A Critical Ayurvedic Perspective on Madatyaya (Alcoholism) - Juniper Publishers

 Addiction & Rehabilitation Medicine - Juniper Publishers

Abstract

Alcohol abuse is one of the genuine social issues which is quickly expanding consistently. The quickest development is being seen in the non-industrial nations of Asia, more especially in India. Drinking of alcohol makes the existence of a man truly hopeless, alcohol debases the wellbeing of the individual as well as influences his family and society. Alcohol abuse is named as Madatyaya in Ayurveda, which is one among the way of lifestyle disorder, is additionally impairing habit-forming jumble. It has expanded at a disturbing rate around the world, even in India it is an issue of concern. The ailments caused by Madya in Mithya, Atiyoga and Heenayoga can be cured by taking the Madya in proper way and proper quantity (Samayoga). The classics of Ayurveda narrate this disease Madatyaya with its types, symptoms and treatment. Excessive consumption of Madya directly affects ‘Hridaya’, which is one of the vital organs of body and it is mainly associated with the Rasavaha srotas, Manovaha Srotas and oja. So, we are trying to describe effect of Madatyaya on human body.

Keywords: Madatyaya; Alcohol; Madya; Ayurveda; Alcoholism

Introduction

In Ayurvedic text alcoholism and its withdrawal are described under the heading of Madatyaya and makes Ayurveda very much capable to treat this condition [1]. In charak samhita Madya Varga classified under one of 12 Ahara Varga. It is utilized as Ahara Dravya (Food Supplement), as Anupana (After Drink) or as aushadhi (Medication). Based on use, Madya is categorized into two kinds as medication and as beverage. In Ayurveda based on techniques and natural substances used name of different preparations are: Asava, Arishta, Sura, Varuni and Sidhu. Out of these, initial two are utilized for medication and others for refreshment.

Madya is one which produces Mada. When given in appropriate amount, in time and in proper system, it brings joy, strength, lessens dread, strain. Furthermore, act as an Amrut (Nector) for the body [2]. The patient who has tamas and rajas manas prakruti will easily habituate for alcohol than satvik manas prakriti and vice-versa. In the absence of alcohol, continuous demand of it felt which is known as Panapkrama (Alcohol Withdrawal Syndrome) [3].

Review of Literature

i.Madatyaya has been explained in 24th chapter of Charaka Samhita after VishaChikitsa, in light of the fact that Madhya is having properties like Visha (poison). Charaka clarifies the Madhya Gunas (characteristics), phases of Madatyaya (Alcoholism), liquor addiction, their signs, side effects and Chikitsa (treatment).

ii.In Sushruta Samhita, UttaraTantra 47th chapter, Acharyas portrayed with regards to Madatyaya exhaustively for the sake of Panatyaya Pratisheda.

iii.In Astanga Samgraha, Madatyaya Chikitsa has been mentioned in ninth chapter of Chikitsa Sthana. It specifies Madhya Prayoga in Madatyaya and mentioned the treatment of Mada and Murcha.

iv.In Astanga Hrudaya, Nidana (causative factors) of Madatyaya has been clarified in sixth chapter of Nidan sthana, and in seventh chapter of Chikitsasthana the treatment of Mada (inebriation), Murcha (syncope), Sanyasa (unconsciousness) including Nidana (etiology), and Chikitsa (treatment) of Dwamsaka and Vikshaya has been clarified.

v.In Chikitsastana of Kashyapa Samhita, the author has clarified impacts of Madhya in pregnant ladies and newborn children with their treatment.

vi.In Madhava Nidana, Madatyaya is explained after Krumi Nidana.

vii.In BhavaPrakash, Madatyaya is clarified in Madyama Khanda after Murcha, Bhrama, Nidra,Tandra and Sanyas Adhikarna, trailed by DahaAdhikarana.

viii.Yogaratnakar has clarified a different chapter as Madatyaya Adhikara after Murchadhikara [4].

Effect of Madya

Madya incorporates Tridosha, Rasa and Rakta as dushya and Rasavaha, Raktavaha, Sangyavaha Shrotas. Hridaya is the principle adhisthan because of which people experience the ill effects of Ojakshaya, Dhatukshaya, Sharirkampa, Pralapa, Bhrama, AgniVikar, Anidra etc.

a. Madyaavastha (Acute Intoxication)

Acute intoxication is usually a consequence of deliberate heavy drinking either small doses at short intervals, or a large dose at a time.

b. Prathama Avastha (Stage of excitement)

The individual goes overthrill, enthusiastic, appropriate appearance of the traits of food and drink, and the insight and inventiveness of music, tune, humor and stories. This outcomes in strong rest and post-waking sensations. Subsequently, this phase of inebriation is conductive to joy [5].

c. Madhyama Avastha (Stage of in-coordination)

The individual frequently recalls things and regularly fails to remember them, his voice becomes unintelligible and confounded, and he talks sense and babble simultaneously. His development, pose, drinking, eating and talking all are improper [6].

d. Antima Avastha (Stage of narcosis)

Subsequent to intersection of second stage and in the start of the third stage, people become dormant like a messed up tree with his psyche tormented with inebriating morbidities and obviousness. However alive, he looks like dead individual. He becomes unequipped for perceiving satisfying things and companions. He was deprived of all joy for which he had taken liquor. He loses every sense of qualification of legitimate, cheerful and helpful things from some unacceptable, hopeless hurtful ones separately; along these lines, no shrewd individual will at any point prefer to put himself in such a phase of inebriation. He is denounced and reproached by all people and disdained by them. As the normal result of this extravagance, he experiences agonies and infections constantly [7].

e. Chronic Intoxication

Habitual drunkards are either psychotic or neurotic and usually take alcohol as a mean to escape from the stress and strains of life. They have been taking alcohol for a long and continued period.

f. Madatyaya

Madatyaya comprises of two words Mada and Atyay. Mada implies Harsh (Sense of wellbeing) Atyay implies Atikrama (excess). The excess intake of Madya cause poisonous impacts. Poisonous impacts depend upon the prakruti and dosh of the person [8,9]. In Sharangadhara Samhita while characterizing the term Madakari, Madhya is included in the drugs having Tamoguna predominently causes insanity are known as Madakari (intoxicants) [10].

Types of Madatyaya

Madatyaya is Tridoshaja vyadhi. Its types named on Dosha which is dominating in presenting the symptoms. Charak explains types of Madatyaya as Vataja, Pittaja and Kaphaja and considers the disease as Tridoshaja.

a. Vataja Madatyaya

Nidana: If a person is excessively emaciated because of Krodha, Shoka, Bhaya, Vyavaya, Chankramana, Sahasa, while eating Ruksha type of food, less quantity of food or limited quantity of food, drinks Madya at night which is excessively fermented, then this leads to the impairment of his Nidra and Vataja type of Madatyaya instantaneously develops [11].

b. Pittaja Madatyaya

Nidana: If a person, indulging in food that is Amla, Ushna and Teekshņa, having wrathful disposition and having likeing for excessive exposure to the fire and sun, drinks excess quantity of Madya that is Teekshna, Ushna and Amla, then he suffers from the Pittaja type of Madatyaya [12].

c. Kaphaja Madatyaya

Nidana: If a person who is habituated to Madhura, Snigdha and Guru Ahara, who does not perform Vyayam, who takes Diwaswapn and who indulges in Sukhaseenata, excessively drinks Madya which is not an old one or which is prepared of Guda, and Paishtika, then he immediately develops Kaphaja Madatyaya [13].

Upadrava of Madatyaya

Hikka associated with Jwara, Vamathu, Vepathu, Parshwashoola, Kasa and Bhrama [22].

Asadhya Lakshna

The following are the characteristics of Asadhya Lakshana: Heenottaraushitam, Atisheetam, Amandadaaham,Tailaprabhaasyam,Jihvaushtiha,Dantamasitam, Vaaneel and Peetanayana rudhirataa [23].

General Line of Treatment

All types of madatyaya are tridosaja.Treatment should be based on the dominant dosas.However,most of the time treatment is started for kapha dosa as pitta and vayu are manifested towards the end in most of the cases of madatyaya [24].

a. Counselling

i.Motivational counselling

ii.Group counselling

b. RelaxingTherapies: Musictherapy,Siropichu,Sirodhara,Ppadabhyang,Takradhara.

c. Padanshik Chikitsa Madya used in small amount or tapering doses.

d. Shodhana Chikitsa

i.If fit for Vamana- Sadyo vamana with Yastimadhu Phanta and Saindhava jala.

ii.If unfit for Shodhana- symptomatic treatment.

e. Shamana Chikitsa

Single drugs used

i.Brahmi

ii.Ashwagandha

iii.Bhringaraja

iv.Kushmanda

v.Jatamansi

vi.Shankhapushpi

vii.Mandukparni

viii.Guduchi

Discussion

Alcohol whenever taken in appropriate way, time, with healthy food, in ideal proportion, as per own solidarity then it is pretty much as advantageous as Amrita. Generally, 80 % alcohol assimilate in small digestive system and significantly more utilized in liver that is the reason it shows its poisonous impact on liver and damages it. According to Ayurvedic texts Madatyaya has clinical manifestations like alcoholism. For any illness fundamental causative variables are unevenness of Dosha and Dushya. So, drug having Tridosha shamak impact, and which increases oja, bala, dhatu, having deepana, pachana, anulomana, yakrita uttejak, mutral, raktavardhak, raktashodhak, vishaghna, rasayan, medhya, hepatoprotective properties can be used judiciously for madatyaya.

In this way, Madatyaya described in Ayurveda can be correlated with chronic alcoholism and its complications upto some degree. Ayurveda has a unique understanding of human physiology and pathology, diagnosis and treatment. On sudden abstinence of alcohol, agni which maintains the equilibrium of the body gets altered, leading to the formation of ama. The ama causes srodhorodha (blockage of circulatory channels) and results in deficit of bala. The anulomana property of vata gets derranged and affects the functions of the body as well as mind. As we know that Madya for Madataya is the main Chikitsa Sutra mentioned in Ayurveda, play an important role in Alcohol Withdrawal, as sudden withdrawal may cause serious complication.

Madya which is used should be made up of particular medicinal herbs and given in tapering doses. Such a protocol seems safe as well as effective in the management of Alcohol withdrawal syndrome. Hence it is important to know the properties of Madya for understanding its effect on the body. It will be useful to minimize its hazardous action and in treating disease.Charaka Samhita discussed different formulations as per type of Madatyaya are Kharjooradi Mantha, Punarnavadi Ghrita, Ashtanga Lavana etc. It also quotes the Complications of untreated Madatyaya.

Conclusion

Subsequently, it is concluded that Madatyaya is well explained in Ayurveda, which helps in diagnosis and management depending on the involvement of the Dosha. Charak’s view towards alcoholism has great value because of its scientific literature study and description of physical & mental characteristic symptoms. Ayurveda also accept that it is cardiotoxic as well as dependent drug. Symptoms of pittaj madatyaya may be compared with alcoholic hepatitis. Concept of alcoholic addiction may be high lightened in terms of Dhwansaka & Vikshay. The chronic alcoholism may be compared with Pan Vibhram as mentioned. If we review & compare entire views of all Acharyas we can come to certain concrete conclusions regarding Madatyaya and its causes, symptoms, pathophysiology & excellent line of treatment that has been elaborately explained by Acharya charak and put intense light on the same, more effectively than other classical texts of ancient time.

The Ayurvedic management protocol along with the rehabilitation measures are effective in alleviating the symptoms of Alcohol withdrawal and associative conditions. Shamana therapy or even Shodhana therapy can be administered as per the severity of the condition of the affected person. One need to be careful in selection of appropriate procedure as it is based on Rogi and Roga Bala. Thus Ayurveda have ultimate and effective solution in the management and rehabilitation of madatyaya.

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Substance use Disorder: A Burning Issue - Juniper Publishers

 Addiction & Rehabilitation Medicine - Juniper Publishers

Abstract

Substance use disorder (SUD) has infiltrated all socio-cultural and economic strata causing loss of productivity. Mental and substance use disorders are a major public health concern everywhere and responding to the burden they cause is a challenge for health systems in both developed and developing regions. Treatment rates for people with mental and substance use disorders remain low, with treatment gaps of over 90% in developing countries. Developing countries are facing an escalating burden of non-communicable disease, with mental and substance use disorders among the most significant. Many developing countries spend less than 2% of their health budgets on mental health. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses. Studies suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits patients with substance use disorder. In this article, we will give a brief overview about substance use disorder.

Keywords: Substance use disorder; Alcohol; Nicotine

Introduction

Substance use disorders are important health concern worldwide. Substance use is a chronic disorder which is associated with significant mortality and morbidity. These disorders also account for significant health care utilization and medical costs. Substance use disorders occur when a person’s usage of alcohol, prescription drugs, or illegal drugs causes problems in his or her life and daily activity [1]. Treatment of substance use disorder involves detoxification and prevention of relapse. The major problem in treating patients with substance use disorders is relapse. Addiction is a chronic disorder that requires long-term treatment. Anticraving agents play the key role in the prevention of relapse. These medications generally reduce drug craving and reduce the likelihood of relapse to compulsive drug use. Anticraving agents along with other psychotropic drugs are used for management of the substance use disorders [2]. In India, substance abuse has infiltrated all socio-cultural and economic strata causing loss of productivity. Mental and substance use disorders are a major public health concern everywhere and responding to the burden they cause is a challenge for health systems in both developed and developing regions. Treatment rates for people with mental and substance use disorders remain low, with treatment gaps of over 90% in developing countries [3,4]. Developing countries are facing an escalating burden of non-communicable disease, with mental and substance use disorders among the most significant. Many developing countries spend less than 2% of their health budgets on mental health [5]. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses. Studies suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits patients with substance use disorder [6]. Substance abuse causes acute and chronic physical, psychological and social effects in varying amounts along with serious social problems in the form of crime, unemployment, family dysfunction and disproportionate use of medical care. Science has not yet explained fully the psychological processes leading to drug abuse. Substance abuse affects above 50 million people worldwide. Abuse of legally prescribed drugs is also increasing rapidly [7]. In India, the abuse of alcohol, cannabis and raw opium has been traditionally known. The abuse of synthetic narcotic drugs and psychotropic substances is comparatively new. Substance abuse has affected all socio-cultural and economic classes causing loss of productivity [8]. Family stress, lack of coping skills, peer pressure, personality disorder, co-morbid psychiatric illnesses, social stress and market forces act as risk factors [9].

Survey shows that around 20-30% of adult males and 5% of adult females use alcohol while 57% of the male and 10.8% of the female drug users consume opiates in some form or other. Rapid assessment survey on substance abuse shows that the primary abused drugs are heroin (36%), other opiates (29%) and cannabis (22%); 75% of addicts start drug abuse before 20 years of age; in urban areas heroin abuse is more while in other sites cannabis abuse is more [10,11]. The family remains the primary source of attachment, nurturing, and socialization for humans in our current society. Therefore, the impact of substance use disorders (SUDs) on the family and individual family members merits attention. Each family and each family member are uniquely affected by the individual using substances including but not limited to having unmet developmental needs, impaired attachment, economic hardship, legal problems, emotional distress, and sometimes violence being perpetrated against him or her. For children there is also an increased risk of developing a SUD themselves.

Thus, treating only the individual with the active disease of addiction is limited in effectiveness. The social work profession more than any other health care profession has historically recognized the importance of assessing the individual in the context of his or her family environment. Social work education and training emphasizes the significant impact the environment has on the individual and vice versa. This topic was chosen to illustrate how involving the family in the treatment of a SUD in an individual is an effective way to help the family and the individual. The utilization of evidence-based family approaches has demonstrated superiority over individual or group-based treatments [12]. Substance use disorder (SUD) is a disease whose social costs are high. The negative effects of drug abuse go well beyond the health and condition of the person who suffers from SUD. Research has shown a strong link between addiction and the disruption of family relationships, including severe psychosocial and physical effects on family members described as depression, anxiety, and stress. Parents’ depression when living with a partner suffering from SUD can contribute to the mental, physical, and social neglect of the family’s children, further aggravating the family’s anxiety and stress [13].

Management of substance use disorders

Substance use disorder (SUD) has been conceptualized as a chronic relapsing medical illness with relapses and remissions and a strong genetic component similar to diabetes type II and hypertension [6]. Risk for relapse is heightened because the neurobiological changes in brain pathways created by many years of alcohol and/or drug use do not completely revert to normal after the detoxification process. The intensity and nature of the behavioral intervention can influence the outcome of treatment for patients with SUDs. The use of medications in the treatment of SUD can also play a major role in preventing relapse and facilitating longer periods of abstinence. More effective medications have been developed over the past 30 years, and subsequently, pharmacotherapy has progressively played a more important role in the treatment of addictions. Medications are mostly used as adjuncts to psychosocial treatments and the role of pharmacotherapy in treatment depends on the specific type of SUD [14]. Pharmacological agents have three broad objectives: management of acute withdrawal syndromes through detoxification, attenuation of cravings and urges to use illicit drugs (initial recovery), and prevention of relapse to compulsive drug use [2].

Conclusion

Treatment of substance use disorder involves detoxification and prevention of relapse. The major problem in treating patients with substance use disorders is relapse. Addiction is a chronic disorder that requires long-term treatment. Anticraving agents play the key role in the prevention of relapse. These medications generally reduce drug craving and reduce the likelihood of relapse to compulsive drug use. Anticraving agents along with other psychotropic drugs are used for management of the substance use disorders.

To Know more about  Addiction & Rehabilitation Medicine

Click here:  https://juniperpublishers.com/gjarm/index.php

To Know more about our Juniper Publishers

Click here: https://juniperpublishers.com/index.php     

Substance use Disorder: A Burning Issue - Juniper Publishers

Addiction & Rehabilitation Medicine - Juniper Publishers

Abstract

Substance use disorder (SUD) has infiltrated all socio-cultural and economic strata causing loss of productivity. Mental and substance use disorders are a major public health concern everywhere and responding to the burden they cause is a challenge for health systems in both developed and developing regions. Treatment rates for people with mental and substance use disorders remain low, with treatment gaps of over 90% in developing countries. Developing countries are facing an escalating burden of non-communicable disease, with mental and substance use disorders among the most significant. Many developing countries spend less than 2% of their health budgets on mental health. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses. Studies suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits patients with substance use disorder. In this article, we will give a brief overview about substance use disorder.

Keywords: Substance use disorder; Alcohol; Nicotine

Introduction

Substance use disorders are important health concern worldwide. Substance use is a chronic disorder which is associated with significant mortality and morbidity. These disorders also account for significant health care utilization and medical costs. Substance use disorders occur when a person’s usage of alcohol, prescription drugs, or illegal drugs causes problems in his or her life and daily activity [1]. Treatment of substance use disorder involves detoxification and prevention of relapse. The major problem in treating patients with substance use disorders is relapse. Addiction is a chronic disorder that requires long-term treatment. Anticraving agents play the key role in the prevention of relapse. These medications generally reduce drug craving and reduce the likelihood of relapse to compulsive drug use. Anticraving agents along with other psychotropic drugs are used for management of the substance use disorders [2]. In India, substance abuse has infiltrated all socio-cultural and economic strata causing loss of productivity. Mental and substance use disorders are a major public health concern everywhere and responding to the burden they cause is a challenge for health systems in both developed and developing regions. Treatment rates for people with mental and substance use disorders remain low, with treatment gaps of over 90% in developing countries [3,4]. Developing countries are facing an escalating burden of non-communicable disease, with mental and substance use disorders among the most significant. Many developing countries spend less than 2% of their health budgets on mental health [5]. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses. Studies suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits patients with substance use disorder [6]. Substance abuse causes acute and chronic physical, psychological and social effects in varying amounts along with serious social problems in the form of crime, unemployment, family dysfunction and disproportionate use of medical care. Science has not yet explained fully the psychological processes leading to drug abuse. Substance abuse affects above 50 million people worldwide. Abuse of legally prescribed drugs is also increasing rapidly [7]. In India, the abuse of alcohol, cannabis and raw opium has been traditionally known. The abuse of synthetic narcotic drugs and psychotropic substances is comparatively new. Substance abuse has affected all socio-cultural and economic classes causing loss of productivity [8]. Family stress, lack of coping skills, peer pressure, personality disorder, co-morbid psychiatric illnesses, social stress and market forces act as risk factors [9].

Survey shows that around 20-30% of adult males and 5% of adult females use alcohol while 57% of the male and 10.8% of the female drug users consume opiates in some form or other. Rapid assessment survey on substance abuse shows that the primary abused drugs are heroin (36%), other opiates (29%) and cannabis (22%); 75% of addicts start drug abuse before 20 years of age; in urban areas heroin abuse is more while in other sites cannabis abuse is more [10,11]. The family remains the primary source of attachment, nurturing, and socialization for humans in our current society. Therefore, the impact of substance use disorders (SUDs) on the family and individual family members merits attention. Each family and each family member are uniquely affected by the individual using substances including but not limited to having unmet developmental needs, impaired attachment, economic hardship, legal problems, emotional distress, and sometimes violence being perpetrated against him or her. For children there is also an increased risk of developing a SUD themselves.

Thus, treating only the individual with the active disease of addiction is limited in effectiveness. The social work profession more than any other health care profession has historically recognized the importance of assessing the individual in the context of his or her family environment. Social work education and training emphasizes the significant impact the environment has on the individual and vice versa. This topic was chosen to illustrate how involving the family in the treatment of a SUD in an individual is an effective way to help the family and the individual. The utilization of evidence-based family approaches has demonstrated superiority over individual or group-based treatments [12]. Substance use disorder (SUD) is a disease whose social costs are high. The negative effects of drug abuse go well beyond the health and condition of the person who suffers from SUD. Research has shown a strong link between addiction and the disruption of family relationships, including severe psychosocial and physical effects on family members described as depression, anxiety, and stress. Parents’ depression when living with a partner suffering from SUD can contribute to the mental, physical, and social neglect of the family’s children, further aggravating the family’s anxiety and stress [13].

Management of substance use disorders

Substance use disorder (SUD) has been conceptualized as a chronic relapsing medical illness with relapses and remissions and a strong genetic component similar to diabetes type II and hypertension [6]. Risk for relapse is heightened because the neurobiological changes in brain pathways created by many years of alcohol and/or drug use do not completely revert to normal after the detoxification process. The intensity and nature of the behavioral intervention can influence the outcome of treatment for patients with SUDs. The use of medications in the treatment of SUD can also play a major role in preventing relapse and facilitating longer periods of abstinence. More effective medications have been developed over the past 30 years, and subsequently, pharmacotherapy has progressively played a more important role in the treatment of addictions. Medications are mostly used as adjuncts to psychosocial treatments and the role of pharmacotherapy in treatment depends on the specific type of SUD [14]. Pharmacological agents have three broad objectives: management of acute withdrawal syndromes through detoxification, attenuation of cravings and urges to use illicit drugs (initial recovery), and prevention of relapse to compulsive drug use [2].

Conclusion

Treatment of substance use disorder involves detoxification and prevention of relapse. The major problem in treating patients with substance use disorders is relapse. Addiction is a chronic disorder that requires long-term treatment. Anticraving agents play the key role in the prevention of relapse. These medications generally reduce drug craving and reduce the likelihood of relapse to compulsive drug use. Anticraving agents along with other psychotropic drugs are used for management of the substance use disorders.

To Know more about Addiction & Rehabilitation Medicine

Click here: https://juniperpublishers.com/gjarm/index.php

To Know more about our Juniper Publishers

Click here: https://juniperpublishers.com/index.php