Validity of Madatyayachikitsa for chronic low-dose oral consumption of paint thinner infused with alcohol: A case report of an adolescent

Abuse of paint thinner through oral consumption, combined with alcohol, for recreation purpose poses a serious threat. A rarely documented, alternative route of substance use in an adolescent, different from the conventional mode, is presented in this case report of a 19-year-old male with a significant level of substance use and depressive symptoms. Based on Diagnostic and Statistical Manual-5 criteria, the patient meets the diagnostic requirements for Alcohol Use Disorder with concurrent inhalant use disorder, along with a major depressive episode. As per the symptomatology, the diagnosis of Madatyaya (~alcohol abuse) was made to amend the treatment protocol as per the classical Ayurveda principles of Madatyaya . A stepwise regimen was implemented first, treating Kaphasthana (~seat of Kapha dosha ) through Vamana (~therapeutic emesis), followed by Pittasthana (~seat of Pitta dosha ) through Virechana (~therapeutic purgation) to complete the detoxification sequence, and Shamana chikitsa (~palliative therapy). The outcome indicated a reduction in the severity scores on the Diagnostic Interview for Anxiety, Mood, and OCD and related Neuropsychiatric Disorders (DIAMOND) interview, from marked severity to moderate severity after intervention. Moreover, the scores on the Hamilton Depression Rating Scale (HDRS) also declined from 21 to 10. The severity profile at the one-month follow-up visit indicated mild severity on the DIAMOND score and remission state on HDRS, with the substance use recovery evaluator suggesting a good level of recovery. This case study provides positive insight on therapeutic response of Shodhana chikitsa (~purification therapies) integrated with Shamana chikitsa in managing the case of alcohol and thinner addiction.