Engaging in acupuncture or advertising as a practitioner without a license is a criminal offense in many jurisdictions (e.g., a Class 1 misdemeanor in North Carolina).
The restriction is intended to protect public safety due to the invasive nature of the procedure. Risks of unlicensed use include: NC General Statutes - Chapter 90 Article 30 buy acupuncture needles without license
All acupuncture needle packaging must bear a warning stating: "Caution: Federal law restricts this device to sale by or on the order of qualified practitioners of acupuncture as determined by the States" . Engaging in acupuncture or advertising as a practitioner