Denny Chapin is the Managing Editor of AllTreatment.com, a directory of drug rehab centers and resource for substance abuse information. He has written for other blogs like Drug WarRant and Morning Donut.
Ibogaine: A Radical Approach to Heroin AddictionTreatment
Treatment for addiction to a physically addictive drug, like heroin or alcohol, are often two pronged: first is the use of replacement drugs (replacement therapy) to prevent major withdrawal while giving the patient a drug that is technically "safer" (Methadone for heroin), and second is aversion therapy, where drugs are used to actually produce displeasing, painful side effects when an addict uses their drug of choice. A replacement drug to heroin is methadone, which helps a patient reduce intense opiate withdrawal symptoms while preventing them from getting "high" which in turn helps an addict break the addiction towards that high. An aversion drug to heroin is naltrexone which will literally make a heroin user or alcoholic sick if they consume their drug of choice. Modern addiction treatment for depressants like alcohol and heroin use a combination of pharmalogical and behavioral therapies to encourage a sober, clearer perspective on life. And while these therapies do help many people get off and completely quit using heroin, there are serious negatives associated with replacement therapy and aversion therapy.
First is the simple truth that methadone still effects a patient's opioid receptors in the same way as heroin without causing the elation, meaning a recovering addict is still dependent on drugs, just less pleasing drugs.
Methadone is often sold illegally to other addicts at a high market price, whereupon the addict who has sold their medication needs another form of opiate, often relapsing back to heroin. And aversion therapies are so unpleasant that patients oftentimes discontinue the use of these drugs to avoid the side-effects they inevitably experience when relapsing.
Both treatments are better than no treatment, but are far from a perfect solution, and until recently, these treatments were the only major treatments the medical field had knowledge about. Recently, however, the medical community has been learning about a new form of pharmacological treatment that comes from the root of an African plant called "Ibogaine".
Ibogaine is considered a psychedelic drug, closest to the tryptamine in its chemical composition, which has seen a lot of study for its use in treating opioid withdrawal symptoms in heroin addicts. Instead of binding to opioid receptors like methadone, ibogaine acts as a 'reset switch' of the neural pathways effected by substance abuse, returning the body's natural chemical levels to normal.
Administration of ibogaine is significantly different than any other treatment chemical because it produces noticeable hallucinations during the beginning of the experience, usually ending four hours after administration. These effects mimic other tryptamine drugs like DMT or Psilocybin, and are often considered dream-like and can be very intense and disturbing--this is the main reason why Ibogaine isn't used recreationally, as most users find the hallucinations unpleasant. After these emotionally difficult effects pass, patients experience a phase of introspection whereupon they feel emotionally open, calm, and empathetic, similar to the effects recorded from drugs like MDMA and other empathogens.
At this stage, psychotherapists treating patients with ibogaine do their hardest work, discussing the experiences, feelings, and beliefs the patient holds about their addiction with the goal of coming to closure with these often negative, suppressive psychological issues.
Most therapies using ibogaine focus primarily on the introspective phase, noting that the more emotionally vulnerable, open, and emotive a patient is about their addiction (usually seen as a shameful aspect of their life which this drug allows them to compartmentalize), the higher the likelihood that their desire toward inebriation diminishes.
Beyond this introspective, psycho-therapeutic aspect of ibogaine, perhaps its most noticeable effect is the alleviation of opioid withdrawal symptoms. Ibogaine literally removes the gnawing, painful, sickening experience of withdrawing from heroin and other opiates which can normally last for up to seven days, something which methadone treatment seeks to prevent, not alleviate. In this regard, ibogaine is the most novel addiction treatment drug being researched today.
But because the drug has historically been seen only as an exotic psychedelic drug from Africa, it was made a schedule 1 illegal drug in 1970 with the Controlled Substances Act, despite being an extremely esoteric, unheard of, non-researched substance at the time. There are currently 12 countries across the world that offer ibogaine treatment clinics, with illegally run clinics sprouting up in major U.S. cities like New York and Los Angeles. Only the future will tell about ibogaine's potential legal use as a heroin addiction treatment, but moving forward, hopefully ibogaine can offer a new, more effective form of treatment for patients willing to go through the grueling psychological and emotive process it seems to demand.