Article

Ibogaine and Subjective Experience: Transformative States and Psychopharmacotherapy in the Treatment of Opioid Use Disorder

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  • Substance Use and Policy Analysis, Aotearoa New Zealand
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Abstract

This article examines the therapeutic potential of ibogaine, a powerful oneiric alkaloid derived from Tabernanthe iboga, through exploring the subjective experiences of 44 participants from two observational treatment studies for opioid use disorder. Following treatment with ibogaine HCl, the participants (Mexico, n = 30; New Zealand, n = 14) completed the States of Consciousness Questionnaire (SCQ) to quantify the magnitude of their psychotropic experience. Participants were asked to provide written transcripts of their experiences, with those supplied being analyzed thematically through an iterative process, to produce a set of coded themes. Mean SCQ scores in many domains exceeded 0.6, the cutoff score for a “complete mystical experience,” with 43% of participants achieving this in more than five of seven domains. Qualitative data described multiple phenomenological themes, including auditory and visual phenomena. Ibogaine’s strong oneiric action promoted cyclic visions leading to confronting realizations involving remorse and regret for participants’ actions towards others, but also release from feelings of guilt and worthlessness. Many participants reported feeling a sense of spiritual transformation. We propose that the reported experiences support the meaningfulness of ibogaine’s oneiric effects as a discrete element in its capacity for healing, which is distinct from pharmacological actions associated with reduced withdrawal and craving.

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... On the other hand, there are others who suggest that altered perception is not required to elicit a therapeutic response [13,14]. In the case of ibogaine, limited research on subjective experiences suggests its capacity for healing and long-term positive psychological effects are distinct from its pharmacological actions associated with reduced withdrawal symptoms and cravings [15][16][17]. Evidence suggests that a single ibogaine treatment can effectively reduce withdrawal symptoms and achieve sustained reduction or cessation of substance use in dependent individuals for several months after the initial treatment [18]. ...
... The compound's hallucinogenic effects may promote a beneficial psychotherapy-like process that can support abstinence for several months after ibogaine administration [18]. It has been proposed in previous studies that the subjective effects (experiential understanding and interpretation of the emotional and cognitive impacts) produced by ibogaine can play a significant role in treating SUD beyond the purely pharmacological action of the molecule that reduces cravings and withdrawal symptoms [15]. Both ibogaine's multi-target profile [7] and its hallucinogenic properties should be considered in its overall anti-addictive effects. ...
... Lotsof and Alexander stated that ibogaine's positive effect on drug use and interpersonal functioning seems to centre on the integration of these experiences and their transformation into a shift in behavioural and cognitive patterns [3]. The psychological insights facilitated by ibogaine, as described in our sample as well as previous research [15][16][17], enable participants to review specific conflicting psychological issues or maladaptive patterns, thereby strengthening the therapeutic process. These effects have been also described as fundamental to assisted psychotherapies involving hallucinogens, such as psilocybin or ayahuasca [10,29]. ...
Article
Introduction: Ibogaine is one of the alkaloids naturally found in plants such as Tabernanthe iboga, which has been traditionally used by members of the Bwiti culture. Since the discovery of its anti-addictive properties by Howard S. Lotsof in 1962, ibogaine has been used experimentally to treat substance use disorders (SUD), especially those involving opioids. We aim to provide a detailed understanding of the underlying psychological aspects of underground ibogaine use for the treatment of SUD. Methods: Semi-structured interviews were carried out with 13 participants with SUD, which motivated their self-treatment with ibogaine. The data were analysed using the grounded theory approach and considered the context of the treatment, and the nature of the occurring hallucinogenic and cognitive phenomena during the treatment experience. Results: We identified several psychological effects that the study respondents experienced , which seem to play a substantial role in the therapeutic process concerning SUD. The evoking of interpersonal and transpersonal experiences, autobiographical memories, and preparation, integration and motivation for a lifestyle change are important components that participants reported during and after ibogaine intake. Discussion and Conclusion: Ibogaine is increasingly being used for the treatment of SUD, due in part to the limited treatment options currently available. Its beneficial effects seem to be related not only to its complex pharmacology but also to the subjective experience that ibogaine induces. The main aspects of this experience are related to autobiographical memories and valuable personal insights, which together appear to help individuals cope with their SUD. K E Y W O R D S hallucinogenic, iboga, psychedelic, qualitative analysis, substance use disorders
... Ibogaine was also found to have similar transformative effects too (Brown et al., 2019). Observational studies have described participants' increased reflection, forgiveness, and self-forgiveness (Brown et al., 2019), which allowed them to enhance empathy and to attain relief from guilt (Heink et al., 2017), thus enabling personal transformation. ...
... Ibogaine was also found to have similar transformative effects too (Brown et al., 2019). Observational studies have described participants' increased reflection, forgiveness, and self-forgiveness (Brown et al., 2019), which allowed them to enhance empathy and to attain relief from guilt (Heink et al., 2017), thus enabling personal transformation. Also quantitative results (Brown et al., 2019) sustained ibogaine's psychotropic effects as being psychologically profound, leading to far reaching transformations (pp. ...
... Observational studies have described participants' increased reflection, forgiveness, and self-forgiveness (Brown et al., 2019), which allowed them to enhance empathy and to attain relief from guilt (Heink et al., 2017), thus enabling personal transformation. Also quantitative results (Brown et al., 2019) sustained ibogaine's psychotropic effects as being psychologically profound, leading to far reaching transformations (pp. 3-4), which is consistent with numerous other studies exploring ibogaine (Naranjo, 1969(Naranjo, , 1974Lotsof and Alexander, 2001;Schenberg et al., 2014;Heink et al., 2017;Camlin et al., 2018;Rodger, 2018) and other hallucinogens' effects, such as DMT, LSD, as well as mescaline (Hood, 1975;Griffiths et al., 2008;MacLean et al., 2011). ...
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The concept of transformative experience (TE) has been widely explored by several disciplines from philosophy to neurobiology, and in different domains, from the spiritual to the educational one. This attitude has engendered heterogeneous models to explain this phenomenon. However, a consistent and clear understanding of this construct remains elusive. The aim of this work is to provide an initial comprehensive interdisciplinary, cross-domain, up-to-date, and integrated overview on the concept of TEs. Firstly, all the models and theories on TEs were reviewed to extract and analyze TEs’ main components emerging from different disciplines. Then, this preliminary analysis was integrated with an in-depth examination of redundancies and particularities across domains and disciplines, to provide an integrated theoretical framework of TEs and a preliminary interdisciplinary operational definition of TEs. This examination, in turn, can help organize current research and theories, thus providing suggestions for operationalizing TEs as well as encouraging new interdisciplinary research endeavors.
... Avšak vyššie opísané náročné psychedelické skúsenosti môžu viesť ku katarzii a terapeutickému potenciálu a seba-rozvoju Bouso et al., 2012Bouso et al., , 2013Brown et al., 2019;Dominguez-Clavé et al., 2016;Johnson et al., 2008Johnson et al., , 2018Tylš et al., 2016). Aj užívatelia psychedelík na Slovensku subjektívne opisujú ako okrem iného aj náročné psychedelické skúsenosti môžu viesť k "otvorenosti mysle a inej perspektíve", "seba-spoznaniu, seba-pochopeniu, seba-rozvoju", "filozofickým a spirituálnym vhľadom ohľadne Celistvosti" či liečbe na viacerých úrovniach . ...
... Negatívny zážitok, tzv. "bad trip" sa všeobecne pokladá za najväčšie negatívum a riziko spájané s užitím psychedelík (Brown et al., 2019;Cakic et al., 2010;Nour et al., 2016). ...
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Introduction. With growing interest in hallucinogens, majority of psychedelic research focus mostly on the therapeutic potential and benefits. The objective of this paper is to explore how users of psychedelics verbalize their experience and perceived risks of using such substances. Methods. The authors used a questionnaire with open-ended and multiple-choice items. The sample included persons with at least one phenomenological experience with psychedelics (N = 422, age M=27.78; SD=7.84; SE=0.38; 35.1% women). Qualitative data were analyzed using concepts of The Grounded Theory using the Atlas.ti suite. Results. The target group uses terms taken from the English language (“bad trip”, “set and setting”, “sitter”, or the grammatically localized version of the word „psychedelic“), with shared and well-understood semantic meaning within the community. The central domain “inappropriate set and setting” and its inadequate preparation is linked to the negative experience of “bad trip” which can lead to difficult “integration of experience” or even “psychotic disorders”. Users of psychedelics report various harm reduction strategies which are consistent with relevant literature. Conclusion. This study illustrates that Slovak users of psychedelics seem to understand and use the established terminology of international discourse related to these substances. At the same time, the authors suggest that users seem to use various relevant strategies to lower risks associated with the use of psychedelics.
... It may be in the alleviation of withdrawal and craving during acute detoxification and post-treatment (Glick et al., 1998;Mash et al., 2018;Schenberg et al., 2014). Others argue that a transformative psychological event as a result of an emotionally salient or spiritual experience leads to improvement in symptoms (Brown, Noller & Denenberg, 2019;Roger, 2018). ...
... Forum participants' descriptions of the therapeutic effect of ibogaine-induced visions echoes that described by patients in previous studies (e.g. Brown et al., 2019;Davis et al., 2018): the sometimes-challenging visions provide grounds for self-reflection and a greater level of self-awareness. It was acknowledged by some forum participants that similar insights into behaviour and consequences could be achieved through psychotherapy or meditation, but that 'being shown' insights by a guiding presence was appealing. ...
Article
Background: Ibogaine is a psychedelic drug used by for-profit clinics and lay-people to treat addiction, despite some reported fatalities and a lack of rigorous clinical research. Little is known about ibogaine therapy from a consumer perspective. Online discussions generate and disseminate information about ibogaine therapy and provide a window into how people understand ibogaine's risks and uses. We examined views expressed in online fora in order to describe a consumer perspective of ibogaine therapy for addiction, and to elucidate the role of online fora in mediating people's understanding of, and engagement with ibogaine. Methods: We thematically analysed 40 threads comprising posts from 101 individual contributors from two popular online fora; Reddit (n = 20) and Drugs Forum (n = 20). Results: Our analysis identified three primary themes: (1) online fora as a resource for do-it-yourself research; (2) the therapeutic interaction in ibogaine therapy, and; (3) therapeutic mechanisms of ibogaine. Online fora were a key resource for information about ibogaine therapy, where personal experiences and evidence-based information were valued. Treatment arrangements, risks, and harm reduction were discussed at length by forum participants. Discussions of therapeutic effects focused on pharmacological mechanisms but positive psychological changes resulting from the psychedelic experience were also reported. Clinic-based treatment was preferred by many forum participants due to safety concerns, but money and time and treatment intent sometimes necessitated lay-administration of ibogaine. Microdosing of ibogaine was also frequently discussed. Conclusion: Online fora appear to have facilitated a sense of community where individuals are held to account for the success of ibogaine therapy. Fora discussions illustrate that neuroscientific explanations of addiction and behaviour have explanatory salience for people involved in ibogaine therapy. Online fora could be used as a platform for clinician and peer-led support and harm-reduction interventions, and for further research monitoring treatment practices and long-term outcomes.
... Subjective reports portray the ibogaine experience as entering into an intense dream-like episode while awake, involving memory retrieval and prospective imagination, without producing the typical interferences in thinking, identity distortions, and space-time alterations produced by classical psychedelics (e.g. DMT, LSD, psilocybin) [8][9][10][11][12][13][14] . Thus, ibogaine is often referred as an oneirogenic psychedelic 8,10,15 . ...
... In addition, the spectra were normalized to obtain the relative power by dividing the power value of each frequency by the sum across frequencies. The traditional frequency bands depicted in the figures were taken as: delta (1-4 Hz), theta (5-10 Hz), sigma (11)(12)(13)(14), beta (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) and gamma (30-100 Hz). ...
Preprint
Full-text available
Ibogaine is a psychedelic alkaloid that has attracted scientific interest because of its important antiaddictive properties evidenced in observational studies in humans, and in models for substance-use-disorders in rodents. Its subjective effect has been described as intense vivid dream-like experiences occurring while awake; hence, ibogaine is often referred to as an oneirogenic psychedelic. While this unique dream-like profile has been hypothesized to aid the antiaddictive effects in the past, the electrophysiological signatures of the ibogaine psychedelic state remain unknown. In our previous work, we showed in rats that ibogaine administration promotes a waking state with abnormal motor behavior, accompanied by a decrease in NREM and REM sleep. Here, we performed an in-depth analysis of the intracranial electroencephalogram during "ibogaine wakefulness". Ibogaine induced gamma oscillations with larger power than control levels but less coherent and less complex; i.e., this state shows clear REM sleep traits within the gamma frequency band. Thus, our results provide novel biological evidence for the association between the psychedelic state and REM sleep, and an empirical basis for the oneirogenic conjecture of ibogaine.
... Ibogaine has been used to treat opioid dependence for decades and evidence of its efficacy is growing. 50,51 In an observational study, 30 people with an average of 3 previous opioid dependence treatment attempts were treated with ibogaine for daily opioid use. 50 Half of the participants reported no drug use at the 1-month follow-up, with no clinically significant adverse effects. ...
... Several pharmacological theories exist to explain the drug's efficacy in attenuating opioid cravings and withdrawal symptoms; however, individuals treated with ibogaine also reported a powerful sense of meaning as a result of their intense ibogaine-facilitated treatment which reduced or eliminated their opioid dependence. 51 In a double-blind, randomized, active-placebo controlled trial of 70 long-term heroin users who were treated with either low dose or high dose ketamineassisted psychotherapy, those treated with high dose ketamine had significantly greater rates of abstinence (p<.05) and reduced cravings at the 2-year follow-up. 52 Consistent with other ketamine-assisted therapies, there were no reported adverse events (beyond an acute increase in blood pressure during the session) nor was any consequent ketamine dependence reported. ...
Article
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Background Psychedelic-assisted therapy research is demonstrating unprecedented rates of success in treating mentalillness, addictions, and end-of-life distress. This psychedelic renaissance is a turning point in how com-plex human conditions can be treated and has implications for nursing knowledge, advocacy, and practice internationally. Objective This article aims to explore the current state of knowledge in the field of psychedelic-assisted therapy and the practice implications for nurses. MethodsA scoping review of the literature was undertaken with a focus on mental health, addictions, and palliative care indications. Commentaries, syntheses, and reviews from the last 20 years were included, as well as all relevant primary study results. We then explored what is known about the nurse’s past and present role in this field. ResultsThe nurse’s role in psychedelic-assisted therapy and research has been hitherto mostly invisible and thus remains under-explored and undefined. The profession is ideally positioned, however, to contribute to the future of this promising field. Conclusion As advocates for safe, ethical, and interdisciplinary practice, nurses can lead the development of psychedelic-assisted therapy practice, ethics, research, advocacy, policy, and education. This article provides guidance and support for prescient nursing leadership in these areas.
... 1−3 It is considered an atypical psychedelic drug capable of inducing waking dream-like states (oneirogenic effects) and vivid memory recall and replay. 4,5 Anecdotal reports and openlabel case studies with volunteers seeking detoxification from heroin and cocaine indicated ibogaine's ability to interrupt the drug-dependence phenotype via rapid and lasting relief of drug withdrawal symptoms and cravings. 6−8 Two recent open-label observational clinical studies with subjects diagnosed with opioid dependence confirmed the earlier reports by showing a significant reduction of withdrawal symptoms (3 days posttreatment) and an improvement of quality of life (up to 12 months) after a single ibogaine therapeutic session. ...
... 9,10 In addition, a sustained antidepressant effect (evaluated at 1 and 12 months post-treatment) was recently reported, 7,10 consistent with other observations of ibogaine's attenuation of depressive symptoms in humans. 5,11,12 The addiction-interrupting and antidepressant properties of ibogaine are of high interest considering the renaissance of psychedelic research and re-emerging use of psychedelic compounds as experimental therapeutics in neuropsychiatric disorders. 13−15 Extensive preclinical work recapitulated the clinical effects of ibogaine in rodent models of substance use disorders (SUDs), including attenuation of self-administration of opioids, cocaine, nicotine, and alcohol, as well as a reduction of opioid withdrawal symptoms in opioid-dependent animals. ...
Article
Full-text available
Anecdotal reports and open label case studies in humans indicated that the psychedelic alkaloid ibogaine exerts profound anti-addictive effects. Ample preclinical evidence demonstrated the efficacy of ibogaine, and its main metabolite noribogaine, in substance use disorder rodent models. In contrast to addiction research, depression-relevant effects of ibogaine or noribogaine in rodents have not been previously examined. We have recently reported that the acute ibogaine administration induced a long-term increase of brain-derived neurotrophic factor mRNA levels in the rat prefrontal cortex, which led us to hypothesize that ibogaine may elicit antidepressant-like effects in rats. Accordingly, we characterized behavioral effects (dose and time-dependence) induced by the acute ibogaine and noribogaine (20 and 40 mg/kg, i.p.) administration in rats using the forced swim test (FST). We also examined the correlation between plasma and brain concentrations of ibogaine and noribogaine and the elicited behavioral response. We found that ibogaine and noribogaine induced a dose- and time-dependent antidepressant-like effect without significant changes of animal locomotor activity. Noribogaine’s FST effect was short lived (30 minutes) and correlated with high brain concentrations (estimated > 8 M of free drug), while the ibogaine’s antidepressant-like effect was significant at 3 hours. At this time point, both ibogaine and noribogaine were present in rat brain at concentrations that cannot produce the same behavioral outcome on their own (ibogaine ~ 0.5 M, noribogaine ~ 2.4 M). Our data suggests a polypharmacological mechanism underpinning the antidepressant-like effects of ibogaine and noribogaine.
... 1−3 It is considered an atypical psychedelic drug capable of inducing waking dream-like states (oneirogenic effects) and vivid memory recall and replay. 4,5 Anecdotal reports and openlabel case studies with volunteers seeking detoxification from heroin and cocaine indicated ibogaine's ability to interrupt the drug-dependence phenotype via rapid and lasting relief of drug withdrawal symptoms and cravings. 6−8 Two recent open-label observational clinical studies with subjects diagnosed with opioid dependence confirmed the earlier reports by showing a significant reduction of withdrawal symptoms (3 days posttreatment) and an improvement of quality of life (up to 12 months) after a single ibogaine therapeutic session. ...
... 9,10 In addition, a sustained antidepressant effect (evaluated at 1 and 12 months post-treatment) was recently reported, 7,10 consistent with other observations of ibogaine's attenuation of depressive symptoms in humans. 5,11,12 The addiction-interrupting and antidepressant properties of ibogaine are of high interest considering the renaissance of psychedelic research and re-emerging use of psychedelic compounds as experimental therapeutics in neuropsychiatric disorders. 13−15 Extensive preclinical work recapitulated the clinical effects of ibogaine in rodent models of substance use disorders (SUDs), including attenuation of self-administration of opioids, cocaine, nicotine, and alcohol, as well as a reduction of opioid withdrawal symptoms in opioid-dependent animals. ...
Preprint
Anecdotal reports and open label case studies in humans indicated that the psychedelic alkaloid ibogaine exert profound anti-addictive effects. Ample preclinical evidence demonstrated the efficacy of ibogaine, and its main metabolite noribogaine, in substance use disorder rodent models. In contrast to addiction research, depression-relevant effects of ibogaine or noribogaine in rodents have not been previously examined. We have recently reported that the acute ibogaine administration induced a long-term increase of brain-derived neurotrophic factor mRNA levels in the rat prefrontal cortex, which led us to hypothesize that ibogaine may elicit antidepressant-like effects in rats. Accordingly, we characterized behavioral effects (dose and time-dependence) induced by the acute ibogaine and noribogaine (20 and 40 mg/kg, i.p.) administration in rats using the forced swim test (FST). We also examined the correlation between plasma and brain concentrations of ibogaine and noribogaine and the elicited behavioral response. We found that ibogaine and noribogaine induced a dose- and time-dependent antidepressant-like effect without significant changes of animal locomotor activity. Noribogaine’s FST effect was short lived (30 minutes) and correlated with high brain concentrations (estimated > 8 mM of free drug), while the ibogaine’s antidepressant-like effect was significant at 3 hours. At this time point, both ibogaine and noribogaine were present in rat brain, at concentrations which cannot produce the same behavioral outcome on their own (ibogaine ~ 0.5 mM, noribogaine ~ 2.4 mM). Our data suggest a polypharmacological mechanism underpinning the antidepressant-like effects of ibogaine and noribogaine.
... In a proof of concept trial of psilocybin assisted therapy for alcohol use disorder, Bogenschutz et al. (2015) reported that psilocybin administration sessions within a context of psychotherapy combining Motivational Enhancement Therapy and therapy designed to prepare for, and debrief from, the psilocybin sessions, led to significant increases in abstinence following psilocybin administration; encouragingly, these gains were maintained at 36 week follow-up. In naturalistic studies, ibogaine has been reported as a specific treatment for opioid use disorder (Brown et al., 2019), but as of this review, this had not been tested in a clinical trial setting. In the 1960s and 1970s, LSD was extensively studied as a treatment for alcohol use disorder, and a meta-analysis of six randomized controlled trials including 536 subjects demonstrated a beneficial effect (Krebs and Johansen, 2012). ...
Article
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Post-traumatic stress disorder (PTSD), a common condition with potentially devastating individual, family, and societal consequences, is highly associated with substance use disorders (SUDs). The association between PTSD and SUD is complex and may involve adverse childhood experiences (ACEs), historical and multi-generational traumas, and social determinants of health as well as cultural and spiritual contexts. Current psychosocial and pharmacological treatments for PTSD are only modestly effective, and there is a need for more research on therapeutic interventions for co-occurring PTSD and SUD, including whether to provide integrated or sequential treatments. There is a current resurgence of interest in psychedelics as potential treatment augmentation for PTSD and SUDs with an appreciation of the risks in this target population. This paper reviews the historical perspective of psychedelic research and practices, as well as the intersection of historical trauma, ACEs, PTSD, and SUDs through the lens of New Mexico. New Mexico is a state with high populations of Indigenous and Hispanic peoples as well as high rates of trauma, PTSD, and SUDs. Researchers in New Mexico have been leaders in psychedelic research. Future directions for psychedelic researchers to consider are discussed, including the importance of community-based participatory approaches that are more inclusive and respectful of Indigenous and other minority communities.
... Thus, due to the slow release of ibogaine along with the complex pharmacodynamics of ibogaine and noribogaine, including their ability to modify addiction-related neural circuitry through the activation of neurotrophic factor signaling (He, 2005;Marton et al., 2019), these compounds can apparently elicit long-lasting and potentially irreversible behavioral and neurochemical changes in the brain of subjects, even after administration of a single ibogaine dose Noller et al., 2018). Part of the success of ibogaine may also be explained by the creation of a profound dream-like experience after ibogaine administration that activates long-term memory, forcing a deep introspection that aids comprehension and resolution of conflicts related to the substance use disorder of the subject (Davis et al., 2018;Mash et al., 2018;Brown et al., 2019). Doses ranging from 4 to 29 mg/kg in the form of extracts/ hydrochloride have been orally administered to achieve efficacy in patients pursuing release or at least interruption from drug dependency (Alper, 2001;dos Santos et al., 2017). ...
Article
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The psychedelic alkaloid ibogaine is increasingly used as an oral treatment for substance use disorders, despite being unlicensed in most countries and having reported adverse events. Using wild-type and genetically modified mice, we investigated the impact of mouse (m)Abcb1a/1b and Abcg2 drug efflux transporters, human and mouse OATP drug uptake transporters, and the CYP3A drug-metabolizing complex on the pharmacokinetics of ibogaine and its main metabolites. Following oral ibogaine administration (10 mg/kg) to mice, we observed a rapid and extensive conversion of ibogaine to noribogaine (active metabolite) and noribogaine glucuronide. Mouse Abcb1a/1b, in combination with mAbcg2, modestly restricted the systemic exposure (plasma AUC) and peak plasma concentration (C max ) of ibogaine. Accordingly, we found a ∼2-fold decrease in the relative recovery of ibogaine in the small intestine with fecal content in the absence of both transporters compared to the wild-type situation. Ibogaine presented good intrinsic brain penetration even in wild-type mice (brain-to-plasma ratio of 3.4). However, this was further increased by 1.5-fold in Abcb1a/1b;Abcg2 −/− mice, but not in Abcg2 −/− mice, revealing a stronger effect of mAbcb1a/1b in restricting ibogaine brain penetration. The studied human OATP transporters showed no major impact on ibogaine plasma and tissue disposition, but the mOatp1a/1b proteins modestly affected the plasma exposure of ibogaine metabolites and the tissue disposition of noribogaine glucuronide. No considerable role of mouse Cyp3a knockout or transgenic human CYP3A4 overexpression was observed in the pharmacokinetics of ibogaine and its metabolites. In summary, ABCB1, in combination with ABCG2, limits the oral availability of ibogaine, possibly by mediating its hepatobiliary and/or direct intestinal excretion. Moreover, ABCB1 restricts ibogaine brain penetration. Variation in ABCB1/ABCG2 activity due to genetic variation and/or pharmacologic inhibition might therefore affect ibogaine exposure in patients, but only to a limited extent. The insignificant impact of human CYP3A4 and OATP1B1/1B3 transporters may be clinically advantageous for ibogaine and noribogaine use, as it decreases the risks of undesirable drug interactions or interindividual variation related to CYP3A4 and/or OATP activity.
... Furthermore, those studies that assessed substance craving via structured interviews or self-reports (HCQN, MCCN, CCQN, ASI-Lite) found an immediate and prolonged reduction in opioid or cocaine craving (Mash et al., 2000Noller et al., 2018;Prior & Prior, 2014). Studies that examined depressive symptoms, with scales like BDI or POMS (Brown et al., 2019;Mash et al., 2000Mash et al., , 2001Mash et al., , 2018Noller et al., 2018) and symptom severity of PTSD via PCL-5 (Davis et al., 2020), found significant symptom reduction for prolonged periods (weeks to months after discharge). ...
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Background Iboga and its primary alkaloids, ibogaine and noribogaine, have been of interest to researchers and practitioners, mainly due to their putative efficacy in treating substance use disorders (SUDs). For many SUDs, still no effective pharmacotherapies exist. Distinct psychoactive and somatic effects of the iboga alkaloids set them apart from classic hallucinogens like LSD, mescaline, and psilocybin. Aims The study team performed this systematic review focusing on clinical data and therapeutic interventions involving ibogaine and noribogaine. Methods The team conducted a search for all publications up to December 7, 2020, using PubMed and Embase following PRISMA guidelines. Results In total, we identified 743 records. In this review, we consider 24 studies, which included 705 individuals receiving ibogaine or noribogaine. This review includes two randomized, double-blind, controlled clinical trials, one double-blind controlled clinical trial, 17 open-label studies or case series (including observational or retrospective studies), three case reports, and one retrospective survey. The published data suggest that ibogaine is an effective therapeutic intervention within the context of SUDs, reducing withdrawal symptoms and craving. Data also point toward a beneficial impact on depressive and trauma-related psychological symptoms. However, studies have reported severe medical complications and deaths, which seem to be associated with neuro- and cardiotoxic effects of ibogaine. Two of these fatalities were described in the 24 studies included in this review. Conclusion Treatment of SUDs and persisting comorbidities requires innovative treatment approaches. Rapid-onset therapies such as the application of ibogaine may offer novel treatment opportunities for specific individuals. Rigorous study designs within medical settings are necessary to warrant safe application, monitoring, and, possibly, medical intervention.
... In addition, the spectra were normalized to obtain the relative power by dividing the power value of each frequency by the sum across frequencies. The traditional frequency bands depicted in the figures were taken as delta (1−4 Hz), theta (5− 10 Hz), sigma (11)(12)(13)(14), beta (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), and gamma (30− 100 Hz). ...
Article
Full-text available
Ibogaine is a psychedelic alkaloid that has attracted large scientific interest because of its antiaddictive properties in observational studies in humans as well as in animal models. Its subjective effect has been described as intense, vivid dream-like experiences occurring while awake; hence, ibogaine is often referred to as an oneirogenic psychedelic. While this unique dream-like profile has been hypothesized to aid the antiaddictive effects, the electrophysiological signatures of this psychedelic state remain unknown. We previously showed in rats that ibogaine promotes a waking state with abnormal motor behavior along with a decrease in NREM and REM sleep. Here, we performed an in-depth analysis of the intracranial electroencephalogram during “ibogaine wakefulness”. We found that ibogaine induces gamma oscillations that, despite having larger power than control levels, are less coherent and less complex. Further analysis revealed that this profile of gamma activity compares to that of natural REM sleep. Thus, our results provide novel biological evidence for the association between the psychedelic state and REM sleep, contributing to the understanding of the brain mechanisms associated with the oneirogenic psychedelic effect of ibogaine.
... [37][38][39][40][41][42] The primary adverse effects of ibogaine include cardiovascular effects (e.g., Q-wave/Twave interval prolongation, bradycardia, arrythmias, and in rare cases, sudden cardiac death), 43 ataxia, nausea, and vomiting, 44 and psychological effects (e.g., auditory and visual hallucinations, re-experiencing traumatic memories, acute fear, distress, or guilt). 31,45 5-Methoxy-N,N-Dimethyltryptamine 5-MeO-DMT is a psychedelic tryptamine found in plant species 46 and notably in the venomous secretions of the Sonoran Desert/Colorado River toad. 47 In observational studies, 5-MeO-DMT demonstrates therapeutic potential across a variety of psychiatric symptoms that correspond with common sequelae in Veteran populations. ...
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Background U.S. Special Operations Forces Veterans are at increased risk for a variety of mental health problems and cognitive impairment associated with military service. Current treatments are lacking in effectiveness and adherence. Therefore, this study examined psychedelic treatment with ibogaine and 5-methoxy-N,N-dimethyltryptamine for trauma-related psychological and cognitive impairment among U.S. Special Operations Forces Veterans. Method We conducted a survey of Veterans who completed a specific psychedelic clinical program in Mexico between 2017 and 2019. Questions probed retrospective reports of mental health and cognitive functioning during the 30 days before and 30 days after treatment. A total of 65 people completed treatment during this time frame and were eligible for contact. Of these, 51 (78%) completed the survey and were included in data analyses (mean age = 40; male = 96%; married = 55%; Caucasian/White = 92%; Operation Enduring Freedom/Operation Iraqi Freedom Service = 96%). Results Results indicated significant and very large reductions in retrospective report of suicidal ideation (p < .001; d = −1.9), cognitive impairment (p < .001; d = −2.8), and symptoms of posttraumatic stress disorder (p < .001; d = −3.6), depression (p < .001; d = −3.7), and anxiety (p < .001; d = −3.1). Results also showed a significant and large increase in retrospective report of psychological flexibility (p < .001; d = 2.9) from before-to-after the psychedelic treatment. Increases in the retrospective report of psychological flexibility were strongly associated with retrospective report of reductions in cognitive impairment, and symptoms of posttraumatic stress disorder, depression, and anxiety (rs range −0.61 to −0.75; p < .001). Additionally, most participants rated the psychedelic experiences as one of the top five personally meaningful (84%), spiritually significant (88%), and psychologically insightful (86%) experiences of their lives. Limitations: Several limitations should be considered including the retrospective, self-report, survey design of the study, and the lack of randomization and blinding, thus making these finding preliminary. Conclusion U.S. Special Operations Forces Veterans may have unique treatment needs because of the sequela of problems associated with repeated trauma exposure and the nature of the exposure. Psychedelic-assisted therapy with these under-researched psychedelics may hold unique promise for this population. However, controlled studies are needed to determine whether this treatment is efficacious in relieving mental health and cognitive impairment among U.S. Special Operations Forces Veterans.
... While ibogaine-assisted psychotherapy has reduced withdrawal symptoms and drug relapse, to date, there have yet to be any controlled trials of ibogaine. A qualitative study (Brown, Noller, & Denenberg, 2019) revealed 19 minor themes contained within three major themes: vision content (e.g., auditory and visual effects, spirit beings), perceptions (e.g., physical experience of vision, perceptions of family members, sense of oneness with everything), and process (e.g., reviewing one's life, letting go, transformation). ...
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Research on psychedelics has seen a recent revival, with many clinical trials focused on their therapeutic potential to treat a range of mental health conditions. The purpose of this systematic review was to evaluate clinical trials of psychedelic-assisted psychotherapy for mental health conditions from the present wave of psychedelic research (1990s to present). A total of 43 studies met criteria and were included. The conditions reviewed were substance use disorders; anxiety and/or depression, often associated with terminal illness; posttraumatic stress disorder; and obsessive– compulsive disorder. Quantitative results indicate that psychedelics can significantly reduce clinical outcomes associated with these mental health conditions. Common themes identified from qualitative reports included increased acceptance and processing of emotions, connectedness to others, forgiveness, self-compassion, insights into the self, peak or mystical experiences, ego dissolution, positive changes in worldview, motivation and commitment to change, changes in the relationship to the substance of abuse for those with substance use disorder, and acceptance of death for those with terminal illness. No serious, long-term adverse events were reported directly attributable to drug ingestion. We discuss the strengths and limitations of the research base, along with suggestions for clinical practice, potential therapeutic mechanisms, and directions for future research. Despite promising results, further work is needed to determine which psychedelic is best suited for diverse mental health conditions, the most appropriate type of psychotherapy to employ, and the psychological and neurobiological mechanisms underlying clinical benefits. Keywords: psychedelics, psychotherapy, review, mental health, ego
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In 1965, I was training in clinical toxicology in the pharmacology department of the University of California San Francisco (UCSF) and living in the Haight Ashbury. I studied various psychedelics, including LSD, mescaline, and ibogaine, in human and animal models. The psychedelics were then being used as a therapeutic drug in clinical settings and researched as a potential antipersonnel agent by the U.S. government. Then, using psychedelics became a rite of passage for the emerging countercultural movement. After adverse reactions and negative publicity, states began to criminalize these drugs, beginning in 1966. The federal government eventually moved these drugs to Schedule 1 classification, shutting down research almost entirely.
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Substance use and related mental health epidemics are causing increasing suffering and death in diverse communities. Despite extensive efforts focused on developing pharmacotherapies for treating substance use disorders, currently approved medications do not reverse the persistent neurocircuitry and psychological changes that underlie addiction states, highlighting an urgent need for radically different therapeutic approaches. Ibogaine provides an important drug prototype in this direction, as a psychoactive iboga alkaloid suggested to have the ability to interrupt maladaptive habits including opioid use in drug-dependent humans. However, ibogaine and its major metabolite noribogaine present considerable safety risk associated with cardiac arrhythmias. We introduce a new class of iboga alkaloids - "oxa-iboga" - defined as benzofuran-containing iboga analogs and created via structural editing of the iboga skeleton. The oxa-iboga compounds act as potent kappa opioid receptor agonists in vitro and in vivo but exhibit atypical behavioral features compared to standard kappa psychedelics. We show that oxa-noribogaine has greater therapeutic efficacy in addiction models and no cardiac pro-arrhythmic potential, compared to noribogaine. Oxa-noribogaine induces long-lasting suppression of morphine intake after a single dose in rat models of addiction and persistent reduction of morphine intake after a short treatment regimen. Oxa-noribogaine maintains and enhances the ability of iboga compounds to effect lasting alteration of addiction-like states while addressing iboga's cardiac liability. As such, oxa-iboga compounds represent candidates for a new kind of anti-addiction pharmacotherapeutics.
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Background: Ibogaine is a monoterpene indole alkaloid used in medical and nonmedical settings for the treatment of opioid use disorder. Its mechanism of action is apparently novel. There are no published prospective studies of drug use outcomes with ibogaine. Objectives: To study outcomes following opioid detoxification with ibogaine. Methods: In this observational study, 30 subjects with DSM-IV Opioid Dependence (25 males, 5 females) received a mean total dose of 1,540 ± 920 mg ibogaine HCl. Subjects used oxycodone (n = 21; 70%) and/or heroin (n = 18; 60%) in respective amounts of 250 ± 180 mg/day and 1.3 ± 0.94 g/day, and averaged 3.1 ± 2.6 previous episodes of treatment for opioid dependence. Detoxification and follow-up outcomes at 1, 3, 6, 9, and 12 months were evaluated utilizing the Subjective Opioid Withdrawal Scale (SOWS) and Addiction Severity Index Composite (ASIC) scores, respectively. Results: SOWS scores decreased from 31.0 ± 11.6 pretreatment to 14.0 ± 9.8 at 76.5 ± 30 hours posttreatment (t = 7.07, df = 26, p < 0.001). At 1-month posttreatment follow-up, 15 subjects (50%) reported no opioid use during the previous 30 days. ASIC Drug Use and Legal and Family/Social Status scores were improved relative to pretreatment baseline at all posttreatment time points (p < .001). Improvement in Drug Use scores was maximal at 1 month, and subsequently sustained from 3 to 12 months at levels that did not reach equivalence to the effect at 1 month. Conclusion: Ibogaine was associated with substantive effects on opioid withdrawal symptoms and drug use in subjects for whom other treatments had been unsuccessful, and may provide a useful prototype for discovery and development of innovative pharmacotherapy of addiction.
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Background: The psychoactive indole alkaloid ibogaine has been associated with encouraging treatment outcomes for opioid dependence. The legal status of ibogaine in New Zealand provides a unique opportunity to evaluate durability of treatment outcomes. Objective: To examine longitudinal treatment effects over a 12-month period among individuals receiving legal ibogaine treatment for opioid dependence. Method: This observational study measured addiction severity as the primary outcome in 14 participants (50% female) over 12 months post-treatment using the Addiction Severity Index-Lite (ASI-Lite) following a single ibogaine treatment by either of two treatment providers. Secondary effects on depression were assessed via the Beck Depression Inventory-II (BDI-II). The Subjective Opioid Withdrawal Scale (SOWS) was collected before and immediately after treatment to measure opioid withdrawal symptoms. Results: Nonparametric comparisons via Friedman Test between baseline and 12-month follow-up for participants completing all interviews (n = 8) showed a significant reduction for the ASI-Lite drug use (p = 0.002) composite score. Reductions in BDI-II scores from baseline to 12-month follow-up were also significant (p < 0.001). Significant reductions in SOWS scores for all participants (n = 14) were also observed acutely after treatment (p = 0.015). Patients with partial data (n = 4) also showed reductions in ASI-Lite drug use scores and family/social status problems. One patient enrolled in the study died during treatment. Conclusion: A single ibogaine treatment reduced opioid withdrawal symptoms and achieved opioid cessation or sustained reduced use in dependent individuals as measured over 12 months. Ibogaine’s legal availability in New Zealand may offer improved outcomes where legislation supports treatment providers to work closely with other health professionals.
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Psychedelic drugs have historically been used for ritualistic purposes and to help individuals gain insight. Ibogaine, a naturally occurring psychoactive substance, has been reported to have anti-addictive properties that aid in the treatment of substance use disorders. An online survey obtained retrospective data from individuals who used ibogaine in the past. Individuals who used ibogaine tended to describe thematically similar experiences post-treatment. This study adds to the literature by using the 5d-ASC, a psychometrically sound measure of altered states of consciousness (ASCs), to examine the ASCs induced by ibogaine and discusses the demographic characteristics of those who seek ibogaine treatment (N = 27). The study also examined several aspects of ibogaine treatment experience, including reasons for seeking treatment, course of treatment, and treatment outcome. Results indicated a positive correlation between the various dimensions of the ASCs and the outcome (ability to make changes in one’s life, cravings, and how changed the person was as a result of ibogaine treatment). While this study is limited in generalizability due to high attrition and low sample size, it deepens the understanding of the phenomenological experience of ibogaine and explores the possible utility of ibogaine in the treatment of substance use disorders.
Article
Introduction Ibogaine is a naturally occurring psychoactive indole alkaloid derived from the roots of the rainforest shrub Tabernanthe iboga.Ibogaine is used by indigenous peoples of Western Africa in low doses to combat fatigue, hunger, and thirst, and in higher doses as a sacrament in religious rituals (Goutarel et al., 1991). The use of ibogaine for the treatment of drug dependence was based on anecdotal reports by groups of self-treating addicts that the drug blocked opiate withdrawal and reduced craving for opiates, cocaine, and other illicit drugs for extended time periods (Shepard, 1994; Alper et al., 1999). Preclinical studies supported these early claims and provided proof-of-concept in animal models (Dzoljic et al., 1988; Glick et al., 1992). Addiction is a behavioral pattern of drug abuse characterized by compulsive use, loss of behavioral control, and a high tendency to relapse. An integrated medical, psychosocial, and spiritual treatment is often needed to achieve recovery in addicted patients. Ibogaine is a unique pharmacotherapy for the treatment of substance abuse disorders because it fosters a life change or may work as a transition-based therapy similar to the goals set in the 12-step fellowship programs. While ibogaine's effects on behavior are complex, the beneficial actions of the drug on withdrawal symptoms and cravings are because of an interaction of the active metabolite noribogaine with neurotransmitters in the brain reward and addiction circuit.
Article
A measure of reported mystical experience is presented. This "Mysticism Scale, Research Form D (M scale)," has 32 items, four for each of 8 categories of mysticism initially conceptualized by Stace (1960). Items on this scale are both positively and negatively expressed to avoid problems of response set. A factor analysis of the M Scale indicated two major factors, a general mystical experience factor (20 items) and a religious interpretation factor (12 items). Preliminary evidence indicates that those high on the M Scale have more intrinsic religious motivation as defined by Hoge's (1972) scale, are more open to experience as defined by Taft's (1970) ego permissiveness scale, have more intense religious experience as defined by Hood's (1970) scale, and have moderately higher scores on the L, Hs, and Hy scales of the MMPI.
Article
Conversion of ibogaine to its active metabolite noribogaine appears to be mediated primarily by CYP2D6. We compared 168 h pharmacokinetic profiles of both analytes after a single oral 20 mg dose of ibogaine in 21 healthy subjects who had been pretreated for 6 days with placebo or the CYP2D6 inhibitor paroxetine. In placebo-pretreated subjects, ibogaine was rapidly converted to noribogaine. Median peak noribogaine concentrations occurred at 4 h. Compared with placebo-pretreated subjects, paroxetine-pretreated subjects had rapid (Tmax = 1.5 h) and substantial absorption of ibogaine, with detectable levels out to 72 h, and an elimination half-life of 10.2 h. In this group, ibogaine was also rapidly converted to noribogaine with a median Tmax of 3 h. Extent of noribogaine exposure was similar in both groups. CYP2D6 phenotype was robustly correlated with ibogaine AUC0-t (r = 0.82) and Cmax (r = 0.77). Active moiety (ibogaine plus noribogaine) exposure was ∼2-fold higher in paroxetine-pretreated subjects. Single 20 mg ibogaine doses were safe and well tolerated in all subjects. The doubling of exposure to active moiety in subjects with reduced CYP2D6 activity suggests it may be prudent to genotype patients awaiting ibogaine treatment, and to at least halve the intended dose of ibogaine in CYP2D6 poor metabolizers. This article is protected by copyright. All rights reserved
Article
The chapter focuses on a contemporary history and description of the medical subculture of the informal treatment scenes of the United States and Europe, and the political subculture of ibogaine advocacy. In 1995, Dr. Curtis Wright, then the U.S. Food and Drug Administration (FDA) ibogaine project officer passed a statement that intimates a relationship of public opinion to regulatory scientific policy. The statement was made at a time when the FDA, partly in response to highly motivated and organized public advocacy, was modifying its drug development process to accommodate the more rapid evaluation and approval of agents used to treat the human immunodeficiency virus (HIV). As with treatments for HIV, ibogaine has been associated with a vocal activist subculture, which has viewed its mission as advocating the availability of a controversial treatment to a stigmatized and marginalized minority group of patients who suffer from a life-threatening illness. Wright's perception of significant public interest in ibogaine was derived from two related subcultural contexts. One such context is the medical subculture of the informal ibogaine treatment scene, and the other is the political subculture of advocacy for the development and availability of ibogaine. The period of time spanned by the history presented in this chapter extends from the early 1960s to the present, and it is thus termed a “contemporary” history of ibogaine. Ibogaine has a long history of use as a ritual hallucinogen in Africa. However, the early 1960s marked the advent of the attempt to develop ibogaine as a treatment for substance dependence in the United States and Europe.
Article
Background: Narcotics Anonymous is a worldwide fellowship that employs the Twelve-Step model for members dependent on drugs of abuse. The spiritual orientation of its program of abstinence has not been subjected to empirical study. Methods: Responses of 527 American Narcotics Anonymous meeting attendees to a structured questionnaire were evaluated for the roles of cognitive and psychosocial aspects of spirituality in their recovery. Results: Respondents had last used drugs or alcohol on average 6.1 years previously. They were found to be more oriented toward a spiritual than a formally religious orientation than probability samples of the general population. Aspects of membership such as affiliation toward other members and the experience of spiritual awakening were associated with lower rates of drug or alcohol craving, whereas scores on depression were associated with higher craving scores. Conclusions: Spiritual renewal combined with an abstinence-oriented regimen in Narcotics Anonymous social context can play a role in long-term recovery from drug addiction.
Article
A large body of historical evidence describes the use of hallucinogenic compounds, such as psilocybin mushrooms, for religious purposes. But few scientific studies have attempted to measure or characterize hallucinogen-occasioned spiritual experiences. The present study examined the factor structure of the Mystical Experience Questionnaire (MEQ), a self-report measure that has been used to assess the effects of hallucinogens in laboratory studies. Participants (N=1602) completed the 43-item MEQ in reference to a mystical or profound experience they had had after ingesting psilocybin. Exploratory factor analysis of the MEQ retained 30 items and revealed a 4-factor structure covering the dimensions of classic mystical experience: unity, noetic quality, sacredness (F1); positive mood (F2); transcendence of time/space (F3); and ineffability (F4). MEQ factor scores showed good internal reliability and correlated with the Hood Mysticism Scale, indicating convergent validity. Participants who endorsed having had a mystical experience on psilocybin, compared to those who did not, had significantly higher factor scores, indicating construct validity. The 4-factor structure was confirmed in a second sample (N=440) and demonstrated superior fit compared to alternative models. The results provide initial evidence of the validity, reliability, and factor structure of a 30-item scale for measuring single, hallucinogen-occasioned mystical experiences, which may be a useful tool in the scientific study of mysticism.
Article
The potential for deriving new psychotherapeutic medications from natural sources has led to renewed interest in rain forest plants as a source of lead compounds for the development of antiaddiction medications. Ibogaine is an indole alkaloid found in the roots of Tabernanthe iboga (Apocynaceae family), a rain forest shrub that is native to equatorial Africa. Ibogaine is used by indigenous peoples in low doses to combat fatigue, hunger and in higher doses as a sacrament in religious rituals. Members of American and European addict self-help groups have claimed that ibogaine promotes long-term drug abstinence from addictive substances, including psychostimulants and cocaine. Anecdotal reports attest that a single dose of ibogaine eliminates withdrawal symptoms and reduces drug cravings for extended periods of time. The purported antiaddictive properties of ibogaine require rigorous validation in humans. We have initiated a rising tolerance study using single administration to assess the safety of ibogaine for the treatment of cocaine dependency. The primary objectives of the study are to determine safety, pharmacokinetics and dose effects, and to identify relevant parameters of efficacy in cocaine-dependent patients. Pharmacokinetic and pharmacodynamic characteristics of ibogaine in humans are assessed by analyzing the concentration-time data of ibogaine and its desmethyl metabolite (noribogaine) from the Phase I trial, and by conducting in vitro experiments to elucidate the specific disposition processes involved in the metabolism of both parent drug and metabolite. The development of clinical safety studies of ibogaine in humans will help to determine whether there is a rationale for conducting efficacy trials in the future.
Article
Although the importance of validity has long been accepted among quantitative researchers, this concept has been an issue of contention among qualitative researchers. Thus, the first purpose of the present paper is to introduce the Qualitative Legitimation Model, which attempts to integrate many of the types of validity identified by qualitative researchers. The second purpose of this article is to describe 24 methods for assessing the truth value of qualitative research. Utilizing and documenting such techniques should prevent validity and qualitative research from being seen as an oxymoron.
Article
Ibogaine is an indole alkaloid derived from the bark of the root of the African shrub Tabernanthe iboga. Psychoactive properties of ibogaine have been known for decades. More recently, based on experimental data from animals and anectodal reports in human, it has been found that this drug has anti-addictive effects. Several patents were published between 1969 and 1995. The pharmacology of ibogaine is quite complex, affecting many different neurotransmitter systems simultaneously. However, the pharmacological targets underlying the physiological and psychological actions of ibogaine are not completely understood. Ibogaine is rapidly metabolized in the body in noribogaine. The purpose of this article was to review data from the literature concerning physicochemical properties, bio-analytical methods, and pharmacology of ibogaine; this article will be focused on the use of this drug as anti-addictive agent.
Article
The chapter discusses the use of ibogaine in three different contexts: a drug user group, a self-help organization, and a clinical research setting. Each discussion is followed by the self-report of a subject who has taken ibogaine within the setting being reviewed. These settings contrast with the use of iboga in Gabon, Africa as a practice of the Bwiti, an African religion sometimes referred to as an initiation society, during which ibogaine-containing plants are provided in rites to assist in the transition from adolescence into adulthood, for psychiatric healing, or for other purposes. With regard to the future of ibogaine therapy, a look at methadone therapy may provide an understanding of what might go right and what might go wrong in the development of effective medications to treat chemical dependence. If a reduction in chemical dependence is to be accomplished, whether with ibogaine, its analogs, or other modalities, it will require that patients be better treated and better respected. The chapter concludes by stating that ibogaine therapy offers a unique opportunity both for the physician and the patient.
Article
The chapter offers information on the formation of International Addict Self-Help (INTASH), the introduction of ibogaine in the addict self-help scene in Holland, and the contribution of the addict self-help movement to the development of ibogaine treatment. The chapter also describes the INTASH intake, treatment, and aftercare procedures and the importance of addict self-help involvement in future developments with the clinical use of ibogaine. Ibogaine was introduced to the addict community in 1990 by Howard Lots of and Bob Sisko from the International Coalition for Addict Self Help (ICASH). The late Nico Adriaans, Josien Harms, and others formed an informal organization, Dutch Addict Self Help (DASH), which today is called “INTASH,” to treat addicts with ibogaine. INTASH performed four initial treatments with ibogaine on opiate-dependent poly-drug users, some of whom had been in methadone maintenance programs for many years. The successful results of these treatments were impressive. The goal of the self-help organization was to provide treatment with ibogaine in a nonjudgmental and trusting environment. A clinical argument can be made that ibogaine is safer and more effective than ultra-rapid detoxification with naltrexone or naloxoneIbogaine already is available in the currently existing international black market where it is being bought and sold in the streets and used without the proper medical screening and attention that is needed, which can lead to possibly hazardous situations.
Article
Personal experiences with primary process thinking are described under conditions of intoxication with the South American hallucinogenic decoctionyaje, under LSD, and under reverie. The essential psychological equivalence of these conditions is contrasted with that of the schizophrenic. The former are considered to be examples of the oneiric state, also seen in conditions of sensory deprivation and prolonged sleeplessness. Suggestions regarding a neurophysiological basis of the oneiric state and the schizophrenic state are offered.
Article
Hallucinogens (psychedelics) are psychoactive substances that powerfully alter perception, mood, and a host of cognitive processes. They are considered physiologically safe and do not produce dependence or addiction. Their origin predates written history, and they were employed by early cultures in a variety of sociocultural and ritual contexts. In the 1950s, after the virtually contemporaneous discovery of both serotonin (5-HT) and lysergic acid diethylamide (LSD-25), early brain research focused intensely on the possibility that LSD or other hallucinogens had a serotonergic basis of action and reinforced the idea that 5-HT was an important neurotransmitter in brain. These ideas were eventually proven, and today it is believed that hallucinogens stimulate 5-HT(2A) receptors, especially those expressed on neocortical pyramidal cells. Activation of 5-HT(2A) receptors also leads to increased cortical glutamate levels presumably by a presynaptic receptor-mediated release from thalamic afferents. These findings have led to comparisons of the effects of classical hallucinogens with certain aspects of acute psychosis and to a focus on thalamocortical interactions as key to understanding both the action of these substances and the neuroanatomical sites involved in altered states of consciousness (ASC). In vivo brain imaging in humans using [(18)F]fluorodeoxyglucose has shown that hallucinogens increase prefrontal cortical metabolism, and correlations have been developed between activity in specific brain areas and psychological elements of the ASC produced by hallucinogens. The 5-HT(2A) receptor clearly plays an essential role in cognitive processing, including working memory, and ligands for this receptor may be extremely useful tools for future cognitive neuroscience research. In addition, it appears entirely possible that utility may still emerge for the use of hallucinogens in treating alcoholism, substance abuse, and certain psychiatric disorders.
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Report on the staten island project. The ibogaine story
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Evidence for the efficacy and transformative power of ibogaine in the treatment of substance dependence
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