Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes
This observational field study (n=30) investigated the effects of ibogaine on opioid detoxification amongst individuals who sought addiction treatment at a private clinic and found that the treatment had a substantiative effect of reducing drug use up to 1 month, or even up to 12 months amongst select individuals.
Authors
- Brown, T. K.
- Alper, K.
Published
Abstract
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.
Research Summary of 'Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes'
Introduction
Ibogaine is a monoterpene indole alkaloid derived from Tabernanthe iboga that has been used in medical and nonmedical settings to treat substance use disorders, most commonly for opioid detoxification. Earlier case series, uncontrolled reports and preclinical studies suggest ibogaine and its metabolite noribogaine can reduce opioid withdrawal signs and decrease self-administration of opioids and other drugs in animals, and some human reports have described prolonged abstinence in subsets of treated individuals. The compound’s pharmacology appears distinct from classical μ-opioid receptor agonists and NMDA antagonists, and proposed mechanisms include effects on GDNF expression and antagonism at α3β4 nicotinic receptors, although no single mechanism clearly explains the prolonged behavioural effects observed. This observational study set out to characterise detoxification outcomes and longer-term drug-use trajectories following ibogaine treatment in people with DSM-IV opioid dependence. Brown and colleagues report clinical and self-reported substance-use outcomes up to 12 months after treatment in a naturalistic sample treated at two private clinics in Baja California, Mexico, aiming to describe detoxification efficacy, subsequent changes in Addiction Severity Index Composite (ASIC) scores and subjective opioid withdrawal (SOWS) ratings, and to identify baseline features associated with more favourable outcomes.
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Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
- APA Citation
Brown, T. K., & Alper, K. (2018). Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes. The American Journal of Drug and Alcohol Abuse, 44(1), 24-36. https://doi.org/10.1080/00952990.2017.1320802
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