What is Ibogaine?
Ibogaine is a naturally occurring psychoactive compound found in a number of plants, principally in a member of the dogbane family known as iboga (Tabernanthe iboga). Ibogaine-containing preparations are used in medicinal and ritual purposes within African spiritual traditions of the Bwiti, who claim to have learned it from the Pygmy. In recent times, it has been identified as having anti-addictive properties. Ibogaine is an indole alkaloid that is obtained either by extraction from the iboga plant or by semi-synthesis from the precursor compound voacangine, another plant alkaloid. A full organic synthesis of ibogaine has been achieved but is too expensive and challenging to produce any commercially significant yield.
In the early 1960s, ibogaine was accidentally discovered to cause sudden and complete interruption of heroin addiction without withdrawal within 24 hours. Since that time, it has been the subject of scientific investigation into its abilities to interrupt addictions to heroin, alcohol, and cocaine. Anecdotal reports also suggest that ibogaine may have potential to drive introspection that helps elucidate the psychological issues and behavior patterns that drive addictions or other problems. However, ibogaine therapy for drug addiction is the subject of some controversy. Due to its hallucinogenic properties, it has been placed in the strictest drug prohibition schedules in the United States and a handful of other countries. Canada and Mexico both allow ibogaine treatment clinics to operate and openly contribute to further understanding of the addictive process.
While ibogaine’s prohibition has slowed scientific research into its anti-addictive properties, the use of ibogaine for drug treatment has grown in the form of a large worldwide medical subculture. Ibogaine is now used by treatment clinics in 12 countries on six continents to treat addictions to heroin, alcohol, powder cocaine, crack cocaine, and methamphetamine, as well as to facilitate psychological introspection and spiritual exploration.
At doses of around 3–5 mg/kg of body weight, ibogaine has a mild stimulant effect. The high-dose ibogaine experience of 10 mg/kg or greater most commonly occurs as two distinct phases: the visual phase and the introspective phase.
The visual phase is characterized by open-eye visuals, closed-eye visuals, and dreamlike sequences. Objects may be seen as distorted, projecting tracers, or having moving colors or textures. With the eyes closed, extremely detailed and vivid geometric and fractal visions may be seen. Subjective reports often include a movie-like recollection of earlier life experiences as well as dreamlike sequences with symbolism of one’s present or anticipated future. Other effects in the visionary phase may include laughing, sensations of euphoria or fear, and temporary short-term memory impairment. The visionary phase usually ends after one to four hours, after which the introspective phase begins.
The introspective phase is typically reported to bring elevated mood, a sense of calm and euphoria, and a distinct intellectual and emotional clarity. Subjects often report being able to accomplish deep emotional and intellectual introspection into psychological and emotional concerns. It is also during this period that opioid addicts first notice the absence of withdrawal cravings. The duration of the introspective phase is highly variable, usually lasting hours but sometimes lasting days.
Side effects and safety
One of the first noticeable effects of large-dose ibogaine ingestion is ataxia, a difficulty in coordinating muscle motion which makes standing and walking virtually impossible without assistance. Xerostomia (dry mouth), nausea, and vomiting may follow. These symptoms are long in duration, ranging from 4 to 24 hours in some cases. Ibogaine is sometimes administered by enema to help the subject avoid vomiting up the dose. Psychiatric medications are strongly contraindicated in ibogaine therapy due to adverse interactions. Some studies also suggest the possibility of adverse interaction with heart conditions. In one study of canine subjects, ibogaine was observed to increase sinus arrhythmia (the normal change in heart rate during respiration). Ventricular ectopy has been observed in a minority of patients during ibogaine therapy It has been proposed that there is a theoretical risk of QT-interval prolongation following ibogaine administration. This risk was further demonstrated by a case reported in the New England Journal of Medicine documenting prolonged QT interval and ventricular tachycardia after initial use.
There are 12 documented fatalities that have been loosely associated with ibogaine ingestion. Exact determinations of the cause of death have proven elusive due to the quasi-legal status of ibogaine and the unfamiliarity of medical professionals with this relatively rare substance. No autopsy to date has implicated ibogaine as the sole cause of death. Causes given range from significant pre-existing medical problems to the surreptitious consumption of other drugs in conjunction with ibogaine. Most legal and illegal psychoactive drugs are strongly contraindicated during or immediately after ibogaine treatment, which presents a risk in undersupervised or self-treating subjects.
Treatment for opiate addiction
The most-studied long-term therapeutic effect is that ibogaine seems to catalyze partial or complete interruption of addiction to opioids. An integral effect is the alleviation of symptoms of opioid withdrawal. Research also suggests that ibogaine may be useful in treating dependence on other substances such as alcohol, methamphetamine, and nicotine and may affect compulsive behavioral patterns not involving substance abuse or chemical dependence.
Proponents of ibogaine treatment for drug addiction have established formal and informal clinics or self-help groups in Canada, Mexico, the Caribbean, Costa Rica, the Czech Republic, France, Slovenia, the Netherlands, Brazil, South Africa, the United Kingdom and New Zealand, where ibogaine is administered as an experimental drug. There also exist clandestine drug-treatment facilities in the countries where it is illegal. Although the full nature of ibogaine is still emerging, it appears that the most effective treatment paradigm involves visionary doses of ibogaine of 10–20 mg/kg, producing an interruption of opiate withdrawal and craving. Many users of ibogaine report experiencing visual phenomena during a waking dream state, such as instructive replays of life events that led to their addiction, while others report therapeutic shamanic visions that help them conquer the fears and negative emotions that might drive their addiction. It is proposed that intensive counseling and therapy during the interruption period following treatment is of significant value. Some patients require a second or third treatment session with ibogaine over the course of the next 12 to 18 months, as it will provide a greater efficacy in extinguishing the opiate addiction or other drug dependence syndrome. A minority of patients relapse completely into opiate addiction within days or weeks. A comprehensive article (Lotsof 1995) on the subject of ibogaine therapy detailing the procedure, effects and aftereffects is found in “Ibogaine in the Treatment of Chemical Dependence Disorders: Clinical Perspectives”. Ibogaine has also been reported in multiple small-study cohorts to reduce cravings for methamphetamine.
Chronic pain management
In 1957, Jurg Schneider, a pharmacologist at CIBA, found that ibogaine potentiates morphine analgesia. Further research was abandoned, and no additional data was ever published by Ciba researchers on ibogaine–opioid interactions. Almost 50 years later, Patrick Kroupa and Hattie Wells released the first treatment protocol for concomitant administration of ibogaine with opioids in human subjects, indicating ibogaine reduced tolerance to opioid drugs. Kroupa et al. published their research in the Multidisciplinary Association for Psychedelic Studies Journal demonstrating that administration of low-”maintenance” doses of ibogaine HCl with opioids decreases tolerance.
Ibogaine and its salts were regulated by the U.S. Food and Drug Administration in 1967 pursuant to its enhanced authority to regulate stimulants, depressants, and hallucinogens granted by the 1965 Drug Abuse Control Amendments (DACA) to the Federal Food, Drug, and Cosmetic Act. In 1970, with the passage of the Controlled Substances Act, it was classified as a Schedule I-controlled substance in the United States, along with other psychedelics such as LSD and mescaline. Since that time, several other countries, including Sweden, Denmark, Belgium, and Switzerland, have also banned the sale and possession of ibogaine. Although illegal, ibogaine has been used by hundreds of drug addicts in the United States and abroad. Howard Lotsof, a pioneer in bringing awareness to ibogaine’s success in helping hardcore drug dependents to quit their addiction, and others have been offering willing persons the treatment. In the Czech Republic and Slovenia, taking advantage of less prohibitive legal systems, ibogaine has been applied to people coming from the U.S. and other countries seeking a safe haven.