Homoeopathic Perspective in the Management of Substance Use Disorders: A Systematic Review

Abstract

Background: Substance abuse has become a widespread global issue. It includes abuse of illegal substances, namely marijuana, heroin, cocaine and methamphetamines, and legal substances, including alcohol, nicotine or prescribed medicines. Aim of Review: This review assesses the role of Homoeopathy in the therapeutic management of substance use disorders (SUD) through a systematic web-based literature search. Methods: A comprehensive search was conducted online and manually to identify homoeopathic research studies published between 1993 and 2022 on SUD in international databases and the Central Council of Research in Homoeopathy library. Relevant studies were categorised and assessed in terms of study designs, number of participants, evidence grades and clinical outcome parameters. A total of 21 full-text studies were screened and evaluated. Risk of bias (RoB) was assessed for all studies and model validity was appraised for the included RCTs'. Results: 10 studies (3 Randomised Controlled Trials, 3 Observational studies, 1 Pilot study, 1 observational comparative study, 1 Retrospective cohort study and 1 case series) were included and 11 studies were excluded with reasons. 03 studies have a level of evidence of 1b with an 'A' grade of recommendation, which consists of the RCTs only. The most commonly prescribed medicines identified were: Arsenic album, Nux vomica, Lycopodium, Pulsatilla, Sulphur, Staphysagria, Belladonna, Ipecac, Chamomilla, Rhustox, Phosphorus and Lachesis. A high risk of bias was elicited in most of the observational studies accentuating the need for more robust methodological studies. Conclusion:  The majority of the studies have a small number of recruitments. Pragmatic studies with larger sample sizes and validated outcome measures may be designed further to validate the promising role of homoeopathic medicines in SUDs and generate quality evidence.