Curing heroin addiction is a complex task. The condition is chronic, recurring, and claims the lives of thousands of Americans each year. Sufferers and their loved ones want there to be a known cure, but there is no easy fix despite years of research. Treatment options are available, but they don’t necessarily “cure” heroin addiction. Heroin addiction requires extensive treatment, and even with that, many people unfortunately relapse. Sadly, many have lost their lives in association with relapse, overdose, or health complications related to their addiction.
But what if there was a drug that could cure heroin addiction in as little as 30 hours? According to human anecdotal reports, ibogaine, a mind-altering psychedelic drug, may be the answer. Unfortunately, ibogaine remains illegal under federal law, so little research has been conducted on its efficacy and safety. This article will discuss ibogaine treatment, the research that has been conducted, and the potential risks of use.
Ibogaine is a naturally occurring psychoactive alkaloid that comes from the iboga plant of West Central Africa. There, it is commonly used in high doses for sacred rituals and in low doses to combat thirst, hunger, and fatigue. In western culture, ibogaine has been used as an adjunct to psychotherapy from as early as the 1950s, and has also become a subject of addiction research in recent decades. It has reportedly been used in a variety of settings to treat addiction to a variety of drugs, particularly heroin and other opioids.1
Its development as a treatment for heroin addiction has taken place primarily outside of traditional clinical and medical settings, as the drug holds a Schedule 1, federally controlled status, making formal research opportunities in the United States virtually impossible.1 It is also illegal in France, Sweden, Switzerland, Denmark, Belgium, and Australia, but is largely unrelated in most other countries. Ibogaine is often distributed in informal settings and clinics.1,2 Despite it being illegal, there are many anecdotal reports of ibogaine’s success from Americans who have taken the drug illegally or traveled to other countries for treatment.
Ibogaine is a psychedelic drug with mind-altering properties similar to but distinct from classic hallucinogens, such as LSD and psilocybin (“magic mushrooms”).1 The ibogaine psychedelic experience consists of 3 main phases, which include:1,3
Scientists and addiction professionals still don’t fully understand the pharmacological anti-addictive properties of ibogaine. Ibogaine is much different from other heroin addiction treatment medications, such as methadone and buprenorphine. Unlike these, ibogaine is not a competitive opioid agonist, meaning it does not displace heroin at opioid receptors. However, it does interact with the opioid receptors along with many other central nervous system receptors. It appears that ibogaine has a complex mechanism of action, influencing the release and reuptake of many neurotransmitters, including serotonin, which is an important signaling molecule within the brain responsible for regulating mood, social behavior, sleep, appetite, and more.1,5
Animal studies of ibogaine as a treatment for addiction began in the mid-1980s. By the early 1990s, the National Institute on Drug Abuse (NIDA) was funding and conducting ibogaine research. These studies demonstrated that ibogaine significantly reduced self-administration of drugs such as cocaine, heroin, morphine, methamphetamine, nicotine, and alcohol, as well as decreased withdrawal symptoms. However, several rat studies suggested the potential for neurotoxicity with ibogaine. In these studies, rats that were given an ibogaine dose of 100 mg/kg experienced degeneration in certain brain cells, which aroused concern regarding ibogaine safety. That said, the dosages given in these studies were considerably higher than effective human doses. When further research was conducted, it revealed that rats did not experience the neurocellular degeneration at lower doses comparable to the human-effective dose.1,6
Clinical trials were conducted outside the United States between 1962 and 1993. A Dutch study of 33 heroin addicts who were treated with ibogaine doses ranging from 6–29mg/kg revealed that 25 of them were free of opioid withdrawal symptoms within 24-72 hours. However, a 24-year-old female died after receiving the highest dose. This death sparked enormous fear over the safety of ibogaine, and in 1995, NIDA decided not to move forward with its planned human clinical trials, ending all potential research in the United States.1,7
Recent observational studies in humans have been conducted at ibogaine treatment centers in Mexico and Brazil, both of which have found significant results in reduction of withdrawal symptoms in 20% and 61% of participants, respectively. There were no serious adverse reactions or deaths involved in either of these studies. The study in Brazil, which had a much higher success rate, used ibogaine as a treatment in combination with psychotherapy.8,9
While ibogaine has shown incredible potential as a therapeutic treatment for addiction, there are many adverse effects and serious risks that need to be considered. Some immediate side effects that may occur when taking ibogaine include: 1,3
In addition to some of these commonly-experienced ibogaine side effects, there is a risk of more serious complications, including death. While previous research has shown ibogaine to be a potential neurotoxin, re-evaluation of animal studies has demonstrated this only to be true at doses much higher than those needed to achieve the drug’s anti-addictive properties.6,10 However, some people have experienced severe adverse reactions, many of which are cardiovascular (e.g., arrhythmias, sudden cardiac arrest).10 For this reason, a person with known heart problems should never take ibogaine. Other reports of toxicity were due to drug-to-drug interactions.11 Because there is not enough research surrounding its effects, there is no way to ensure a safe experience when taking ibogaine.
For the most part, ibogaine is not associated with extensive dangers and risks; however, ibogaine-related deaths have occurred. A total of 19 deaths were reported between 1990 and 2008. There were a number of factors involved in these deaths including pre-existing cardiovascular conditions, seizures occurring as a result of alcohol or benzodiazepine withdrawal, and co-administration of other prescription medications or illicit drugs. While there is a small risk of death when taking ibogaine, it is comparable to methadone treatment with 1 fatality for 427 ibogaine treatment episodes and 1 fatality in 364 to 476 methadone prescriptions.12
Still, due to the associated risks, legality issues, and lack of research, there is no current push for FDA approval of ibogaine as treatment for heroin addiction. Further research and evaluation needs to be completed to determine if the drug is a safe and effective treatment for addiction.