The authors randomly assigned 60 subjects entering methadone maintenance treatment to receive “specific” or “nonspecific” (placebo) auricular acupuncture; patients were followed for 6 months. The two groups did not differ in acupuncture attendance, self-reported withdrawal symptoms, or drug use, by self-report or urinalysis. Their reports of heroin and cocaine cravings differed in a direction opposite to expectation, with greater cravings in the specific than the nonspecific group. The combined acupuncture groups bad fewer cocaine-positive urine results than a no-acupuncture historical comparison group over the 6 months. Results are discussed in relation to recruitment for such studies, selection of an appropriate acupuncture placebo, and the need to control for potentially confounding variables in future studies.