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[ Science and Tech ]

How A Psychedelic Drug Could Help Treat Alcohol and Opiate Addiction

For 24 hours, Gordon barely moved a muscle. With decades of alcohol abuse and a string of failed relationships and treatment attempts behind him, he wound up a broken man living in a Catholic monastery. But now, blindfolded and reclining comfortably under the careful supervision of a registered nurse, he was ready to try one more lease on life. The drug was now taking effect and Gordon was soon transported far beyond the confines of his small bed in Cancun, Mexico.

Like many other psychedelics, there was a sense of uneasiness as the drug initially came on. Gordon felt “an intense understanding that something serious was happening.” But this drug isn’t like any other psychedelic, and it is certainly not what Gordon would describe as a “happy drug.” 

“You visit various people and places in your life on a level that I can only say for me was excruciating,”  Gordon reiterated. The trip however, which he likened to “a waking dream state,” also brought him a much different sense of self.

“I had the ability to project myself at will, physically,” he said of the experience. “I was traveling above the planet and I was coming down at will to these places with fields and landscapes. Everything was imbued with such a sense of wonder and euphoria. But not euphoria like being wasted on alcohol, but the euphoria of just standing and beholding scenarios, realizing if I die right now, there is no problem. It is all good.”

According to Gordon, when he woke up the next day, his decades-long addiction to alcohol had all but disappeared. 

Addiction Reset

The drug that was administered to 47-year-old Gordon at the Clear Sky Recovery Center is called ibogaine, a psychoactive substance found in the Tabernanthe Iboga shrubs of central West Africa. Originally used as a spiritual rite of passage for West Africa’s indigenous peoples, it has since grown to become a tool for many individuals in Europe and America to help curb addiction. 

This is not only due to the drug’s ability to generate highly introspective hallucinogenic states, but also its claim to fame in the world of recovery, it’s alleged ability to reset the receptors in the brain of an addict, and repair them retroactively, to what they were like before any drop of Alcohol or molecule of opiate had ever had an affect on them. In other words, ibogaine could be the only addiction treatment method with the ability to literally reset a person’s addiction.

You may be asking yourself then, “Why hasn’t ibogaine become the standard method of treatment for addiction already?” The answer to that question is not so easy to answer.

Firstly, ibogaine is not a “cure” for addiction. It requires plenty of after-treatment to ensure long-term sobriety. In addition, there have been cases of individuals with preexisting health issues dying after being administered Ibogaine without medical supervision. Although medically supervised ibogaine treatment has boasted extremely promising results, the money required to provide safe and successful ibogaine treatment is exorbitant. The funding for this kind of treatment and research also becomes much harder to attain when said drug is considered Schedule 1, deeming it to have to have “no currently accepted medical treatment use” and a “high potential for abuse”. As a result, underground clinics continue to proliferate and provide unsafe treatment.

Yet with all of these unresolved issues, ibogaine’s enormous potential as an anti-addiction aide can not be ignored. While plenty of double blind studies have shown empirical improvement in animal tests, more human studies need to be conducted. And to fully understand ibogaine treatment in the 21st century, it is first necessary to understand a little bit more about the drug and its history.

The Physical Reality of Addiction

For Gordon, ibogaine marked the end of his quest to reach a tenable state of recovery. Previously, he had gone through nearly every permutation of conventional recovery, all of which had followed the popular 12-Step treatment model. He describes these treatment methods as well as their detox protocol as “almost ineffectual” due in large part to their reliance on prescription meds that feed the same receptors as alcohol, opiates, and other habit forming substances. And even if able to conquer a detox, relapse rates are close to 95% once clear of the drug. That’s the thing with ibogaine, it takes you back to a time before your brain touched alcohol or opiates. The urge to use again is almost always non existent. This is no doubt the reason why the 12-step model only works for a small percentage of people according to most studies. Take the urge away, and your left with a community of people that would have a much higher chance at success (long term sobriety). 

Ibogaine deals with the what he calls the “physical reality of addiction.” In other words, “You’re not just dealing with the mental, spiritual problems that grow and increase the more that you drink,” but also the realization that the entire physiology of a person with long-term addiction issues is also “f**ked.” So while ibogaine helps work through the spiritual and psychological hang-ups that lead to addiction, it also helps individuals deal with the physical damage and withdrawal symptoms that are indicative of extended drug use.

This ability to reverse the so-called “physical reality” of drug addiction was first discovered by the late Howard Lotsoff in 1962. Lotsoff was a New Yorker with a serious heroin addiction. At the age of 19, he decided to ingest ibogaine in hopes of experiencing a new high. When he woke up from a long and arduous trip though, Lotsoff also discovered that his cravings for opiates had completely subsided. This began a lifelong quest to research, advocate and popularize the benefits of ibogaine as an aide for addiction treatment, including a series of human trials in the Netherlands during the 1980’s.

The process by which ibogaine worked on the drug-dependent part of Lotsoff’s brain involved the resetting of his brain’s neuron-chemistry. When Lotsoff ingested ibogaine, it was converted by the liver into nor-Ibogaine. Nor-Ibogaine is a psychoactive metabolite that acts as a serotonin reuptake inhibitor, which allowed Lotsoff to return to his pre-addictive state both mentally and physically. For these effects to fully kick in can often take up to 72 to 96 hours. When it kicks though, an individual feels as if they had overcome withdrawal after many months of treatment.

A Unique Molecule

According to Neuroscientist Dr. Deborah Mash, who is one of the leading researchers of ibogaine treatment, the ibogaine molecule is “unique”. As she puts it:

 “This molecule does something to human consciousness, something to the brain, something to craving and withdrawal signs that’s very different than anything we know about right now.”

Dr. Mash had previously completed a fellowship at Harvard University before becoming a faculty member in the Department of Neurology of the University of Miami School of Medicine. She first heard of the drug while doing speaking engagements for her research on coca-ethylene and was initially a skeptic. In fact, she compared her first impressions of Lotsoff and his ibogaine research to that of a “snake oil salesman.” 

After visiting the Netherlands though in 1992 to see Lotsoff conduct ibogaine trials first-hand, she was soon won over by the amazing transformations that she witnessed.

But Dr. Mash also believed that ibogaine research should be in the hands of medical experts and neuroscientists like herself. “There’s something real fundamental about this molecule that maybe explains its efficacy,” she says, “and if these anecdotal reports that were out there in the addict self-help movement were true and could be validated, then together with our knowledge of the structural chemistry of the molecule, we might get some fundamental insight into the process of addiction itself.”

By 1993, Dr. Mash would become the first person to administer a legal dose of ibogaine to a human subject. However, she would soon discover that the research of ibogaine would be a long and winding road.

a Catch-22

The conditions in which Gordon was administered ibogaine at Clear Sky Recovery were strict and scrupulous. He says that he was “under a very strict medical protocol in terms of screening” and that they were always “keeping under observation the people who are dosed.” Clear Sky itself was actually founded by the only two clinicians in the world who were personally trained by Dr. Mash to conduct ibogaine treatment at the now defunct Healing Visions institute. The facility which was founded in 1996 on the islands of St. Kitts, W.I. by Dr. Mash had to close its doors after failing to procure the necessary funds to continue her initial human trials in 1993. 

Since ibogaine is considered Schedule 1, she was also forced to move her medically-monitored operations outside of US borders. After Healing Visions was forced to close in its new location, once again for lack of funding, Clear Sky opened to fill the void left in its absence. Neither Clear Sky nor Healing Visions have had any major medical complications in their existence.

However, most ibogaine treatment options available today are not like Clear Sky or Healing Visions. The majority of treatment options are offer unsupervised treatment in countries where ibogaine is most likely unregulated. Thus the Catch 22 scenario, the stigma that prevents many prospective benefactors from funding proper scientific ibogaine research is fed by the proliferation of these unregulated treatment centers, which exist solely because of the demand for ibogaine in the absence of proper medical centers. And it is under these unsafe conditions that some desperate clients have even lost their lives.

Death and Stigma

Of course, there is a credible case to be made against any addiction treatment method that can be proven fatal, and ibogaine is no different. A closer analysis of these deaths reveal that they all have a lot in common. And what they all have in common perhaps says more about the setting in which the ibogaine was administered than the inherent dangers of ibogaine itself.

“Ibogaine has to be administered by a medical doctor,” Dr. Mash told us, “Because you have many people who are addicted or take other drugs, they may have other liver problems or cardiac problems. Ibogaine has a narrow therapeutic to toxic window, so people have gotten into trouble because they have taken ibogaine in unsafe settings.”

The most recent death occurred late last year when an Australian man died during ibogaine treatment on Koh Phangan Island, where ibogaine is unregulated. According to reports, the man had died due to respiratory problems, though it is uncertain whether he died after taking ibogaine or while on a different drug before being administered ibogaine. What is certain though is that the woman working as an assistant to the man, Kelly Lynn Miller, 36, had no medical training. Not only that, but she had actually fled to Thailand to avoid a five-year-sentence for killing a man while under the influence.

The other handful of deaths that have been linked to ibogaine also follow a similar narrative. The death always occurs in an unregulated setting and the person who died is almost always being supervised by unqualified individuals. Also, like Dr. Mash explained, the victims of these underground ibogaine clinics had many preexisting health issues that would have easily been addressed in a medical setting.

In addition to the apparent dangers that would be mitigated if the process was more highly regulated, a general sense stigma always surrounds new and uncharted scientific territory. “I think the scientific community wasn’t ready,” she told Al Jazeera America in terms of her initial attempts to get funding in 1993. “Like anything new in science, you’re always going to come up against your colleagues.”

Funding the Future of Ibogaine

At the end of the day, ibogaine research is not possible without funding, and like any drug, lots of it. As Dr. Mash explained to us: “The normal path of drug development is either you get a pharmaceutical company or you form a business around it. You raise money from the private sector to bankroll development, which is very very expensive.” What very, very expensive translates to is roughly $700 million for a clinical trial.

And although she was initially able to procure the legal and financial means to launch the first human trials in 1993, the research must be continuous. “At the University of Miami School of Medicine, we’ve taken this thing just about as far as we could launch it,” She says. “Without the finances, without the research dollars, without a foundation to support us, without venture capital money this thing isn’t going to go much farther.”

Issues like stigma and the uncertainty of ibogaine’s safety can certainly factor into whether or not a pharmaceutical company or wealthy VC decides to invest millions into a radical new anti-addiction drug. But, as Dr. Mash has proven at various times during her career, it is possible to get funding for new drugs like ibogaine, but it’s a long and laborious task.

This is something that Lotsoff had not been particularly successful in doing during his lifetime, with Mash stating that he often “had no money and he was never able to generate any money from any investors.” Dr. Mash on the other hand, who has worked independently of Lotsoff since the 1990’s, continues on her quest to seek funding for her research into ibogaine. Currently, she is in the process of working on a new series of human ibogaine trials. These trials involve the testing of the active metabolite nor-Ibogaine which, as mentioned earlier, is created after ibogaine is transferred in the liver.

A “Cure” for Addiction?

If there are any lessons to be learned from ibogaine, it is that there remains no simple “cure” for addiction. As miraculous as ibogaine can be for people suffering from addiction and withdrawal, it is still necessary to take the next step and seek after-treatment to ensure long-term recovery. As award winning writer Johan Hari states:

“The opposite of addiction is not sobriety. The opposite of addiction is (human) connection” 

But if there is any hope for addiction sufferers with no other viable options, then ibogaine has shown itself to be one of the most promising tools. As Dr. Mash told us: “We have such a big problem in this country and we need somebody brave and bold to step up and say ‘What we have right now does not work, let’s think outside the box and do something different.”

In addition, the lack of proper medical funding is not going to stop desperate people from getting their hands on ibogaine illegally. “If people want access to ibogaine, they are going to demand it and they are going to get it,” she says. As a result, the scientific community “have to demand that people who are administering ibogaine have all the bells and whistles, that they’ve got the doctors trained to understand what they are doing and that nobody is put into harm’s way.”

So what are we left with when it comes to this promising, yet controversial plant? That’s the billion dollar question, quite literally, because if someone is able to harness the ability to “reset” the brain to its state prior to Alcohol or Opiate use, it could all but take over the multi-billion dollar detox industry. More importantly than money, ibogaine’s potential to save lives and increase quality of life for millions of addicts just seems to great to ignore.