Pharmacodynamics of psychoactive substances & Role of Homeopathic medicines in Mitigating their abuse

Abstract: Down the ages, psychoactive substances such as tea, coffee, beer and wine are used in order to be more attentive, improve performance and engage in recreational activities. But the chronic or excessive use of these substances may have a negative impact on one’s mental, emotional & physical well-being. This article explores the pharmacodynamics of commonly used psychoactive substances. It also discusses how homeopathy can help reduce both the immediate symptoms and long-term effects of these psychoactive substances.

Keywords: Psychoactive substances, caffeine, alcohol, tea, coffee, tobacco, drug abuse, addiction, withdrawal, pharmacodynamics, homoeopathy, rubrics, etc.

Introduction:  Drug is any substance or product that is used or is intended to be used to modify or explore physiological systems or pathological states for benefit of the recipient. ^(1,2,3,4) The term drugs are also being used to mean addictive/ abused substances. ⁽¹⁾ Out of all the drugs ICD-10 recognizes the following drugs or drug classes, the self-administration of which may produce mental and behavioral disorders, including dependence ⁽⁵⁾ : 

1. Alcohol
2. Opioids
3. Cannabinoids
4. Sedatives or hypnotics
5. Cocaine
6. Other stimulants including caffeine
7. Hallucinogens
8. Tobacco
9. Volatile solvents
10. Other psychoactive substances and drugs from different classes used in combination.  

The effects of these medications on the human body are explained in detail in this article, which falls under Pharmacodynamics. 

Pharmacodynamics {Greek: Pharmacon- drug, dynamis- power} 

This includes physiological and biochemical effects of drugs and their mechanism of action in the macromolecular/ subcellular/ organ system. The study of pharmacodynamics will assist us in examining the harmful effects of the psychoactive substance on the human body. ⁽¹⁾ This article also aims to list down various homoeopathic medicines that might provide an all-natural and individualized approach of treatment of the symptoms developed due to drug dependence of the psychoactive substances and then tackle the withdrawal symptoms.

     Core Discussion:

1. Alcohol: {Arabic word “Alkahl” that means “something subtle”}

Chemically alcohols are hydroxy derivatives of aliphatic hydrocarbons. ⁽¹⁾ They are believed to produce CNS depression by promoting GABA_A receptor mediated synaptic inhibition as well as inhibition of the excitatory amino acid receptors. ⁽²⁾ Alcohol produces simultaneous changes in many neurotransmitters and increases the fluidity of neuronal cell membranes. In small doses alcohol interferes with cortical functions such as conduct, judgement, self-criticism, and release of inhibitory tone but larger doses depress the medullary processes. ^(1,2)

Toxicity ^(1,4) :

1. Effects of moderate drinking- Nausea, vomiting, flushing, hangover, etc.
2. Acute alcoholic intoxication- Hypotension, gastritis, hypoglycemia, collapse, respiratory depression, coma and death.
3. Chronic alcoholism- Nutritional deficiencies, impaired mental & physical performance, neurological afflictions are common- polyneuritis, pellagra, tremors, seizures, loss of brain mass, Wernicke’s encephalopathy, Korsakoff’s psychosis. Alcoholic cirrhosis of the liver, hypertension, cardiomyopathy, CHF, arrhythmia, stroke and skeletal myopathy are other complications.
4. Withdrawal symptoms- Anxiety, sweating, tremor, impairment of sleep, confusion, hallucinations, delirium tremens, convulsions and collapse.

Homoeopathic perspective:

Rubrics related to alcohol abuse in various repertories:

Repertory	Chapter	Rubric
Kent (6)	Urine	Albuminous: alcohol: after abuse of
	Chill	Alcohol, abuse of
BTPB (7)	Vision	Agg: Alcohol, abuse of
	Urine	Condition of urination: Alcohol, abuse of
Phatak (8)	Albuminuria	Alcohol after abuse of

Therapeutic insights on alcohol abuse from Hom. Materia Medica: 

Acetic acid-Hering: Headache from abuse of alcohol (9)

Crotalus Horridus-Hering: Indicated in diseases caused by abuse of alcohol (9)

Lachesis-Hering: Blowing expiration, cannot bear neck touched, left sided apoplexy, especially if after mental emotions or abuse of alcohol (9)

Lycopodium-Hering: Ascites from liver affections, after abuse of alcohol (9)

Nux Vomica-Hering: Tearing in the infraorbital branch of the trigeminus, clear water from the eye and nostril of affected side, face numb after abuse of liquor (9)

Veratrum Album-Hering: Vertigo, with cold sweat on forehead, with loss of vision, sudden fainting; from abuse of alcohol (9)

Cannabis Sativa-Boericke: Cataract from abuse of alcohol (10)

Carboneum Sulphuratum-Boericke: Very useful in patients broken down by abuse of alcohol (10)

Calc Ars. –J.H.Clarke: Complaints of drunkards after leaving off alcohol.(11)

Capsicum –Boericke: Abstainers from accustomed alcoholics (10)

2. Caffeine:

Caffeine is one of the active ingredients found abundantly in tea, coffee, cola beverages and chocolates. ⁽⁴⁾ Within an hour of consumption, caffeine is quickly and fully absorbed. It is found in bodily fluids and easily penetrates cell membranes, including those in the brain. Its main stimulatory action mechanisms seem to be phosphodiesterase inhibition and adenosine receptor blockage. The main byproduct of caffeine metabolism and excretion in humans is paraxanthine, which likewise has pharmacologic effects. Paraxanthine may exacerbate withdrawal symptoms and tolerance development with repeated caffeine dosage.  With repeated use, a tolerance to certain of the physiological effects of caffeine develops. ⁽¹²⁾

Toxicity ⁽⁴⁾ :

1. Effects of moderate drinking- Increased alertness, decreased drowsiness, and lessened fatigue.
2. Acute intoxication- Headache, tremors, nervousness, irritability and slight increase of blood pressure.
3. Chronic usage- Insomnia, headache and depressive mental state.
4. Withdrawal symptoms- Headache, yawning, nausea, drowsiness, lethargy, rhinorrhea, irritability, nervousness and depression.

Homoeopathic perspective: Master Hahnemann has written an article on the effects of coffee wherein he explains both the advantages and disadvantages of drinking coffee. He has mentioned that though moderate coffee drinking is safe and may have some preventive effects against specific diseases, however excessive consumption of coffee can have negative effects like anxiety, insomnia and an increased risk of fractures, particularly in women and children. ⁽¹³⁾

Rubrics related to alcohol abuse in various repertories:

Repertory	Chapter	Rubric
Tea
BTPB (7)	Stomach & Epigastrium	Digestion Weak: Tea abuse of
Boericke (14)	Generalities	Complaints: abuse of tea
	Nervous System	Sleep: Tea, abuse
Coffee
Kent (6)	Face	Pain: Coffee: After abuse of
	Sleep	Sleeplessness: Coffee, after abuse of
	Chill	Chilliness: Coffee, abuse of
Boericke (14)	Circulatory System	Pain, Neuralgic, angina pectoris: Abuse of coffee from
	Nervous system	Sleep: Insomnia, remedies in general: Cause, occurrence: Coffee abuse
	Generalities	Complaints, abuse of Coffee

    Therapeutic insights on caffeine abuse from Hom. Materia Medica: 

Tea

Abies Nigra –Phatak: Indigestion of those who abuse the drinking of tea (15)J.H. Clarke: The dyspepsia caused by abuse of tea (11)

Ferrum –C. Hering: Cough worse from abuse of Tea (9)

China –Pulford: Uterine hemorrhage from excessive tea (15)

Selenium –Allen: Bad effects from excessive tea drinking or abuse of chamomile tea when hemorrhage results (16)

Coffee

Chamomilla-Phatak: Over sensitiveness from abuse of coffee (14)

Gratiola-Phatak: Neuralgia due to abuse of coffee (14)

Acetic acid-Hering: Headache from abuse of coffee (9)

Nux Vomica-Hering: Semilateral Headache from excessive use of coffeeTearing in the infraorbital branch of the trigeminus, clear water from the eye and nostril of affected side, face numb after abuse of coffee (9)

Phosphorus-Hering: Vertigo from abuse of coffee (9)

Ignatia-Kent: Headaches from abuse of coffee (17)

3. Tobacco:

The active ingredient present in tobacco is nicotine, which is a cardiotoxic poison. ⁽⁴⁾ It binds with the nicotine receptors present in the autonomic ganglia thereby mediating the complex actions. ⁽³⁾

Toxicity:

1. Acute poisoning- Nausea & vomiting, Diarrhea, pain in abdomen, salivation, tachycardia, anxiety, headache, blurred vision, confusion, paralysis, coma. ⁽³⁾
2. Chronic poisoning- Recurrent craving for tobacco, cough, impaired memory, amblyopia. ⁽³⁾
3. Withdrawal symptoms- Frequent change in mood, insomnia, restlessness, constipation, headache and anxiety. ⁽⁴⁾

Homoeopathic perspective:

Rubrics related to tobacco abuse in various repertories:

Repertory	Chapter	Rubric
Kent (6)	Mind	Anxiety: tobacco, from smoking
	Head	Pain, headache in general from tobacco smoking
	Vision	Loss of vision: tobacco
	Sleep	Sleeplessness, tobacco abuse after
Boericke (10)	Eye	Vision: amaurosis (blindness), tobacco
	Stomach	Indigestion dyspepsia remedies in general, cause tobacco
	Circulatory	Palpitations, cause: tobacco
	Generalities	Complaints abuse of tobaccoComplaints abuse of tobacco, boys in
BTPB (7)	Stool	Aggravation & amelioration, tobacco abuse of

    Therapeutic insights on tobacco abuse from Hom. Materia Medica: 

Abies Nigra –

Phatak: Indigestion of those who smoke or chew tobacco (14)

Acetic acid-Phatak: Headaches from abuse of tobacco (14)

Agnus castus-Boericke: Tachycardia caused by tobacco in neurotic young men (10)

Bryonia alba-Phatak: jerking toothache when smoking or chewing tobacco (14)

Caladium seg. –Allen: Destroys craving for tobacco (16)

Chininum Ars. –Phatak: Ill effects of tobacco (14)

Gelsemium-Boericke: Insomnia from tobacco (10)

Hepar Sulph-Phatak: Trembling weakness after tobacco smoking (14)

Ipecac-Allen- Excessive nausea & vomiting after abuse of tobacco (16)

Lycopersicum-Phatak: Headache begins in the occiput spreads all over the head settles with great violence in temples, worse tobacco smoke. (14)

Natrum Mur-Phatak: trembling of the whole body from smoking tobacco (14)

Plantago major-Phatak: Produces disgust for tobacco (14)

Kalmia-Boericke: Tobacco heart (10)

Conclusion: In today’s world, the widespread use of psychoactive substances has become a common coping mechanism. However, over usage of these can have detrimental effects on one’s health. With the customized approach, homeopathy can become a useful tool for detoxification, dependency management, and mental & physical balance restoration.

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Dr. Akshay Sanjaybhai Rajgor 

M.D. (Hom.)

Asst. Prof. Department of Practice of Medicine 

Baroda Homoeopathic Medical College & Hospital, Vadodara