Treatment of acute opioid withdrawal with ibogaine
In a case series of 33 open‑label, non‑medical treatments for opioid detoxification, ibogaine resolved signs of acute opioid withdrawal without further drug‑seeking within 24 hours in 25 patients (sustained for 72 hours), with varied outcomes in the remainder and one possible fatality; the authors conclude that ibogaine’s apparent effectiveness warrants systematic clinical investigation.
Authors
- Alper, K. R.
- Lotsof, H. S.
- Frenken, G. M. N.
Published
Abstract
Ibogaine is an alkaloid with putative effect in acute opioid withdrawal. Thirty‐three cases of treatments for the indication of opioid detoxification performed in non‐medical settings under open label conditions are summarized involving an average daily use of heroin of .64 ± .50 grams, primarily by the intravenous route. Resolution of the signs of opioid withdrawal without further drug seeking behavior was observed within 24 hours in 25 patients and was sustained throughout the 72‐hour period of posttreat‐ment observation. Other outcomes included drug seeking behavior without withdrawal signs (4 patients), drug abstinence with attenuated withdrawal signs (2 patients), drug seeking behavior with continued withdrawal signs (1 patient), and one fatality possibly involving surreptitious heroin use. The reported effectiveness of ibogaine in this series suggests the need for systematic investigation in a conventional clinical research setting.
Research Summary of 'Treatment of acute opioid withdrawal with ibogaine'
Introduction
Ibogaine is an indole alkaloid derived from the African shrub Tabernanthe iboga that has been claimed to possess anti-addictive properties, including efficacy in ameliorating acute opioid withdrawal. Earlier research supporting this claim comprises animal studies showing reduced morphine and heroin self-administration and attenuation of withdrawal signs, plus multiple anecdotal and case reports from an informal treatment network operating outside conventional research settings. The compound’s pharmacology is complex: it does not act as a classic dopamine or opioid agonist/antagonist or as an amine re-uptake inhibitor, but has affinities for NMDA, kappa opioid, sigma, and nicotinic receptors. Because its mechanism is unknown, NMDA antagonism and other interactions have been proposed as possible mediators of an effect on opioid withdrawal. This paper by Alper and colleagues aims to present a systematic series of open-label case observations drawn from that informal treatment network to assess ibogaine’s apparent effects on acute opioid withdrawal over the first 72 hours after the last opiate use. The authors focus on opioid withdrawal because it is a well-recognised, time-limited clinical syndrome that may provide clearer outcome measures than other substance withdrawal states and because opioid dependence has been the principal indication for which patients have sought ibogaine treatment.
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Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
- APA Citation
Alper, K. R., Lotsof, H. S., Frenken, G. M. N., Luciano, D. J., & Bastiaans, J. (1999). Treatment of acute opioid withdrawal with ibogaine. The American Journal on Addictions, 8(3), 234-242. https://doi.org/10.1080/105504999305848
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