E-ISSN:2456-3110

Case Report

Ayurvedic management

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 11 November
Publisherwww.maharshicharaka.in

Ayurvedic management of Alcohol Use Disorder

Nisha C N1*, Hegde R2
DOI:10.21760/jaims.8.11.26

1* Nisha C N, Post Graduate Scholar, Department Of Pg Studies In Manovijnana Evam Manasaroga, Alva's Ayurveda Medical College, Moodubidire Dk, Karnataka, India.

2 Raviprasad Hegde, Associate Professor, Department of PG Studies in Manovijnana Evam Manasaroga, Alva’s Ayurveda Medical College, Moodubidire DK, Karnataka, India.

Substance use disorders are chronic relapsing disorders, leading to significant impairment in psychosocial functioning. Nicotine and alcohol are most widely consumed psychotropic drugs worldwide. The common use of both increases the risk of noncommunicable diseases to many folds. Conventional therapies have not been able to alter the outcome of these disorders significantly and frequent relapses continue to occur. Hence there is a need to look at complementary and alternate systems of medicine. Ayurveda remains one of the most ancient and yet living traditions practiced widely in India and has a sound philosophical and experiential basis. The planning of an effective adequate management of alcohol use disorder in Ayurveda with the aid of Ahara, Vihara, Achara and Aushadhi depends upon the strength of the disease (Roga) and the stamina of the patient (Rogi). Here is an attempt made to explain a case study of alcohol use disorder with holistic Ayurvedic management.

Keywords: Ayurveda, Madya, Alcohol use disorder, Shodhana, Raja Yapana Basti

Corresponding Author How to Cite this Article To Browse
Nisha C N, Post Graduate Scholar, Department Of Pg Studies In Manovijnana Evam Manasaroga, Alva's Ayurveda Medical College, Moodubidire Dk, Karnataka, India.
Email: 		Nisha C N, Hegde R, Ayurvedic management of Alcohol Use Disorder. J Ayu Int Med Sci. 2023;8(11):163-167.
Available From
https://jaims.in/jaims/article/view/2783

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-09-13 2023-09-25 2023-10-05 2023-10-15 2023-10-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 22.58

© 2023by Nisha C N, Hegde Rand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Nisha C N. et al. Ayurvedic management of Alcohol Use Disorder

Introduction

A drug is defined (by WHO) as any substance that, when taken into the living organism, may modify one or more of its functions. 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.[1] Alcohol is one such psychoactive drug which is consumed all over the world, but the habit of being dependent on alcohol for coping with any emotions, trauma, depression, or any reason is where the addiction part takes birth. When one is involved in alcohol use, it's not just health that is at stake; it also brings out numerous mental and social impacts, from weight gain to liver dysfunction to aggressive behaviour at home, loss of income, unemployment, and harm to an unborn baby. Understanding alcohol addiction and looking for accessible natural treatments are instrumental ways of lessening the impact of alcohol on a person. Alcohol addiction also known as Alcoholism or Alcohol abuse. In Ayurveda, Alcohol addiction is called as Manasikam Visargah, Madyapash, Madyasakti. (Madya: Alcohol, Pash: Habit, Aasakti: Craving).[2]

A diagnosed case of alcohol use disorder was managed with an Ayurveda treatment protocol including Snehapana, Virechana, Basti, Nasya etc.

Aims and Objectives

A case study of Ayurvedic management of alcohol use disorder.

Basic Information of Patient

Name: XYZ

Age: 35 years

Gender: Male

Occupation: Unemployed

Socio-economic status: Upper middle class

Chief complaints

Patient came with the complains of tremors in both the hands and disturbed sleep since past 3-4 months.

History of present illness

35 years old male patient who is an alcoholic since past 20 years complains of tremors in both the hands and disturbed sleep since past 3-4 months. He started consuming alcohol due to peer pressure in college. He has tried to quit alcohol in 2013 and was able to do it for 2 years but relapsed. He also has the habit of chewing tobacco since 20 years. The patient is seeking help to quit these habits so he came to our hospital for treatment.

History of past illness: Nothing significant.

Family history: All are said to be healthy, No history of alcoholism in the family.

Premorbid personality:  Introverted, sedentary, despondent, self-centred, lack of acceptance of responsibility.

Marital status: Married

Mental Status Examination:

General appearance and behaviour:§   Looks uncomfortable, evasiveness, adequate dressing, good hygiene and self-care.
Speech§  Non-spontaneous, decreased volume, hesitant.
Mood and affect§  Mood- Sad; Affect - Euthymic.
Thought§  Non-goal-oriented.
Perception§  No hallucinations.
Cognition§  Consciousness – Intact§  Orientation – Oriented to time, place, person§  Attention – Slightly decreased§  Concentration – Slightly decreased§  Memory – Immediate-Intact, Recent-Intact, Remote-Intact§  Intelligence- Intact
Insight§  Grade 6
Judgement§  Partially impaired.

Investigations

Before treatmentAfter treatment
SGOT - 47 IU/LSGOT - 24 IU/L
SGPT - 42 IU/LSGPT - 25 IU/L
Alkaline phosphatase - 252 IU/LAlkaline phosphatase - 192 IU/L
Total bilirubin - 2.0mg/dLTotal bilirubin - 0.9mg/dL
Direct bilirubin - 0.5mg/dLDirect bilirubin - 0.2mg/dL
Indirect bilirubin - 1.5mg/dLIndirect bilirubin - 0.7mg/dL
USG Abdomen & Pelvis - Fatty changes in liver, Cystitis.USG Abdomen & Pelvis - No obvious sonological abnormalities.

Treatment Protocol

1st Set:

1) Tab. Arogyavardhini Rasa 2-2-2 (A/F)
2) Kumaryasava 15mL tid with 30mL water (A/F)
3) Brahmi Vati 1-0-1 (A/F)
4) Shiropichu with Brahmi Taila
5) Amalaki Takradhara


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All above medicines were given for 7 days.

2nd Set:

  • Snehapana with Indukantha Ghrita for 6 days.
  • Sarvanga Abhyanga with Ksheerabala Taila and Bhashpa Sweda for 4 days.
  • Virechana withTrivrut Leha (50gm) and warm milk (100ml).
  • Samsarjana Karma for 5 days.

On 6th Day

Raja Yapana Basti (Kala Basti)

Anuvasana Basti with 60mL Brahmi Taila.

Procedures:

  • Deep relaxation and meditation
  • Anuloma-Viloma Pranayama

Advised Discharge Medicine:

1) Tab. Brahmi Vati 1-0-1 (A/F) for 30 days
2) Tab. Arogyavardhini Rasa 1-0-1 (A/F) for 30 days
3) Saraswatharishta with gold 20mL BD with 40mL water (A/F) for 30 days

1st Follow-Up:

1) Sarvanga Abhyanga with Ksheerabala Taila
2) Shashtika Shali Pinda Sweda
3) Nasya with KBT 101, 16-16 drops each nostril
4) Tab. Brahmi Vati 1-0-1 (A/F)
5) Tab. Arogyavardhini Vati 1-0-1 (A/F)
6) Saraswatharishta with gold 20mL BD with 40mL water (A/F)
7) Avipathikara Churna 0-0-1tp with milk (B/F)

All above medicines were given for 10 days.

Advised Discharge Medicine

1) Tab. Arogyavardhini Rasa 1-0-1 (A/F) for 30 days
2) Saraswatharishta with gold 20mL BD with 40mL water (A/F) for 30 days
3) Ashwagandha Rasayana capsules 12-0-0 with warm milk (B/F) for 30 days

2nd Follow-Up:

1) Sarvanga Kayaseka with Ksheerabalataila for 7 days
2) Matrabasti with Kalyanaka Ghrita 60mL for 7 days
3) Saraswatharishta with gold 20mL BD with 40mL water (A/F) for 7 days

Advised Discharge Medicine

1) Shivagutika 1-0-1 with milk (B/F) for 3 months

3rd Follow-Up:

1) Nityavirechana with Avipathikara Churna 15gm with warm milk for 5 days
2) Udvartana with Triphala Churna for 5 days
3) Bhashpa Sweda for 5 days

Advised Discharge Medicine:

1) Tab. Mentat 1-0-1 (A/F) for 15 days
2) Tab Chitrakadi Vati 1-0-1 (A/F) for 15 days

Discussion

According to Ayurveda, the properties of alcohol are opposite to Ojas and comparable to poison. The only difference is, that alcohol is less powerful than poison, so it doesn't kill the person immediately. Alcohol infiltrates deeply into the tissues (Dhatus). It is dry and causes drying and harshness; it spreads throughout the body and is hot in potency. Alcohol loosens bone joints, dries Ojas, and causes mental disorders.

Procedures

1. Virechana:

Drugs capable of inducing Virechana, possesses Ushna, Tikshna, Sukshma, Vyavayi and Vikasi properties. The Ushna property may help in increasing the quantum of Agni. It can cause Vishyandana of the Dosha in the Koshta from where they can be readily expelled out. Due to Tikshna property, drug is able to disintegrate the Sanghata of Dosha. Due to Vyavayi property such a medicine is able to spread in the whole body prior to its digestion. By virtue of its Vikasi property the drug is able to compel the Doshas to come out of Dhatus. Virechana drug possessing the above properties reaches the Hridaya by virtue of its Virya and then following the Dhamani it pervades the whole body through Sthula and Sukshma Srotas causing Hridaya Shuddhi.[3]

2. Raja Yapana Basti

Yapana Bastis are important sets of Basti mentioned in Charaka Samhita Siddhi Sthana. The Basti which sustain, support and maintain life and promotes longevity is called as Yapana Basti. As the name suggests Raja Yapana Basti is superior amongst all


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the Bastis. It performs dual function of both Anuvasana and Niruha; hence these Bastis are Srotoshodhaka and Brimhana at a time. It is the best Rasayana Basti and it is also indicated in Unmada etc. Manasaroga.

3. Nasya

According to Charaka Samhita, drug administered through nose enters the Uttamanga and eliminates the morbid Doshas residing there. According to Acharya Vagbhata, drug administered through nose reaches Sringataka Marma of Shiras, which is a Sira Marma and formed by the Siras of Nasa, Netra, Kantha and Shrotra. Thus, we can say that drug administered through Nasya may enter Siras above and purifies them. The adjacent nerve called terminal nerves which run along the olfactory system are connected with limbic system of the brain including hypothalamus. This limbic system is connected with the behavioural aspect of human being. Thus, certain drugs administered through the nose may have an impact on immediate psychological functions by acting on the limbic system through olfactory nerves. This treatment opens mental channels, and restores focus, concentration and awareness. With long-term use it can also enhance memory.[4]

4. Takradhara

Takradhara with Jatamansi (Nardostachys jatamansi), aids in Raktagatavata, Anidra, Avasada, Vatapittaja disorder, Ojakshaya and Smriti Nasha.[5]

5. Udvartana

Udvartana is a Bahirparimarjana Chikitsa, which is performed in Pratilomagati as Bahya Rookshana Karma causes liquefication of Kapha and Meda, promotes the metabolism.[6]

Mode of Action of Drugs

1. Saraswatharishta

Saraswatharishtan is one of the best Rasayana drug. It is good for people of all age groups; it improves immunity and strength. Saraswatharishta has shown proven effects in the treatment and management of neurological illnesses and disorders. An in vitro study on Saraswatharishta effect showed that it enhanced the memory of mice treated with Scopolamine (Prabhu et al., 2020), while performing better than Piracetam, a commercial

drug for neuro-protection. In another study, when Albino mice were pre-treated with Saraswatharishta for two weeks, they gained protection against the memory and learning impairment effects of Diazepam (Rajopadhye & Sahasrabudhe, 2020). The above-mentioned examples of experimental research on Saraswatharishta’s effect in mice showed that it imparts neuroprotective properties. 

2. Ashwagandha

Root and leaf extracts of Ashwagandha exhibited noteworthy anti-stress and anti-anxiety activity in animal studies and human studies. It may alleviate these conditions predominantly through modulation of the hypothalamic-pituitary-adrenal and sympathetic-adrenal-medullary axes, as well as through GABAergic and Serotonergic pathways. Ashwagandha is a real potent regenerative tonic (Rasayana of Ayurveda), due to its multiple pharmacological actions like anti-stress, neuroprotective, antitumor, anti-arthritic, analgesic and anti-inflammatory etc. It is useful for different types of diseases like Parkinson, dementia, memory loss, stress induced diseases, malignancy and others.[7]

3. Brahmi Vati

Brahmi Vati balances Vata and Pitta Doshas. According to Ayurveda Sarasangraha, Brahmi Vati is useful for the treatment of the mental fatigue, weak memory, tremors, depression, psychotic condition and insomnia.

4. Arogyavrdhini Rasa

Arogyavardhini Rasa is one of the widely practicing Ayurvedic herbo-mineral formulations in liver disorders. It is Yakrit Prasadana and it is helpful in Pachana of Amavisha and corrects the formation of vitiated Dosha. It has been used for the management of diverse types of Jwara, Kushtha, Medoroga and other Yakrit Vikara.[8]

Conclusion

According to Ayurveda the focus of treatment in alcohol use disorder is to balance Shareerika Dosha as well as Manasika Dosha. Hence treatment adapted in this case are Shodhana Chikitsa and Shamanoushadha which are Medhya and Yakrit Prasadana. The outcome of the Ayurvedic therapy which included detoxification, proper medication, meditation and counselling is much encouraging.


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Patient Perspective

Patient is sober now. He has good inter-personal relationship with family, has started new business.

References

1. Ahuja N. A Short Textbook of Psychiatry, Other Psychotic Disorders: Chapter 4. Jaypee Brothers Medical Publishers (P) Ltd; 2011:33.

2. Ayushakti. The key to alcohol addiction recovery can be Ayurveda. Available from: https://www.ayushakti.com/symptoms-and-illness/type/the-key-to-alcohol-addiction-recovery-can-be-ayurveda

3. Lohith BA. A Textbook on Panchakarma, Virechana Karma: Chapter 5. Chaukhambha Orientalia, A House of Oriental, Antiquarian and Ayurvedic Books; Varanasi; 2016:259.

4. Lohith BA. A Textbook on Panchakarma, Nasya: Chapter 7. Chaukhambha Orientalia, A House of Oriental, Antiquarian and Ayurvedic Books; Varanasi; 2016:375-379.

5. Vagbhat. Astangahrudaya Samhita, Sutrasthana (Gandushadi) verse-22/23. Ayurveda Rasayana Sanskrit commentary by Hemadri. In: Harishastriparadkar, editor. Varanasi: Krishnadas Academy; 2000:301.

6. Patil VC. Principles and Practice of Panchakarma, Chapter 8 Snehana Karma. Edition-Reprint. Chaukhambha Sanskrit Sansthan; New Delhi; 2017:142-43.

7. Singh V, Bhalla M, de Jager P, Gilca M. An overview of ashwagandha: a Rasayana (rejuvenator) of Ayurveda. Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):208-13. doi: 10.4314/ajtcam.v8i5S.9. PMID: 22754076; PMCID: PMC3252722.

8. Singh V, Singh S. Case of Alcoholic Liver Disease treated with classical Ayurveda medicines - A Case Report. J Ayu Int Med Sci. 2022;7(11):250-254.


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