals, counselors, nurses, social workers, and other practitioners understand the legal landscape in their state before pursuing certification or practice. Whether you’re considering attending an acudetox training or want to understand your state’s rules, this is your starting point. However as legal landscapes can change, you should always verify current requirements directly with your state’s statutes and/or licensing board.
National Overview: How Many States Allow ADS Practice?
Far more states than most people realize have statutory pathways allowing non-acupuncturists to practice acudetox.
According to NADA’s official FAQ and my own research, the following 24 states have statutes specifically regulating ADS practice by non-acupuncturists:
Arizona, Arkansas, Colorado, Connecticut, Delaware, Georgia, Indiana, Louisiana, Maine Maryland, Michigan, Missouri, New Hampshire, New Mexico, New York, Oregon, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, West Virginia, and Wyoming.
Additionally, North Carolina, Ohio, and Washington provide more limited pathways – primarily for nurses, nurse practitioners, and physician’s assistants – through physician delegation or administrative nursing rules.
And in three states: Alabama, Oklahoma, and South Dakota; acupuncture itself is not regulated by a practice act, which creates a legally ambiguous (and unprotected) environment for any practitioner.
The key takeaway: roughly 20+ states have some form of statutory ADS authorization. However, the scope, supervision requirements, eligible professions, and settings vary enormously from state to state. This guide walks through what you need to know.
🟢 States with Explicit ADS Statutory Authorization
These states have formal statutes or regulations that explicitly allow non-acupuncturists to perform acudetox under defined conditions. In some cases, an ADS credential, certificate, or license is issued by a state board. Others may require supervision by a licensed acupuncturist.
Arizona
Law: A.R.S. § 32-3922; Arizona Acupuncture Board (Laws 2021, Chapter 312)
Arizona has a formal Acudetox Detoxification Specialist (ADS) certificate issued by the Arizona Board of Acupuncture Examiners. A 2021 law expanded the program by removing the prior limitation that ADS could only work in chemical dependency programs; they can now practice in broader healthcare settings. ADS practitioners must still be supervised by a licensed Arizona acupuncturist, and must obtain signed patient consent prior to treatment. An application fee applies and fingerprints are required.
🔗 Arizona Acupuncture Board – Legislation
Arkansas
Code: 17 CAR § 170-308
ADS must provide a copy of completion of the NADA course, evidence of active certification as an ADS in another state, and register with the Arkansas State Board of Acupuncture & Related Techniques (ASBART). An ADS must be supervised by a licensed acupuncturist and limit their practice to substance abuse only.
Colorado
Law: C.R.S. § 12-245-233
Colorado allows professionals who have been trained in the NADA or equivalent program, to perform auricular acudetox using the NADA protocol within their existing scope of practice.
Connecticut
Law: Conn. Gen. Stat. § 20-195aa(h)
Connecticut allows anyone holding a current NADA certification to perform the five-point auricular protocol in approved setting, as an adjunct therapy for alcohol and drug abuse, or other behavioral health interventions where it is clinically indicated; cannot be practiced as a standalone treatment. Supervision is required but flexible: a licensed physician, physician assistant, advanced practice registered nurse, or licensed acupuncturist may all serve as the supervising provider.
🔗 Conn. Gen. Stat. § 20-195aa(h)
Delaware
Law: 24 Del. Code § 1799F
An ADS license is issued by the Delaware Board of Medical Licensure and Discipline to be renewed biennially. ADS’s must be trained in a NADA or equivalent training program, and may perform the NADA protocol for the purpose of preventing or treating alcoholism, nicotine dependency, substance abuse, or chemical dependency.
Georgia
Rule: 360-6-.06
ADS must submit an application for a license to perform Acudetox and be 21 years of age or older, submit an application fee, successfully complete a NADA equivalent program for the treatment of chemical dependence, complete a nationally recognized clean needle technique course, and submit verification of liability insurance. Locations of Acudetox programs are limited and ADS must be supervised by a licensed acupuncturist or qualified medical provider.
Indiana
Rule: Indiana Professional Licensing Agency
ADS’s must submit an application with an application fee, a criminal background check, verification of licensure or certifications in healthcare professions or occupations, documentation of NADA or equivalent training program completion, and a high school diploma or equivalent. Applicants must also submit a certificate of completion of an approved clean needle technique course. ADS’s must also have a supervising acupuncturist physically present or readily available at all times treatment is being administered by an ADS, in accordance with 844-13-3-2.
🔗 Indiana PLA & Supervisory Practice
Louisiana
Rule: LA State Board of Medical Examiners
ADS license applicants must be 21 or older and have a high school diploma or equivalent. They also need to successfully complete a NADA training and show current certification as an ADS; and, affirm they shall only provide Acudetox under the general supervision of a physician or licensed acupuncturist.
🔗 LA State Board of Medical Examiners
Maine
Law: 32 M.R.S. § 12551–12552
Maine issues a formal state license to qualified acudetox specialists who are not acupuncturists. Licensees carry the title “Licensed Acupuncture Detoxification Specialist” and may use the designations L.A.D.S. or A.D.S., though they may not represent themselves as acupuncturists.
Applicants must already hold a valid, unrestricted Maine license in one of the following professions: certified or licensed alcohol and drug counselor, physician or physician assistant, nurse or nurse practitioner, professional or clinical professional counselor, psychologist, or licensed social worker (conditional, clinical, or master’s-level).
Supervision by a licensed acupuncturist in good standing is required, with standards listed in the law, and an ADS must practice within or in collaboration with a substance use/co-occurring disorders program or other state-approved program.
Maryland
Law: Md. Health Occupations Code § 1A-101; COMAR 10.26.02.07
The Maryland State Acupuncture Board issues formal ADS registrations to eligible non-acupuncturists – including licensed clinical social workers, nurses, licensed professional counselors, and others working in chemical dependency programs. Applicants must complete a minimum NADA approved training program. Supervision by a Maryland-licensed acupuncturist is required.
🔗 COMAR 10.26.02.07 🔗 Maryland Department of Health – ADS Page
Michigan
Law: Michigan Public Health Code, Article 15 (Acupuncture) Regulatory Authority: Michigan Board of Acupuncture
Michigan allows non-acupuncturists to perform the NADA five-point auricular protocol without a separate state license or registration, provided three conditions are met: the practitioner holds a valid NADA certificate of training (or equivalent from a NADA successor organization), limits practice strictly to the auricular protocol for substance use disorder prevention and treatment, and works under the supervision of a licensed acupuncturist or licensed physician.
🔗 Michigan Public Health Code — Article 15, Acupuncture
Missouri
Law: Division 2015 – Acupuncturist Advisory Committee
A certified ADS or AAT (acu-technician) practices under the supervision of a licensed acupuncturist.
🔗 Code of Regulations: Acupuncturist Advisory Committee
New Hampshire
Rule: Acp 700 (RSA 328-G:9-a framework)
New Hampshire recognizes the Acupuncture Detoxification Specialist (ADS) credential under its acupuncture licensing framework, allowing trained professionals to perform auricular acudetox in addiction treatment contexts. New Hampshire requires an ADS to be under general supervision of a licensed acupuncturist, trained in the NADA protocol or equivalent, for the purposes of behavioral health applications, including addictions, mental health, and disaster and emotional trauma. According to the rule, “general supervision” shall be provided by site visit, phone or other electronic means during business hours with at least 2 site visits per year by a licensed acupuncturist licensed in New Hampshire pursuant to RSA 328-G:9.
🔗 Acp 700 (RSA 328-G:9-a framework)
New Mexico
Rule: 16.2.16 NMAC
New Mexico certifies Certified Auricular Detoxification Specialists (CADS) through the New Mexico Acupuncture and Oriental Medicine Board. A CADS is authorized to perform acudetox for the purpose of “harm reduction or treating and preventing alcoholism, substance abuse or chemical dependency, only within a board approved treatment program that focuses on disease prevention, harm reduction, or the treatment or prevention of alcoholism, substance abuse or chemical dependency, and only under the supervision of one or more auricular detoxification specialist supervisor(s) registered with the board.”
New York
Law: N.Y. Education Law § 8211(2) Regulatory Authority: NYS Education Department; NYS Office of Addiction Services and Supports (OASAS)
New York authorizes non-acupuncturists to perform acudetox, but the pathway is institutionally driven rather than credential-driven – meaning authorization flows through the clinical program, not through an individual ADS certificate issued by a state board. To practice legally, a non-acupuncturist must be authorized by a state agency (OASAS or the Department of Health) to provide addiction treatment, work within a state-approved hospital or clinical program, have completed an acupuncture training program acceptable to the NYS Education Department, and practice under the general supervision of a licensed acupuncturist or a physician or dentist certified in acupuncture. Scope is limited strictly to alcoholism, substance dependence, and chemical dependency.
Oregon
Law: Oregon House Bill 2143 (2025); amending ORS 677.761 Regulatory Authority: Oregon Medical Board
Oregon HB 2143 moves Oregon from the restrictive “acupuncturists only” category – where it previously sat – into the authorized ADS states category, creating a formal five-needle protocol (5NP) registration through the Oregon Medical Board. Oregon recognizes Acudetox for the temporary relief from symptoms of substance use disorder, mental health conditions or trauma. Oregon’s law includes a formal disciplinary framework for registered practitioners.
🔗 Oregon HB 2143 (2025) 🔗 Oregon Medical Board
South Carolina
Law: NSC Code § 40-47-755 (2025)
Auricular detoxification therapy may take place under the direct supervision of a licensed acupuncturist or a person licensed to practice medicine under this chapter. A treatment by an auricular detoxification specialist is strictly limited to the five ear-point treatment protocol for detoxification, substance abuse, or chemical dependency as stipulated by NADA.
Rhode Island
Law: R.I. Gen. Laws § 5-69-3.1
Rhode Island explicitly authorizes Acudetox Specialists (ADS) within its chemical dependency professional licensing framework. Individuals licensed as chemical dependency professionals or clinical supervisors may perform auricular acudetox after completing NADA-or equivalent training. Important note: Rhode Island requires that ADS practitioners operate under the general supervision of a licensed acupuncturist. ADS practitioners may not call themselves acupuncturists or practice outside the five-point auricular protocol.
Tennessee
Law: Tenn. Comp. R. & Regs. 0880-12-.05 Regulatory Authority: Tennessee Board of Medical Examiners – Acupuncture Committee
Tennessee issues a formal limited acupuncture certification for ADS practitioners, administered through the Tennessee Board of Medical Examiners. The application process requires a completed application and fees, a recent photograph, two character reference letters from medical professionals (written within the prior 12 months, on professional letterhead), and official documentation of training sent directly from a board-approved program meeting or exceeding NADA standards.
Before practicing, a certified ADS must also provide the board with two additional pieces of documentation: written confirmation that practice will occur within a hospital, clinic, or treatment facility offering comprehensive substance abuse or chemical dependency services including counseling, and a signed statement from the facility’s supervising acupuncturist or licensed physician medical director confirming employment and acceptance of supervisory responsibility.
🔗 Tenn. Comp. R. & Regs. 0880-12-.05
Texas
Law: Texas Occupations Code § 205.303 Updated: September 1, 2023 (HB 1106, 88th Legislative Session)
Texas first passed an Acudetox law in 1999. The law was significantly expanded in 2023 when Governor Greg Abbott signed HB 1106. The updated law no longer limits the protocol to addiction treatment; it now explicitly authorizes use for trauma, physical and emotional stress, and psychological conditions. It expanded the list of eligible healthcare professionals and issues an Acudetox Specialist (ADS) permit through the Texas Medical Board. As part of Texas statutes, 3 hours of continuing education is required per licensing period (renewal every 3 years).
🔗 Texas Occupations Code § 205.303
Vermont
Law: 26 V.S.A. §§ 3401–3411 (Acupuncturists Act) Administrative Rules: Part 4 – Certification of Acupuncture Detoxification Technicians
Vermont certifies non-acupuncturists through a formal state credential called the Acupuncture Detoxification Technician (ADT), also referred to as a Certified Acupuncture Detoxification Technician (CADT). Vermont’s framework is notably detailed and structured, with specific requirements around supervision, approved settings, recordkeeping, patient disclosure, and biennial renewal.
🔗 Vermont Office of Professional Regulation — Acupuncturists 🔗 26 V.S.A. §§ 3401–3411
Virginia
Law: Va. Code §§ 54.1-2900 and 54.1-2901(A)(3) Regulatory Authority: Virginia Board of Medicine
Virginia law explicitly exempts any person from acupuncture licensure requirements when performing the five-needle auricular protocol (5NP), as long as they:
- Have completed appropriate 5NP training, including NADA or equivalent certification
- Do not use any title, letters, or language implying they are an acupuncturist
- Make no claim that their 5NP practice is licensed, certified, or regulated by the state
There is no required supervising acupuncturist, no state license or registration, no approved setting requirement, and no application process. Your NADA training certificate is sufficient. If you hold a current NADA certificate, practice your professional ethics around titles and representations, and keep your needles in the ear, you are operating within a clear and explicitly protected legal framework.
West Virginia
Law: W. Va. Code § 30-36
The West Virginia Acupuncture Board issues ADS certificates to qualified healthcare professionals – including counselors, nurses, social workers, and others the Board determines eligible- for the treatment of substance abuse, chemical dependency, behavioral therapy, and trauma recovery. ADS certificate holders are prohibited from needling body acupuncture points and may not advertise themselves as acupuncturists.
Wyoming
Law: 252-2 Wyo. Code R. §§ 2-2; W.S. 33-49-102(a)(iv) Regulatory Authority: Wyoming Board of Acupuncture
Wyoming issues a formal Auricular Acupuncturist License for non-acupuncturists through an application process. To obtain a Wyoming Auricular Acupuncturist License, applicants submit an application with a face photograph, an application fee, proof of NADA certification or equivalent training.
🔗 Wyoming Board of Acupuncture — Rules and Regulations 🔗 W.S. 33-49-102
🟡 States with Limited or Conditional ADS Pathways
These states have some statutory authorization for non-acupuncturists, but the scope is significantly restricted – typically to specific professions (e.g., nurses, chiropractors only) or under physician delegation.
Ohio, North Carolina, Washington
These states have some statutory authorization for non-acupuncturists, which is significantly limited to medical professions or under physician delegation.
Ambiguous/No Verified ADS Statute
California, Hawaii, Illinois, Minnesota, Montana
No verified statutory ADS authorization has been confirmed for non-acupuncturists in these states. Practitioners in these states should contact their professional licensing board before performing acudetox under this assumption. The legal landscape here is genuinely ambiguous, and practicing without clear authorization could carry professional risk.
🔴 States Where Acudetox Is Restricted to Licensed Acupuncturists
In the remaining states, the practice of acudetox is treated as a form of acupuncture under state law, and no ADS certification pathway exists for non-acupuncturists. Only licensed acupuncturists (or, in some states, medical doctors) may legally perform the protocol.
These states include: Alaska, Florida, Idaho, Iowa, Kansas, Kentucky, Massachusetts, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Jersey, North Dakota, Pennsylvania, Utah, Wisconsin.
Additionally, three states — Alabama, Oklahoma, and South Dakota — have no acupuncture practice act at all. This does not mean acudetox is freely permitted; rather, it means there is no licensing framework protecting practitioners or clients. Proceeding without legal guidance in these states is inadvisable.
📊 Summary Table: Acudetox Legal Status at a Glance
| Category | States |
|---|---|
| 🟢 Explicit ADS Statute | AZ, AR, CO, CT, DE, GA, IN, LA, MD, ME, MI, MO, NH, NM, NY, RI, SC, TN, TX, VA, VT, WV, WY, OR |
| 🟡 Limited/Conditional (Nurses / Physician Delegation) | NC, OH, WA |
| ⚠️ Ambiguous / No Verified ADS Statute | CA, HI, IL, MN, MT |
| 🔴 Acupuncturists Only | AK, FL, ID, IA, KS, KY, MA, MS, NE, NV, NJ, ND, PA, UT, WI |
| ⬜ No Acupuncture Practice Act | AL, OK, SD |
Note: This table reflects the best available information as of March 2026. State laws change. Always verify with your state licensing board before practicing.
Frequently Asked Questions
Can a licensed counselor, therapist, or social worker perform acudetox? It depends entirely on your state. In states with ADS statutes (like Texas, Maryland, West Virginia, Delaware, and others), licensed counselors and social workers may apply for ADS certification after completing approved training. In states without an ADS statute, the practice is generally restricted to licensed acupuncturists. Check your state’s board before proceeding.
Do I need a separate license or just a training certificate? This varies by state. Some states (Maryland, Delaware, West Virginia, Texas) require a formal ADS license or registration through a state board in addition to NADA training. Others (Colorado, Oregon) recognize a NADA certificate of training as sufficient within an existing professional scope. NADA training alone does not grant legal authority to practice in every state.
What is NADA training and how long does it take? NADA training is conducted by NADA Registered Trainers and includes classroom instruction and supervised clinical hours. Requirements vary by state, but typically involve completing a training of at least 30–70 hours including clinical practicum hours. Upon completion, NADA issues a certificate as an Acupuncture Detoxification Specialist (ADS). All trainings must be conducted by a NADA Registered Trainer to receive an official certificate.
Is acudetox the same as acupuncture? No – and yes, legally speaking, in many states. Clinically, acudetox is a narrow, standardized five-point auricular protocol used as an adjunct treatment. It is not a substitute for full acupuncture practice, which involves diagnosis and individualized treatment across the full body. However, many state laws define acudetox as a form of acupuncture, which is precisely why the legal landscape is so complex for non-acupuncturists. Additionally, at no point can a non-licensed acupuncturist who is certified solely in the acudetox method, hold themselves out as an acupuncturist or acupuncture practitioner.
How do I find a NADA training near me? NADA Registered Trainers lead trainings across the country. All official NADA trainings are listed on the NADA website at acudetox.com. Only trainings led by NADA Registered Trainers in good standing will result in an official NADA certificate of completion.
I already have my NADA certificate – can I practice in my state? A NADA certificate confirms you completed NADA-approved training. Whether you can legally practice depends on your state’s laws, your professional license type, and whether your state requires a separate ADS credential. Review your state’s section above and confirm with your licensing board.
What are the five NADA acudetox points? The five bilateral ear points used in the NADA protocol are: Sympathetic, Shen Men, Kidney, Liver, and Lung.
Ready to Get Certified?
If you’re a licensed therapist, counselor, social worker, nurse, or other behavioral health professional interested in adding acudetox to your practice, I offer NADA-approved acudetox trainings in Colorado for eligible practitioners. Trainings satisfy requirements for ADS certification in states where your license qualifies.
I also offer acudetox sessions for individuals seeking support with addiction recovery, trauma, anxiety, and stress. Sessions are offered in a group chair setting and serve as an adjunct to existing therapeutic work.
→ View Upcoming Trainings → Learn About Acudetox Sessions → Contact Me With Questions
Disclaimer
This article is for informational purposes only and does not constitute legal advice. Acudetox and ADS laws change frequently, and the information above reflects the best available research as of May 2026. The specific supervision requirements, eligible professions, permitted settings, and application processes vary significantly from state to state and are not fully detailed here.
Before performing acudetox in any capacity, practitioners should:
- Verify current regulations directly with their state licensing board or acupuncture board
- Confirm whether their specific professional license qualifies them for ADS status in their state
- Consult with a healthcare attorney if their state’s law is ambiguous
For the most current state-by-state information, visit NADA’s official FAQ and state laws pages.
Sources: NADA (acudetox.com), state statutes and administrative codes cited inline.
