Influence of Comminution Methods and Air Exposure in the Production of Melissa officinalis Mother Tincture.

INTRODUCTION: During the processing of fresh plants, prolonged exposure to the air can cause rapid oxidative changes, and this is further accelerated if they have large surface areas. These changes can ultimately lead to losses in valuable ingredients and deterioration of the final product. Consequently, in the food, cosmetics, and pharmaceutical industries, oxidation and the use of antioxidant conservatives are major considerations during processing and production. However, similar considerations are not currently made for herbal medicines. The differences in the UV-Vis spectra of several commercial herbal mother tinctures were investigated here to determine if the oxidation process occurred and should thus be considered during their production. METHODS: The impact of air exposure on comminuted fresh Melissa officinalis and on the quality of the resulting mother tincture was evaluated using UV-Vis spectrophotometric analysis, antioxidant tests (potassium permanganate and FOLIN-Ciocalteu), and high-performance thin-layer chromatography. RESULTS: A time-dependent decrease in phenolic compounds, UV absorbance, and antioxidant capacity of the Melissa officinalis mother tincture were observed. Specifically, the antioxidant capacity of ground Melissa officinalis in the resulting herbal mother tincture was reduced by 40.47% and 55.52% after 5 and 30 min of air exposure, respectively. CONCLUSIONS: The results indicate that the Melissa officinalis mother tincture is affected if its comminuted starting material is exposed to air during the manufacturing process and that this should be considered when producing fresh herbal medicine plant products in the future.

Nasal Opioid Agonist Treatment in Patients with Severe Opioid Dependence: A Case Series.

INTRODUCTION: Opioid agonist treatment (OAT) is the first-line treatment for opioid dependence. Currently available OAT options comprise oral (methadone and morphine) and sublingual (buprenorphine) routes of administration. In Switzerland and some other countries, severely opioid-dependent individuals with insufficient response to oral or sublingual OAT are offered heroin-assisted treatment (HAT), which involves the provision of injected or oral medical heroin (diacetylmorphine [DAM]). However, many patients on treatment with injectable DAM (i-HAT) suffer from injection-related problems such as deteriorated vein status, ulcerations, endocarditis, and abscesses. Other patients who do not respond to oral OAT do not inject but snort opioids, and are not eligible for i-HAT. For this population, there is no other short-acting OAT with rapid onset of action available unless they switch to injecting, which is associated with higher risks. Nasal DAM (n-HAT) could be an alternative treatment option suitable for both populations of patients. METHODS: We present a case series of 3 patients on i-HAT who successfully switched to n-HAT. RESULTS/CONCLUSIONS: This is the first description of the clinical use of the nasal route of administration for HAT. n-HAT may constitute an important risk-reduced rapid-onset alternative to i-HAT. In particular, it may be suited for patients with injection-related complications, or noninjecting opioid-dependent patients failing to respond to oral OAT.