TCM Herbal Practice on Drug Abuse
Harvey Y. Zhu, D.TCM
July 1999
Abstract:
Traditional Chinese medicine has been used for detoxification in the past 4,000 years. During the Opium War (1840-1842), the TCM physicians invented herbal formulae to treat hundreds of thousand opium smokers and helped them abstain successfully. The herbal formulae were almost lost until the late 1970’s. When reports of drug abuse rose dramatically during the economic open policy in China, Chinese physician rediscovered these formulae and applied them in over a hundred different levels of detoxification centre and hospital in China. Dr. Harvey Y. Zhu has practiced Chinese medicine on drug abuse in China during the 1970’s, and had researched with his colleagues. He recently used his previous experience to treat drug addicts in both the United States and Canada. The herbal formulae introduced here have been such well documented that they not only treat specific drug abuse but also target different aspects of the individual disharmonies. Practitioner is recommended to use other healing strategies to work with and adapt the herbal formulae to meet the changing therapeutic needs of the patient.
Cocaine/Crack
In addition to anxiety, memory loss, weight loss, insomnia, paranoia, skins picking and ulceration, cocaine user has extreme drug craving.
TCM practice considers that liver yang excess due to yin deficiency in both the liver and kidney is the syndrome of cocaine users. Complications can be seen very often. Patient appears to possess excessive manifestations, but is actually suffering a severe deficiency. Red and dry tongue; thready, rapid and weak pulses are the clinical signs. Therefore, nourishing the yin and suppressing the yang is the principle of the herbal treatment. Treatment of liver and kidney is the priority. Heart, lung and spleen should be dealt with afterwards.
The prescription of herbal is suggested as follow:
Antelopis Cornu - (Antelope Horn) - Ling Yang Jia
Haliotidis Concha - (Abalone Shell) - Shi Jue Ming
Scrophulariae Radix - (Scrophularia) - Xuan Shen
Asparagi Radix - (Shiny Asparagus) - Tian Men Dong
Ligustri Fructus - (Privet) - Nu Zhen Zi
Paeoniae Radix - (White Peony) - Bai Shao
Rehmanniae Radix - (Rehmannia) - Sheng Di Huang
Citri Immaturi Pericarpiumont - (Blue Citrus Peel) - Qing Pi
Corydalidis Tuber - (Corydalis) - Yan Hu Suo
Bambusae Concretio Silicea - (Tabasheer) - Tian Zhu Huang
Dioscoreae Bulbiferae Rhizoma - (Dioscorea) -Huang Yao Zi
While on herbal program, patient is advised to avoid pungent flavour and greasy food. Seafood is recommended. Clinical data shows that 81% of the subjects have overcome anxiety within one week while 58% of the subjects have the craving decreased.
If the patient has additional symptoms, such as
Severe insomnia, add:
Salviae Miltiorrhizae Radix - (Red Sage Root) - Dan Shen
Sparganii Rhizoma - (Bulrush) - San Leng
Cyperi Rhizoma - (Cyperus) - Xiang Fu Zi
Saussureae Radix - (Costus Root) - Mu Xiang
Angelicae Radix - (Angelica) - Dang Gui
Gardeniae Fructus - (Gardenia) - Shan Zhi Zi
Agitated depression is the major withdrawal symptom. Soothing the liver qi, clearing away heart fire and tranquilizing the mind can alleviate mental depression.
Herbs are prescribed as follows:
Bupleuri Radix - (Bupleurum) - Chai Hu
Cyperi Rhizoma - (Cyperus) - Xiang Fu Zi
Fossilia Ossis Mastodi - (Dragon Bone) - Long Gu
Ostreae Testa - (Oyster Shell) - Mu Li
Acori Graminei Rhizoma - Shi Chang Pu
Curcumae Tuber - (Turmeric) - Yu Jin
Rehmanniae Radix - (Rehmannia) - Sheng Di Huang
Coptidis Rhizoma - (Coptis) - Huang Lian
Lophatheri Herba - (Lophatherum) - Dan Zhu Ye
Cinnabaris - (Cinnabar) - Zhu Sha
Zizyphi Spinosi Semen - (Jujube Seed) - Suan Zao Ren
Paeoniae Radix - (White Peony) - Bai Shao
Consistent herbal program required from six months to a year.
Tobacco/Nicotine
There are three stages of the symptoms of tobacco users: In the first few days of abstaining, they may be irritated, act aggressively, and have difficulty sleeping. The real challenge comes later. The temptation to pick up the tobacco product again can be very strong and user may be depressed, or feel great anxiety. Any number of events and situations can trigger relapse regardless of stress or relaxation, unhappiness or pleasure. Practitioner should be aware of that patients could possibly gain weight over a period of time once they have successfully abstained (79% of subjects has been recorded in clinical statistics). It is uncertain whether an increased appetite or a changed metabolism or both cause this.
To assist the person abstain from tobacco, TCM practitioner would usually take a step-by-step procedure in which nourishing the heart and calming the mind go first, strengthening the spleen and replenishing qi come after. That is the way we could take care of an individual during the period of abstention. Herbs are prescribed as follows:
Codonopsitis Radix- Dang Shen
Rehmanniae Radix - (Rehmannia)- Sheng Di Huang
Atractylodis Rhizoma - (Atractylodes) - Bai Zhu
Poria - (Hoelen) - Fu Ling
Ophiopogonis Tuber - (Ophiopogon) - Mai Men Dong
Paeoniae Radix - (White Peony) - Bai Shao
Polygoni Multiflori Caulis - He Shou Wu Teng
Crataegi Fructus - (Hawthorn) - Shan Zha
Oryzae Fructus - (Germinated Rice) - Gu Ya
Tritici Fructus - (Germinated Wheat) - Mai Ya
The herbs would technically dig out the nicotine dependence (by supporting the body’s function, physiologically and psychologically); clear the craving (by tranquilizing the mind and relieving the anxiety).
Have the decoction two to three times a day until succeed.
Follow up with herbs to eliminate food stagnancy, regulate gallbladder. This formula can enhance metabolism, keeping body in shape:
Crataegi Fructus - (Hawthorn) - Shan Zha
Alismatis Rhizoma - (Alisma)- Ze Xie
Raphani Semen - (Radish) - Lai Fu Zi
Tritici Fructus - (Germinated Wheat) - Mai Ya
Massa Medicata Fermentata -(Medicinal Leaven) - Shen Qu
Prunellae Spica - (Prunella)- Xia Ku Cao
Pericarpium Citri Reticulatae - (Tangerine Peel)- Chen Pi
Pharbitidis Semenv - (Morning Glory) - Qian Niu Zi
Cassiae Torae Herba - Cao Jue Ming
Poria - (Hoelen) - Fu Ling
Adsuki Bean - Chi Xiao Dou
Pogostemi Herba - (Patchouli) - Huo Xiang
Camelliae Folium - (Tea) - Cha Ye
Alcohol
Common alcohol withdrawal syndrome involves "the shakes", sweating, nausea, anxiety, and the more severe and potentially fatal condition, known as delirium tremens.
In TCM, most cases of alcohol addicts appear chronic intoxicated (alcoholism), develop an internal production of damp heat, leading to a stagnation of the qi and the blood.
Detoxifying liver is the priority. The principle of the treatment is to soothe the liver and to normalize the function of the gallbladder. The patient should be advised to have a healthy diet that is without grease. Herbs are prescribed as follows:
Artemisiae Capillaris Herba - (Capillaris)- Yin Chen
Gardeniae Fructus - (Gardenia) - Shan Zhi Zi
Rhei Rhizoma - (Rhubarb) - Da Huang
Phellodendri Cortex - (Phellodendron) - Huang Po
Alismatis Rhizoma - (Alisma) - Ze Xie
Curcumae Tuber - (Turmeric) - Yu Jin
Bupleuri Radix - (Bupleurum) - Chai Hu
Glycyrrhizae Radix - (Licorice) - Gan Cao
Baphicacanthis Rhizoma Et Radix - (Dyer’s Woad Root) - Ban Lan Gen
Hyperici Herba - Tian Ji Huang
Salviae Miltiorrhizae Radix - (Red Sage Root) - Dan Shen
* One dose a day, three days in a row. Take the following herbs as follow-up to rejuvenate the liver for two to three weeks:
Angelicae Radix - (Angelica) - Dang Gui
Batatatis Rhizoma - (Chinese Yam) - Shan Yao
Astragali Radix - Astragalus) - Huang Qi
Alismatis Rhizoma - (Alisma) - Ze Xie
Amydae Carapax - (Turtle Shell) - Bie Jia
Ostreae Testa - (Oyster Shell) - Mu Li
Sargassum - (Seaweed) - Hai Zao
Bupleuri Radix - (Bupleurum)- Chai Hu
Scutellariae Radix - (Scute) - Huang Qin
Poria - (Hoelen)- Fu Ling
Artemisiae Capillaris Herba - (Capillaris) - Yin Chen
Oldenlandiae Herba - (Spreading Hedyotis) - Bai Hua She She Cao
Scutellariae Barbatae Herba - Ban Zhi Lian
Heroin/Other Opiates
Common symptoms of heroin users are: decreased heart rate, blood pressure & respiration rate; constricted pupils, slurred speech, sedation, nausea and loss of appetite.
We often find deficiency of liver and kidney yin on heroin users. Reddened tongue, thready and rapid pulses are the proven signs. In order to support the heroin users to detoxify, TCM would focus primarily on treating the severe disharmonies in both the digestive system and nerve system by reinforcing with herbal remedy. Herbs are prescribed as follows:
Panacis Quinquefolii Radix - (American Ginseng) - Xi Yang Shen
Coptidis Rhizoma - (Coptis) - Huang Lian
Bupleuri Radix - (Bupleurum) - Chai Hu
Atractylodis Rhizoma - (Atractylodes) - Bai Zhu
Astragali Radix - (Astragalus) - Huang Qi
Aquilariae Lignum - (Aloeswood) - Chen Xiang
Angelicae Radix - (Angelica) - Dang Gui
Glycyrrhizae Radix - (Licorice) - Gan Cao
Saussureae Radix -(Costus Root) - Mu Xiang
Phellodendri Cortex - (Phellodendron) - Huang Po
Pericarpium Citri Reticulatae - (Tangerine Peel) - Chen Pi
Cimicifugae Rhizoma -(Cimicifuge) - Sheng Ma
Gastrodiae Rhizoma - (Gastrodia) - Tian Ma
Fossilia Ossis Mastodi - (Dragon Bone) - Long Gu
Ostreae Testa - (Oyster Shell) - Mu Li
The herbs prescribed above can significantly build up the patient’s healing power, overcome the withdrawal discomforts. Patient must avoid eating any sour taste foods. Success rate is 48% for those who remain on the herbal program for 1 month, while 66% for those who remain on it for 3 months, and 86% for those who remain on it for 7 months.
If the patient has additional symptoms, such as
Watery eyes, yawning, add:
Plantaginis Semen - (Plantain Seed) - Che Qian Zi
Cuscutae Semen - (Dodder) - Tu Si Zi
Rehmanniae Radix - (Prepared Rehmannia) - Shu Di Huan
Running nose, add:
Asari Herba Cum Radice - (Asarum)- Xi Xin
Schizonepetae Herba - (Schizonepeta) - Jing Jie
Cinnamomi Ramulus - (Cinnamon Twigs) - Gui Zhi
Xanthii Fructus - (Cocklebur) - Cang Er Zi
Angelicae Dahuricae Radix - (Angelica) - Bai Zhi
Profuse sweating, add:
Astragali Radix - (Astragalus) - Huang Qi
Oryzae Radix - (Glutinous Rice Stalk) - Nuo Dao Gen
Tritici Fructus - (Wheat) - Fu Xiao Mai
Ostreae Testa - (Oyster Shell) - Mu Li
Heroin user has severe withdrawal symptoms which are muscle pain, joints pain, tearing, nasal discharge, nausea, vomiting, loss of appetite, depression, cold limbs, "gooseflesh", dilated pupils and, increased blood pressure and heart rate.
In terms of TCM, it is believed that a severe deficiency of heart and spleen, and a severe deficiency of qi and blood are the typical syndromes of a heroin user. A pale tongue and a pulse of thready, deficiency type are the clinical evidences. The treatment principle should be nourishing the heart and spleen, relieving mental strain and depression, dispelling wind and eliminating dampness. Herbs are recommended as follows:
Ginseng Radix - (Ginseng) - Ren Shen
Pericarpium Citri Reticulatae - (Tangerine Peel) - Chen Pi
Pinelliae Tuber - (Pinellia) - Ban Xia
Atractylodis Rhizoma - (Atractylodes) - Bai Zhu
Angelicae Dahuricae Radix - (Angelica) - Bai Zhi
Pycnostelmae Herba - (Paniculate Swallowwort) - Xu Chang Qing
Poria - (Hoelen) - Fu Ling
Polyporus - Zhu Ling
Fossilia Ossis Mastodi - (Dragon Bone) - Long Gu
Tritici Fructus - (Wheat) - Fu Xiao Mai
Zizyphi Fructus - (Jujube) - Da Zao
Glycyrrhizae Radix - (Licorice) - Gan Cao
One dosage a day, three days in a row, and add:
Polygoni Multiflori Radix - He Shou Wu
Angelicae Radix - (Angelica) - Dang Gui
One dose a day, take seven days. Remove the following ingredient from the above prescription:
Pycnostelmae Herba - (paniculate Swallowwort) - Xu Chang Qing
Then, advise the patient to continue taking the remedy until complete recovery.
PCP (Phencyclidine)
Impaired coordination, flushed skin, sweating, agitation, amnesia, decreased light and pain sensitivity are acute effects of PCP. Large doses would cause convulsion, coma and death.
In TCM practice, patients are often viewed as having the mind being disturbed, which is caused by the upward perversion of the wind phlegm. White sticky tongue coating and a rolling pulse are the signs of the retaining of phlegm. Therefore, nourishing the heart, easing the mind, dispelling the wind and dissolving the phlegm, are immediately required. Prescription of the herbs is as follow:
Imperatae Rhizoma - Bai Mao Gen
Bambusae Concretio Silicea - (Tabasheer) - Tian Zhu Huang
Fossilia Ossis Mastodi - (Dragon Bone) - Long Gu
Ostreae Testa - (Oyster Shell) - Mu Li
Ramulus Uncariae cum Uncis - Gou Teng
Magnetite - Ci Shi
Paeoniae Radix - (White Peony) - Bai Shao
Lonicerae Caulis Et Folium - (Honeysuckle Stem) - Ren Tong Teng
Poria with Hostwood - Fu Shen
Cinnabaris - (Cinnabar) - Zhu Sha
Acori Graminei Rhizoma- Shi Chang Pu
Follow up with promotion of qi and blood herbal programs that continue enhancing the body resistance. The following herbs are recommended:
Ginseng Radix - (Ginseng) - Ren Shen
Astragali Radix - (Astragalus) - Huang Qi
Codonopsitis Radix - Dang Shen
Atractylodis Rhizoma - (Atractylodes) - Bai Zhu
Poria - (Hoelen) - Fu Ling
Batatatis Rhizoma - (Chinese Yam) - Shan Yao
Glycyrrhizae Radix - (Licorice) - Gan Cao
Rehmanniae Radix - (Prepared Rehmannia) - Shu Di Huang
Angelicae Radix - (Angelica) - Dang Gui
Cnidii Rhizoma - (Cnidium) - Chuan Xiong
Paeoniae Radix - (White Peony) - Bai Shao
Salviae Miltiorrhizae Radix - (Red Sage Root) - Dan Shen
Cervi Cornu Parvum - (Deer Horn) - Lu Rong
Cinnamomi Cortex - (Cinnamon Bark - Rou Gui
Eucommiae Cortex - (Eucommia) - Du Zhong
Lycii Fructus - (Wolfberry) - Gou Qi Zi
Zizyphi Spinosi Semen - (Jujube Seed) - Suan Zao Ren
Polygalae Radix - (Polygala) - Yuan Zhi
Pericarpium Citri Reticulatae - (Tangerine Peel) - Chen Pi
Amomi Fructus - (Amomum) - Sha Ren
Marijuana
Marijuana smoker has a unique clinical sign: bloodshot eyes (red eyes). Other symptoms are chronic cough without lung infection, chest pain, panic attacks and irregular menstrual cycles for women, irritability, mood shifts, impaired concentration, memory lapses and fatigue.
Clinical statistics indicates that marijuana smokers appear mainly to have lung yin deficiency. They may have sticky sputum, dry cough, dry mouth and throat, afternoon fever, night sweating, heat sensations in the palms and soles, a red tongue with small amount of coating and a thready, rapid pulse. Therefore, supplementing qi, nourishing yin and restoring the vital function from collapse are the strategies applied in TCM. Recommended herbs are:
Ginseng Radix - (Ginseng) - Ren Shen
Ophiopogonis Tuber - (Ophiopogon) - Mai Men Dong
Schizandrae Fructus - (Schizandra) - Wu Wei Zi
Fossilia Ossis Mastodi - (Dragon Bone) - Long Gu
Ostreae Testa - (Oyster Shell) - Mu Li
Corni Fructus - (Dogwood Fruit) - Shan Zhu Yu
Magnetite - Ci Shi
Achyranthis Radix - (Achyranthes) - Huai Niu Xi
Red eyes:
Scutellariae Radix - (Scute) - Huang Qin
Gardeniae Fructus - (Gardenia) - Shan Zhi Zi
One dose a day until succeeds.
LSD (Lysergic Acid Diethylamide)
Sensory distortion, dilated pupils, visual illusions, hallucinations, increased heart rate, slightly increase in blood pressure and temperature, gooseflesh, tremors, muscle twitching, nausea are the mostly seen acute effects.
TCM suggests clearing the hollow viscera and dissipating the toxin because the liver fire flares up and agitates the phlegm heat of Yangming. Yellow, sticky tongue coating, string-taut, rolling and rapid pulses can be seen in most cases. The prescription of herbs is:
Cinnamomi Ramulus - (Cinnamon Twigs) - Gui Zhi
Angelicae Radix - (Angelica) - Dang Gui
Glycyrrhizae Radix - (Licorice) - Gan Cao
Rhei Rhizoma - (Rhubarb) - Da Huang
Natrium Sulfuricum - (Mirabilitum) - Mang Xiao
Persicae Semen - (Peach Kernel) - Tao Ren
Paeoniae Radix - (White Peony) - Bai Shao
Moutan Radicis Cortex - (Moutan) - Mu Dan Pi
77% of 13 subjects start urine and bowl discharges in 5 hours while 23% of them have discharges in 10 hours. Repeat the herbal remedy accordingly. Follow up with herbs to nourish the kidney yin:
Rehmanniae Radix - (Rehmannia) - Sheng Di Huang
Scrophulariae Radix - (Scrophularia) - Xuan Shen
Lichi Fructus - (Wolfberry Fruit) - Gou Qi Zi
Ligustri Fructus - (Privet) - Nu Zhen Zi
Cuscutae Semen - (Dodder) - Tu Si Zi
Amydae Carapax - (Turtle Shell) - Bie Jia
Tortoise Plastron - Gui Ban
Haliotidis Concha - (Abalone Shell) - Shi Jue Ming
Pteriae Concha - (Mother of Pearl) - Zhen Zhu Mu
Zizyphi Spinosi Semen - (Jujube Seed - Suan Zao Ren
Thujae Orientalis Semen - (Biotae Semen) - Bai Zi Ren
Ophiopogonis Tuber - (Ophiopogon) - Mai Men Dong
Making decoction:
1. Place the herbs in a non-metal cooking pot, (e.g. clay pot, glass pot, pyrex, etc.) with cold water (1.5-2 litres of water, depending on the size of the pot). Soak it for half an hour or so.
2. Bring the water to boil and cover the pot tightly, then simmer it until it reduces to approximately 2 cups. Strain the decoction out and save it.
3. Re-cook the leftover herbs by adding another 1 litre of water and make 2 cups of decoction with the above-mentioned procedure.
4. Mix up the 4 cups of decoction together. This is a two-day supply.
5. Ready to serve. Keep decoction refrigerated.
6. 2 cups a day. Drink it warm.
Discussion:
1. Chinese herbal practice is base on the philosophy of traditional Chinese medicine. The characteristic is treating the person rather than treating the symptoms. While using the herbs on drug abuse, practitioners should study the constitution of the patient before administering herbal remedy to patient.
2. The amount of the herbs might not be conventional. It is necessary to be modified and varied base on the individual’s symptoms, complexity of drug involvement and, consumption of chemicals.
3. Using traditional Chinese herbs to treat drug addicts should not be a quick fix. Attempts to cut off, or to separate, from mainstream health care are medically wrong and can even be fatal.
4. Drug users always appear in unstable conditions. It is highly recommended that they should be provided with close attention. Respect the TCM rules: ongoing program; daily follow up; preventive, individual and holistic approach; as well as functional back up.
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