Ibogaine Detoxification for Opioid Use Disorder: A Retrospective Chart Review of Withdrawal and Craving Outcomes

Retrospective chart review (Western University of Health Sciences IRB, exempt; single residential ibogaine treatment centre, Mexico; calendar year 2015) of adults with DSM-5 opioid use disorder (OUD) who presented primarily for opioid detoxification. Exclusion: primary non-opioid problem, polysubstance users whose primary substance was not opioids, missing Clinical Opioid Withdrawal Scale (COWS) data. Prior to arrival, patients were converted to short-acting opioids and required to discontinue methadone or buprenorphine ≥4 weeks before treatment. Immediate-release (IR) morphine was maintained until ~4 hours before ibogaine. On arrival: physical examination, 12-lead ECG, toxicology, bloodwork. Treatment: oral ibogaine hydrochloride (Voacanga-derived, GMP-certified) at 18–20 mg/kg total dose (100 mg test dose first, remainder within 2 hours; supplemental 1–5 mg/kg permitted at 72h if post-acute withdrawal persisted; clonidine or gabapentin as adjuncts when indicated). Medical supervision throughout (vital signs, telemetry, IV fluids/electrolytes, on-site emergency clinicians). Programme phases: pre-treatment coaching and screening; 4-day inpatient ibogaine detoxification; 3-day residential; optional aftercare. Primary outcome: clinician-administered COWS (0–48) at ~48h and ~24h pre-ibogaine and ~24h and ~48h post-ibogaine. Secondary outcomes: self-reported SOWS (0–64); three-item Brief Substance Craving Scale (BSCS, 0–12). Baseline demographics and Addiction Severity Index (ASI) composite scores described. Analysis: repeated-measures ANOVA, α=0.05, pairwise comparisons. No trial registry entry; exempt IRB; retrospective design.