But Does It Work?

There may be a new way to get the monkey off your back.  Ibogaine, derived from the Iboga root in Central Africa and used as far back as the 1800s in spiritual practices, has become a new form of addiction therapy, with celebrities, socialites and well-to-do addicts and alcoholics flocking south of the border to treatment centers like Clear Sky Recovery in Cancun and Safe Haven Ibogaine in Rosarito Beach, in an attempt to eliminate their cravings forever.  (Ibogaine is a Schedule I controlled substance in the United States).  But can “curing” a lifelong addiction to drugs and alcohol be as easy as taking a “natural” drug, hallucinating for a few days in a medically-supervised environment and in the comfort of a resort-style facility in Mexico?    

"Addiction Medicine physicians and others have long sought an effective medical solution to treat the disease of addiction,” explains Steve Groth, MD and Addiction Medicine physician at TRIAD Treatment Center in San Juan Capistrano, CA, “Ibogaine is one more such attempt.”  

Groth explains that many experts consider addiction to be a brain disease, but that the underlying pathophysiology and the basic molecular defects that define addiction are unknown.  Therefore, it’s difficult to know what drugs might be useful for treating addiction.  He also points out the only evidence supporting the drug is anecdotal, that it is neither scientific nor supported by well-planned studies, and that the most compelling scientific evidence in favor of ibogaine comes from tests done on lab rats in the 1990s.  

However, Kenneth R. Alper MD and Howard R. Lotsof, a leading advocate for ibogaine, have a different opinion. They co-wrote an article in Psychedelic Medicine entitled The Use of Ibogaine in the Treatment of Addictions, and are bullish on the stuff: “From a pharmacological standpoint, ibogaine is interesting because it appears to have a novel mechanism of action that is different from other existing pharmatherapeutic approaches to addiction.” 

So how does ibogaine work?  There is limited scientific research about the exact mechanics, partially because it is banned in many parts of the world, but research suggests that ibogaine resets neurotransmitters that have been programmed for addiction.  Treatment centers, which offer 6-day ibogaine detox programs starting at around $3,000, administer ibogaine capsules and monitor patients as they embark on a 24-36 hour intense, dreamlike visualization process.  After this period of time, many claim they awake with no physical or mental craving whatsoever. 

What about its safety?  From 1996 to 2006, 19 deaths were reported to have occurred within 72 hours of taking ibogaine, but because the deaths occurred in an uncontrolled environment and because of potential pre-existing conditions it is impossible to evaluate the exact causes of death. But despite a lack of evidence, Alper and Lotsof believe that the testimony of ibogaine patients is enough to warrant further research: “The existence and present expansion of the subculture, based on the word of mouth accounts of those treated, may itself also indicate the possibility of a real pharmacological effect that merits further investigation.”

Groth doubts its efficacy.  “To date, no drug or other treatment regimen has yet been identified which unequivocally and effectively treats addiction.  Ibogaine may possibly be helpful in making the symptoms of detoxification more bearable, and some addicts and alcoholics who have been treated with it claim that their drug cravings have subsequently been lessened or even eliminated.  However, there is no solid, scientific evidence to date, suggesting that the drug is effective in ‘curing addiction,’ nor in maintaining long-term sobriety.” 

Groth believes Alcoholics Anonymous and other 12-step programs are the most effective treatment for addiction, though success rates are estimated as low as five to ten percent for sobriety lasting greater than one year.  Which just goes to show that monkey is hard to kick.

Sources:

(1)  (Alper, K. R., Stajić, M. and Gill, J. R. (2012), Fatalities Temporally Associated with the Ingestion of Ibogaine. Journal of Forensic Sciences, 57: 398–412. doi: 10.1111/j.1556-4029.2011.02008.x).

www.nytimes.com/2010/02/17/us/17lotsof.html?_r=0