HOMEOPATHY FOR
SUBSTANCE USE DISORDER OR DRUG ADDICTION
A drug is
defined by WHO, as any substance that, when taken in to the living organism,
may modify one or more of its functions. This definition conceptualizes ‘drug’
in a very broad way, including not only the medications but also the other
pharmacologically active substances.
The words
‘drug addiction’ and ‘drug addict’ were dropped from scientific use due to
their derogatory connotation. Instead ‘drug abuse’, ‘drug dependence’ ,
‘harmful use’, ‘misuse’, and ‘psychoactive substance use disorders’ are the
terms used in the current nomenclature. A psychoactive drug is one that is capable
of altering the mental functioning.
There are
four important patterns of substance use disorders, which may overlap with each
other.
· Acute
intoxication
· Withdrawal
state
· Dependence
syndrome
· Harmful
use
Acute
intoxication
According to
the ICD-10, acute intoxication is a transient condition following the
administration of alcohol or other psychoactive substance, resulting in
disturbances in level of consciousness, cognition, perception, affect or
behavior, or other psychophysiological functions and responses. This is usually
associated with high blood levels of the drug.
However, in
certain cases where the threshold is low, due to a serious medical illness such
as chronic renal failure or idiosyncratic sensitivity, even a low dose may lead
to intoxication. The intensity of intoxication lessens with time, and effects
eventually disappear in the absence of further use of the substance. The
recovery is therefore complete, except where tissue damage or another
complication has arisen.
The following
codes may be used to indicate whether the acute intoxication was associated
with any complications.
· Uncomplicated
(symptoms of varying severity, usually dose-dependent, particularly at high
dose levels.
· With
trauma or other bodily injury
· With
other medical complications, such as hematemesis, inhalation of vomitus
· With
delirium
· With
perceptual distortions
· With
coma
· With
convulsions
· Pathological
intoxication, only for alcohol
Withdrawal
state
A withdrawal
state is characterized by a cluster of symptoms, often specific to the drug
used, which develop on total or partial withdrawal of a drug, usually after
repeated and/or high-dose use. This, too, is a short-lasting syndrome with
usual duration of few hours to few days.
Typically,
the patient reports that the withdrawal symptoms are relieved by further
substance use.
The
withdrawal state is further classified as:
· Uncomplicated
· With
complications
· With
delirium
Dependence
syndrome
According to
the ICD-10, the dependence syndrome is a cluster of physiological, behavioral,
and cognitive phenomena in which the use of a substance or a class of
substances takes on a much higher priority for a given individual than other
behaviors that once had greater value.
A central
descriptive characteristic of the dependence syndrome is the desire (often
strong and sometimes overpowering) to take psychoactive substances (which may
or may not have been medically prescribed), alcohol, or tobacco. There may be
evidence that return to substance use after a period of abstinence leads to a
more rapid appearance of other features of the syndrome than occurs with
non-dependent individuals.
A definite
diagnosis of dependence should usually be made only if at least three of the
following have been experienced or exhibited at sometime during the previous
year.
· A
strong desire or sense of compulsion to
take the substance.
· Difficulties in controlling the substance-taking
behavior in terms of its onset, termination or levels of use.
· A
physiological withdrawal state when the
substance use has ceased or reduced, as evidenced by the characteristic
withdrawal syndrome for the substance; or use of the same (or a closely
related) substance with the intention of relieving or avoiding withdrawal
symptoms.
· Evidence
of tolerance, such that increased doses of the
psychoactive substance are required in order to achieve effects originally
produced by lower doses (clear examples of this are found in the alcohol and
opiate-dependent individuals who may take daily doses that are sufficient to
incapacitate or kill non-tolerant users).
· Progressive neglect of alternative pleasures or interests
because of psychoactive substance use, increased amount of time necessary to
obtain or take the substance or to recover from its effects.
· Persisting with substance use despite clear
evidence of overtly harmful consequences, such as harm to the liver through
excessive drinking, depressive mood states consequent to periods of heavy
substance use, or drug-related impairment of cognitive functioning; efforts
should be made to determine that the user was actually, or could be expected to
be, aware of the nature and extent of the harm.
A narrowing
of personal repertoire of patterns of psychoactive substance use has also been
described as a characteristic feature of the dependence syndrome (e.g., a
tendency to drink in the same way on weekdays and weekends, regardless of the
social constraints that determine appropriate drinking behavior)
The
dependence syndrome can be further coded as (ICD-10):
· Currently
abstinent.
· Currently
abstinent, but in a protected environment (e.g., in hospital, in a therapeutic
community, in prison etc.).
· Currently
on a clinically supervised maintenance or replacement regime (controlled
dependence, e.g., with methadone, nicotine gum or nicotine patch).
· Currently
abstinent, but receiving treatment with aversive or blocking drugs (e.g.,
naltrexone or disulfiram).
· Currently
using the substance (active dependence).
· Continuous
use.
· Episodic
use (dispsomania).
The
dependence can be either psychic, or physical, or both.
Harmful
use
Harmful use
is characterized by:
· Continued
drug use, despite the awareness of harmful medical and/or social effect of the
drug being used, and/or
· A
pattern of physically hazardous use of drug (e.g., driving during
intoxication).
The diagnosis
requires that the actual damage should have been caused to the mental or
physical health of the user. Harmful use is not diagnosed, if a dependence
syndrome is present.DSM-1V-TR uses the term substance abuse instead, with minor
variations in description.
The other
syndromes associated with the psychoactive substance use in ICD-10 include
psychotic disorder, amnesic syndrome, and residual and late-onset (delayed
onset) psychotic disorder.
Psychoactive
substances
The major
dependence producing drugs are:
· Alcohol
· Opioids,
e.g., opium, heroin.
· Cannabinoids,
e.g., cannabis
· Cocaine
· Amphetamine
and other sympathomimetics
· Hallucinogens,
e.g., LSD, phencyclidine (PCP)
· Sedatives
and hypnotics, e.g., barbiturates
· Inhalants,
e.g., volatile solvents
· Nicotine
· Other
stimulants, e.g., caffeine
Causes
Aetiological
factors in Substance use disorders:
A.
Biological
· Genetic
vulnerability (family history of substance use disorder, e.g., in type 11
alcoholism)
· Co-morbid
psychiatric disorder or personality disorder
· Co-morbid
medical disorders
· Reinforcing
effects of drugs (explains continuation of drug use)
· Withdrawal
effects and craving (explains continuation of drug use)
· Biochemical
factors (e.g., role of dopamine and norepinephrine in cocaine, ethanol, and
opioid dependence
B.
Psychological factors
· Curiosity;
need for novelty seeking
· General
rebelliousness and social non-conformity
· Early
initiation of alcohol and tobacco
· Poor
impulse control
· Sensation-seeking
(high)
· Low
self-esteem
· Concerns
regarding personal autonomy
· Poor
stress management skills
· Childhood
trauma or loss
· Relief
from fatigue and/or boredom
· Escape
from reality
· Lack
of interest in conventional goals
· Psychological
distress
C.
Social factors
· Peer
pressure (often more important than parental factors)
· Modelling
(imitating behavior of important others)
· Ease
of availability of alcohol and drugs
· Strictness
of drug law enforcement
· Intrafamilial
conflicts
· Religious
reasons
· Poor
social/familial support
· ‘Perceived
distance’ within the family
· Permissive
social attitudes
· Rapid
urbanization
HOMOEOPATHIC
REMEDIES
Homoeopathy
today is a growing system and is being practiced all over the world. Its
strength lies in its evident effectiveness as it takes a holistic approach
towards the sick individual through promotion of inner balance at mental,
emotional, spiritual and physical levels. When substance use disorder is
concerned there are many effective medicines are available in Homoeopathy, but
the selection depends upon the individuality of the patient, considering the
mental and physical symptoms.
AVENA
SATIVA
Avena sativa
is one of the best remedies for drug addiction. It is effective for the bad
effects of morphine or heroin addiction. It is a good remedy for those addicted
to cocaine, marijuana, nerviness, tranquilizers or sedatives. Insomnia due to
drug s or alcohol. Sleeplessness with nervous exhaustion and weakness.
NUX
VOMICA
Nux vomica is
effective for the bad effects of alcohol, tobacco, opium, coffee, wine etc. The
patient is nervous and highly irritable. Headache and intoxicated feeling.
Dyspepsia, nausea and vomiting, constipation are other leading symptoms.
MORPHINUM
Morphinum is
used for the bad effects of over use of drugs. Mentally the patient is
depressed and behaves in a dream-like state. Vertigo and dizziness on least
movement of head. Face is dusky red or pallid lividity of face, lips, tongue,
mouth, or throat. Violent throbbing in heart and carotids. Alternation of
tachycardia and bradycardia.
COFFEA
Severe
insomnia due to drug addiction. Hyperactivity of mind and body. Increases the
sensibility of nerves, making them over excitable and over sensitive. Special
senses become over acute, emotions especially joy and pleasurable surprise,
produces dangerous symptoms. Now joyous, now gloomy. Coffea removes the bad
effects of sleeping pills.
CANNABIS
INDICA
Exaltation of
spirits. Constant fear of becoming insane. Horror of darkness. Absent minded,
forgetful. Emotions and sensations are exaggerated.
BELLADONNA
Fear of
darkness and vision of ghosts as a result of drug addiction. Desire to
escape or hide himself. Acuteness of all senses. Changeable moods.
Hallucinations, sees monsters, hideous faces. Spit on faces of other persons.
Easily angered.
HYOSYAMUS
NIGER
Headache from
narcotic addiction. Hallucinations most marked. Talks with imaginary persons to
dead ones. Imagines things are animals. Inclined to laugh at everything. Does
foolish things, behaves like mad. Laughs, sings, talks, babbles and quarrels.
SULPHUR
Sulphur
antidotes the bad effects of Cannabis addiction. Sulphur patient express
sadness and melancholy. They imagine himself a great man. Strong impulsive
tendency to suicide by drowning or leaping from a window.
LACHESIS
Headache from
narcotics addiction. The patient is highly talkative. Sensation of tension in
various parts. Cannot bear anything tight anywhere. Sensation of constriction
in throat, abdomen and head.
PULSATILLA
NIGRICANS
Diarrhea from
heroin addiction. Changeable stools, no two stools alike.
PASSIFLORA
INCARNATA
Sleeplessness
due to drug addiction. Effective for morphine addiction. Give mother
tincture doses.
OPIUM
Drowsiness
and coma from drug addiction. The patient falls into a heavy deep sleep. Thinks
he is not at home. Sees frightful visions of mice, scorpions. Perversion of all
senses. Euphoric state, overexcitement and sleeplessness.
VIPERA
A remedy for
drug addictions by injections.
