Subjective effectiveness of ibogaine treatment for problematic opioid consumption: Short- and long-term outcomes and current psychological functioning

Abstract

Background and aimsVery few studies have reported the effectiveness of ibogaine as a treatment for chronic opioid use. Therefore, this study evaluated the acute subjective effects of ibogaine, outcomes on problematic opioid consumption, and the long-term associations with psychological functioning.MethodsUsing online data collection, 88 patients who received ibogaine treatment in Mexico between 2012 and 2015 completed our survey.ResultsMost participants (72%) had used opioids for at least 4 years and 69% reported daily use. Most (80%) indicated that ibogaine eliminated or drastically reduced withdrawal symptoms. Fifty percent reported that ibogaine reduced opioid craving, some (25%) reporting a reduction in craving lasting at least 3 months. Thirty percent of participants reported never using opioids again following ibogaine treatment. And over one half (54%) of these abstainers had been abstinent for at least 1 year, with 31% abstinent for at least 2 years. At the time of survey, 41% of all participants reported sustained abstinence (>6 months). Although 70% of the total sample reported a relapse following treatment, 48% reported decreased use from pretreatment levels and an additional 11% eventually achieved abstinence. Treatment responders had the lowest rates of depressive and anxious symptoms, the highest levels of subjective well-being and rated their ibogaine treatment as more spiritually meaningful compared with treatment non-responders.ConclusionThe results suggest that ibogaine is associated with reductions in opioid use, including complete abstinence, and has long-term positive psychological outcomes. Future research should investigate the efficacy of ibogaine treatment using rigorous longitudinal and controlled designs.

Ibogaine Detoxification Transitions Opioid and Cocaine Abusers Between Dependence and Abstinence: Clinical Observations and Treatment Outcomes

“…Ibogaine reportedly has helped people transition from heroin and cocaine to sobriety ( Alper et al, 2008 ; Brown and Alper, 2017 ; Davis et al, 2017 ; Noller et al, 2018 ). Because of ibogaine’s oneiric effects and complex pharmacokinetics, we originally suggested that noribogaine should be advanced for opioid detoxification to promote a transition to abstinence ( Mash et al, 2000 , 2001 ; Mash, 2018 ).…”

“…Ibogaine may help opioid dependent patients to transition to sobriety and to establish a substance-free recovery because the oneirophrenic effects have therapeutic benefit as an adjuvant to psychotherapy ( Alper et al, 1999 ; Davis et al, 2017 ; Mash, 2018 ). The elicitation narratives described in this report suggest that ibogaine may promote harm reduction following detoxification from opioids.…”

“…Interestingly, these effects appeared to persist over a long period of time based on self-reports at a 1-month follow up interview. The recent observational studies from Mexico ( Brown and Alper, 2017 ; Davis et al, 2017 ) and New Zealand ( Noller et al, 2018 ) endorse the efficacy of ibogaine as pharmacological treatment for opioid detoxification ( Mash, 2018 ).…”

Psychedelic Treatment for Trauma-Related Psychological and Cognitive Impairment Among US Special Operations Forces Veterans

“… 24 Ibogaine was used in France for over 30 years as an anti-depressant and a stimulant until the mid-1960s. 25 Ibogaine treatment is reported to alleviate a spectrum of mood and anxiety symptoms 25 – 28 and is associated with self-reported improvements in cognitive functioning in individuals with substance use disorders. 29 – 31 During treatment, ibogaine allows the evocation and reprocessing of traumatic memories and occasions therapeutic and meaningful visions of spiritual and autobiographical content, 26 , 29 , 30 , 32 which are of central relevance in addressing PTSD-related psychological content.…”

“… 25 Ibogaine treatment is reported to alleviate a spectrum of mood and anxiety symptoms 25 – 28 and is associated with self-reported improvements in cognitive functioning in individuals with substance use disorders. 29 – 31 During treatment, ibogaine allows the evocation and reprocessing of traumatic memories and occasions therapeutic and meaningful visions of spiritual and autobiographical content, 26 , 29 , 30 , 32 which are of central relevance in addressing PTSD-related psychological content. The benefits of ibogaine may be associated with its effects on serotonin and dopamine transporters, sigma, N-methyl-d-aspartate, nicotinic acetylcholine, and opioid receptors, 29 , 33 , 34 and the production of glial-derived neurotrophic factors 35 and brain-derived neurotropic factor 36 which are identified sites of interest in the treatment of cognitive impairment in neuropsychiatric disorders.…”