Substance use disorders (SUDs) in Latin America and the Caribbean: a narrative review of native medicinal plants as alternative therapies

Background

Latin America and the Caribbean region are currently faced with the challenges of drug and substance use leading to violence and crime, especially among the younger populations. The complex nature of substance use disorder (SUD), the cost and adverse effects of conventional therapies, the deeply rooted cultural practices of medicinal plants usage, and the abundance of rainforest flora and fauna in Latin America and the Caribbean (LAC) are incentives for exploring bioactive compounds in managing SUDs. This review presented native medicinal plants traditionally used for managing SUD in LAC.

Main body.

Articles indexed with Google Scholar, EBSCOhost, Scopus, SciELO, Web of Science, PubMed, PubMed Central, and LILACS databases and gray literature like PAHO, WHO, and CICAD were searched for medicinal plants used in drug addiction. Medicinal plants native to LAC or naturalized and cultivated in the region were included in the study. Twelve medicinal plants belonging to 10 families were identified with potential mechanisms for SUD management and described in this review. The families and plants include Acoraceae (Acorus calamus L.), Malpighiaceae (Banisteriopsis caapi [Spruce ex Griseb.]), Hypericaceae (Hypericum perforatum L.), Asteraceae (Mikania glomerata Spreng; Matricaria recutita L.), Passifloraceae (Passiflora caerulea L.), Piperaceae (Piper methysticum L.f.), Crassulaceae (Rhodiola rosea L.), Lamiaceae (Scutellaria lateriflora L.; Leonotis nepetifolia (L.) R.Br.), Turneraceae (Turnera diffusa Willd. ex Schult.), and Zingiberaceae (Zingiber officinale var. officinale). Most plants produce their ethnopharmacological effects through GABergic activity, opioid receptor interaction, neurotransmitter modulation, NMDA receptor antagonism, antioxidant/anti-inflammatory activity, or through the enhancement of neuroplasticity—pathways for mitigating substance use disorders.

Conclusion

The abundance of rich rainforest medicinal plants in LAC makes them cost-effective alternatives in managing SUD, especially since they are easily accessible and have traditionally proven effective with fewer adverse effects. Reviewed preclinical and clinical studies reveal that select medicinal plants such as B. caapi and H. perforatum may modulate addiction-related neurochemical pathways, curb cravings, and mitigate withdrawal symptoms among substance addiction populations. However, clinical validation of the medicinal plants remains limited, revealing a disconnect between traditional ethnomedical use and current scientific evidence.