Wild lettuce (Lactuca virosa) as a natural remedy for chronic pain in replacement of opioids
“Prescription opioids are often used to treat chronic and acute pain. However, serious risks are associated with their use, and it is important to carefully consider the risks of using prescription opioids as a first line solution. These risks include misuse, opioid use disorder (addiction), overdoses, and death(Prescription Opioid Data | Drug Overdose | Cdc Injury Center, 2020, p. 1).” Since the 1990s, the number of opioids prescribed to patients has grown, the number of overdoses and deaths has also increased. Studies have reported that the number of opioids prescribed and sold for pain has increased, yet Americans have not reported any changes in pain scale(Overview | Drug Overdose | Cdc Injury Center, 2020). There is the option to use over the counter medications but in the long-term use can cause side effects.
Lactuca sativa L. also known as Acrid Lettuce, Allubbyne, Bitter Lettuce, German Lactucarium, Green Endive, Lactucarium, Laitue Amère, Laitue à Opium, Laitue Sauvage, Laitue Scariole, Laitue Serriole, Laitue Vireuse, Lechuga Silvestre, Lettuce Opium, Poison Lettuce, Strong-Scented Lettuce, Wilder lattich(Wild Lettuce (Lactuca Virosa), n.d., para. 2). Wild Lettuce has shown in studies some opioid like pain killing properties. (Gonzálex-lima et al., 1986) Wild lettuce proved also to have a chemical with depressant effects in extracts of the stem. The chemical has sedative effects on motor activity and limp like paralysis resulted after administration of high doses. The experiments further suggest that the depressant L. sativa component acts by interference with basic excitatory processes common to muscular and neural tissues (Gonzálex-lima et al., 1986).
In a sleep behavior study an “HPLC analysis showed that RE contains lactucopicrin (0.02±0.01 mg/g extract), chlorogenic acid (4.05±0.03 mg/g extract), caffeic acid (2.38±0.03 mg/g extract), and chicoric acid (7.02±0.32 mg/g extract) as main phenolic compounds. The mixture of romaine lettuce leaves extract (RE), skullcap root extract (SE) mixture was shown to bind to a gamma-aminobutyric acid type A (GABAA)-benzodiazepine (BZD) receptor stronger than RE or SE single extract (Hong et al., 2018).” This study proves that Lettuce family has a sedative effect on the body, though it works even better with skullcap. “In a hot plate test with mice that have been given Lactuca virosa were evaluated for analgesic effects at doses of 15 and 30 mg/kg. This test proved that Lactuca virosa has sedative properties in the spontaneous locomotor activity test compared to standard drug ibuprofen, at a dose of 30 mg/kg. The analgesic activities of the compounds at a dose of 30 mg/kg in the tail-flick test were comparable to that of ibuprofen given at a dose of 60 mg/kg (Wesołowska et al., 2006a).”
Lactucarium is obtained from L. virosa or L. sativa and used like opium in customary medicine and different formulations form these species were listed in pharmacopoeias of several countries up to the early twentieth century. Smoked dried leaves of the plant can also serve as marijuana alternative. Despite the long history of its use, not much is known about its chemical constituents. “Crystalline lactucin was isolated in pure form by Schenk and Graf in 1936 and its bicyclic lactone structure, related to that of the bitter principle of absinthe, was established independently in the laboratories of Barton and of Šorm in 1958. Apart from the (user-)reported narcotic-euphoric effects resulting in recreational use, there is scant contemporary information on the (psycho)-pharmacological properties of either the latex or its pure ingredients (Scielo – Saúde Pública – Psychoactive Natural Products: Overview of Recent Developments Psychoactive Natural Products: Overview of Recent Developments, 2013).”
Every review has shown that Lactucarium contains lactucin and lactucopicrin, milky substances that act on the central nervous system to produce pain-relieving and sedative effects and also provides a legal high. With that said there are still not enough human studies and the studies in animals are few. There is plenty of evidence that wild lettuce has been used for its opioid like effects on pain since ancient time but there it just not have enough scientific value (Kuballa, 2018). At this time we use wild lettuce in my practice to help with:
Wild lettuce was customarily used by herbalists and general practitioners for bronchitis, irritable coughs, and insomnia now modern herbalists use the herb for respiratory illness, urinary tract disorders, and liver disease. In recent years, there has been a rekindled interest in wild lettuce as a natural pain reliever or for its frivolous use as a mild hypnotic “legal high.”(Wild Lettuce Monograph, n.d.). “Lactucarium, as well as tinctures, extracts, and syrups prepared from wild lettuce, were widely used in official medicine during the 19th century. It is not clear what exactly drove Dr. Koxe to start his experiments, but it is possible that physicians were seeking opium alternatives (Wild Lettuce Monograph, n.d.).”
The alternative Pain Treatment Directory published an article 19 December 2019 on “Three plants that could replace opioids in pain treatment” the article listed Cannabis, Kratom and Wild Lettuce. “Wild lettuce contains two active compounds, lactucopicrin and lactucin, which bind to opioid receptors and produce pain relief. These compounds are used by drug manufacturers to produce medications to treat asthma, urinary tract disorders, painful menstruation and joint pain (Three Plants That Could Replace Opioids in Pain Treatment – Alternative Pain Treatment Directory, 2019).”
People in different cultures traditionally have used wild lettuce in folkloric medicine orally as an alternative option for insomnia, restlessness, excitability in children, painful menses, muscle, or joint pains, and as an opium substitute in cough preparations. Topically, wild lettuce latex is used as an antiseptic.Wild lettuce is used for a recreational “high” for its hallucinogenic effect (Wild Lettuce (Lactuca Virosa), n.d.). In a 2017 study scientist proved that wild lettuce contained high levels of lactucin which promoted pentobarbital-induced sleep. They also learned that the herb contains antioxidant phenolics that protect from the oxidant stress caused by sleep disturbance.(Kim et al., 2017) The parts used of wild lettuce are the latex and leaf because they contain lactucin and lactupicrin. The milky latex, in Wild lettuce is believed to have mild sedative, analgesic, and hypnotic or tranquilizing effects. Lactucin, lactupicrin, and hyoscyamine have all been proposed responsible for the sedative activity, but the active constituent(s) has not been identified. Low concentrations (nanogram amounts) of morphine have been found in Lactuca species and are believed too low to have a pharmacological effect (Wild Lettuce (Lactuca Virosa), n.d.).
“In the herbal materia medica most of the strong-acting analgesics have now been turned into pharmaceuticals (Opium Poppy =>opiates, Coca =>cocaine), other herbs are illegal in most states like Cannabis. Herbalists are left with milder-acting analgesics that are less effective. Botanicals surpass is in supporting specific types of pain. We focus on where the pain occurs and the type of pain. This allows the herbalist to target and manage the pain with milder, less heroic modalities while improving efficacy. In addition, in herbal traditions throughout the world, the use of single herbs is almost unknown. The norm is a compound formula that fit the person being cared for. Combination of herbs creates a synergy of activity and the combined use of analgesics, antinociceptives, anti-inflammatories, nervines and antispasmodics strengthens the therapeutic effects and improves outcomes (Winston, 2018).”
Anxiety
Menstrual cramps
Cough
Arthritis
Urinary infections
We prepare functional teas for the clients need and have had nothing but great reviews. We ensure to complete medication and herbal reconciliation by using our safety references to ensure there is no adverse reactions. We have a wild lettuce roll on that is used for headaches and migraines by applying on temples and for nerve pain by applying affected site. We are not scientist, but we can see how wild lettuce can be a substitute for opioid in our practice. There is talk in the herbalist world that wild lettuce will soon become illegal, I wonder if big pharmacy is getting scared.