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Publications from Crossroads Treatment Center

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Joseph Barsuglia
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5-MeO-DMT is a psychoactive substance found in high concentrations in the bufotoxin of the Colorado River Toad. Emerging evidence suggests that vaporized 5-MeO-DMT may occasion mystical experiences of comparable intensity to those occasioned by more widely studied psychedelics such as psilocybin, but no empirical study has tested this hypothesis. Data was obtained from 20 individuals (mean age = 38.9, male = 55%, Caucasian = 85%) who were administered 5-MeO-DMT as part of a psychospiritual retreat program in Mexico. All participants received 50mg of inhaled vaporized toad bufotoxin which contains 5-MeO-DMT and completed the Mystical Experience Questionnaire (MEQ30) approximately 4-6 hours after their session. Administration of 5-MeO-DMT occasioned strong mystical experiences (MEQ30 Overall Mintensity = 4.17, ± 0.64, range 0–5) and the majority (75%) had “a complete mystical experience” (≥60% on all MEQ30 subscales). Compared to a prior laboratory-based psilocybin study, there were no differences in the intensity of mystical effects between 5-MeO-DMT and a high dose (30 mg/70 kg) of psilocybin, but the intensity of mystical effects was significantly higher in the 5-MeO-DMT sample compared to moderate/high dose (20 mg/70 kg) of psilocybin (MEQ30 Total Score: p = .02, d = 0.81). Administration of vaporized 5-MeO-DMT reliably occasioned mystical experiences in a majority of individuals and was similar in intensity to high dose psilocybin administered in a laboratory setting. The short duration of action may be advantageous for clinical interventions and for studying mystical-type experiences.
Joseph Barsuglia
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Ibogaine is a plant-derived alkaloid and dissociative psychedelic that demonstrates anti-addictive properties with several substances of abuse, including alcohol. 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring psychedelic known to occasion potent mystical-type experiences and also demonstrates anti-addictive properties. The potential therapeutic effects of both compounds in treating alcohol use disorder require further investigation and there are no published human neuroimaging findings of either treatment to date. We present the case of a 31-year-old male military veteran with moderate alcohol use disorder who sought treatment at an inpatient clinic in Mexico that utilized a sequential protocol with ibogaine hydrochloride (1550 mg, 17.9 mg/kg) on day 1, followed by vaporized 5-MeO-DMT (bufotoxin source 50 mg, estimated 5-MeO-DMT content, 5–7 mg) on day 3. The patient received SPECT neuroimaging that included a resting-state protocol before, and 3 days after completion of the program. During the patient's ibogaine treatment, he experienced dream-like visions that included content pertaining to his alcohol use and resolution of past developmental traumas. He described his treatment with 5-MeO-DMT as a peak transformational and spiritual breakthrough. On post-treatment SPECT neuroimaging, increases in brain perfusion were noted in bilateral caudate nuclei, left putamen, right insula, as well as temporal, occipital, and cerebellar regions compared to the patient's baseline scan. The patient reported improvement in mood, cessation of alcohol use, and reduced cravings at 5 days post-treatment, effects which were sustained at 1 month, with a partial return to mild alcohol use at 2 months. In this case, serial administration of ibogaine and 5-MeO-DMT resulted in increased perfusion in multiple brain regions broadly associated with alcohol use disorders and known pharmacology of both compounds, which coincided with a short-term therapeutic outcome. We present theoretical considerations regarding the potential of both psychedelic medicines in treating alcohol use disorders in the context of these isolated findings, and areas for future investigation.
Joseph Barsuglia
added 7 research items
Background: Problematic opioid consumption is currently an epidemic in the United States. Ibogaine is reported to have the ability to interrupt opioid addiction by simultaneously mitigating withdrawal and craving symptoms. Objective: Evaluate opioid withdrawal and drug craving scores using validated clinical instruments in subjects with problematic opioid consumption undergoing a week-long detoxification treatment protocol with ibogaine hcl. Methods: We conducted a retrospective chart review of subjects (n=50, mean age = 31.27, 39% female) admitted to a residential ibogaine treatment center in Mexico during 2015. Subjects were maintained on short acting morphine on days prior to ibogaine administration (18-20mg/kg). Clinical Opioid Withdrawal Scale (COWS) and Brief Substance Craving Scale (BSCS) scores were collected at 48 and 24 hours prior to ibogaine administration, as well as 24 and 48 hours after ibogaine administration. A repeated measures ANOVA was utilized to examine whether there were changes in withdrawal and craving scores over time in response to ibogaine administration. Results: The average ASI composite score for drug use in the past 30 days was 0.206 ± 0.06 (SD), indicating a medium level drug problem. Results indicated that COWS scores decreased over time with pairwise comparisons showing significant decreases between pre and post ibogaine treatment phases (Wilk’s Lambda = 0.463, F (3, 47) = 18.71, p < 0.01, η2= 0.537). In the second analysis, results indicated that BSCS scores showed similar decreases and pairwise comparisons (Wilk’s Lambda = 0.314, F (3, 45) = 32.80, p < 0.01, η2= 0.69). Conclusions: Ibogaine appears to effectively facilitate opioid detoxification by reducing opioid withdrawal and craving. These results warrant further research using rigorous controlled trials.
Human studies on the efficacy of ibogaine in interrupting substance use disorders are limited, and studies on the long-term outcomes are even fewer. Therefore, we designed the current retrospective study to evaluate the subjective effectiveness of ibogaine treatment on problematic opioid consumption, and the long-term associations of treatment with psychological functioning. Using an online data collection procedure, 88 patients who had completed ibogaine treatment at Crossroads Treatment Center between 2011 and 2015 completed our survey. The majority of the sample (72%) had used opioids for four years or more, and 69% had used 30/30 days in the month leading up to treatment. Most participants (80%) indicated that ibogaine treatment eliminated or drastically reduced their withdrawal symptoms, and 50% indicated that ibogaine reduced their craving, for at least one week, and 25% of these participants indicated that it lasted for three months or more. In terms of opioid use following treatment, 30% reported that they never returned to using opioids, 54% of these abstainers had maintained abstinence for at least one year, and 31% of them for at least two years following ibogaine treatment. Additionally, 48% reported that, although they returned to using opioids after treatment, their use had decreased from pre-treatment consumption levels. Treatment response was negatively correlated with depression and anxiety symptoms, and positively correlated with subjective well-being at the time of survey. Specifically, those who never used opioids again statistically had the lowest rates of depressive, anxious, and stress symptoms and the highest levels of subjective well-being at the time of the survey. Taken together, these results suggest that ibogaine is effective at reducing and ameliorating problematic opioid consumption and has long-term positive psychological outcomes in a meaningful proportion of opioid users. Future research should investigate the efficacy of ibogaine treatment using rigorous longitudinal and controlled treatment designs.
Background : 5-MeO-DMT is a potent tryptamine found in high concentrations in the venom of the Colorado River Toad. Practical experience suggests that vaporized 5-MeO-DMT may induce mystical experiences that are relatively brief, yet have comparable or greater intensity than those induced by psilocybin. Quantitative evaluations of 5-MeO-DMT induced mystical experiences have not yet been published. Methods : Study participants were patients (n = 44, 61% male, M age = 34.6 yrs.) from a clinic in Mexico that utilizes 5-MeO-DMT as part of addiction and psychospiritual clinical treatment protocols. All patients received vaporized organic/toadsource 5-MeO-DMT at the median effective dose (50mg raw weight, estimated 5-MeO-DMT content = 57mg, Metzner, 2013). All patients completed the States of Consciousness Questionnaire (SOCQ) 24 hours following treatment. The SOCQ contains all items of the Mystical Experience Questionnaire (MEQ30) (Barrett et al., 2015; Griffiths et al., 2006). Results : The mean endorsement on the MEQ30 following 5-MeO-DMT was 75.5 percent (sd = 16.5) of the maximum possible total score, suggestive of mysticaltype experiences in the sample. A majority of patients (61.4%) had “a complete mystical experience” ( > 60% of the maximum possible score on all MEQ30 subscales: mystical, positive mood, space/time, ineffability). Overall, the MEQ30 exhibited excellent internal consistency (α = .96). Several SOCQ items not contained in the MEQ30 were also endorsed as “strong” or “extreme” by twothirds or more of the sample and included: experiencing overflowing energy and radiant/golden light, and feeling universal or infinite love, closeness with guides, and a hyperreal sense of consciousness (7566% of sample). Significance: The mystical experience occasioned by the 5-MeO-DMT containing toad venom was consistent with MEQ30 ratings with moderate to high psilocybin doses (2030mg/ 70kg) administered in prior research (Barrett, Johnson, & Griffiths, 2015). The short duration of action of 5MeODMT may be advantageous for clinical and psychospiritual interventions.