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How to conduct a safe Ibogaine Treatments
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Ibogaine – an anti addiction medication Ibogaine – an anti addiction medication originating from activists’ effortsoriginating from activists’ efforts
Boaz Wachtel & Howard LotsofBoaz Wachtel & Howard Lotsof
Indigenous use in AfricaIndigenous use in Africa Historical outlineHistorical outline Activist’s tacticsActivist’s tactics Current usesCurrent uses ScienceScience Some thoughts on UN drug conventions Some thoughts on UN drug conventions
and prohibitionand prohibition
Map of indigenous use of Iboga in Africa
Ibogaine Root cutting & Ibogaine Root cutting & templetemple
T. Iboga is Valued for its roots
Root-bark images: Freshly cut roots Tabernanthe iboga fruitTabernanthe iboga fruit
Iboga alkaloids are concentrated Iboga alkaloids are concentrated in the bark of the rootin the bark of the root
Usable forms include scraped or Usable forms include scraped or ground root bark ground root bark
Bwiti Initiates Bwiti Initiates Bwiti MissokoBwiti Missoko--gonde initiationgonde initiation
Photo – Dan Liberman
In all the visions collected, five different reasons given for eating eboga.
In order of frequency the reasons given were:
because of the urging of a dead relative in a dream
because of attacks by witches, causing impotence, sterility, pain, and sleeplessness;
because of discontent with the missionary religions;
because of a desire to know Zame (last of the creator gods);
because of a general malaise and sickliness
Howard Lotsof – Credited for finding the Ibogaine application to treat drug addiction
““Chasing the dragon” to no-Chasing the dragon” to no-wherewhere......
Photo: B.W.
Heroin overdose of a young women, New York City 1992
Photo: B.W.
Americans' Views of the SeriousnessAmericans' Views of the Seriousnessof Health Problemsof Health Problems((Top Ten of ThirtyTop Ten of Thirty--Six ProblemsSix Problems)) SourceSource: : Harvard School of Public Health et alHarvard School of Public Health et al.., 2000, 200044
SourcesSources: : Rice, 1999Rice, 199911; ; ONDCP, 2001ONDCP, 200122; ; Harwood, 2000Harwood, 200033
Substance Abuse Costs Our Nation Substance Abuse Costs Our Nation More than $484 Billion per YearMore than $484 Billion per Year
1864-A first description of T. Iboga is published1864-A first description of T. Iboga is published 1885- A published description of the ceremonial use of 1885- A published description of the ceremonial use of
the T. Iboga in Gabon appears.the T. Iboga in Gabon appears. 1901- I. Is isolated and crystallized from T. Iboga root 1901- I. Is isolated and crystallized from T. Iboga root
barkbark 1939-1970 I. is sold in France as Lambarene ,”a 1939-1970 I. is sold in France as Lambarene ,”a
neuromuscular stimulant” for fatigue, depression and neuromuscular stimulant” for fatigue, depression and recovery from infectious diseaserecovery from infectious disease
Brief Historical Time LineBrief Historical Time Line
Brief Historical Time Brief Historical Time LineLine
•1962-1963 In the USA Howard Lotsof 1962-1963 In the USA Howard Lotsof administered Ibogaine to 19 individuals at administered Ibogaine to 19 individuals at dosages of 6 to 19 mg/kg including 7 with dosages of 6 to 19 mg/kg including 7 with Opioid dependency who noted an apparent Opioid dependency who noted an apparent effect on acute withdrawal symptomseffect on acute withdrawal symptoms•19691969-Claudio Naranjo ,a psychiatrist, -Claudio Naranjo ,a psychiatrist, received a French patent for the received a French patent for the psychotherapeutic use of Ibogaine at a psychotherapeutic use of Ibogaine at a dosage of 4 to 5 mg/kgdosage of 4 to 5 mg/kg•1967-1970 The WHA classifies Ibogaine 1967-1970 The WHA classifies Ibogaine With hallucinogens and stimulants .The With hallucinogens and stimulants .The FDA: assigns Ibogaine Schedule I FDA: assigns Ibogaine Schedule I classificationclassification
Brief Historical Time LineBrief Historical Time Line 1985- Howard Lotsof received a US patent for use of Ibogaine to treat 1985- Howard Lotsof received a US patent for use of Ibogaine to treat
Opioid withdrawal (additional patents for indications of dependency on Opioid withdrawal (additional patents for indications of dependency on cocaine, alcohol, nicotine and poly-substance abuse)cocaine, alcohol, nicotine and poly-substance abuse)
1988-1994-US and Dutch researchers published initial findings in animals: 1988-1994-US and Dutch researchers published initial findings in animals: diminished Opioid self administration and withdrawal + diminished diminished Opioid self administration and withdrawal + diminished cocaine self administrationcocaine self administration
1991-NIDA :Ibogaine Project. (pre-clinical toxicological evaluation and 1991-NIDA :Ibogaine Project. (pre-clinical toxicological evaluation and development of a human protocol)development of a human protocol)
1993-Dr Deborah Mash got approval for human trials. The dosage:1,2,5 1993-Dr Deborah Mash got approval for human trials. The dosage:1,2,5 mg/kg. Activity is eventually abandonedmg/kg. Activity is eventually abandoned
NIDA ends its Ibogaine project: opinions of the industry mostly criticalNIDA ends its Ibogaine project: opinions of the industry mostly critical 1997 begins the Ibogaine Mailing List1997 begins the Ibogaine Mailing List 1990-2001 I. Becomes increasingly available in alternative settings in view 1990-2001 I. Becomes increasingly available in alternative settings in view
of the lack of approval in the USA and Europe. (Panama- St. Kitts)of the lack of approval in the USA and Europe. (Panama- St. Kitts) 2001 – present: Ibogaine use spreads around the world – 30 2001 – present: Ibogaine use spreads around the world – 30
to 40 clinics or non medical operations administer Ibogaine to 40 clinics or non medical operations administer Ibogaine for addition treatment and psychological transformationfor addition treatment and psychological transformation
African use & knowledge
Scientific pre-clinical addiction related (animals)
-1980’s - present
Semi clinical settings (with doctors) -1993 - present
Data from Clinical trials– yet to arrive
Underground treatments
-1988-present
Ibogaine Data Generation Evolution
1.
Lotsof anti-addiction discovery
-Hundreds of years
-Early 60’s
Purified Chemical Purified Chemical Proposed as an approved regulated drugProposed as an approved regulated drug
Total Alkaloid extractTotal Alkaloid extract
Courtesy Sara Glatt
Ibogaine Ibogaine Activist OrganizationsActivist Organizations
International Coalition for Addict International Coalition for Addict Self-Help (ICASH)Self-Help (ICASH)
Dutch Addict Self-HelpDutch Addict Self-Help (DASH) (DASH)
Cures-Not Wars Cures-Not Wars (ibogaine and other (ibogaine and other issues)issues)
Ibogaine UndergroundIbogaine Underground
Example of Activists’ tactics to draw Example of Activists’ tactics to draw government and media attention to promote government and media attention to promote
Ibogaine researchIbogaine research
Treatment provider’s sleeping quarters at an apartment in Rotterdam where many treatments took place
Always seek local support - like here Always seek local support - like here
from the squatters community NL.from the squatters community NL.
““typical” hang out in typical” hang out in Amsterdam Amsterdam
The Ibogaine medicalization movement is part of the progressive harm reduction and addict’s human rights movement (New York,
1992 demonstrating against mandatory minimum sentences)
Typical closed circuit monitors used during Ibogaine Typical closed circuit monitors used during Ibogaine treatmentstreatments
The late professor of Psychiatry Yan Baastians – the first doctor to observe and conduct Ibogaine treatments with Howard Lotsof (Lieden, Holland 1991)
The Journal of the American Medical Association VolThe Journal of the American Medical Association Vol. . 288 No288 No. . 24, pp24, pp. . 3096-3096-3101, December 25, 20023101, December 25, 2002
© 2002 © 2002 American Medical AssociationAmerican Medical Association. . All rights reservedAll rights reserved
Addiction Treatment Strives for Legitimacyby Brian Vastag
New York -- Some drugs are made in laboratories. Others, like penicillin, are discovered by accident. And then there's ibogaine, a sacramental substance from West Africa that some say interrupts heroin, cocaine, and other addictions. Over the past 40 years, the tale of ibogaine's flirtation with legitimacy boasts more twists than the roots of Tabernanthe iboga,
the shrublike source of ibogaine .After riding the backpacks of Westerners to the radical 1960s New York City underground, ibogaine rose from a counterculture star to a serious project funded by the National Institutes of Health (NIH). In 1995, after spending several million dollars on laboratory and animal studies, the NIH decided not to pursue ibogaine development. Since then, patent disputes have divided the drug's champions; a growing network of informal clinics has sprung up; and pharmacologists have discovered that ibogaine works
on the brain in a manner unlike that of any other known drug
282 papers (pre-clinical, clinical, anecdotal etc.) published to-date on Ibogaine, it’s analogs and other Alkaloids in the plant, as found at the US National Library of Medicine (Pubmed)
Ibogaine Treatment Providers (Medical, Ibogaine Treatment Providers (Medical, non medical and psychological non medical and psychological
sessions)sessions)
5 in UK5 in UK 4 in France, 2 in Germany4 in France, 2 in Germany 5 in Africa (2 in South Africa)5 in Africa (2 in South Africa) 7 more in Europe – 2 in Holland (one with 7 more in Europe – 2 in Holland (one with
extract), Slovenia,extract), Slovenia, 2 in Canada, 3 – Mexico, 1 – Bahamas,2 in Canada, 3 – Mexico, 1 – Bahamas, 1 Brazil, 1 Ecuador, 1 Pakistan, 2 Thailand1 Brazil, 1 Ecuador, 1 Pakistan, 2 Thailand 2 Australia, 1 New Zealand2 Australia, 1 New Zealand Few underground treatments in the USA Few underground treatments in the USA
and in many more countries and in many more countries
Conclusions: Opioid withdrawal is the most common reason for which individuals took ibogaine. The focus on opioid withdrawal in the ibogaine subculture distinguishes ibogaine from other agents commonly termed “psychedelics”, and is consistent with experimental research and case series evidence indicating a significant pharmacologically mediated effect of ibogaine in opioid withdrawal.
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The purpose of this document is to provide information. Treatment providers and patients are solely responsible for their actions.
Manual for Ibogaine TherapyScreening, Safety, Monitoring & Aftercare
Second Revision
byHoward S. Lotsof & Boaz Wachtel
Contributing Authors Marc Emery, Geerte Frenken, Sara Glatt
Brian Mariano, Karl Naeher Martin Polanko, Marko Resinovic
Nick Sandberg, Eric Taub Samuel Waizmann, Hattie Wells
© 2003
Intake ProcedureIntake Procedure
many individuals have been doing detox many individuals have been doing detox work work not accordingnot according to the standard of to the standard of modern medicine and security measures.modern medicine and security measures.
Interview – Personal and Medical history, GP report.Interview – Personal and Medical history, GP report. Find out level of self motivation (not family’s or Find out level of self motivation (not family’s or
partner’s motivation), drug use and past partner’s motivation), drug use and past treatments.treatments.
A minimum of ECG under stress, A minimum of ECG under stress, A clinical chemistry panel (chem 25) a complete A clinical chemistry panel (chem 25) a complete
blood count with differential platelets (CBC),blood count with differential platelets (CBC), HIV blood screen, HIV blood screen, liver count liver count
Necessary equipment for Necessary equipment for medical & non clinical settingsmedical & non clinical settings
DefibrillatorDefibrillator EKG monitorEKG monitor ResuscitatorResuscitator StretcherStretcher First Aid KitFirst Aid Kit Doctor’s case # 1& 2 (if doc present)Doctor’s case # 1& 2 (if doc present) TelephonesTelephones Car with room for laying downCar with room for laying down
Subjective EffectsSubjective Effects
AcuteAcute :: The onset of this phase is within 1 to 3 hours The onset of this phase is within 1 to 3 hours
of ingestion with a duration of 4 to 8 hoursof ingestion with a duration of 4 to 8 hours The predominant reported experiences The predominant reported experiences
appear to be a panoramic readout of long-appear to be a panoramic readout of long-term memory (“visit to the ancestors, term memory (“visit to the ancestors, archetype”)archetype”)
““Oneiric experience”Oneiric experience”
Subjective EffectsSubjective Effects
Evaluative or visualizationEvaluative or visualization:: Onset after 4 to 8 hours after ingestion with a Onset after 4 to 8 hours after ingestion with a
duration of 8 to 20 hoursduration of 8 to 20 hours The volume of material recalled slowsThe volume of material recalled slows Attention is still focused on inner subjective Attention is still focused on inner subjective
experience rather than external environment.experience rather than external environment. Patients are easily distracted and annoyed Patients are easily distracted and annoyed
and prefer little environmental stimulationand prefer little environmental stimulation
Subjective EffectsSubjective Effects
Residual stimulationResidual stimulation The onset of this phase is approximately 12 The onset of this phase is approximately 12
to 24 hours after ingestion with a duration to 24 hours after ingestion with a duration in the range of 24 to 72 hours. in the range of 24 to 72 hours.
Allocation of attention to the external Allocation of attention to the external environmentenvironment
Less subjective psychoactive experienceLess subjective psychoactive experience Mild residual subjective arousal or vigilanceMild residual subjective arousal or vigilance Some patients report reduced need for Some patients report reduced need for
sleep for several days to weekssleep for several days to weeks
Frequent but temporary side Frequent but temporary side effects of Ibogaineeffects of Ibogaine
Coordination disturbances Coordination disturbances (unstable gait and tendency to (unstable gait and tendency to fall)fall)
Hallucinations-like experiences Hallucinations-like experiences Sleep disturbancesSleep disturbances Concentration and speech Concentration and speech
troublestroubles Heart rate and blood pressure Heart rate and blood pressure
changeschanges Nausea and vomitingNausea and vomiting Dizziness Dizziness Light sensitivityLight sensitivity TirednessTiredness Muscles sorenessMuscles soreness
Pharmaco-dynamics and Therapeutic Pharmaco-dynamics and Therapeutic Applications of Iboga and IbogaineApplications of Iboga and Ibogaine
By Robert Goutarel, Honorary Research DirectorBy Robert Goutarel, Honorary Research Director; ; Otto Gollnhofer and Roger Sillans, Ethnologists, COtto Gollnhofer and Roger Sillans, Ethnologists, C..NN..RR..SS. .
((French National Scientific Research CenterFrench National Scientific Research Center) ) ((Translated from French by William JTranslated from French by William J. . GladstoneGladstone))
Psychedelic Monographs and Essays, Volume 6:70-111, 1993Psychedelic Monographs and Essays, Volume 6:70-111, 1993
““The women take iboga in smaller quantities than The women take iboga in smaller quantities than the ones taken in the Bwiti initiationthe ones taken in the Bwiti initiation. . In their In their case, the visions do not go beyond the third case, the visions do not go beyond the third ((FreudianFreudian) ) stage during which genies, good or stage during which genies, good or evil, communicate to the women that they are in evil, communicate to the women that they are in possession of the causes of the affliction or illness possession of the causes of the affliction or illness for which they were consulted”for which they were consulted”
Drug Self-AdministrationDrug Self-Administration
Reduction in morphine, heroine, cocaine, alcohol and Reduction in morphine, heroine, cocaine, alcohol and nicotine self-administration.nicotine self-administration.
The effects are apparently persistent (five days in rats) but The effects are apparently persistent (five days in rats) but water intake stopped just for a day.water intake stopped just for a day.
The resultsThe results improved with repeated treatments.improved with repeated treatments. Noribogaine has also been reported to reduce |Morphine, Noribogaine has also been reported to reduce |Morphine,
Cocaine and Heroine self administration. Cocaine and Heroine self administration. Some of the Iboga alkaloids tested produce tremors.Some of the Iboga alkaloids tested produce tremors. 18-MC reduces drugs intake but not water intake.18-MC reduces drugs intake but not water intake.
•The results suggest that Ibogaine provided a safe and effective treatment for withdrawal from heroin and methadone.
•These preliminary results demonstrate that single doses of Ibogaine were well tolerated in drug-dependent subjects.
•Our observations of the safety of Ibogaine have not been limited to opiate-dependent subjects.
•To date, we have evaluated ibogaine’s safety in more than 150 drug-dependent subjects that were assigned to one of three fixed-dose treatments under open label conditions; 8, 10, 12, mg/kg Ibogaine.
•To date, no significant adverse events were seen under these study conditions.
Ibogaine in the treatment of heroin withdrawal
Mash DC, Kovera CA, Pablo J, Tyndale R, Ervin FR, Kamlet JD, Hearn WL.Departments of Neurology and Pharmacology, University of Miami Schoolof Medicine, Miami, FL 33124, USA
Objective Opiate Withdrawal Signs and Ibogaine Signs: Human ObservationsObjective Opiate Withdrawal Signs and Ibogaine Signs: Human Observations
SignsSignsOpiate WithdrawalOpiate WithdrawalIbogaineIbogaine Ibogaine + OpiatesIbogaine + Opiates
Diarrhea Diarrhea
Yawning Yawning
Rinorrhea Rinorrhea
Piloerection Piloerection
Lacrimation Lacrimation
Mydriasis Mydriasis
Shivering Shivering
Restlessness Restlessness
Vomiting Vomiting
Muscle Twitches Muscle Twitches
Abdominal Cramps Abdominal Cramps
Sweating Sweating
Anxiety Anxiety
SleeplessnessSleeplessness
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Chronic Chronic
Yes Yes
Yes Yes
Yes Yes
Yes Yes
Yes Yes
No No
Rare Rare
No No
No No
No No
No No
No No
Post 20 Hrs ibogaine Post 20 Hrs ibogaine
Acutre/motion related Acutre/motion related
No No
No No
No No
No No
Yes Yes
* * 3%3% - - 12%12% , ,66 days post days post
Rare Rare
No No
No No
No No
5% (moderate) 5% (moderate)
No No
Post 20 Hrs ibogaine Post 20 Hrs ibogaine
Acutre/motion related Acutre/motion related
No No
No No
*16% - 25% *16% - 25%
3% 3%
Yes Yes
It appears that the most effective It appears that the most effective treatment involvestreatment involves::
1. Visionary doses of Ibogaine (that produce an 1. Visionary doses of Ibogaine (that produce an interruption of interruption of opiateopiate cravings and appetite), cravings and appetite),
2. Intensive counseling + therapy during the 2. Intensive counseling + therapy during the interruption period.interruption period.
3. maintainig a healthy life style and occupation 3. maintainig a healthy life style and occupation
Few patients require a second or third session Few patients require a second or third session over the course of the next 12 to 18 months to over the course of the next 12 to 18 months to completely rid themselves of opiate addiction. completely rid themselves of opiate addiction.
A minority of patients relapse back into A minority of patients relapse back into opiateopiate addiction.addiction.
Howard Lotsof and Norma Alexander Lotsof near the FDA Building in Maryland, 1992
First scientific publication of ibogaine First scientific publication of ibogaine antiaddictive effectsantiaddictive effects
Ibogaine effects on cocaineIbogaine effects on cocaine
A key paper relating to ibogaine effects on opioid A key paper relating to ibogaine effects on opioid
narcotics.narcotics.
Ibogaine effects on alcoholIbogaine effects on alcohol
Why ibogaine is not availableWhy ibogaine is not available
1. Industry deems ibogaine not to be profitable (single administration modality)
2. The molecule is found in nature and cannot be owned
3. Stigmatized patient population with liability higher than general population.
4. Government, industry and academia chose to place their interest to treat narcotic dependence in the development of opiate drugs with which they are familiar.
5. Ibogaine represents a new scientific paradigm to the understanding of addiction.
6. Lack of prioritization of pharmacotherapies.
7. Intellectual conformity.
Harm reduction (HR) policy is de signed to reduce the private and socialcost of illegal drug use within the frame work of existing law. It is distinct fromdecriminalization or legalization, whichwould require de jure or de facto changesin national and international law. HR pol icy also differs from coercive demand andsupply-side policies, which indirectly aimto reduce drug damage by suppressing illegal markets.
.
Harm Reduction, Rational Addiction and the Optimal Prescribing of Illegal Drugs, Journal article by Richard
Stevenson; Contemporary Economic Policy, Vol. 12, 1994
HR policy tackles public health issues directly by seeking to improve the welfareof individual users. Many strategies havebeen proposed, but the principal ingredients of most programs are educational and advisory services, syringe exchanges, treatment and maintenance services. Some programs also employ outreach workers to contact drug users most at risk from HIV infection and other health hazards
Something to think about for UN Something to think about for UN PeoplePeople
Even by itself, a millennium of sacramental Even by itself, a millennium of sacramental indigenous use of Ibogaine in Africa is a sound indigenous use of Ibogaine in Africa is a sound enough foundation to approve the use of enough foundation to approve the use of Ibogaine in the west. Ibogaine in the west.
It certainly strengthens the safety and efficacy It certainly strengthens the safety and efficacy claims made by its proponents and users of claims made by its proponents and users of Ibogaine in the west. That is true for other Ibogaine in the west. That is true for other sacraments as well. sacraments as well.
The evidence of the therapeutic effects of The evidence of the therapeutic effects of Ibogaine for socio/medical improvements across Ibogaine for socio/medical improvements across few cultures is therefore well established by few cultures is therefore well established by now and supported with data obtained from now and supported with data obtained from thousands of addiction treatments + unbiased thousands of addiction treatments + unbiased scientific work across the globe.scientific work across the globe.
Ibogaine related research stands out in Ibogaine related research stands out in entheogens' history because its efficacy, entheogens' history because its efficacy, especially for the anti addiction indications, has especially for the anti addiction indications, has been scientifically measured both in animals been scientifically measured both in animals and humansand humans..
••Historically speaking, all the might and Historically speaking, all the might and "services" offered by Colonialist missionaries in "services" offered by Colonialist missionaries in western Africa were not sufficient to conquer western Africa were not sufficient to conquer the place at heart that Ibogaine won, the place at heart that Ibogaine won, throughout centuries, among the Bwiti Iboga throughout centuries, among the Bwiti Iboga worshipers of a holy 'tree of life', a key for worshipers of a holy 'tree of life', a key for harmony with nature, one self, and for harmony with nature, one self, and for communicating with their ancestors.communicating with their ancestors.
Therefore: Outlawing the sacramental use of Therefore: Outlawing the sacramental use of foreign entheogens for adults by any society is foreign entheogens for adults by any society is an act of cultural ignorance and racial an act of cultural ignorance and racial supremacy of the highest order. The FDA is a supremacy of the highest order. The FDA is a barrier that popular sacramental medicines, barrier that popular sacramental medicines, including Ibo and medical cannabis, can not including Ibo and medical cannabis, can not cross due to issues of patents, legal status and cross due to issues of patents, legal status and money. money.
•• Denying people legal access to entheogens can Denying people legal access to entheogens can be explained, maybe, with the desire of be explained, maybe, with the desire of governments to monopolize the consciousness governments to monopolize the consciousness of people so behavior of the masses can be of people so behavior of the masses can be predicted under conditions of controlpredicted under conditions of control. .
••
Freeing the mind and spirit from government/media dictated Freeing the mind and spirit from government/media dictated consciousness and fighting human rights abuse in the consciousness and fighting human rights abuse in the name of “war on drugs” and FDA rules is the task at hand. name of “war on drugs” and FDA rules is the task at hand.
Monotheistic, abstinence base religions, suppress Monotheistic, abstinence base religions, suppress competition with holy plant based religions. The strength competition with holy plant based religions. The strength of abstinence based opposition to plant based faiths of abstinence based opposition to plant based faiths negatively influence the will of western governments and negatively influence the will of western governments and UN drug conventions to support use of sacred plants and UN drug conventions to support use of sacred plants and associated science. associated science.
Entheogens, or plant teachers, promote independent Entheogens, or plant teachers, promote independent thinking, communal awakening as well as the preservation thinking, communal awakening as well as the preservation of personal health and that of nature. of personal health and that of nature.
These traits directly conflict with economic forces benefiting These traits directly conflict with economic forces benefiting from western government's love affair with the abstinence from western government's love affair with the abstinence based belief systems, taxes from legal drugs, endless based belief systems, taxes from legal drugs, endless industrial growth models and the horrendous feeding of industrial growth models and the horrendous feeding of the monster called the prison/industrial complexthe monster called the prison/industrial complex. .
Thank youThank you
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