Recreational Snake Bite as a form of New Psychoactive Substance Use: An Emerging Trend?
Year: 2025
Type: article
Abstract: Sir, For centuries, humans have used psychoactive substances to alter their mental state. In India, cannabis remains common, with 0.66% of individuals aged 10–75 years using it in a harmful or dependent pattern.[1] New psychoactive substances (NPS), not covered by international drug treaties, are also rapidly emerging.[2] Although scientific data on NPS in India are limited, media reports frequently mention seizures of mephedrone and ketamine. The UNODC identifies India as a major NPS source in Asia, with clandestine labs involved.[3] Beyond synthetic drugs, some use animals or their secretions – termed “psycho-fauna” – to get intoxicated. In India, recreational use of snake venom is an old practice,[4] with recent case reports drawing scientific interest. Effects include euphoria, relaxation, and drowsiness, possibly due to neurotoxins acting on nicotinic acetylcholine receptors or psychological responses in emotionally intense settings, often linked to impulsive, novelty-seeking traits and prior substance use. We present the case of a 22-year-old male from urban northern India with a 7-year history of tobacco dependence and 4 years of cannabis dependence. He reported frequent visits to commercial sex workers and brief and unstable relationships. Over the past 4 years, he experimented with heroin, cocaine, benzodiazepines, and lysergic acid diethylamide, mainly during city trips with friends. Two years ago, he learned about snake bites as a means of intoxication and tried it at a rave party in a metropolis after consuming cannabis and whiskey. A controlled bite to his tongue led to euphoria, increased libido, talkativeness, unsteady gait, and deep sleep. The effects lasted 6 h, followed by 12 h of sleep, with no medical complications. He did not repeat the experience. His birth and developmental history was normal. He initially performed well in school but lost interest by the 4th standard, frequently fought, and dropped out after failing the 8th grade. He exhibited impulsive behavior and engaged in deceit and theft to support substance use. Family relationships were strained, and his mother showed high levels of expressed emotion. There was no known family history of psychiatric illness. On admission, he had no withdrawal symptoms, stable vitals, and no neurological deficits. Cognitive functions and ophthalmological examinations were normal. He reported nicotine cravings and was in the contemplation stage. Routine blood tests were normal. Personality assessment using DSM-5 diagnostic criteria revealed traits consistent with Cluster B personality features; however, these did not meet the threshold for a formal personality disorder diagnosis. He received motivational enhancement therapy, and his parents underwent psychoeducation. He was prescribed low-dose lorazepam (later tapered) and started on naltrexone 25 mg for cannabis dependence and impulsivity. The patient denied any persisting desire to engage in snakebite-related behavior. Reports of recreational snakebites are rare in the scientific literature. Existing cases suggest individuals use them to achieve a strong or prolonged high, or to relieve stress, even without prior substance use.[5,6] Most involve young males with a history of polysubstance use, especially opioids.[7] One report noted snakebites being used as a cheaper alternative to opioids or alcohol.[8] Our patient, although not a chronic opioid user, exhibited polysubstance use, consuming alcohol, and cannabis prior to the snakebite – likely to reduce anxiety. Reported effects include euphoria, drowsiness, and deep sleep without tissue damage, suggesting neurotoxicity. Suspected snakes include species from the Elapidae family such as Bungarus caeruleus (krait), Naja naja (cobra), Opheodrys vernalis (green snake), and the rat snake. Two main theories explain the reported highs. One is true envenomation: α-bungarotoxins activate nicotinic acetylcholine receptors and increase calcium influx, while α-neurotoxins may induce opioid-independent analgesia.[5] The release of serotonin, bradykinin, and peptides may further explain sedative effects.[6] However, true envenomation typically causes fatal complications, making it an unlikely sole explanation. Some propose that mild envenomation might cause psychoactive effects without systemic toxicity, although evidence remains limited.[5] The second theory is the “dry bite hypothesis,” supported by findings that up to 60% of Indian snakebites are dry.[9] Except for one report,[7] all cases involved individuals already intoxicated, including ours. Our patient also showed high novelty-seeking, had multiple casual sexual partners, used Viagra, and visited commercial sex workers since age 16. Seeking new highs, he viewed snakebite as the ultimate experience. The combination of novelty-seeking, peer influence, rave-like settings, and substance use may produce a powerful subjective high – even with a dry bite – leading one author to suggest the effect may be more psychological than chemical.[10] We propose that both neurochemical and psychological mechanisms likely co-occur. Consistent subjective reports across the cases suggest involvement of nicotinic acetylcholine receptors and the mesolimbic dopaminergic system. Psychological factors – substance use, novelty-seeking, and emotionally charged contexts – are undeniable. Further research and public health awareness are needed to understand and address this emerging, potentially dangerous trend. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Institution: All India Institute of Medical Sciences Gorakhpur
Language: English
Subfield: Genetics
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W4413629584