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Significance of “Unofficial” Ibogaine Treatment Scenes. The existence of these scenes indicates demand for alternatives to existing treatment options.
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Significance of “Unofficial” Ibogaine Treatment Scenes • The existence of these scenes indicates demand for alternatives to existing treatment options. • Averse events including fatalities indicate the need for appropriate prospective medical evaluation of patients, monitoring within the treatment, and reliable formulations of ibogaine. • “Anecdotal” or “case report” evidence suggests a possible neurobiological drug action. • All of the above strongly support the need for appropriate clinical trials to evaluate safety and efficacy in order to gain official approval
1. Alper, K.R., Beal D., and Kaplan C.D. (2001). A Contemporary History of Ibogaine in the United States and Europe. In Ibogaine:Proceedings of the First International Conference (The Alkaloids Volume 56), pp. 249-281. Academic Press, San Diego, California.2. Lotsof, H.S., and Alexander N.E. (2001). Case studies of ibogaine treatment: implications for patient management strategies. In Ibogaine:Proceedings of the First International Conference (The Alkaloids Volume 56), pp. 293-313. Academic Press, San Diego, California.3. Alper, KR, Lotsof, HS, Frenken, GMN, Luciano, DJ, and Bastiaans, J. Treatment of Acute Opioid Withdrawal with Ibogaine. American Journal on Addictions 8: 234-242, 1999.4. Frenken G. (2001). From the roots up: ibogaine and addict self-help. In Ibogaine:Proceedings of the First International Conference (The Alkaloids Volume 56), pp. 283-292, Academic Press, San Diego, California.5. Mash, D.C., Kovera A. , Pablo J., Tyndale R., Ervin F.R., Kamlet J.D., and Hearn W.L. (2001). “Ibogaine in the Treatment of Heroin Withdrawal” Ibogaine:Proceedings of the First International Conference (The Alkaloids Volume 56), (K. Alper and S.D. Glick Eds.), pp. 155-171. Academic Press, San Diego, California.6. Stolarof MJ. The Secret Chief. (1997) Multidisciplinary Association for Psychedelic Studies, Charlotte NC, 144 pages.7. Kastelic , A. “Self-Help Use of ibogaine in Slovenia” Presented at the First International Conference on Ibogaine. New York, NY, Nov. 5 1999.
Reports of Ibogaine Treatment in Humans Case studies presented to NIDA in March 1995; 41 individuals receiving a total of 52 treatments Published case reports (high degree of overlap with the above) describing a total of 56 treatments Open label prospective study N=32 (Mash et al.)
Published Ibogaine Case Studies • One paper describing 33 treatments for opioid dependence; complete resolution of withdrawal signs and absence of drug-seeking behavior in 25 (76%)1. • Total of 13 treatments, mainly for opioid dependence, in four additional papers2,3,4,5. 1. Alper, KR, Lotsof, HS, Frenken, GMN, Luciano, DJ, and Bastiaans, J (1999). Treatment of Acute Opioid Withdrawal with Ibogaine. American Journal on Addictions 8: 234-242.2. Cantor, M. (1990). ``Interviews: ibogaine treated addicts''. The Truth Seeker 117(5), 23-26. 3. Luciano, DJ. (1998). Observations on treatment with Ibogaine. American Journal on Addictions 7, 89-90.4. Sheppard, S.G. (1994). A preliminary investigation of ibogaine: case reports and recommendations for further study. J.Subst.Abuse Treat. 11, 379-385.5. Sisko, B. (1993). Interrupting drug dependency with ibogaine: a summary four case histories. Multidisciplinary Association For Psychedelic Studies (MAPS) Newsletter 4: 15-24.
Drug Abstinence Following Ibogaine Treatment (unpublished, presented to NIDA March 1995) Reported Time Interval of Post- treatment Drug AbstinenceN (%) Alper, K.R. (2001). Ibogaine: A Review. In Ibogaine: Proceedings of the First International Conference (The Alkaloids Volume 56), (K. R. Alper and S.D. Glick, Eds.), pp. 1-38. Academic Press, San Diego, California.
Table 1 from: Alper, KR, Lotsof, HS, Frenken, GMN, Luciano, DJ, and Bastiaans, J. Treatment of Acute Opioid Withdrawal with Ibogaine. American Journal on Addictions 8: 234-242, 1999. Retrospective Case Series From Early1960’s U.S. and Late 1980’s-Early 1990’s Dutch Informal Scenes: Subjects
Table 2 from: Alper, KR, Lotsof, HS, Frenken, GMN, Luciano, DJ, and Bastiaans, J. Treatment of Acute Opioid Withdrawal with Ibogaine. American Journal on Addictions 8: 234-242, 1999. Retrospective Case Series From Early1960’s U.S. and Late 1980’s-Early 1990’s Dutch Informal Scenes: Outcomes
Prospective Open Label Study (Mash et al. 2001) 1 • 32 patients treated for opioid (heroin or methadone) withdrawal. • Withdrawal Symptoms measured using the Objective Opiate Withdrawal Scale (OOWS) • Fixed dose of 800 mg ibogaine HCl given approximately 12 hours after the last opiate dose • OOWS significantly reduced at 12 and 24 hours post ibogaine administration; the level of discomfort at these acute relative to post-treatment time points was as low as the level seen 1 week later. Objective signs of opiate withdrawal rarely seen and none increased at later time points. • Decreased craving at <72 hours post-treatment; these reductions were maintained at 6 to 9 days post-treatment • Depression scores reduced relative to pre-treatment at 6 to 9 days and 1 month post-treatment 1. Mash, D.C., Kovera A. , Pablo J., Tyndale R., Ervin F.R., Kamlet J.D., and Hearn W.L. (2001). “Ibogaine in the Treatment of Heroin Withdrawal” in Ibogaine: Proceedings of the First International Conference (The Alkaloids Volume 56), (K. Alper and S.D. Glick Eds.), pp. 155-171. Academic Press, San Diego, California.
Examples of Disease Specific Advocacy • HIV: Aids Coalition to Unleash Power (ACT UP); Treatment Action Group (TAG) • Opiate Dependence: Dutch Junkiebond, Danish Drug Users Union • Psychiatric Disorders: National Alliance for the Mentally Ill (NAMI)
