HERBAL THERAPY IN THE TREATMENT OF DRUG ADDICTION

Laxman Singh*, Renu Suyal and I. D. Bhatt

G.B. Pant National Institute of Himalayan Environment and Sustainable Development, Kosi- Katarmal, Almora, Uttarakhand, India

*Correspondence: [email protected]

ABSTRACT A search for novel herbal therapy for the phenomenon of substance abuse has progressed significantly in the past decade. The powerful potential of phytotherapy being equally competent to the counterpart i.e. synthetic analogue and is presumed to be safe without any side effects. As a result of which a large numbers of herbal formulations are being prepared and are being tested for its psychotherapeutic potential in a variety of animal models. The objective of this article is to highlight some of the herbal extracts from the Indian sub-constituents, having significant therapeutic potential against drug addiction. Herbal remedies, although have demonstrable psychotherapeutic potentials, but proper scientific validation with adequate proof is still in its initial stage. Hence, in future studies it deserves special attention, taking into considerations the growing rate of abuse addiction.

Keywords: Phytotherapy, Drug addiction, Herbal therapy.

INTRODUCTION globe consume one drug or the other (Sharma et al., 2017). Plants have evolved intrinsic mechanisms to synthesize an array To an estimate, the binge addiction alone results into of biologically active compounds that are in turn important for 2.5 million death per year, while, cocaine, heroin and other them to survive and perpetuate. One such special category of drugs accounts to about 0.1 to 0.2 million deaths per year plants are the psychoactive plants, which have been used since (UNDOC 2010). India being no exception and is caught in the prehistoric times to lessen physical pain or mind-altering the hands of drug abuse. Over the years, the number of cases purposes, as promptly written in several ancient literatures. related to drug abuse is increasing day by day. The epidemic Some of the widely used, active psychoactive compounds vicious circle it engulfs is mainly the youth generation, who includes; caffeine, nicotine, cocaine, and , which become attracted knowingly or unknowingly. In recent years, are known for their direct affect on the nervous system and the country has seen major transformation in the family thus, changing the behavioral state of mind. Activities such structuring, changes in cultural values, increasing economic as hallucinogens that distort reality, sedatives/narcotics that stress and most importantly declining supportive bonds that induce sleep, calmative or anxiolytics, antidepressants, and are figured as the leading cause to substance abuse. stimulants that wake the mind are reported. But, over time, According to the UN report on registered heroin addiction in regular usage of such substances and its derived products India is about 1 million, but there is a fear that the figure could such as alcohol, opioids, cigarettes tobacco and diversion of be much more than this to about 5 million (Miller et al., 1993). prescription drugs has resulted in a habitual behavioural intake, Cannabis, opium, heroin, methamphetamine are the most as a result of which in today’s scenario abuse and addiction commonly used soothing substance after alcohol and tobacco. has become a common practice. Thus, this is perceived as a Taking this into account, Government of India conducted a complex chaos associated with biological, emotional, and National household survey (2004) on drug use in the country. social factors, leading to heath deterioration, loss of economic The survey was conducted by Institute of Development and prosperity of the family, transmission of infectious diseases Communication and is the first systematic documentation on (like HIV/AIDS), social disorder, crime etc and is one of the prevalence of drug abuse in the country.The survey revealed major health problem concerns internationally. that the primary substance abuse in the country was due to According to the report of United Nations Office on Drugs alcohol intoxication accounting to about (21.4%) actively and Crime (UNODC) approximately 5 per cent of the world’s followed by cannabis (3.0%) and use of opioids (0.7%). populations were found to be indulged in activities such as According to Drug Abuse Monitoring System Data, number illicit drug abuse in 2010. The world statistics on trade of drugs of patients visit for rehabilitation, were indulged in intake of al- account to about $500 billion, and is believed to be third largest cohol (43.9%), opioids (26%) and cannabis (11.6%) (Ray 2004). business sector around the globe next to petroleum products and Taking this into consideration, in future discourse relapse and arms trade. Approximately about 190 million people around the rehabilitation against these substances become utmost priority.

ENVIS Bulletin Himalayan Ecology, Vol 26, 2018 91 Over the year many synthetic analogue have been RESULTS AND DISCUSSION formulated and prescribed, but at point of time, there are re- Rehabilitation and discontinuation of substance addictions port of development of side effects and tolerance development. remains a challenging task of research in present scenario. Therefore, the search for alternative and complementary Several allopathic drugs i.e. , disulfiram, approaches becomes necessary. metadoxine, , gamma hydroxybutyric acid (GHB), In this regards herbal therapy has gained significant impetus chlordiazepopxide, and have been tried and for drug withdrawal prevention, possibly and relapse mainly tested to prevent relapse but they are known to have their own due to minimal side effects. merits and demerits. Frequent use of these drugs often leads to hypotension, METHODOLOGY impairment in consciousness, depression, agitation and anxiety Information was collected and retrieved using popular disorders etc. Other than this the modern pharmacological search engine such as Microsoft academic, Google approaches are known to play a key role in achieving complete Scholar, and Mendeley. The keywords used were herbal to partial abstinence and preventing relapse, their efficacy is still remedies, drug dependence and addiction, phytotherapy, limited, accompanied with a great deal of side effects, tolerance complementary medicines. The data was congregated development, and sensitization or dependence to such drugs through the Boolean information retrieval method using (Abenavoli et al., 2009). “AND” / “OR” operators.

Table 1. Preclinical research based on ethno-pharmacological applications targeting substance abuse

Type of Species Tested model Extract Results References addiction

Administration of Ws root extract inhibited Withania Albino mice (Laka Opiate (mor- development of tolerance to analgesic effect Kulkarni et al., somnifera WS root extract strain) phine) of morphine while inhibiting development of 1997 (L.) Dunal withdrawal jumps WSE markedly reduces motivation for drinking and seeking ethanol and could be Adult male Wistar rats WS extract Alcohol Peana et al., 2014 an alternative phytotherapic approach for the treatment of excessive alcohol drinking Hyperforin reduces alcohol intake and help in Hypericum Marchigian Sardinian HPE ( 3.8% Panocka et al., Alcohol the treatment of mild to moderate depression perforatum L. (msP)rats hyperforin) 2000 and alcoholism HPE markedly reduces ethanol intake in msP Marchigian Sardinian Perfumi et al., HPE ( 0.3% hypericin) Alcohol rats (125 or 250 mg/kg) without modifying (msP)rats 1999 food intake with 30-40% reduction At a dose of 100 mg/kg/day, the extracted Pueraria , , and isoflavonoid (daidzein, daidzin, and ) lobata Female P rats puerarin (isoflavonoid) Alcohol supressess alcohol consumption by 75%, Lin et al.,1996 (Willd.) from plant extract 50%, and 40% respectively without any toxic Ohwi effect Ginger possess anti-addictive property against Zingiber chronic usage of morphine due to anti-inflam- Torkzadeh-Mahani Officinale Male Wistar rats Ginger root extract Morphine matory and antioxidant properties and ability et al., 2014 Roscoe to reduce morphine-induced glial activation and neuroinflammation Extract caused faster removal of ethanol from Ginkgo Rat Water extract Alcohol blood of normal rat due to enhanced alcohol Sakai et al., 1989 biloba L. dehydrogenase (ADH) activity Boerhaavia diffusa root extract possess hepatoprotective activity as it decreases the serum activities of marker enzymes Boerhaavia Male Wistar rats Root extract Alcohol such as aspartate aminotransferase, alanine Devaki et al., 2004 diffusa L. aminotransferase, alkaline phosphatase, lactate dehydrogenase and gamma glutamyl transferase etc.

92 ENVIS Centre on Himalayan Ecology Presently efforts are being made to focus on the development Lin RC, Guthrie S, Xie CY, Mai K, Lee DY, Lumeng of low-toxicity and high-efficiency natural remedies, with urge L, Li TK (1996). Isoflavonoid compounds extracted to deepen our understanding of the complementary approaches from Pueraria lobata suppress alcohol preference in a used in traditional and folk medicine. Taking in account the pharmacogenetic rat model of alcoholism. Alcoholism: beneficial effects and application of herbal medicines has led to Clinical and Experimental Research, 20(4): 659-663. the isolation and characterization of pure and active compounds such as Withanolide D and Withaferin A from Withania Miller WR, Sanchez VC (1993). Motivating young adults somnifera, Daidzin, daidzein and puerarin from Pueraria lobata, for treatment and lifestyle change. In: Howard G, editor. tanshinones I and II, cryptotanshinone, and miltirone from Issues in Alcohol Use and Misuse in Young Adults. Notre Salvia miltiorrhiza, hyperforin from Hypericum perforatum, and Dame: University of Notre Dame Press, 55–82 ginsenosides from Panax ginseng, that are some of the widely studied and well known species that suppress substance intake Perfumi M, Ciccocioppo R, Angeletti S, Cucculelli M, in experimental animals (Abenavoli et al., 2009; Rezvani et al., Massi M (1999). Effects of Hypericum perforatum extract 2002; Zhu et al., 2017). These substances are known to put forth on alcohol intake in Marchigian Sardinian alcohol- their effects by influencing several of the neurological systems, preferring rats. Alcohol and Alcoholism, 34(5): 690-698. thereby suppressing drinking behaviour. Table 1 provides a brief summary of selected herbal products found in India and their Peana AT, Muggironi G, Spina L, Rosas M, Kasture SB, suppressant effects on substance abuse. Cotti E, Acquas E (2014). Effects of Withania somnifera Considering the limitations of the available on oral ethanol self-administration in rats. Behavioural pharmacotherapeutic agents, herbal remedies may provide an pharmacology, 25(7): 618-628. alternative. Herbal extracts and constituents with demonstrable psychotherapeutic effects in animal models deserve further Panocka I, Perfumi M, Angeletti S, Ciccocioppo R, Massi clinical trials and evaluation. As, the use of these formulation M (2000). Effects of Hypericum perforatum extract on in most the therapeutics is still in its infancy stage. Collective ethanol intake, and on behavioral despair: a search for investigation on clinical and behavioural studies of herbal the neurochemical systems involved. Pharmacology remedies would provide a unique opportunity for the Biochemistry and Behavior, 66(1): 105-111. development of new pharmacotherapies for drug withdrawal symptoms and provide relapse. Rezvani AH, Parsian A, Overstreet DH (2002). The Fawn-Hooded (FH/Wjd) rat: a genetic animal model of CONCLUSION comorbid depression and alcoholism. Psychiatr. Genet., Herbal therapy treatment is known to offers assessable advantage 12: 1–16. over the existing pharmacological intervention. Less cost aided with safe for consumption, with least side effects further adds Sakai K, Saitoh Y, Ikawa C, Nishihata T (1989). Effect of value to this. Thus usage of herbal therapy to prevent relapse Water Extracts of Aloe and Some Herbs in Decreasing and to achieve complete rehabilitation remains a challenging Bllod Ethanol Concentration in Rats. Chemical and task of research. Further behavioral and clinical studies of herbal Pharmaceutical Bulletin, 37(1): 155-159. remedies might provide a break through, for the development of new pharmacotherapies for substance addiction withdrawal and Sharma B, Arora A, Singh K, Singh H, Kaur P (2017). Drug thereby preventing relapse. abuse: Uncovering the burden in rural Punjab. Journal of Family Medicine and Primary Care, 6 (3): 558-562. REFERENCES Abenavoli L, Capasso F, Addolorato G (2009). Phytotherapeutic Torkzadeh S, Nasri S, Esmaeili S (2014). Ginger (zingiber approach to alcohol dependence: new old way. Phytomedicine, officinale roscoe) prevents morphine-induced addictive 16: 638–644. behaviors in conditioned place preference test in rats. Addiction & Health, 6(1-2): 65. Devaki T, Shivashangari KS, Ravikumar V, Govindaraju P (2004). Hepatoprotective activity of Boerhaavia diffusa on United Nations Office on Drugs and Crime (UNODC) ethanol-induced liver damage in rats. Journal of Natural Vienna, Austria: UNDOC; 2010. World Drug Report Remedies, 4(2): 109-115. 2010, United Nations \Publication, Sales No.E.10.XI.13

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