Urine samples were collected 3 times weekly (Monday, Wednesday, and Friday) while the patient remained in treatment and were tested for the presence of cocaine metabolite (benzoylecognine) using fluorescence polarizatyion immunoassay (TDx; Abbott Laboratories, Abbott Park, Ill), which has been shown to be a reliable and precise assay.27 Samples with benzoylecognine levels of 300 ng/mL or more were considered positive for cocaine. For the range of doses between 13 and 130 mg of topically used cocaine, the test result will remain positive for at least 3 days after cocaine use. This is a clinically reasonable sensitivity for illicit cocaine use by either topical (ie, nasal), freebase, or intravenous routes. The Addiction Severity Index (ASI),28 the Treatment Credibility Scale,29 and the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES Version 8D)30 were administered before treatment (ie, at entry into the trial) and at the end of the 8-week trial (ie, at the 8-week follow-up). The ASI is a structured interview commonly used in addiction research that provides composite scores assessing the severity of 7 addiction-related problem areas. The Treatment Credibility Scale is a 5-item questionnaire that assesses confidence in treatment for the target disorder on scales from 1 (not at all) to 6 (very confident); items were averaged to provide a single treatment credibility score (Cronbach α = .88). The SOCRATES is a 19-item questionnaire assessing readiness for substance abuse treatment. Items are rated on scales from 1 (strongly disagree) to 5 (strongly agree), and 3 composite scores are calculated (α values range from .60 to .96). An overall treatment readiness score was calculated by subtracting the "ambivalence" score from the sum of the "problem recognition" and "taking action" scores. A 10-item assessment of therapeutic alliance with the acupuncturist–relaxation trainer, modified from the therapeutic alliance scale,31 was administered at the end of the first treatment session and again in weeks 4 and 8. Items were rated on 7-point scales from 1 (never) to 7 (always) and averaged (Cronbach α = .92). Acute subjective effects of treatment sessions were assessed weekly on 5-point scales from 0 (not at all) to 4 (extreme), as follows: (1) 5 items assessed pain (ie, pain in ears on needle insertion and pain at needle sites during session) and de qi–associated sensations (ie, warmth in ears, activity in ears, and radiating sensations from ears to face, neck, or shoulders); (2) 5 items assessed relaxation effects relative to presession levels (eg, relaxed, heaviness, warmth, sleepiness, looser muscles); (3) 5 items assessed satisfaction with the session (eg, session enjoyment, stress reduction, feelings of happiness and peacefulness, and increased confidence in acupuncture as a treatment for cocaine problems); (4) as an additional measure of treatment desirability, participants were asked how much they would be willing to pay for such a treatment session in the future (nothing, $5, $10, $15, $20); and (5) as a measure of duration of treatment effects, 1 item, asked the following day, asked how long the previous session's effects lasted (0 indicated no effect; 1, less than 1 hour; 2, 2-3 hours; 3, all afternoon; and 4, all night). As in previous studies,32 items in each category were averaged.