Herbal therapy in opioid withdrawal syndrome: A systematic review of randomized clinical trials

Document Type : Review Article(s)

Authors

1 1. Student Research Committee, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran 2. Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

2 1. Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran 2. Department of Traditional Medicine, Faculty of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran

3 Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran

4 Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran

5 Department of Forensic Medicine and Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

10.22122/ahj.2022.91972

Abstract

Background: Medicinal plants have revealed much attention as an alternative or complementary treatment for 
opioid withdrawal syndrome. The current review collects all available literature to verify the efficiency of herbal 
remedies in the management of symptoms associated with opioid withdrawal.

Methods: A systematic literature search was conducted from January 1990 to May 2021 on four bibliographic 
databases (Scopus, PubMed, Embase, and Web of Science) using the search terms “medicinal plant”, 
“withdrawal syndrome”, “opioid”, and all their equivalents. All randomized controlled trials (RCTs), published 
in the English language were included for data synthesis. The search was performed according to the preferred 
reporting items for systematic reviews and meta-analyses (PRISMA). The Cochrane risk of bias tool was used 
to verify the quality of the included clinical trials.

Findings: A total of 12 RCTs were collected and used for data synthesis. The results of these studies indicated 
that herbal medicines were effective in treating opioid withdrawal syndrome and could alleviate the withdrawal 
symptoms, such as abdominal constrictions, diarrhea, bone pain, perspiration, and insomnia, when compared 
to conventional medications such as buprenorphine, clonidine, and methadone. However, more than 30% of 
RCTs were found to be at high risk of bias in the areas of selection, performance, detection, attrition, and 
reporting.

Conclusion: Although several RCTs have proven that herbal remedies are effective in reducing opioid 
withdrawal symptoms, the findings need to be viewed more carefully. Further RCTs with more participants, 
longer duration, and less risk of bias are needed in the claimed cases.

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