Ibogaine, a psychoactive indole alkaloid found in the West African shrub Tabernanthe iboga, has gained recognition for its potential in treating substance use disorders (SUDs). It has a historical background in Western medicine, initially used as a neuromuscular stimulant and later for its unique properties in attenuating cravings and withdrawal symptoms in addiction cases.
The scientific research on ibogaine provides insights into its potential effectiveness and safety concerns in treating drug dependence. Here are key findings from various studies:
- Efficacy in Treating Drug Dependence: A retrospective study in Brazil found that ibogaine treatment, combined with psychotherapy, led to abstinence in 61% of participants, with no serious adverse reactions or fatalities reported. Those treated multiple times showed a statistically significant increase in abstinence duration compared to single treatments (Schenberg et al., 2014).
- Animal Model Efficacy: A systematic review and meta-analysis of animal studies concluded that ibogaine reduced drug self-administration, especially within the first 24 hours after administration. However, it also caused motor impairment and cerebral cell loss (Belgers et al., 2016).
- Transitioning to Sobriety: Clinical observations and treatment outcomes suggest that ibogaine may effectively transition opioid and cocaine-dependent individuals to sobriety. This conclusion is based on public testimonials and preclinical studies, although rigorous validation in humans is needed (Mash et al., 2018).
- Potential Safety Concerns: The relationship between ibogaine and heart health is delicate, with alarming reports of life-threatening complications and sudden deaths associated with its use. These adverse reactions are thought to be linked to ibogaine’s tendency to induce cardiac arrhythmias (Koenig & Hilber, 2015).
- Cardiac Risks and Safety in Detoxification: A descriptive open-label observational study on the safety of ibogaine in opioid-dependent individuals showed clinically relevant but reversible QTc prolongation, bradycardia, and severe ataxia. This highlights the importance of close monitoring during treatment (Knuijver et al., 2021).
- Systematic Review of Ibogaine/Noribogaine: A systematic review assessing the role of ibogaine and noribogaine in treating substance use disorders (SUD) highlighted some efficacy but also raised concerns about cardiotoxicity and mortality, underscoring the need for further research to evaluate their therapeutic efficacy and safety (Mosca et al., 2022)
The New Zealand Experience
In New Zealand, Ibogaine has been a subject of significant interest, especially after legislative changes in 2010 that allowed its prescription as a non-approved medicine for therapeutic use. The New Zealand model of Ibogaine treatment involves comprehensive assessment, the development of a treatment plan, and post-treatment support, emphasizing the importance of aftercare and continued counselling.
Ibogaine in Australia
Ibogaine has been subject to quite a few critical new stories in Australia due to its potential for cardiotoxicity however, looking at the science, relative to methadone (a popular treatment for opioid addiction) it has a much better mortality rate profile. As such Ibogaine is classified as a Schedule 4 substance on the Therapeutic Goods Administration poisons list in Australia. This classification makes it a prescription-only medicine. However, it’s important to note that Ibogaine is not a controlled substance under Australian state and federal laws.
