Monday, February 18, 2013

Smoking and alcohol de-addiction

An overview on the use of homoeopathic medicine in de-addiction
Anxiety and stress are unavoidable if one has to succeed and achieve a target. Many individuals have limitation both at physical and mental levels. Because of pressure of work and other factors they easily get stressed. They start with milder forms of stimulants like tea and coffee, then step up with cigarette/tobacco use or may be alcohol and drugs. The temporary benefit they achieve is not balanced by such individuals between the stimulatory effects and toxic and addictive nature of the product they use. With time the consumption goes on increasing to achieve the desired goal. Such people get trapped and manifest many symptoms of addiction, both acute and chronic, up to an extent of pathological derangements. At that particular stage, it is difficult to withdraw from the addiction.

There have been hundreds of substances causing addiction like caffeine in the form of tea and coffee, cocaine, cannabis, opium/morphine/heroin, nicotine and tobacco, alcohol, etc. Caffeine initially acts as a stimulant, but profuse and prolonged use of caffeine containing product may cause irritability, irregular heartbeats, psychomotor agitation, disorientation, delusions, hallucinations, mania, depression, etc. Dependents of cocaine usually have the symptoms of lethargy, psychosis, depression, akathisia, and fatal overdose. Though most of the psychoactive drugs can be categorized in to either stimulant, depressant, or hallucinogen, exceptionally cannabis has a mixture of all these properties. Effects of opium derivatives like morphine and heroin include depressed respiration, clouded mental functioning, nausea and vomiting, suppression of pain and spontaneous abortion in a short term, infectious diseases like HIV/AIDS and hepatitis B and C, bacterial infections, abscesses, infection of heart lining and valves, collapsed veins, arthritis and other rheumatologic problems in long term.

Tobacco smoking and alcoholism are more common in India, killing thousands of people every year. They have many health consequences. They adversely affect stomach, intestines, liver, heart, nerves, pancreas, brain and other organs. In many cases they result in malnutrition, sexual problems, brain cell damage, cancer of digestive organs, high blood pressure, sleeping disorders, etc. Their psychological and psychiatric problems like lack of judgement and coordination, depression, poor memory and concentration, etc. affect the daily life drastically. This article mainly discusses about the effects of tobacco use and alcohol addiction and how homoeopathy can be helpful in de-addiction.

Smoking and other forms of tobacco use
There have been reports pouring in about how smoking and use of tobacco are affecting the health quotient of India. According to the Indian Council for Medical Research (ICMR) report, India is the 4th largest producer of tobacco. It ranks second in the world after China in cigarette and bidi production. There are 18.4 crore users in India with 4 crore cigarettes, 8 crore bidis and 6 crore using chewable forms of tobacco. About 45% of Indian men and 12% of women use some form of tobacco. Tobacco kills 90 persons per hour, 2200 per month and 800000 per year! By 2020 it is predicted that 13% of all deaths will be due to tobacco related diseases.1 As per reports, approximately half of all cancers in men in India are tobacco related, while over 60% of those suffering from heart disease below the age of 40 years are smokers. India has one of the highest rates of oral cancer in the world, with 90% of the patients being tobacco chewers.2 Cigarettes contain cancer causing toxic agents such as tar, etc. The combination of an addictive substance (nicotine) with mutagens has made tobacco the foremost human poison.3

Smoking adversely affects both mind and body. In fact every organ in the body is affected by smoking in one or the other form. Initial adverse symptoms include headache, disturbed appetite affecting weight, drowsiness or sleeping disturbances. Over a period, symptoms such as anxiety, tension, restlessness, frustration, impatience, difficulty in concentration, irritability and depression are felt.4

Alcohol dependence – a big concern
India is one of the major sufferers from alcohol dependence, like from tobacco use. As per report by Indian Alcohol Policy Alliance, the Indian arm of Global Alcohol Policy Alliance (GAPA) functioning with the aim to prevent alcohol related harm through evidence based policy intervention, advocacy and capacity building, there are over 6 crore alcohol users in India. Per capita consumption of alcohol increased by 106.7% over the 15-year period from 1970 to 1996. About 80% of alcohol consumption is in the form of hard liquor or distilled spirits which contains high concentration of alcohol. Hazardous drinking (alcohol consumption which confers the risk of physical and/or psychological harm5) is significantly associated with severe health problems  such as head injuries and hospitalizations.6

Can homoeopathy manage withdrawal symptoms effectively?
Yes, experts and institutes involving in de-addiction programs assure, based on their expertise for decades, that all the withdrawal symptoms are perfectly and effectively manageable by homoeopathic medication. In many de-addiction centers, it is being practically proved and practiced to help the patients to struggle with the withdrawal symptoms. It has been proved that a range of homoeopathic medicine is much more effective to the withdrawal suffering heroin addicts than the placebo method. On homoeopathic treatment all the withdrawal symptoms relieve within 5 days whereas on placebo method it continues up to 15 days. Apart from these, there are some other unique advantages of homoeopathic treatment.7
• It is non-narcotic and non-addictive. It does not cause any known physical dependence.
• Homoeopathic detoxification is rapid (generally completed within 14 days) compared to the month duration in other systems.
• The homoeopathic approach to detoxification is the most effective, rapid, safe, non-habit forming and cost-effective therapy. In the context of underdeveloped and developing countries this is the best way to handle withdrawal symptoms, hence it needs to be specially popularized.

Studies and reports about use of homoeopathy in drug dependence and its withdrawal symptoms
There have been studies and reports on the efficacy of homoeopathy in drug dependence and its withdrawal symptoms. For instance, a study8 conducted by Navjyoti Drug Demand Reduction Training Institute, with 169 patients addicted primarily to opium, its alkaloid derivatives either natural or synthetic (Morphine, Codeine, Heroine, Pethidine and other Narcotic etc.), has found that homoeopathic medicines have acted better in relieving the acute withdrawal symptoms than the placebo in each group. Symptoms like lachrymation, sneezing, yawning, abdominal pain, constipation, anxiety & irritability have particularly responded better to the medicine than placebo. The medicines used were Arsenicum album, Nux vomica, Rhustox, Pulsatilla, Ipecac and Chamomilla. The study revealed that out of these six medicines four medicines namely Arsenic album, Nux-vomica, Rhus tox, Pulsatilla appear more frequently indicated. Based on the findings of the study, Arsenicum album, Nux vomica, Rhus tox., and Pulsatilla were found to be effective.
Another study9 conducted by Central Council for Research in Homoeopathy, at its Clinical Research Unit, Varanasi (U.P.) with 241 cases, 209 cases had showed improvement in withdrawal symptoms whereas 32 cases did not improve. Rhus toxicodendron (n=85) was found to be most effective medicine. Other medicines found effective were Avena sativa (n=43), Nux vomica (n=34), Arsenic album (n=26), Bryonia alba (n=8) and Chamomilla (n=7). Rhus toxicodendron, Arsenic album, Chamomilla were found to be effective in 10M potency, Bryonia alba & Nux vomica in 200C potency and Avena sativa in mother-tincture.

Specific drugs for tobacco and alcohol de-addiction
Daphne indica – a drug for tobacco de-addiction
This drug was proved and introduced by Bute. Its homoeopathic tincture is made from the bark.10 It is covered by Homoeopathic Pharmacopoeia of India.11 Literatures indicate it usefulness in craving for tobacco, especially in cases trying for cessation of smoking tobacco. It is a common ingredient in many preparations in the market. Use of Daphne indica 1x is specific for de-addiction helping elimination of associated symptoms. Daphne indica acts on the tissues, muscles, bones and skin. It helps elimination of fetid breath, offensive urine and sweat. Withdrawal symptoms cover pains which are erratic and electric-like, sudden, lightning jerks in different parts of the body.12-17 A report submitted to the University of Johannesburg has found that a homoeopathic anti-smoking complex containing Daphne indica with 30 participants is effective in the treatment of smoking cessation.18

Quercus robur – a drug for alcohol de-addiction
Quercus robur is a drug prepared from the common oak.10 It was introduced to homoeopathic practice by Burnett.12,19 Dr. Schroyens also mentions this for alcoholism.15 Cooper had observed it useful in specific sensations like "felt as if in a vice; dared not move for fear of a fit of apoplexy, an attack of giddiness”, and "deafness with noises in the head".12 It is officially covered by Homoeopathic Pharmacopoeia of United States20 and mentioned in German Homoeopathic Pharmacopoeia21.

Different species of Quercus but containing similar phytochemicals have been used in Indian medicine for symptoms like diarrhoea, dysentery, gastric catarrh, swelling of spleen and other alcoholic symptoms.22 Its chief actions are on alcoholism, constipation, diarrhoea, giddiness, gout, intermitting fever, dropsy (splenic), leucocythaemia splenica and other affections of spleen.10,12,13,15,19,23 It specifically cures symptoms of depressive nervousness, taciturn state (habitually reserved and uncommunicative), drunken feeling in head, gnawing at pit of stomach, craving for alcohol, pain in spleen and diarrhoea.23 Quercus diminishes the craving for alcohol and antidotes the alcoholic state, and giddiness with spleen trouble.12

Other drugs useful for de-addiction with their indications12-17
Arsenicum album
Hallucinations as result of substance addiction like visions of ghosts, etc. are covered. Indicated in great weakness and diseases from overuse of alcohol. Suicidal tendency and constant annoying by bugs and vermin are most marked.
Avena sativa
It has a selective action on brain and nervous system. Most of the mental symptoms from alcohol and tobacco use are covered. This is a specific remedy for de-addiction. It is a sedative and tonic par excellence for depletion. It is good for loss of initiative and will.
Bryonia alba
Often indicated for exceedingly irritable; everything puts him out of humor. Delirium is notable with symptoms like ‘wants to go home’. Alcohol withdrawal symptoms like vertigo, nausea, faintness on rising, confusion, bursting, splitting headache, as if everything would be pressed out are also covered.
Cannabis Indica
It is most useful in acute alcoholism. Symptoms like violence, talkativeness and active mind are covered. Like Arsenicum album, delusions and hallucinations related to exaggerated subjects, time, space, etc. are also relieved over a period. Flushed face, dilated pupils, easy perspiration are indicated.
Chamomilla
One of the important drugs for de-addiction, it is more suited to irritable and restless people. Whining restlessness. Impatient, intolerant of being spoken to or interrupted; extremely sensitive to every pain; always complaining. Aftereffects of anger and vexation. Mental calmness contraindicates this drug.
Ipecacuanha
In alcoholics, stomach complaints are predominant. Irritable; holds everything in contempt. Full of desires, for what they know not. Constant nausea and vomiting, with pale, twitching of face. Vomits food, bile, blood, mucus. Stomach sometimes feels relaxed, as if hanging down.
Nux vomica
It is one of the important anti-alcoholic remedies. Alcoholic symptoms like tremor, other nervous affections, headache, and bad taste are covered. It also corresponds to delirium tremens, where every little noise frightens and the victim finds no rest any place, springs up at night and has frightful visions. The tremor is marked with ugliness and irritability and gastric disturbance.
Pulsatilla
Disposition and mental state are the chief guiding symptoms to the selection of Pulsatilla. Weeping tendency. Timid, irresolute. Fears in evening to be alone, dark, ghost. Likes sympathy. Easily discouraged. Morbid dread of the opposite sex. Highly emotional.
Opium
Literature indicates it suites “old sinners” who have had delirium tremens over and over again. There is a constant expression of fright or terror. Hallucinations like visions of animals, ghosts, etc. are covered. Sleep is disturbed with stertorous breathing. Also indicated in cases simulating apoplexy.
Rhus toxicodendron
Thoughts of suicide is predominent. Extreme restlessness, with continued change of position is marked. Delirium, with fear of being poisoned. Sensorium becomes cloudy. Great apprehension at night, cannot remain in bed.

References

  1. Raj Kumar, Suraj Prakash, Alka Singh Khushwah, Harsh Kumar, Smoking cessation-control measures, 2005, Volume 22, Issue 2, Page : 68-73
  2. Nyo Nyo Kyaing, Regional Situation Analysis of Women and Tobacco in South-East Asia, World Health Organization – Regional Office for South-East Asia. Available at: http://www.searo.who.int/LinkFiles/NMH_regSituationAnalysis.pdf.
  3. Tobacco Control Foundation of India, Tobacco facts. Available at: http://tobaccoindia.org/Tobacco-Facts.html.
  4. David Zieve, David C. Dugdale, Nicotine addiction and withdrawal, Medline Plus Medical Encyclopaedia, National Institutes of Health, U.S. Department of Health and Human Services. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000944.htm. Retrieved on: 23 July 2012.
  5. Thomas F. Babor, John C. Higgins-Biddle, BRIEF INTERVENTION - For Hazardous and Harmful Drinking, A Manual for Use in Primary Care, World Health Organization, Department of Mental Health and Substance Dependence. Available at: http://whqlibdoc.who.int/hq/2001/who_msd_msb_01.6b.pdf.
  6. Alcohol Related Harm in India – a fact sheet, Indian Alcohol Policy Alliance, V15, Green Park Extn., New Delhi 110 016. Available at: http://www.addictionindia.org/images-ttkh/alcohol-related-harm-in-india-a-fact-sheet.pdf.
  7. Training and Documentation Unit, Navjyoti Delhi Police Foundation, Drug Abuse - Frequently Asked Question. Available at: http://www.navjyoti.org.in/publication/Drug%20Abuse%20-%20FAQ.pdf
  8. Ajay Grover, Bharat Bhushan & Rajesh Goel, Double blind placebo controlled trial of Homoeopathic medicines in the management of withdrawal symptoms in Opium addicts and its alkaloid derivatives-dependents, Indian Journal of Research in Homoeopathy, Vol. 3, No. 1, January-March 2009
  9. Yogindra Rai, Withdrawal symptoms of drug abuse, Clinical Research Studies, Series-l. Central Council for Research in Homoeopathy, 2008; 125-129.
  10. P. N. Varma, Indu Vaid, Encyclopaedia of Homoeopathic Pharmacopoeia, Updated edition 2007, B. Jain Publishers, New Delhi.
  11. Homoeopathic Pharmacopoeia of India, Ministry of Health and Family Welfare, Government of India.
  12. J. H. Clarcke, Dictionary of Practical Materia Medica, Reprint Edition 1992, B. Jain Publishers, New Delhi.
  13. W. Boericke, New Manual of Homoeopathic Materia Medica & Repertory [with Relationship of Remedies], Second Re-Augmented & Revised Edition Based on Ninth Edition, Reprint Edition 2002, B. Jain Publishers, New Delhi.
  14. J. T. Kent, Repertory of the Homoeopathic Materia Medica and a Word Index, Reprint Edition 1995, B. Jain Publishers, New Delhi.
  15. F. Schroyens, Synthesis Treasure Edition 2009V, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
  16. R. Murphy, Homeopathic Remedy Guide, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
  17. R. Murphy, Repertory Version 3, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
  18. Grové, Yolani, Efficacy of Anti Smoking Complex in nicotine withdrawal and smoking cessation. Thesis/dissertation submitted to Department of Homoeopathy, University of Johannesburg. Available from: https://ujdigispace.uj.ac.za/handle/10210/2349.
  19. J. C. Burnet, Diseases of Spleen, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.
  20. Homoeopathic Pharmacopoeia of the United States, Southeastern, PA, Homeopathic Pharmacopeia Convention of the United States (available by subscription at http://www.hpus.com/)
  21. German Homeopathic Pharmacopoeia (GHP) Vols 1 and 2. Stuttgart, Medpharm Scientific Publishers, 2006.
  22. K. M. Nadkarni, Indian Materia Medica, Edited by A. K. Nandkarni, Volume 1, Bombay Popular Prakashan, Mumbai – 34
  23. C. Richardson-Boedler, Psychic causes of Illness: Applying Homeopathy and Bach flowers therapy to Psychosomatic illness, Part Two : Keynote Materia Medica of the Bach Remedies, under ‘Homeopathic indications for Quercus robur’, RadarOpus 1.33, Archibel S.A. Rue Fontaine St. Pierre 1E, Zoning Industriel de la Fagne, 5330 Assesse, Belgium.

Source: Dr. R. Valavan, An overview on the use of homoeopathic medicine in de-addiction, Homoeopathy for All, February 2013

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