Abstract

Sir, Drug use and abuse is as old as mankind itself. Human beings have always had a desire to eat or drink substances that make them feel relaxed, stimulated, or euphoric. As time went by, “home remedies” were discovered and used to alleviate aches, pains and other ailments. Most of these were naturally occurring substances. No refinement had occurred and isolation of specific compounds (drugs) had not taken place. The use of various insects as substances of abuse is interesting and has not been reported in detail in medical literature. The Indian spiny tailed lizard (Uromastyx hardwickii) is found patchily distributed in the Thar desert, Kutch and surrounding arid zones in India and Pakistan. Since ancient times, these are hunted by the locals in the belief that the oil extracted from the fat of the lizard's body is an aphrodisiac and is used as an embrocation and as a cure for impotence.[1] We would like to illustrate a case report on lizard being used as a substance of abuse in a cannabis addict. A 25-year-old male prisoner, with a 15-year history of cannabis abuse, shifted his drug of abuse to lizards due to non-availability of cannabis in prison. He would burn lizards and take the charred remains and fill them in a bidi and inhale deeply. He claimed “instant high” on this substance equating it as pleasurable as cannabis. He was introduced to this practice of smoking lizard powder by other jail inmates who were drug addicts and due to non-availability of drugs, started abusing lizard powder. On his release from prison, he started using cannabis again and also continued the use of lizard powder by mixing it with cannabis (sulfa) and smoked it in a bidi. After a month of smoking this combination, he presented with an acute psychotic episode with grossly disorganized behavior and was admitted for the same. He was diagnosed with cannabis induced psychosis. His initial Brief Psychiatric Rating Scale score (BPRS) was 59 and he was treated with tablet risperidone 6 mg/day and benzodiazepines for sedation. His condition improved in a week, BPRS score was 30; but he continued to be apathetic, anergic and slothful. His attention and concentration were also impaired. There was also history of apathy, anergia and amotivation for the past few years. Past history and family history of any psychiatric disorder was negative. The diagnosis of comorbid amotivational syndrome was considered and patient was started on tablet dothiepin 75 mg/day. His symptoms improved and he was followed-up for 1 year during which he did not abuse any substance and his mental condition was normal. During adverse conditions due to non-availability of drugs or other substances of abuse, the man has found alternatives in the form of lizard powder, snake and scorpion venom and wasp sting.[2345] The psychoactive properties of lizard, which cause addiction are not known. Thus, future research should be directed at finding the root cause of this addiction and long term affects of such addictions.

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