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Session 2: Clinical studies and clinical application of traditional & indigenous medicine

Development of Detoxicant Standardized Sapium insigne (Roxb.)

Benth. (Yar-ke) Extract and Assessment of Its Clinical Efficacy on
Opiate Addicts

Myint Myint Than*, Gyaw Htet Doe**, Win Myint *, Wah Wah Win**,
Theim Kyaw*, Kyaw Soe*, Yi Yi Myint*

*Department of Traditional Medicine, **Department of Medical Services
Ministry of Health, Nay Pyi Taw, Myanmar

Background and rationale: Traditional medicine has recently received wide attention in
the treatment of drug addiction. The plant Sapium insigne (Roxb.) Benth. (Yar-ke) is the origin
of Shan State of Myanmar. It is also called Ta-see-fray-tan which means the royal antidote or
powerful detoxifying agent. Main therapeutic usefulness is antinarcotic action on opiate ad-
dicted patients. There is some mention about the detoxification process whereby drug users
who are detoxed using Yar-ke reported suffering from opiate withdraw symptoms. It is seemed
to be a very promising herbal source.
Objectives:
- To conduct scientific investigation to prove clinical effectiveness of S. insigne in
opiate addicts
- To standardize the herbal pharmacopoeia monograph of S. insigne
Methods: Scientific investigation on bark of Yar-ke, the water extract of the bark was
studied on the 63 opiate dependent patients to assess its detoxification effect on withdrawal
symptom. The control group 20 was on standard treatment for opiate addiction with Tincture
of Opium (TO) as the main opiate substitute whereas the experimental test group 43 was
treated with the aqueous extract of S. insigne. The water extract of bark was pharmacognostically,
phytochemically and physicochemically standardized.
Results: The clinical effectiveness was assessed by the absence of opiate withdrawal
symptoms by the Subjective Opiate Withdrawal Scale and Clinical Opiate Withdrawal Scale
(SOWS and COWS) and when two consecutive negative urine tests were obtained for opiates
conducted 24 hours apart. The strong points of S. insigne are the significantly shorter duration
of the detoxification period needed than control group. In the alanine aminotransferase (ALT)
tests, comparison of the mean change values between the two groups showed statistically
significant, the test group displayed reduction in ALT levels whereas control group showed
elevated levels. Herbal pharmacopoeia monograph of Yar-ke bark was documented for its
quality standards.
Conclusion: This research finding suggested that S. insigne (Yar-ke) can be used to
assist patients go through the detoxification period with a 100% success rate.
Key words: Sapium insigne, opiate detoxification, standardization