INTRODUCTION:

Drug addiction affects both brain and behavior. It has multifaceted impacts on the patients’ body, mind, and nervous system. There are different types of drugs that cause addiction as marijuana, opium, cocaine, heroin, meth and pain medications. Drug abuse is considered as a great challenge to social and public heath in the world. To date, 185 million addicts are there around the world. According to the statistics, with 1,200,000 permanent drug abusers and 600,000 occasional abusers, herbal medicine has a long history in treatment of diseases and the majority of people have tendency to use such medications.

But there are a lot of questions because of the novelty of this treatment method in treating addiction, this lack of information are more evident. In this review, we highlighted on some herbal and drugs derived from them in treatment of addiction¹.

Fig 1: Drug addiction

These polymers used for modified release. Modified release systems² are designed to reduce the frequency of dosing by modifying the rate of drug absorption has been available from many years. This type of release dosage³ forms is far better than the conventional release dosage forms. Mucoadhesive⁴ are synthetic or natural polymers that will interact with the mucus layer which is present in the body at buccal cavity, and gastric mucosal layers. Antibiotics⁵can be used for preparation of tablets. The specific approach to their use is dependent on the individuals affected and stage of the disease. Researchers⁶ are developing customized picoparticles the size of molecules that can deliver drugs directly to diseased cells in your body. Antibiotics⁷ are also used to treat this disease. Oral modified⁸ drug delivery systems can be classified in to two broad groups Single Unit dosage forms and multiple unit dosage forms. The advances⁹ and progress made by pharmaceutical industry have greatly contributed in terms of treatment of disease, thereby enhancing the quality of life. Mucilage and Gums are hydrophilic polysaccharides¹⁰. Smoking is bad for your health¹¹.

Fig 2: Recreational drug use

A drug is any substance (other than food that provides nutritional support) that, when inhaled, injected, smoked, consumed, absorbed via a patch on the skin, or dissolved under the tounge causes a temporary physiological (and often psychological) change in the body¹².

Recreational drug use¹³:

Recreational drug use is the use of a psychoactive drug to induce an consciousness for pleasure, by modifying the perceptions, feelings, and emotions of the user. When a psychoactive drug enters the user's body, it induces an intoxicating effect. Generally, recreational drugs are in three categories: depressants (drugs that induce a feeling of relaxation and calm); stimulants (drugs that induce a sense of energy and alertness); and hallucinogens (drugs that induce perceptual distortions such as hallucination). In popular practice, recreational drug use generally is a tolerated social behavior, rather than perceived as the serious medical condition of self-medication. However, heavy use of some drugs is socially stigmatized. Recreational drugs include alcohol (as found in beer, wine, and distilled spirits) cannabis and hashish; nicotine (tobacco); caffeine (coffee and tea); and the controlled substances listed as illegal drugs in the Single Convention on Narcotic Drugs (1961) and the Convention on Psychotropic Substances (1971) of the United Nations. What controlled substances are considered illegal drugs varies by country, but usually includes methamphetamines, heroin, cocaine, and club drugs. In 2015, it was estimated that about 5% of people aged 15 to 65 had used illegal drugs at least once (158 million to 351 million).

Cannabis is a commonly used recreational drug

Fig 3: Cannabis

Signs of Drug Addiction¹⁴:

You keep taking a drug after it's no longer needed for a health problem. You need more and more of a substance to get the same effects (called "tolerance"), and you can take more before you feel an effect. You feel strange when the drug wears off. You may be shaky, depressed, and sick to your stomach, sweat, or have headaches. You may also be tired or not hungry. In severe cases, you could even be confused, have seizures, or run a fever. You can't stop yourself from using the drug, even if you want to. You are still using it even though it's making bad things happen in your life, like trouble with friends, family, work, or the law. You spend a lot of your time thinking about the drug: how to get more, when you'll take it, how good you feel, or how bad you feel afterward. You have a hard time giving yourself limits. You might say you'll only use "so much" but then can't stop and end up using twice that amount. Or you use it more often than you meant to. You've lost interest in things you once liked to do. You've begun having trouble doing normal daily things, like cooking or working. You drive or do other dangerous things (like use heavy machines) when you are on the drug. You borrow or steal money to pay for drugs. You hide the drug use or the effect it is having on you from others. You're having trouble getting along with co-workers, teachers, friends, or family members. They complain more about how you act or how you've changed. You sleep too much or too little, compared with how you used to. Or you eat a lot more or a lot less than before. You look different. You may have bloodshot eyes, bad breath, shakes or tremors, frequent bloody noses, or you may have gained or lost weight. You have a new set of friends with whom you do drugs and go to different places to use the drugs. You go to more than one doctor to get prescriptions for the same drug or problem. You look in other people's medicine cabinets for drugs to take. You take prescribed meds with alcohol or other drugs.

What causes drug abuse¹⁵?

While some people can use recreational and prescription drugs without becoming addicted, many individuals who start using drugs become physically and emotionally dependent on them. Drug abuse causes vary greatly, depending on each individual and the extent of his or her addiction. The extent of a person’s vulnerability to his or her addiction depends on their social environment, their mental and physical health, and their genes. There are countless other factors that contribute to drug addiction as well. Once a person is addicted to drugs, he or she generally needs professional help and support to overcome their addiction. Understanding the underlying causes of an addiction can help and addicted person to deal with the issues that lead to their drug abuse. For some individuals, the cause of their drug abuse is solely due to peer pressure. For many others, however, the reason for their excessive drug use is much more complicated.

Effects of drug addiction (physical and psychological) psychological effects of drug addiction^16,
17:

The psychological effects of drug addiction come from the reason the user is addicted to drugs, as well as the changes that take place in the brain once a person becomes a drug addict. Initially, many people start using drugs to cope with stress or pain an effect of drug addiction is creation of a cycle where anytime the user encounters stress or pain, they feel the need to use the drug. This is one of the psychological effects of drug addiction involved in "craving" of the drug. Craving is an effect of drug addiction whereby the addict is obsessed with obtaining and using the drug, to the exclusion of all else. One of the psychological effects of addiction involved in craving is the belief the addict cannot function or handle life without use of the drug. Other psychological effects of drug addiction include: Wild mood swings, depression, anxiety, paranoia, violence, Decrease in pleasure in everyday life, Complication of mental illness, Hallucinations, Confusion, Psychological tolerance to the drug's effects creating a desire to do ever-increasing amounts of the drug, Desire to engage in risky behavior.

Physical effects of drug addiction¹⁸:

Physical effects of drug addiction vary by drug but are typically seen in all systems of the body. Some of the primary physical effects of drug addiction take place in the brain. Drug addiction changes the way the brain functions and impacts how the body perceives pleasure. These effects of drug addiction are because the drug repeatedly floods the brain with the chemicals dopamine and serotonin during drug use. The brain adapts and comes to expect, and depend on, these drug-induces highs. Physical effects of drug addiction are also seen in babies of drug abusers as well as in mortality statistics. One effect of drug addiction is: children born to drug-using mothers can be cognitively affected throughout life. Regarding mortality, one-in-four deaths are due to the effects of drug addiction. Other physical effects of drug addiction include: Contraction of HIV, hepatitis and other illnesses, Heart rate irregularities, heart attack, Respiratory problems such as lung cancer, emphysema and breathing problems, Abdominal pain, vomiting, constipation, diarrhea, Kidney and liver damage, Seizures, stroke, brain damage, Changes in appetite, body temperature and sleeping patterns.

Fig 4: Respiratory problems

Fig 5: Ginseng plant

Medicinal Plants and Addiction Treatment: Ginseng extract¹⁹:

The analgesic effects of opioids are blocked by ginseng extract in non-opioid dependent manner. Also, tolerance to and dependence on morphine are inhibited by it. Ginseng extract inhibited tolerance to and dependence on morphine and eliminated the suppressive effect of the development of morphine tolerance by co-exposure to footshock stress, but not psychological stress. Other mechanism, through which Ginseng extract could exert its effect, was inhibition of behavior sensitization to morphine, methamphetamine and cocaine. Moreover it inhibited the appearance of the recurrent phenomenon (reappearance of the sensitized state was observed at the time of re-administration of methamphetamine and cocaine even after a 30-day discontinuation of drug administration) of the effect of methamphetamine and cocaine.

Passion flower:

Passion flower has sedative anti-anxiety effects. It was found that about 60 drops of passion flower extract with a maximum daily dose of 0.8 mg of clonidine showed a significant superiority over clonidine alone in the management of mental symptoms associated with detoxification.

Passiflora and passiflora plus clonidine were equally effective in treating the physical symptoms of withdrawal syndromes of opiates addicts. These results suggested that passiflora extract may be an effective adjuvant agent in the management of opiate withdrawal.

Fig 6: Passion flower

Caulis Sinomenii²⁰:

Caulis Sinomenii is a Chinese plant and is known is named Qing Feng Teng. The analgesic, sedative, and anxiolytic-like actions are effective for improving drug dependence which is associated with abnormal monoaminergic transmission. Caulis Sinomenii and sinomenine can suppress the acquisition of place preference induced by morphine and modulate histamine level in the central nervous system in morphine-dependent mice.

Fig 7: Caulis Sinomenii plant

Camellia sinensis²¹:

Fig 8: Camellia sinensis plant

Camellia sinensis or green tea is a worldwide popular herb which contains (-)-epigallocatechin gallate that attenuated withdrawal signs dose-dependently. It has inhibitory effects on morphine-induced increased cAMP concentrations in the locus coeruleus also D-2 dopamine receptor signaling.

Nigella satvia²²:

Nigella satvia has various advantages in the Islamic medicine and it is mentioned in the hadith by prophet Mohammad (PBUH) as a cure to every pain except for death.

Sangi^23,24 made a study in Karachi between 2003 and 2005 in which 500 mg Nigella satvia was orally given to 50 men addicted to opioid 3 times a day for 12 days and then for 12 weeks regarding the withdrawal syndrome. It is very effective in the addiction and, infections and weaknesses which are among the main causes of pain after addiction. There is no remarkable side effects were detected in these patients. Nigella satvia has anti-allergic, antibacterial, sympatholytic medicine and nutritional characteristics as it is rich in amino acids, also it could be appropriate for treating the symptoms of the withdrawal syndrome.

Fig 9: Nigella satvia plant

Peganum harmala²⁵:

Peganum harmala is characterized to be one of the antagonists of serotonin and inhibitors of monoamine oxidase. It contains an alkaloid harmaline. It plays a role eliminating some of the withdrawal symptoms. It acts by influencing the opioid circuits and receptors as well as the limbic system and autonomic nervous system in the brain stem. It was found in a study that oral peganum harmala powder reduces the incidence of the withdrawal symptoms.

Fig 10: Peganum harmala plant

Chamomile^26,27:

Injection of 10, 20, and 30 mg/kg chamomile extract can reduce chronic and acute withdrawal symptoms.

Administration of chamomile²⁸ extract along with morphine significantly reduced withdrawal signs in rats. Kesmati et al. Found that chamomile hydroalcoholic extract containing apigenin and chrisin (phytoestrogen) induced sedative effects on some of the morphine withdrawal symptoms as rearing and grooming. It was suggested that theses phytoestrogens act with some neurochemical systems of dependence in the CNS and reduce the symptoms of morphine withdrawal syndrome.

Fig 11: chamomile plant

Datura^29,30:

The analgesic and anti-inflammatory effect of datura is due to hyoscine and scopolamine. Datura can reduce the incidence of the withdrawal symptoms by its anti-cholinergic effects and this occur by applying their effects through the limbic system and the neuronal circuits affecting the autonomic system. It reduces the withdrawal symptoms, specially diarrhea and bruxism after using it in male ra.

Fig 12: datura

Berberis³¹:

Berberine from berberis is an isoquinoline alkaloid. It has anticonvulsant, anti-spasm effects and reduces diarrhea and nausea by weakening the sympathetic system. It acts as an inhibitor to the calcium channel and eliminates tachycardia in the withdrawal phase.

Berberine³² petreatment prior to every morphine treatment reduced depression- and anxiety-like symptoms strongly associated with morphine discontinuation, probably by modulating hypothalamic corticotrophin-releasing factor and the noradrenergic system in the CNS. Therefore, berberine may be a useful compound in the development of alternative medicines for treating morphine withdrawal- related symptoms, such as depression and anxiety.

Fig 13: Berberine plant

Valeriana³³:

Various extracts from the roots of plants of the genus Valeriana are used in herbal medicine of many cultures as mild sedatives and tranquilizers. Valerian could help in treating insomnia and agitation also if given in higher doses are effective in treatment of tension and spasm. Valerian is commonly used for the treatment of insomnia and anxiety. Valerian extracts allosterically modulate GABA-A receptors and induced an anxiolytic activity. This activity is closely related to valerenic acid.

Valerenic acid and valerenol³⁴, common constituents of valerian, enhanced the response to GABA at multiple types of recombinant GABA (A) receptors.

Fig 14: Valeriana plant

Asafetida³⁵:

It was found that scores of abstinence reactions was decreased significantly after Asafetida injection, also inhibits inhibit the weight loss compared with morphine-dependent rats.

Fig 15: Asafetida plant

L-Tetrahydropalmatine (l-THP)³⁶:

Levo-tetrahydropalmatine (l-THP) is an active constituent of herbal preparations containing plant species of the genera Stephania and Corydalis and has been approved and used in China for a number of clinical indications under the drug name Rotundine. The pharmacological profile of l-THP includes antagonism of dopamine D₁, and D₂ receptors as well as actions at dopamine D3, alpha adrenergic and serotonin receptors.

The putative utility of l-THP as an anti-addiction agent is due to its blockade of D₃ receptors. Its affinity for D3 receptor³⁷ is lower than for D₁ and D₂ receptors. It also block the pre-synaptic autoreceptors which leads to an increase in dopamine release as well as it antagonize a-adrenergic and serotonin receptors, it may have utility for treating opioid addiction.

Since L-THP^{38, 39} antagonizes dopamine D₁/D₂ receptors and acts on dopamine D₃ receptors, as well as a-adrenergic and serotonin receptors, it may have utility for treating opioid addiction. The antagonism of l-THP^{40, 41} to dopamine receptor antagonists leads to attenuation of locomotor activity also, increases thresholds for intracranial self stimulation so it has sedative and hedonic properties.

Fig 16: Stephania plant

CONCLUSION:

Drug addiction affects both brain and behavior. It has multifaceted impacts on the patients’ body, mind, and nervous system. A psychoactive drug is to induce consciousness for pleasure, by modify the perceptions, feelings, and emotions of the user. When a psychoactive drug enters the user's body, it induces an intoxicating effect. While some people can use recreational and prescription drugs without becoming addicted, many individuals who start using drugs become physically and emotionally dependent on them. Drug abuse causes vary greatly, depending on each individual and the extent of his or her addiction. The psychological effects of drug addiction come from the reason the user is addicted to drugs, as well as the changes that take place in the brain once a person becomes a drug addict. Initially, many people start using drugs to cope with stress or pain an effect of drug addiction is creation of a cycle where anytime the user encounters stress or pain, they feel the need to use the drug. This is one of the psychological effects of drug addiction involved in "craving" of the drug. Various Medicinal Plants used for Addiction Treatment are Ginseng extract, Passion flower, Caulis Sinomenii, Camellia sinensis, Nigella satvia, Peganum harmala, Chamomile, Datura, Berberis, Valeriana, Asafetida, L-Tetrahydropalmatine (l-THP).

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Received on 03.08.2018 Modified on 19.09.2018

Res. J. Pharm. Dosage Form. & Tech. 2018; 10(4): 259-265.

DOI: 10.5958/0975-4377.2018.00038.1

What causes drug abuse15?

What causes drug abuse¹⁵?