Could the Psychedelic Drug Ibogaine Help Treat Opioid Addiction?
There are currently over 2.5 million Americans who have an opioid use disorder. Those who receive medication-assisted treatment for opioid addiction are prescribed methadone, buprenorphine, or naltrexone. While these medications have been proven to be effective treatments for opioid addiction, they do have side effects and are not completely risk-free. Is there another medication out there that can treat opioid addiction without such risks? Is there a quick fix to help relieve the withdrawal symptoms? Some in the medical subculture believe the psychedelic drug ibogaine may be a potential treatment for opioid addiction.
What is ibogaine?
Ibogaine is a powerful psychoactive substance, extracted from the iboga plant found in central Africa. The plant has been used by the indigenous people of Cameroon and Gabon for centuries during healing ceremonies and spiritual rituals.
Howard Lotsof inadvertently discovered ibogaine as a potential treatment for opioid addiction in 1962. Lotsof, who at the time was addicted to heroin, wanted a psychedelic high and ingested ibogaine. After the effects from ibogaine wore off, Lotsof noticed he no longer had the desire to take heroin and did not experience withdrawal symptoms. This led Lotsof to examine ibogaine as a possible treatment for drug addiction.
While scientists and health professionals are still learning exactly how ibogaine affects the human body, it is believed to impact the neurotransmitters in the brain and block neurotransmitter receptors that are involved with addiction. The drug also causes hallucinations and a wide array of other side effects that can last up to 24 hours or longer after an initial dose.
What studies are out there?
Because no traditional clinical trials have been conducted in the United States, proponents of ibogaine primarily use preclinical studies, animal testing, and anecdotal evidence to support the use of ibogaine as a treatment for opioid addiction. Some of this research has produced promising results.
There have been case studies demonstrating long term abstinence from opioids after receiving ibogaine. One study described the case of a 37 year old female with a long history of opioid addiction who abstained from opioids for 18 months after using ibogaine. Her previous longest period of abstinence was for only two months while she was on methadone maintenance treatment.
There are several other reports from around the world about individuals experiencing successful abstinence from opioids following ibogaine treatment, including individuals from New Jersey and South Africa. Additionally, observational studies conducted in countries where ibogaine is legal show some positive results of ibogaine treatment. For example, a study in New Zealand concluded that ibogaine treatment reduced opioid withdrawal symptoms and improved individuals’ chances of opioid abstinence in the months following ibogaine treatment.
Cause for concern
Proponents of ibogaine treatment must look closely at the vast concerns regarding the drug. First, ibogaine is illegal and is a Schedule I drug in the United States, which means that it is believed to have high potential for abuse and no accepted medical use.
Moreover, ibogaine has myriads of safety concerns. A study published in 2012 reported on 19 deaths from ibogaine from 1990 to 2008. And just last year, a study was published arguing that ibogaine-related deaths will continue due to lack of medical supervision during administration of the drug and limited knowledge of the drug’s effects.
There are also problems concerning the lack of research regarding the effects of ibogaine use. One study published last year reported ibogaine doses currently given as an opioid treatment are substantially too high, especially for individuals with preexisting health conditions.
Equally important is the absence of carefully controlled randomized clinical trials. Treatment or self-administration decisions should never be made on the basis of single case report or other uncontrolled studies, especially for medicines with high rates of side effects and abuse potential. In addition, a very large number of research studies would need to be done to make addiction experts regard ibogaine as a safe and effective alternative to medications like methadone, Suboxone, or Vivitrol.
What should be done?
While even advocates of ibogaine do not claim it as the end-all cure to opioid addiction, there is promise in ibogaine’s ability to promote abstinence from opioids. Yet many double blind randomized controlled trials – would need to be conducted on ibogaine before it is used as an opioid treatment. For now, it remains an illicit drug with no proven medical benefits.
Given that there are three medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of opioid addiction, and that these medications have repeatedly been shown to be effective in a range of quality research studies, individuals with opioid addiction are advised to seek treatment from qualified providers who can offer such medication-assisted treatment without the risks of an untested drug like ibogaine.
Jason Besser, MPP
Jason is a Research Associate at Center on Addiction