The effects of Ajwain (Trachyspermum copticum L.) in Opioid Withdrawal Syndrome: A Narrative Review

Addiction and dependence on substances in modern societies is a common phenomenon and one of the main causes of people's disability and also reducing their quality of life. In the past years, researchers have proposed different treatment methods for the treatment of opioid use disorders, the most important of which are treatment with agonist drugs such as methadone, buprenorphine, and opium tincture (opium syrup). Stopping the use of these drugs is associated with symptoms called opioid withdrawal syndrome, which can include things like diarrhea, pain in the limbs, sweating, heart palpitations, anxiety, stress, runny nose, and restlessness. Research has shown that some medicinal plants can be somewhat effective in reducing the mentioned symptoms. Among these, the Ajwain plant has received much attention due to its frequent consumption in Iran and its significant effects in reducing the symptoms mentioned above in other diseases. Ajwain is a one-year plant whose most important compounds include thymol, carone, limonene, and dilapiol, and among these phenolic compounds are the main components of this plant, which are responsible for its bioactive properties. Therefore, we tried to introduce its effectiveness in this review study, emphasizing the capabilities of this plant in the treatment of opioid withdrawal syndrome.

This study is a research of the narrative review type in which the information sources used were selected and included in the survey from Scopus, PubMed, Google Scholar, and Science Direct databases - during the last 23 years. Keywords Ajwain, addiction, morphine, naloxone, methadone, and withdrawal syndrome were searched in the mentioned databases. Finally, the selected articles have been evaluated and the results have been summarized and reported in tabulated format.

The results of this study have shown that the use of herbal medicine can be effective in reducing dependence and also in reducing the symptoms of opioid withdrawal syndrome. In addition, several studies have shown that plants that have a high percentage of thymol in their composition can significantly reduce the symptoms of opioid withdrawal syndrome by affecting the serotonergic, cholinergic, GABAergic, and adrenergic systems. The mechanism of the thymol effect in Ajwain can be attributed to sodium channel inhibition chloride channel stimulation and increased expression of GABA A receptors.

Since the opioid withdrawal syndrome is considered a determining factor for the continued use of opioids and relapse, it seems that less dangerous solutions should be sought to treat the complications caused by the opioid withdrawal syndrome. The results of the current review study have also shown the effective role of herbal medicine in controlling the symptoms of opioid withdrawal syndrome. Therefore, due to the importance of the topic, its wide application, easy access in the geography of Iran, and the cost-effectiveness of this medicinal plant, it is suggested to conduct further studies in this field.