Food Hygine in Islam: Narcotics by Dr Abdul Wadud

[Ahmed Mateen]

Narcotics

by Dr. Sayed Abdul Wadud

The word () with the root (K-M-R) means “to cover”. The word is often used for wine because it covers human consciousness; but it includes all sorts of narcotics which induce drowsiness, sleep, stupor, insensibility and exhilaration beyond control. According to Hazrat Umar ‘Khumar’ means a substance which produces disturbance in the human intellect.

In earlier times wine used to be the commonest narcotic. Thus the word ‘Khumar’ came to be used for wine alone. But in modern age the narcotics both natural and synthetic have emerged in a large number, and thus came under the heading ‘Khumar’.

The holy Quran has prohibited the consumption of intoxicants. If we put together the Quranic verses related to intoxication chronologically, we have a unique example of a graduated, proclamation. In the beginning we find:

‘Oh ye who believe! Approach not prayers with a mind befogged until you can understand all what you say.” (4:43)

The prayer in congregation is the basic institution for the establishment of an Islamic social order. To keep up the solemnity of the occasion, the holy Quran gives certain fundamental instructions. One such instruction is that you must be attentive and vigilant during prayers. It is no use attending the prayers in a dazed state of mind unless you understand what you say. The consumption of wine was a very frequent practice amongst the Arabs of pre-Islamic era. So the first instruction was to abstain from its use in order to avoid befogging of mind during prayers. Practically it made the consumption of wine extremely difficult because the interval between the prayer timings is very small except between the morning and afternoon prayers or between late night and morning prayers.

This is followed by the statement that sin is greater that the advantage in case of wine, when it is said:

“They ask thee concerning narcotics and gambling. Say: In them is a great debility and some profit for men; but their debility is greater than the profit.” (2:219)

Here in this verse, the holy Quran has pointed out two such things which can serve as an obstacle in the way of the establishment of the Quranic social order. One of them being the intoxicants which befog the human mind and thus hamper the mental as well as the physical activities of man. The other obstacle is the money earned without labour which also includes gambling. There are certain profits also which are attached to these two aspects of human activities but the Quran says that their deleterious effects are far greater than the profits. These things make a man ease-loving and lazy, and produce slackness of motivation and determination. Such a person looses interest in the dynamic pursuits of life and is consequently left staggering in the race of life. Thus the holy Quran prevents man from running after wealth earned by easy means and also from indulgence in intoxicants.

Then there is the final stern warning against the use of narcotics when it is described as a disgusting crime, like the worship of idols, and an abomination of Satan’s handiwork:

“Oh ye who believe! Narcotics and gambling, dedication of stones and (divination by) arrows are an abomination - of Satan’s handiwork: eschew such (abomination) that you may prosper.” (5:90)

Here again the use of intoxicants are included in the list of practices which deserve aversion or disgust, which stupify human intellect and impair man’s faculty of determination as well as stamina for work.

Alcohol
The deleterious effects of alcohol on the mental, physical, moral and social aspects of man are too well known, but it shall be worth-while if we describe in some detail its effects on man from medical point of view, because that would give a better picture of what the Quran describes as

“Its deleterious effect is greater than its usefulness; and also when it is said that it is and abomination.

Effects of Alcohol on man
Effect on nervous system. - It differs a good deal in individuals. In small quantities it produces a feeling of well-being and good fellowship along with increased confidence in the mental and physical powers of the subject of experiment. Larger quantities are followed by a certain amount of excitement, marked by laughter, loquacity and gesticulation. Even at this stage, self-control is partially lost and will-power is weakened. The speech may be brilliant but often betrays the speaker; the movements are more lively but they are often undignified. The loss of self control is often indicated further by outbursts of anger and unreasonableness, or by the indulgence in maudlin sentimentality and sensual fancies. The sense of responsibility and the power of discrimination between the trivial and the important are lost and the individual has no regard for the feelings of others or the ordinary conventions of life. If the bout be further continued, the movements become uncertain, the speech becomes difficult and stammering, the gait becomes a stagger and a torpid slumber follows. On awakening from slumber, a very great depression generally sets in together with nausea and vomiting and want of appetite which may last for several days and is associated with all the symptoms of acute gastric catarrh. Very large quantities of alcohol lead to deep torpid sleep which eventually passes into total unconsciousness resembling the condition in chloroform anesthesia. The condition may last for several hours and end in death from failure of respiration but in other cases the anesthesia is less deep and after a very prolonged sleep, the patient recovers.

The effects of alcohol vary greatly, however in different individuals and in the same individual at different times. When drinking is indulged in, in company, the excitement stage is a very common phenomenon, but if alcohol is taken without the exhilarating accompaniments of bright lights and exciting companionship, it is much less frequent.

Excitement after taking alcohol is due not to true stimulation of the motor areas of the brain but is the result of these areas being freed from control by the weakening of the highest functions of the brain, the will and self-restraint. Alcohol even in the smallest of quantities, tends to lessen the activity of the brain, the drug appearing to act most strongly, and therefore in the smallest quantities, on the most recently acquired faculties, to annihilate those qualities that have been built up through education and experience - the power of self-control and the sense of responsibility. The brilliancy of speech is due to the speaker having lost his habitual shyness and nervousness.

The amount of work and endurance under alcohol have long been a subject of study from the early experiments of Parkes, who found that those regiments who were not supplied with alcohol marched further and were in better condition at the end of the day, than others to whom alcohol was given. This writer, who had been in the army during the Second World War, personally observed this fact. Our Brigade on the Burma front, comprised of three Battalions, one British, one Gurkhas and one Indian. Out of the whole lot, the British battalion was always bad on the line of march. I particularly remember one occasion, when on Christmas Eve of 1944, we halted over a hill top in Burma. There was an airdrop of food and all sorts of alcoholic drinks, which the British troops enjoyed to their fill. At midnight, orders came in from the Divisional Headquarters to move further, early the next morning. The march on that Christmas day of '44 was perhaps the longest we had ever had in one day - about 31 miles. We too fared badly but the British troops, who had been under the effects of alcohol the night before, were in a terrible condition.

The experiments of Durig in climbing, lead to the same result; the total work done being smaller under alcohol, with the expenditure of energy greater.

Forms of work requiring larger drafts upon the intelligence than the marching of soldiers are also performed less correctly with alcohol than without it. The capacity for work depends not so much on the strength of the muscles, as on the condition of the brain. Under alcohol, skilled work is performed more slowly and far more errors occur in it than in normal conditions and these errors may lead to serious accidents in industry.

Effects of alcohol on digestion

There exists a widespread belief in both lay and medical circles that small quantity of alcohol taken before meal increases the appetite, while after food it accelerates the digestion. As a matter of fact when alcohol is administered in the usual form of wine, spirits or beer, digestion in the stomach is influenced in two opposite directions. The action on the digestive ferments is deleterious while the changes in the stomach wall, the increased secretion of gastric juice and the accelerated absorption of food may possible be beneficial in many cases. These two opposing factors may neutralize each other, as in the case of experimental dog in which the rate of digestion is scarcely altered.

Value of alcohol as a food

Only 5% of the ingested alcohol is excreted while the rest of that absorbed from the stomach and bowel amounting to 95% undergoes combustion in the tissue and thus produces heat and energy. Therefore technically it is a food but this does not imply that it is an advisable food in all conditions. Alcohol taken in addition to the carbohydrates and fat, which in turn is used to build up reserves of energy in the body. Alcohol itself cannot be stored in the tissue and is therefore utilized in place of carbohydrates which are deposited as glycogen and there is an increase of fat in the body which is a common observation in those who drink.

Effect of alcohol on growth and progeny

Stockard found that when male guinea-pigs are intoxicated daily with alcohol for a week and then crossed with normal females, the litters are often small and present numerous abnormalities and this tendency may be transmitted through several generations; this indicates severe injury to the germ plasma of males, which is inherited by the descendants. Others have made analogous observations, such as that the tests degenerate in both animals and man under the prolonged and excessive ingestion of alcohol; similarly the litters born of animals treated with alcohol are often small and are prone to die early.

Effects of alcohol on infection

Persons addicted to the use of alcohol are known to show less resistance in acute disease, and in operations accompanied by shock, than the more temperate individuals, and in vary intemperate cases the prognosis must be guarded in an attack which would ordinarily be accompanied with little danger. Results in experimental animals have invariably shown a greater susceptibility to infections and a greater morality than in control animals, which had received no alcohol.

Aphrodisiac powers

Alcohol is generally credited with Aphrodisiac powers, that is, with increasing sexual desire, although no less an authority than Shakespeare states that it prevents the consummation of sexual intercourse. The unquestionable tendency towards sexual excess observed in intoxication is due, not to any effects on the generative organs, but to the loss of self-control, from the cerebral action of the poison.

Use of alcohol as a medicine

Externally it is used in treating bedsores in which it is often applied in order to harden the skin. It is also used as a mild antiseptic. The indications for internal use of alcohol are ill-defined, and cases which one physician would teat with alcohol often progress as favorably without it in the hands of another. It has been prescribed very largely in the past as a 'stimulant' but drugs are now available which are far superior to alcohol in their stimulant action. The action which lends alcohol its value in therapeutics is not its stimulant but its narcotic action, which allays the anxiety and distress of the patient, promotes rest and sleep. But again drugs much superior in their narcotic effect are available. Cases of hemorrhage, shock and other forms of severe and sudden depression of the heart and central nervous system have been frequently treated with alcohol but its beneficial effect in such cases has been much questionable in recent years and the belief that it is of little value is certainly widely held at present. Alcohol has a beneficial effect on cases of 'chill' which is a sudden constriction of the blood vessels of the nose and throat, as it causes dilatation of peripheral blood vessels, but there are other drugs with the same effect such as volatile oils and comfier. Alcohol may be used in cases of distress of mind from any cause, such as grief, business anxiety or depression; alcohol acts by its narcotic action on the brain, but the danger of alcohol habit is so great that most physicians refuse to take the responsibility of prescribing the drug in such cases.

In Epilepsy, alcohol produces prolonged nervous disturbance, which is very deleterious in such patients. In chronic conditions of cachexia and loss of flesh in general, and during convalescence alcoholic preparations are often advised simply as foods or stomachaches.

In the treatment of diabetes by the withdrawal of carbohydrates, alcohol has been advised to maintain the supply of energy, which it does without increasing the sugar of the blood and urine.

Habitual use

In regard to the habitual use of alcohol by healthy persons, all authorities agree that it is a luxury, that it is entirely unnecessary for the growth and maintenance of the body and that it neither promotes greater healthfulness, nor in any way retards the onset of disease. It is true that it is utilized by the body as a food but its value as such is limited because only small quantities can be taken without disturbance of nervous system. The symptoms of chronic alcoholism are very common. The earliest symptoms are generally observed in the stomach, throat and larynx and consist of chronic catarrh. Fatty degeneration occurs in the liver especially and also in the arterial walls throughout the body and favors the development of high blood pressure. The heart undergoes fatty changes accompanied by dilation and weakness. In central nervous system its causes shrinkage of nerve cells and thus leads to impairment of memory, self-control and other higher mental processes. In worst cases, tremor, convulsive attacks, hallucinations and mania occur, followed by idiocy and paralysis.

The disastrous effects of the abuse of alcohol are seen in the statistics of the hospitals, prisons and asylums in nearly all countries. A large percentage of crime is admittedly done under the influence of alcohol or as a direct result of alcoholic excess, which is also responsible for a large part of the poverty and misery of the lowest classes of the population. It must also be taken into account that only the more extreme cases come under the categories of criminals and lunatics and an enormous number of cases of disease caused or aggravated by alcohol escape recognition. Attempts have been made to demonstrate that the effects of alcohol are hereditary, that the children of alcoholics supply a larger proportion of cases of insanity and crime than those of the rest of the population. The deleterious effect of the alcoholic habit in the parent on the nutrition of the offspring is, however, a well establishes fact.

One can learn from the above description that, from the medical point of view, the beneficial effects of the use of alcohol are too small as compared with the disadvantages and dangers inherent in it. Of course, the moral effects on the individual as well as on the society are far too deleterious. There are probably no passages in the Quran that have been the subject of such a variety of interpretations as those, which deal with he prohibition of wine. Some interpreters have placed it in the list of unlawful objects, but as described already, the subject of () lawful and ( ) unlawful carries an entirely different import. It is symbolic of one’s membership of the Islamic social order. Only those things are unlawful which the Quran has categorically described as unlawful and these are carrion (dead animal flesh), blood, flesh of swine and that on which any name, besides that of Allah, has been invoked. The order for the prohibition of unlawful articles was not a graduated proclamation as in the case of wine. These were ordered to be stopped forthwith. The vise of drinking wine was deep-rooted amongst the Arabs of pre-Islamic era. Thus its use was gradually eliminated from the society by the graduated descent of Wahi; firstly that you approach not prayers with a befogged mind.

Secondly that the deleterious effects of wine are greater than its usefulness and finally, it is a thing (alcohol) deserving aversion and disgust, a thing which lowers the human dignity and a thing which debilitates the human mind and body. Thus the believers in the Quran gradually and voluntarily forsook the practice of drinking wine till it really became an object of hate amongst them.

So far, we have dealt with the subject of alcoholic drinks only but there is a big variety of other articles which come under the category of () and which produce befogging of mind or drowsiness or unconsciousness depending on the amount consumed. In medicine all general anesthetics and drugs used for the treatment of psychosomatic, psychoanalytic, or psychoreactive disorders characterised by tension, excitement, unrest, anxiety, sleep disturbances, irritabiliy, aggressiveness etc., as well as drugs used for relieving pain, come under this heading. The medicinal value of these drugs is great but there are also dangers inherent in their misuse. Some of the drugs like opium lead to habit formation with dire consequences. Previously, intoxicants were used only in the lowest strata of human society. But now even educated young men all over the world, with high living and low thinking, are getting addicted to them, that is because having dissociated themselves from divine guidance, their ideas about personal freedom as well as about discipline have undergone perversion.

Opium

Other narcotics which come under the heading of ()- Opium has been used in medicine since remote periods. Although many substitutes have been proposed for it in later years, it still occupies a position of its own in therapeutics.

It is the dried juice of Papaver Somniferum, a poppy which is grown chiefly in the

Indo-Pakistan subcontinent, China, Egypt, Persia and Asia Minor, but has been cultivated in colder climates and is said to produce a more powerful Opium there. Opium owes its activity to a large number of alkaloids of which morphine, codeine, papeverine, narcotine and thebaine are the most important. The action of opium is mainly due to a large amount of morphine contained in it. Morphine acts chiefly on the central nervous system but it also affects some peripheral organs such as intestines.

Symptoms: In man, small quantities of morphine (1/8gr, 8mgs) lessons the voluntary movements and produces a drowsiness which soon passes into sleep, unless the patient is continually aroused by his surroundings. As long as he is kept awake, his actions and movements show nothing abnormal but it is impossible to keep his attention directed to any one subject for long and as soon as he is left to himself for a few moments, he sinks into sleep. After small quantities there is no difficulty in arousing him, in fact, the sleep seems lighter than usual and may resemble rather a state of abstraction. In this condition (euphoria) the imagination is not depressed to the same extent as the reason; the self-control and judgement are lessened and although the stream of thought may seem more rapid and image is more vivid than usual, the logical sequence and the ideas of time and space are lost and the condition may rather be compared to dreaming than to a real increase of the intellectual powers. This stage of abstraction is not by any means generally observed and soon passes into sleep, but the unchecked imagination may still persist in the form of dreams. Even in this early stage, pain is felt acutely, the respiration is slow and the pupils contracted.

In larger quantities (1/4-1/2gm, 15-30mgs), morphine produces deep dream-like sleep from which the patient is still easily aroused, but which returns at once when he is left undisturbed. As the dose is increased, the sleep deepens into torpor from which he can be awakened only with difficulty and eventually all efforts to arouse his attention are fruitless and he sinks into a coma, which may be reached very soon.

Cannabis
The hemp plant, especially when cultivated in warm climates as in the Indo-Pakistani subcontinent, Egypt or the southern United States, adds to the development of products, which induce marked derangement of the central nervous system. Known in Punjab as “Bhang”, it is frequently used by Fakirs living in graveyards. The active principle of Indian hemp has been found to be a red oil or resin boiling at a high temperature, which they term cannabinol. This was found to induce the typical effects of cannabis in man and animals.

Symptoms: The effects of cannibis Indica are chiefly due to the changes in the central nervous system in which it induces a mixture of depression and stimulation similar to that seen under small doses of morphine. Its action is much less constant, however and seems to depend very largely on the disposition and the intellectual activity of the individual. The preparations used also vary considerably in strength and the activity of even the crude drugs seems to depend very largely on the climate and season in which it is grown. Soon after administering the drug, the patient passes into a dreamy semi-conscious state in which judgement seems to be lost, while the imagination is untrammeled by its usual restraints. The dreams assume the vividness of visions or of boundless extravagance and of course, vary with the character and pursuits of the individual. The eastern races seem to take the drug generally out of an amorous nature.

An imaginative believer sees the gardens of paradise and finds himself surrounded by troops of “hoors” of unspeakable beauty, while the less imaginative person finds himself unaccountably happy and feels constrained to active movement, often of a purposeless and even absurd character. Ideas and all measurement of time and space are lost. True hallucinations may appear but are often absent. The chief feature of the action being merriment, comfort, well being and self-satisfaction. Often less present thoughts obtrude themselves, however, such as the fear of impending death or of some imminent indefinite danger. During this period the consciousness is not entirely lost, for the patient often feels that his dreams are unreal, his satisfaction unfounded and his movements ridiculous, but he cannot restrain them. He can give a coherent account of his condition when aroused and answer questions intelligently. The sensation of pain is lessened or is entirely absent and the sense of touch is less acute than normally.

Later the dreams alternate with periods of complete unconsciousness from which the patient can be aroused easily and the symptoms eventually pass into tranquil sleep from which he awakens refreshed and as a rule, without any feeling of depression or nausea.

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