A HOLISTIC APPROACH FOR ALCOHOLICS

Introduction:

Alcoholism has become a global problem in modern era due to increased stress and changed life style. Family conflicts, lower socio-economic status, workplace tension, failure in life, unfulfilled dreams are some of the common stressors which make the individuals to be addicted to alcohol. To overcome stressful events, one has to be satvavan. When one person is deprived of his satva, his natural threshold to the stress is reduced and he will be in search of some psychoactive substances like alcohol and other drugs by which he can forget the stressful situation temporarily.
This behaviour makes him addicted and eventually he becomes dependent. Whenever he tries to be devoid of psychoactive substance, he develops withdrawal symptoms.

Heavy and prolonged alcohol usage results in serious health problems like severe gastritis, cirrohosis of liver, alcoholic hepatitis, mood disorders, anxiety diseases, anti-social personality disorders etc.,
According to ayurveda, withdrawal state can be compared to sannipatika, condition of madatyaya.

Symptoms of Sannipatika Madatyaya

Kampa / Vepathu – Tremors
Hrudaya vyatha – Mental Anguish
Pralapa – Delirium
Vamathu – Vomiting
Ati Sveda – Excessive Sweating
Prajagara – Insomnia
Pramoha – Fainting
Trushna – Thirst
Hikka – Hiccups
Bhrama – Vertigo

Incurable conditions of Madatyaya

Weakness in the upper lip – Hina uttara oshta
Excess coldness of the body – Shareera Atisheetata
Severe burning sensation – Teevra daha of the body
Oily coloured body – Taila varna
Bluish colouration of the tongue – Shyava varna lips and teeth
Red coloured eyes – Rakta netrata
Management of Madatyaya

Many safe treatment modalities have been explained for Madatyaya by Acharyas
They include

  1. Shodhana Chikitsa
  2. Shamana Chikitsa
  3. Satvavajaya Chikitsa

Brief resume of the clinical study

Alcoholism is the condition, which is included under the broad heading of substance abuse disorders. And this not only leads to various psychosomatic symptoms, but also causes many emotional setbacks in the form of disturbed interpersonal relationship, poor marital status and social stigma etc. It is necessary to help the patient to come out of this problem through numerous pharmacological and non-pharmacological methods. The common pharmacological drugs alone may not be sufficient to revert the pathology, as psychological intervention is important for the total management of such conditions with this intention mind combined psychobiological approach towards alcoholism was planned in this trial.

Objectives of the study:

To see the efficacy of combined therapy i.e. shodhana chikitsa (virechana), shamana chikitsa (shrikhandasava and kharjooradi mantha), satvajaya chikitsa (psycho therapy) in the management of alcoholism.
Materials and methods:
Source of data:
20 patients were selected from the OPD of Manasa Roga department of SDMCA&H, Hassan.
Inclusion criteria:
Twenty patients between the age group of 20 and 50 years and diagnosed case of alcoholism with respect to alcoholic withdrawal state except with drawl seizures and delirium tremors.
Exclusion criteria:

  1. Patients with other drug dependence
  2. Patients taking treatment already for madatyaya
  3. Patients with severe liver toxicity
  4. Patients having systemic and metabolic disorders like DM, hypertension etc.

Diagnostic and Assessment criteria

Patients with following symptoms are diagnosed as suffering from the disease Madatyaya w. r. t withdrawal state

  1. Kampa (Tremors)
  2. Hrudaya Vyatha (Mental Anguish)
  3. Pralapa (Delirium)
  4. Vamathu (Vomiting)
  5. Prajagara (Insomnia)
  6. Ati sveda (Excess sweating)
  7. Pramoha (Fainting)
  8. Trushna ( Thirst)
  9. Hikka (Hiccups)
  10. Bhrama (Vertigo)

All these symptoms are assessed by self-gradation method as
No symptom – 0
Mild – 1
Moderate – 2
Severe – 3

Treatment plan

  1. Virechana (purgation therapy) – after Pravicharana Snehana for 3 days followed by sarvanga abyanga and Bashpa sweda. Virechana was given with Rechaka vati, Trivrut and Draksha kashaya.
  2. Sri kandasava – 15 – 20ml with water tds and Kharjooradi Mantha – 50-60ml tds for a period of 1 month.
  3. Psychotherapy – in the form of counseling with relaxation therapy and aversion therapy. (By using multiple behavioral therapies, instrument aversion therapy is given. Through the electrodes, pain stimulus is given by electric current and patient is made to consume alcohol. By repeating this for several days or times (4-5 days) the unconditioned reflexes become conditioned and whenever person consumes alcohol because of activation of conditional reflexes, pain stimulus will be there and person refuses and hates the alcohol.)

Ingredients of kharjuradi Mantha

Kharjura – Dadima
Draksha – Tintidika
Amlika – Amalaka
Changeri – Parushaka

Ingredients of Srikhandasava :

Srikhanda – Maricha
Jatamasmsi – Haridra
Daruharidra – Chitraka
Khana – Usira
Tagara – Nagakesara
Chandana – Dhatri
Pada, Khana – Pippali
Chavya – Lavanga
Elavaluka – Lodhra
Guda – Dhataki

Follow up:

After one month, the patients were followed at regular intervals of one month for a period of 5 months during which the treatment continued.

Observation and results:

Patients came for the treatment were males only which shows that intensity of problem is more in men in the society. Most of them are between 25-40 years and having the interpersonal problems.
After the one month of follow up, almost all the symptoms were reduced by more than 70% symptoms like tremors, delirium and Hrudayavyaha were still persistent in small extent.

Overall effect of the therapy

Among 20 patients, 15 patients got complete remission of all the symptoms and completely stopped alcohol intake and five patients were readdicted because of some family and environmental problems.
So psychotherapy in the form of counselling helps the patient to realize the problem and helps him to come out of the same. Aversion therapy will help refuse and hate alcohol.

Conclusion

Holistic approach with the purificatory therapy, internal medicine and psychotherapy for the management of alcoholism is beneficial. Also psychotherapy helps the person to lead the life in a positive way.

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