A TYPICAL APPEARANCE OF ADDICT IDENTlFiOii jiUi^ MARKS - SibLiV oi CHASER n DESCRIPTION OF BROWN SUGAR AlVl) ms EFFECTS Hie western world came uader the infhience of psychoactive dn^ after the second world war. With the Hippie' culhre in 1960s the problem became more serious and with each passing di^, the number of drug addicts is on the rise. Till IS^Os, their use was negligible in India and was mostly restricted to social or religious occassions. According to one estimate before 1982, the number of addicts to drugs other ttian alcohol was barely 2500 in Bombay. But with the introduction of Brown sugar in 1982 the number of addicts suddenly rose to about 80,000 in 1987 in the city of Greater Bombay, llitsct ihidia has become a transit point on the route of drug supply to the west, the dnig scene in other cities of India is equally aluminig. Even rural areas particulariy in PiMyab lud also to some extent in R^aathim and Jamiinu-Kashmir. with its loi^ border witft Pakistan, are gradually being swallowed u{> by (he drug habit Brown sugar and LSD top the list of drugs vMdi produce addiction most '«Mli)y Moat (kt^ are depressaeta. Hiey reduce the activity of the Central Nervous Syatem. liowevo* aa^hctmnines, cocaine, caflSne (in tea and coilfee) and nicotine (in tobacco) are atimulauta. The;^ raise the activity of the central nervous syatenL The present society consisits of many evil men and women who are particulariy on the look &r youngirtera wiko tcuvf be &cii^ an oocaiMiooal uptiet in their emotional li&. Un&rtunately, modem science has given them vi^i^ons to destroy individuals and even the whole oommunities with great ease and at hi^ profit to themselveiL Hieir 18 deadliest weapon today is the dnig popularly known in India as 'Brown Sugar', 'Qard', 'Smack', or 'Horse'. A aan^le of Brown sugar analysed in 1983 showed the percentage of Heroin to be ISH, whereas san^le analysed in 1985 bad 3-6% heroin only. It is adulterated with almost any substance - chalk powder, rat-poison and so on. The in^nirities of 'Brown Si^ar' oMy addiliockally ham the user, but the addiction ia caused by its herob content only. Heroin is &rmed throi^ some chemical reactions from opium Morphine, one of the alkaloids present in Opium was discovered in 1805, is a bitter tasting powder. It is a powerfiU sedative and strong analgetic. Morphine was found to produce addiction. Hence scientists ^tenq)ted to se]}arate the part of moiphine molecule viiJcb gives relief from pain. Towards the end of 19th century, it was discovered that when moqihine is treated by the chemical • acetic tmfaydride - it is converted into another powenfiil pain killer called Heroin. Unibrtunat(»ly, Heroin was found to be even more dangerous ttkan morphine. It acta more rapidly, its eJ9ects are much stronger and worst of all, it is extremely addictive. Even a couple of doses of heroin could make apetson its slave fbr Ufe. Brown-sugar is avuilable in quarters (small glatn bottles) and Fudi. One qpurter consists of 6 Pudis. Brown-si^ir wrapped in tisaie paper is known as PudL As mentioned above Heroin ie derived from 'Ahlphen' or Opium Opium iii the dined extract dtitaxotA by incision of the unripe capsules of die white poppy, Papayer 19 Somnlferum, a piatA which grown in India. This extract or opium has been used for pleasure sod medical use for tttousaods of years. The practice of using opium for diarrhoea and for making children quiet was wide-8{»vad all over the world till the 1920s. Papaver Somnlferum arAhlphena is described in Ayurvedic Materia Medica. Some of ttie medicines containing Opium or Ahlphena, oreAhlphenasava, Akiphen- vati, Ahipkena-guda-varti, Ahipkena-karpumdl oil, Crahanl-Kapat, Dugdha-vati etc. TSeae roodioines are indicated in various disorders such as Diarrhoea, {Atisaar) 0-uhani, Shotha, Arsha, Body-ai^, Rakta-atisaar, Pakyva-atlsaar etc. Ahipheoa is rookxha, sookxhma, vjfavayl and vikasi; it is tikta and Vaabaya. in taste, katu in vipaka and is of ushna veerya\ It is also described as Madakar^. Sook^ma, Vyavayi, Vikasi ondMadakari properties ofAhlphena cause sedadon and evoke a feeling of happiness i.e. ei^ihoria, when taken in small doses. But if Ahlphena is consumed fiar longer period,thi»e Vayavee/a sod Tej'as properties cause body and mind to deteriocate. Prolong iMe of.VtIphena gives rise to Dhatu-Kshaya and Vat-PrakopcP. From Ahlphena, different alkaloids were derived. Morphine, the active alkaloid of die opium poppy was isolated in the mid-oineteedh century, Heroin (diacefyl morphine) was derived in 1898. Si&sequently odier similar drugs, syn&etic or semi-synihetic opiates have been produced. All the derivatives obtained from Papaver Somnlfenwt are poisonous. According to Ayurveda, the prq>ertie» of poisons 20 are opposite ofOJas. Laghu, Uskna, Teekshna, Sookskma, Amta, Vyavayi, Vlkasi, Rooksha, Vlshad and Sara are tiic ten properties of apoison^ The efiects of Opium poisonii^ can be conveniefldy understood if we comprehend (he meaning of all the propwtiei of Vlsha or Poiitoa Ibere sre ttiree stages of Opium poisoning viz (1) Excitement (2) Sopor and (3) Narcosis. 1. Stage of Excitement : This st^ may be absent if die dose taken is lai^. In achilta, a euphoric feeling of well-being and ease comes en early. There may be a certain pleasurable mental excitement, umally of very small dur^on. Laughter, hallucin^ons and rapid heart rate occur. Tlie breath may smell of Opium. In children convulsions are a marked feature of this stage. Z. Stage of Sopor : The stage ofexcitemeot is soon followed by weariness, giddiness, a sense of weight in the limbs, diminution of sensibility, aiid a strong tendency to sleep from which (he patient can be roused by external stimuli The pupils are contracted, the &ce and lips cyanosed, and an itching sensation is feh all over the skin. The pulse and reqjiration are almost nminal. 3. Stage ofNarcosti : The patient passes into deep cmna from which be cannot be roused. The muscles are relaxed and reflexes are abolished. The pi^ils are contracted to pin-point and do not react to light Tltey tax^ dilate terminally when asphyxia ensues but still do not react to ligjbL The conjunctiva ai-e red. The blood pressure fidls. Tlie pulse is small in volume and weak at first but later becomes slow and fiill as coma develops. Ilie breatfaiug is slow, the rate beiAg 2 to 4 per 21 minute, sibling and iiregular. 'Rui ia known as Cheyne-Stokea breathing or Chhinna Shwas. The temperature ia niboormal and sldn cold and bathed in sweal There ia cyanoaia. Froth eacapea from the mouth. Coma deepena and deadi resulta from aapfayxia due to re^>iratory paralyaia and nu^ be preceded aometimea in atfcilta and oflen in children by twitdiing and apasata of nmaclea or convulaive aeizurei. Tbt above descri|iliiin of Opium poiaoning. quoted from modem medical text­ book is not &und in Ayurvedic text-books. But all these signs and symptoms vMch are produced by Opium can be explained according to the properties of Ahipkena. Ahiphena is l^sha aodMadakari havii^ramo dosha in excess (as well as raJo dosha), destroys the intelligence and brings about intoxicati<m. These Madakari substances are Laghu, Jtuksha, Ashu, Vlshada, Vyawayi, Tikshna, VHmshi, Sukshma, and Ushna. Due to Siiksha guna, Vata ia aggravated; due to Ushna, Pitta; due to Sukshma, rakta or blood ia vitiated. Btin^ Ashukari it follows the fi>od juice immediately, due to Vyavayi guna it ^n-eads to the body rapidiy, due to pungentness it kills the marma (vital seats); due to Vlkashl guna it is Prana-hara or life-taking. Being Laghu it ia very di£Bcult to treat and being Vlshada ita progress is unstoppable in the Dos^a. Due to all these gunas the poisons spoil dte Doshas, tfieir places and kill die person^. If heroin or Opium or brown-sugar consumption ia dmiptty atof^d, it prothicea withdrawal symptoms. Due to prolonged, regular consumption of brown-sugar, the body develops tolerance to Brown-sugar. The phenomenon by which ingested 22 iiubstances are digested and asstfflilated eistly is known lis Satmy<^. The concept of Satmya is peculifir to Ayurvedsi A substar«ce (dnig 'vc ditit) which achieves Satmya in die bo(^, needs to be given in greater quantity the next time in order to produce the same desirable effect The concept cXSatmya is thui similar to 'toleraDce' development, where increasii^ doses of drqgs are required to pro<kicA torn same ff^i i When regular practices • consumption of dnigs or diet or habits - wf sbiiipily stopped / d>andoned, the body reacts in an simoraval wsy, producing witiidrawal syn^oms. The diagnostic criteria for Opiod wididrawal / grades of Opiate withdrawal for different drugs and diagnostic criteria for opiod intoxication according to Che Diagnostic and Statistical Manual for Mental Disorders, third edition (i.e. DSM -DI-R) are given in tabular form : 23 TABLE 1 ; DSM -HI-R DIaimofttc Criteria for OntoJ WMidriiwal A. Cesaation of prolonged moderate or heavy uae of an opiod, or reduction in (he amount of opiod used followed by at least 3 of the following : 1. Craving for an opiod 2. Nausea or vomitiqg 3. Muade acfaea 4. r ACT iiMlion or rfainofrfaoea 5 Pupillary dilatation, piloerection or sweatiAg 6 I>iflrTbi>»ii 7 YaMviffi 8. Fever 9. Inaomnia B. Not due to any pliyaical or other mental diaorder. 2A. TABLE 2 : Gmdcs of QHJU wWawlrayal for dWcrciH diKitt Grsde SyiqHoms and Si^is Hours afierlast (lose M<Nphine Heroin Mediadoae 0 Craving &r drug Amdety 6 4 12 1 YwMoag Penpiration LacrimatioQ 14 8 34-48 Rhmorrlio^a Ten' ileep 2 Mydriuts Piloerection Muflole twitcbea 16 12 48-72 Adting booes aod muaclefl Anorexia 3 Iiiioiniia HyperteuiioD Fever Tadiypooea 24-36 18-24 Twliycvdia Reetiessnera Nawea 4 Vomitiqg Diarrik>ea Spoataneoufl ejaoulatioa 36-48 24-36 Haemoconceidration 2S TABLZ 3 : PSM-ffl-R : Dfauwiitlc crltcriiifrmteihitoxkidfw A Recent use of an opiod B Maladaptive b^ncvioml dsaQgea (e.g.