Is it a miracle drug that can cure a range of addictions from heroin to nicotine, or does it amount to a game of chance that can cause brain damage or death? In the midst of an opioid epidemic, ibogaine may hold promise of another public health advance that could save lives.
Ibogaine is an African ritualistic drug that some heroin addicts claim has removed their craving in a single dose. And this belief is backed up by a growing body of published scientific evidence that ibogaine works in ways not fully understood to do what its advocates claim.
But there are also scientists who are skeptical, including top addiction and drug officials in the U.S. government. Ibogaine is classified as a dangerous,illegal drug in the United States. There have been at least two deaths of female addicts treated with ibogaine in Europe possibly related to overdose in medically unsafe circumstances.
Those who have used ibogaine say they experienced a conscious but dream-like state in which the events of their life rolled before them in a sort of high-speed movie that gave them insight into where their addiction destructive had taken them. In the initial period just after administration, users feel drowsy and inert. Later, the craving and compulsion to use drugs are allegedly removed. There are no clinical trials of ibogaine in the United States yet.
Ibogaine has been credited with successfully treating cocaine, heroin and nicotine addictions. Although there are no human studies of ibogaine, its effects on opiate withdrawal in animals have been documented.
"Ibogaine produces hallucinations acutely," according to Stanley Glick, MD, a researcher in the Department of Pharmacology and Neuroscience at Albany Medical College in Albany, N.Y. who has published many scientific papers on ibogaine in animals. "In doses used for treatment (500-800 mg), it can cause a dream-like state. Ibogaine appears to have multiple modes of action; there's still a lot of research that needs to be done."
Glick admits that most of the evidence for ibogaine as an anti-addictive drug is anecdotal, "When you hear the same story over and over you have to give it some credence. I personally know an attorney in Chicago who was treated with ibogaine once and has been free of drugs and cravings for years."
Ibogaine is a sacramental drug derived from an African shrub, tabernanthe iboga. It was first isolated and identified at the early part of the 20th Century. It has been extensively studied in rats and is the focus of more than 150 recently-published scientific papers.
"Ibogaine acts on opioid receptors in the brain, and it's a rapid Prozac," says Deborah Mash, PhD, neurology and pharmacology professor at the University of Miami Medical School. She ws a member of a team at the University of Miami that received approval from the U.S. Food and Drug Administration in 1995 to conduct clinical trials of ibogaine in cocaine addicts. The trials were halted because of a lack of funds.
"Ibogaine is a pro-drug that stays in the body for a long time," Mash said. "In 19 hours the ibogaine itself is out of the system. The ibogaine, which doesn't produce visions, is the right target for medication development. It really gets someone's attention and makes them ready for treatment."
Ibogaine also has drawn the interest of high-ranked officials of the federal Center for Substance Abuse Treatment (CSAT)—not all of it positive.
"The evidence suggests that ibogaine is not safe in animals because of continuing reports of dmage to the cerebellum," according to CSAT Director Westley Clark, MD. "There needs to be a lot more research into ibogaine before it cn be considered safe for humans. It's premature to recommend ibogaine when other approaches to addiction that are not as dramatic as ibogaine are known to be effective. If it sounds too good to be true, it probably is. Taking ibogaine is a game of Russian roulette."
"The only positive effect of ibogaine is that it decreases the symptoms of opiate withdrawal, which is fairly well documented in animals," said Alan Trachtenberg, MD, medical director of the CSAT Office of Pharmacology and Alternative Therapies. "Its efficacy is not known in humans. "We're aware of reports of deaths of people who have taken ibogaine. There have been many of these one-shot cures for heroin through the years. All sorts of dangerous things have been tried to cure heroin and morphine addiction."
A November 1999 conference directed by Kenneth Alper, MD, assistant professor of the Departments of Psychiatry and Neurology at New York University School of Medicine, focused on how ibogaine works as a possible new approach to treating addictions.
"Ibogaine has activity at a variety of receptors in the brain and its effects may result from complex interactions between multiple neurotransmitter systems," according to the conference program. There is evidence to suggest tht ibogaine treatment might result in the resetting or normalization of neuroadaptations related to sensitization or tolerance."
For 60-year-old Colin of Miami, a recovering chronic drug ddict and alcoholic, ibogaine was the "catapult into recovery" that he believes has kept him clean and sober for many months. "Alcohol and opiates kicked my butt," he said. "I'd been in prison and was living on the streets of Denver sick and drunk," he said.
"I'd been in prison and was living on the streets of Denver sick and drunk. People were dying all around me and I went into a recovery home. Icame home to check in and my father said he wanted to take me to Sr. Kitts in the Caribbean to try a new drug."
Because he was so sick, Colin first had to be treated in a Miami hospital before undergoing the trip to St. Kitts and the ibogaine treatment at a clinic there.
"I didn't know what to expect when I took it," Colin said. "The intent seems to be important with ibogaine. I didn't struggle. My intent was honest; I wanted to live. It was a visionary physical and emotional experiemce. I went on an adventure and didn't feel I was on Earth. It reset me and now I have no urges, no cravings for drugs or alcohol.
"Before the ibogaine treatment I was drinking a half-gallon of vodka every day and taking all the drugs I could find. It took sway my cravings. It was like I was catapulted into recovery. It totlly opens you up."
Colin said the ibogaine treatment enabled him to "really gain some ground rapidly in recovery" and he has followed up with regular attendance at Alcoholics Anonymous and Narcotics Anonymous meetings. "I'd say the ibogaine and recovery programs complement each other and work together, Colin said.
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