Ibogaine offers hope -- and hazards -- to addicts

Dec 13 2017

Ibogaine offers hope — and hazards — to addicts

Among scientists and others interested in possible cures for drug addiction, one hotly debated topic has been the merits and dangers of ibogaine, a psychedelic compound found in the Tabernanthe iboga root, native to western Central Africa.

Recovered addicts, and a few scientists, contend that ibogaine, can cure addiction, along with depression, in about 70 percent of patients.

Addicts seeking a cure have sought treatment at ibogaine clinics, most of them in Mexico and Central America, where the drug is legal. In the past decade, the number of ibogaine clinics worldwide has grown from a handful to about 40, according to Scientific American.

Yet, ibogaine has some dangerous side effects. It has been estimated that one in 400 people die from taking the drug, because they have pre-existing heart conditions, had seizures due to acute alcohol withdrawal,  used it with other drugs not recommended for treatment with ibogaine, or from taking opioids while under the influence of ibogaine.

Because ibogaine has not received regulatory approval in North America or Europe, the people prescribing and using it have no medical training or certification, according to regulatory officials.

A number of deaths have resulted from people treating themselves at home, using ibogaine they bought online, officials say.

In the U.S., ibogaine is a Schedule 1 substance which, like heroin, is described as a drug “with no currently accepted medical use and a high potential for abuse”. It is similarly classified in some other countries.

In the United Kingdom, using ibogaine for its psychedelic properties is illegal, under the 2016 Psychoactive Substances Act. But the act provides exemptions for approved scientific research “and for healthcare professionals acting in the course of their duty”.

Two small, startup companies, DemeRx and Savant HWP, are pursuing clinical trials of substances derived from ibogaine that might help drug addicts.

San Carlos, Calif.-based Savant HWP has received more than $6.7 million in National Institute on Drug Abuse (NIDA) grants, to conduct human trials of 18-MC.

Results of an unpublished double-blind, placebo-controlled study conducted by Savant HWP’s partner company in Brazil in 2014 showed all volunteers who were given therapeutic dosages of 18-MC suffered no adverse effects from the drug.

Savant HWP plans to begin clinical trials of 18-MC in 2018, starting with cigarette smokers in Brazil, and then testing opioid and cocaine addicts in the U.S.
Savant is developing a unique approach. Unlike currently available anti-addiction medicines such as methadone and naltrexone, its synthetic compound 18-MC directly targets the mechanism in the brain which causes drug cravings: severely fluctuating dopamine levels.

The other startup firm working on an ibogaine derivative, New Zealand-based DemeRx, has been testing a substance called noribogaine. Company founder Deborah C. Mash, who has patented noribogaine and related compounds, led a team of researchers which tested its safety on 36 healthy (drug-free) male subjects. No adverse effects were seen in the results, published in 2015.

DemeRx has filed an Investigational New Drug application in the U.S. and is currently running a Phase II, proof-of-concept trial to evaluate noribogaine’s use as an alternative to methadone or Suboxone, in medication-assisted treatment for opiate addicts.

One ibogaine treatment center near Vancouver, B.C., Liberty Root Therapy, Inc., has treated more than 250 opiate addicts under medical supervision. Trevor Millar, who founded Liberty Root four years ago, told the Washington Post that between 75 and 50 percent of his clients experience “a 100 percent detox from opioids.”

Liberty Root has treated a number of addicts from the U.S., says Millar, who is pushing for more clinical trials in Canada.

Edward Conn, an addiction counselor in England who formerly used ibogaine to treat addicts, has taken a more skeptical view of the drug. Conn told The Guardian  he now considers ibogaine a high-risk drug being used by untrained individuals who are willing to try unconventional cures for their addiction.

“There is no shortage of people wowed by reports of ibogaine cures; I’ve seen it for 20 years. How many official clinics exist? None. Ask yourself why,” he told the Guardian. But those who sell it are continuing to tout it as a cure for a wide range of psychological problems, such as depression, anxiety, and ADHD.

Still, ibogaine does work for some people, Conn says. “It’s most effective for individuals who have stopped their drug-using lifestyle and are stable on low-dose methadone, and least effective on individuals still engaged in drug use.”