Why is ibogaine being used to treat addiction?

Why is ibogaine being used to treat addiction?

Despite the rise of psychedelic and plant-based substances picking up speed more than ever before, you would be forgiven for having heard of psilocybin and ayahuasca but not having heard of ibogaine. Ibogaine is a plant-based psychedelic alkaloid that is being heralded by many researchers as the ‘plant with anti-addictive properties. 

At any given time, more than 22 million Americans (around 9% of the US population) are battling substance abuse, and with the ongoing opioid crisis killing 131 Americans every day,

the world is screaming for a revolution in how we help addicts and those who are drug or substance-dependent.

As research continues globally into the potential for this drug to change the way we fight, heal, and process addiction, ibogaine must be approached with caution. Many see ibogaine as a ‘vast uncontrolled experiment,’ with risks around the treatment already becoming clear but, controversy aside, let’s get into it.

What is ibogaine?

Ibogaine is a plant-based psychedelic that originates from the roots of the Tabernanthe iboga plant - a rainforest shrub originally found in tropical forests in West Africa, particularly surrounding the Congo Basin. The roots of the T. iboga plant contain three key alkaloids - ibogaine, ibogaine, and ibogaine.

What are alkaloids?

Alkaloids are basic, naturally occurring organic compounds containing at least one nitrogen atom. Out of the three alkaloids in the T. iboga plant, ibogaine is the most abundant.

To be consumed, ibogaine must be extracted from the tree root bark, where it is then ground into a powder form and orally ingested. 

How has it been used so far?

Like many plant-based therapeutic substances and medicines, ibogaine has been used by indigenous communities for its healing properties for a long time.

In small doses, it is used to combat low-level fatigue and exhaustion, as well as helping to restore good health, increase sexual arousal and reduce a temperature/fever.

In higher doses, the ibogaine substance transitions into a more potent substance, delivering strong hallucinogenic effects. Local communities have long harnessed these hallucinogenic effects for community rituals as well as initiation and religious ceremonies.

How was it first discovered?

Despite being used by indigenous communities for significantly longer, the Western medical world first acknowledged the plant-based psychedelic in the 1860s. However, it wasn’t until 1962 when ibogaine was first put on the US-map by a heroin addict who found that the plant not only was extremely powerful in alleviating his heroin withdrawal symptoms but that it also stopped his cravings for the drug too.

A lot of testimonies since then have been anecdotal but we are starting to see more medical studies emerge that discuss the potential power of this plant in the fight against addiction.

Let’s get into the science

The most exciting potential of ibogaine is that it is considered to be ‘anti-addictive’ - and Xaver Koenig and Karlheinz Hilber from the Medical University of Vienna have confirmed just this - that ibogaine is showing promising anti-addictive power in both animal and human studies.

How does it actually work?

The real power of ibogaine is the effect that it has on neurotransmitters and their impacts in the brain.

Neurotransmitters are often referred to as ‘the body’s chemical messengers’. Neurotransmitters are the molecules used by the nervous system to transmit messages around the body (including, but not limited, to messaging between neurons).

These neurotransmitters help the brain to regulate our day-to-day and second-by-second state by controlling and contributing to the chemical, biological and physiological processes that we need to survive - like breathing, heart rate, muscle contractions, mood, sleep, appetite, concentration, and so much more.

A great deal of research has gone into the neurobiology of addiction and the addiction cycle, and each substance impacts the brain and body differently.

Opioids, for example, attach to opioid receptors in the brain, increasing dopamine (causing the high) and reducing pain signaling (which is why these become so dangerous when given as prescription meds).

Alcohol, however, interacts with the inhibitory neurotransmitters GABA and glutamate in the brain, delivering the euphoric feeling, with a side of sedation, relaxation, and anxiety-reduction.

Research so far has yet to exactly conclude how ibogaine’s pharmacological profile impacts the addiction cycle but increasing levels of research suggests that it alters, changes and interacts with addiction-related pathways between nerve cells in the brain, critically changing signaling in the brain regions that play a role in the behavioral drivers of addiction.

So, it gets to work in the brain?

Yes. Ibogaine is a tryptamine which means that it can affect several different neurotransmitters at the same time.

It is thought that ibogaine can attenuate drug-seeking behavior due to its essential affinities for N-methyl-d-aspartate (NMDA), kappa-opioid, sigma, and nicotine receptors. It also is thought to modify GDNF and BDNF expression in brain regions (particularly those involved in mesocorticolimbic and nigral Dopaminergic Circuits).

What this means is that ibogaine changes and alters the structure of our brain and the work it works—pretty powerful stuff.

What else? 

Ibogaine also impacts serotonin production within the body (another neurotransmitter). Like with other psychedelics (i.e. LSD and psilocybin) - ibogaine is thought to activate the 5-HT2A serotonin receptor (HTR2A) in the brain, creating more of this brain hormone that helps to improve mood, happiness, and wellbeing.

The power of ibogaine is not limited to any one drug or substance, but ibogaine is thought to be particularly effective for curbing opioid cravings, which could play a hugely important role in the global progress towards mitigating the US opioid epidemic. that is raging on.

Let’s get into the studies 

Science is starting to back up the claims, particularly as countries like New Zealand have started to legalize ibogaine which is increasing the ability to research into the power of this plant.

Most recently, a 2017 observational study of opioid addicts looked at the impact over 365 days of participants who received a single ibogaine treatment. The study showed a significant reduction in the assessment of ‘addiction severity', with all participants in the study also showing a significant reduction in withdrawal symptoms from the opioids.

Prior to this, in 2014, a study in Brazil worked with 75 participants across a broad spectrum of substances (alcohol, cocaine, crack cocaine and cannabis) with the study showing that, after just one ibogaine treatment, the average abstinence from the drug was 5.5 months. Interestingly, those participants who received multiple treatments of ibogaine saw this figure increase - abstaining from substance engagement and/or abuse for a medium of 8.4 months. 

In 2016, a Mexican study also confirmed that ibogaine had significant effects on opioid withdrawal symptoms for subjects who failed other withdrawal treatments. They concluded that it might provide a powerful discovery in the battle against addiction where other medications, treatments, and approaches fail.

It must be noted, however, that like with any plant-based medicines and pharmaceuticals more generally, ibogaine is not risk-free.

Between 1990 and 2008, 19 people have died from taking ibogaine, up to 76 hours after taking the dose. However, with the vast majority of these cases, post-mortem autopsy, toxicological and investigative reports, and summaries explained that this was likely due to pre-existing medical comorbidities rather than the cardiotoxicity of the plant itself. More on this cardiotoxicity shortly.  

What are the risks?

Despite promising results, the risks of ibogaine cannot be ignored.

A leading 2017 study on ibogaine concludes that ‘the safety profile of ibogaine is unacceptable’ due to its accumulation and build-up in the adipose tissue in the body that can, in turn, be able to cause cardiotoxicity within the body due to the inhibition of hERG potassium channels.

Cardiotoxicity is a condition that causes damage to the heart muscles and stops it from pumping and beating properly - and it is thought that ingestion of ibogaine may increase the likelihood of these heart-related issues due to its tendency to induce irregular heartbeats, palpitations and cardiac arrhythmias.

A 2015 study that looked at the heart and ibogaine also confirmed that it could influence and lower the heart rate and interact with the cardiovascular system.

So, is it too risky?

The risks exist, and the controversy does too. However, these aside, it is still thought that, with adequate medical supervision and proper screening for those with pre-existing heart conditions, ibogaine may become a major player in the future of addiction treatment.

There are many interested parties if investment in ibogaine research and development is anything to go by. In 2012, the National Institute on Drug Abuse pledged $6.5 million to develop a non psychoactive version of ibogaine called 18-methoxycoronaridine (18-MC) - with phase 1 of their human clinical trials now complete and, today, Universal Ibogaine has created a team of professionals to help navigate bringing ibogaine to the forefront of the market and global stage. The company has currently raised $6 million to support its clinical development.

As we wait and see what ongoing development, research, and clinical trials have to say, we hold out hope that plant-based and alternative therapies may be able to help change the way we fight, heal, and process addiction today.

Is ibogaine the answer? Maybe. But until then, we will just have to wait and watch the potential this plant-based psychedelic drug holds for many worldwide.

Interested in seeking Ibogaine treatment? We suggest checking out Clear Sky Recovery in Mexico led by Dr. Alberto Sola (who received his training from Dr Deborah Mash & Dr Jeffrey Kamlet). They run a medically-based, 7-day inpatient program to treat you in a comfortable, safe environment with 24-hour medical supervision.