From Rasa Shastra to Grocery Counter: What Ayurveda Lost in the Age of Commercialisation

He was a working man in his late thirties who came to the hospital with pain in his stomach, weakness, and a low haemoglobin level. Addiction or any poisoning was not suspected, but on questioning, a clearer picture of self-medicating for months with an over-the-counter Ayurvedic product called Kamini came into light. It was purchased without a prescription from a local grocery store.

What Is Kamini?

Kamini Vidrawan Ras is an Ayurvedic formulation sold in small pellet or tablet form, typically marketed for male sexual health. It is widely available over the counter at Ayurvedic and grocery stores across India, and has been illegally imported into countries including Australia, New Zealand, and the United Kingdom.

What many buyers do not know is that Kamini contains Papaver somniferum, the opium poppy. Opium content of 2–20 mg per tablet.¹ It is a scheduled substance available only by prescription in most countries.

The Evidence: What Published Research Says

Opioid Dependence

A 2024 case series from the Department of Psychiatry and Haematology at Christian Medical College, Ludhiana, described three male patients who presented with abdominal pain, generalised weakness, and anaemia. All were found to be opioid-dependent due to Kamini use, with significantly elevated blood lead levels.² All three responded to chelation therapy.

A 2022 case series from an addiction medicine clinic in Australia described 12 patients who developed opioid use disorder after using Kamini, with durations of use ranging from 6 months to 8 years. Eleven of the twelve were born in India. Nine required buprenorphine maintenance treatment.¹

Similarly, another Australian case series reported another cohort of 12 male patients, aged 27–41, predominantly of north Indian origin, all treated with opioid substitution therapy for Kamini dependence.³

A 2025 Indian case series documented five males with confirmed opioid dependence who had transitioned from natural opium (afeem/doda) to products like Kamini and Barshasha, believing them to be safer and non-addictive.⁴

Heavy Metals Contamination in Ayurvedic Medicines

Another harm is heavy metal contamination. Lead contamination may arise through intentional adulteration, raw material contamination, or inadequate manufacturing controls.²

A systematic review of heavy metal toxicity from Indian traditional medicine systems identified 220 documented cases from 51 case reports and 14 case series. Lead was the most common culprit (n=156), followed by mercury (n=47) and arsenic (n=11). Among the analysed drug samples, 83.7% contained concentrations of heavy metals above permissible levels.⁵

A 2022 study from PGIMER Chandigarh tested common over-the-counter Ayurvedic preparations from local markets using inductively coupled plasma mass spectrometry (ICP-MS), finding toxic concentrations of lead, mercury, arsenic, and cadmium in a significant proportion of samples.⁶

A retrospective study of 386 CAM products from 91 patients presenting with adverse events at a South Indian tertiary centre (2021–2023) found mercury exceeding WHO limits in 34% of products, cadmium in 25%, arsenic in 21%, and lead in 14%.⁷

The clinical picture of lead toxicity from Kamini is non-specific, including abdominal pain, weakness, anaemia, basophilic stippling on peripheral blood smear, and elevated blood lead levels. It mimics many common conditions and is easily missed if a clinician does not ask the right question.

Beyond addiction medicine and haematology, some gastroenterologists in north India describe encountering severe chronic gastrointestinal complications in long-term Kamini users, including profound opioid-related gut dysmotility and suspected stricture disease. Although systematic published data remain limited, the clinical observations raise concern that the burden of death associated with chronic OTC opioid-containing preparations may be substantially under-recognised.

What Classical Ayurveda Actually Says About Metals

The use of metals in Ayurvedic medicine is not adulteration. It is called Rasa Shastra, the branch of Ayurveda focused on the therapeutic use of metals, minerals, and mercury. Rasa Shastra texts, developed primarily from the 8th century onwards, describe elaborate procedures for purifying toxic substances before therapeutic use.

The main process is Shodhana (purification). The Charaka Samhita acknowledges the existence of sthavara visha (poisons of mineral and plant origin) and describes the conditions under which toxic substances can be rendered medicinal.⁸

A foundational principle from the Charaka Samhita says:

नास्त्यभोज्यं नास्त्यभेष्यं नास्त्यव्याधिकरं जगत्। योगस्तु विद्यते सर्वं नैव यन्न भिषग्विदुः॥

Nāstyabhojyaṃ nāstyabheṣyaṃ nāstyavyādhikaraṃ jagat | Yogastu vidyate sarvaṃ naiva yanna bhiṣagviduḥ ||

There is nothing in the world that is not food, not medicine, not capable of causing disease. What matters is the knowledge of how to use it rightly, and that is the domain of the physician

— Charaka Samhita, Sutrasthana

Charaka did not say metals are harmless. He said that everything, including what is toxic, can be medicinal when used correctly, by someone who knows. The trained Vaidya, the precise method, the proper Shodhana, the correct dose are essentially required.

The ancient scholars, Acharya Charaka, Sushruta, and Vagbhata, were aware of the therapeutic value of metallic and mineral-origin substances, but restricted their use carefully. Rasashastra, formalised as a discipline after the 8th century, encoded them into elaborate purification protocols.

The classical system was never intended for metal-containing preparations to be sold over the counter, self-prescribed, and consumed without physician guidance. The required essentials built into Rasa Shastra, including Shodhana, dosage control, and physician supervision, are what the OTC market bypasses entirely. Many qualified Ayurvedic practitioners do not endorse the unsupervised OTC use of formulations such as Kamini, particularly outside of physician supervision and classical therapeutic indications

The Line Between Classical Practice and the Commercial Market

Metals (bhasmas) are considered therapeutically essential in Rasa Shastra; they are added after Shodhana in classical formulations. However, many recent reports demonstrate that herbal medicines are being adulterated with toxic quantities of heavy metals far beyond any therapeutic intent.

The Government of India has mandated that Ayurvedic products specify their metallic content on labels. However, prominent Ayurvedic scholar M.S. Valiathan has pointed out that without robust post-market surveillance and adequate laboratory infrastructure, meaningful quality control of Ayurvedic medicines remains extremely difficult to enforce in practice.¹⁰

India currently lacks a clearly visible and consistently enforced surveillance framework specifically targeting opioid-containing Ayurvedic OTC products. Meanwhile, the patient trusts the label.

The Global Scenario

New Zealand’s National Public Health Service reported 22 cases of elevated blood lead levels linked to Ayurvedic medicines since October 2023, with implicated products sourced both internationally and locally.

In Australia, the Therapeutic Goods Administration (TGA) has issued formal warnings about Kamini tablets, confirming they contain scheduled substances available only by prescription. Despite this, supply through Indian grocery stores persists.

The global reach of this problem shows two sides. One, the deep trust Indian communities place in traditional medicine, wherever they are, and second, the complete absence of international harmonisation in regulating herbal products that cross borders.

What Needs to Change

Maintain a low threshold for testing blood lead levels in patients with anaemia and/or abdominal pain who report chronic self Ayurvedic product use. ²

The DGCI must develop specific surveillance frameworks for opioid-containing preparations marketed under the Ayurvedic banner. Mandatory heavy metal testing before market authorisation, strict OTC restrictions, and online sale prohibitions for products containing scheduled substances.

The problem is commercialisation that strips away every essential requirement the classical system was built on. Ayurveda practitioners who speak out about this distinction are defending their science, not undervaluing it.

For Patients and Families, “Ayurvedic hai toh safe hai” is not a medical fact. It is a cultural assumption, and in some cases, a dangerous one. No preparation should be self-prescribed based solely on its label.

Conclusion

Charaka wrote that nothing in the world is inherently medicine or poison. It depends entirely on how it is used, by whom, and with what knowledge. Ayurveda, at its classical best, was always a system of deep knowledge held by trained physicians. The tragedy of Kamini is not that Ayurveda is dangerous. It is that an ancient system built on careful, physician-supervised use has been reduced to an unlabelled pellet sold at a grocery counter.

The true prevalence of Kamini-related toxicity is unknown. Published literature likely captures only a fraction of cases due to underreporting, limited toxicology testing, social stigma around substance use, and low clinician awareness.

All that glitters is not always gold. Sometimes, it is lead.

References

1. Khan T, Ariyawansa P, Quinn J, Hayllar J. Kamini, a little recognised source of illicit opioid: A case series of 12 patients. Drug Alcohol Rev. 2022; 41(6):1404–7.
2. Abhilasha, P., Vats, K., Gautam, N., Kaur, V., Singla, M., Pavitra Ds, Gupta, M., Chaudhary, V., Joyal, W., & John, M. J. (2024). A New Source of Opioid and Lead Toxicity on the Block-Kamini: An Emerging Health Hazard-A Case Series. Indian journal of psychological medicine, 02537176241255046. Advance online publication. https://doi.org/10.1177/02537176241255046
3. Naren T, Silkoff D, Forsythe M, Cook J. Case series on treatment of dependence to Kamini Vidrawan Ras with opioid substitution therapy. Drug Alcohol Rev. 2022; 41(6):1408–11.
4. Ahmad H, Ahuja S, Suthar N. Opioid-containing Herbal Medicines and Dependence: A Potential Epidemic— A Case Series. Indian J Psychol Med [Internet]. 2026 [cited 2026 May 28]; 02537176261422341. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12932130/.
5. Mukhopadhyay S, Abraham SE, Holla B, Ramakrishna KK, Gopalakrishna KL, Soman A, et al. Heavy Metals in Indian Traditional Systems of Medicine: A Systematic Scoping Review and Recommendations for Integrative Medicine Practice. J Altern Complement Med. 2021; 27(11):915–29.
6. Bhalla A, Pannu AK. Are Ayurvedic medications store house of heavy metals? Toxicology Research [Internet]. 2022 [cited 2026 May 28]; 11(1):179–83. Available from: https://academic.oup.com/toxres/article/11/1/179/6508743. https://doi.org/10.1093/toxres/tfab124
7. Philips CA, Oommen TT, Theruvath AH, Sreemohan A, Baby A, Ahamed R, et al. Analysis of 386 alternative medicinal products implicated in liver injury reveal clinically relevant associations with potentially hepatotoxic botanicals, pharmaceutical adulteration, heavy metal contamination, and undisclosed animal content. Front Gastroenterol [Internet]. 2026 [cited 2026 May 28]; 5. Available from: https://www.frontiersin.org/journals/gastroenterology/articles/10.3389/fgstr.2026.1784785/full.
8. Charaka Samhita, Sutrasthana
9. Savrikar SS, Ravishankar B. Introduction to ‘Rasashaastra’ the Iatrochemistry of Ayurveda. Afr J Tradit Complement Altern Med [Internet]. 2011 [cited 2026 May 28]; 8(5 Suppl):66–82. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252715/
10. Valiathan, M.S.. (2006). Ayurveda: Putting the house in order. Current Science. 90. 5-6.

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