Treatment of Acute Opioid Withdrawal with Ibogaine

Summary & key facts

This report describes 33 open-label treatments with the alkaloid ibogaine given for acute heroin withdrawal in non-medical settings. In 25 of the 33 people, visible signs of opioid withdrawal stopped within 24 hours and stayed absent during 72 hours of observation. The authors note the results are from uncontrolled, non-clinical cases and say systematic clinical research is needed.

Key facts:

• The report summarizes 33 cases of ibogaine used for opioid detoxification under open-label conditions in non-medical settings.
• Average reported daily heroin use among the patients was 0.64 grams (± 0.50 g), and most used heroin by intravenous injection.
• In 25 out of 33 patients, signs of opioid withdrawal resolved within 24 hours and remained resolved during a 72-hour posttreatment observation period.
• Other outcomes included: 4 patients with drug-seeking behavior but no withdrawal signs; 2 patients who were abstinent with reduced (attenuated) withdrawal signs; and 1 patient with drug-seeking behavior plus continued withdrawal signs.
• There was one death reported in the series; the authors state it possibly involved surreptitious (hidden) heroin use rather than being definitively linked to ibogaine.
• The study was uncontrolled, open-label, and conducted outside standard clinical research settings; the authors say these limitations mean the findings need confirmation in systematic clinical trials.

Abstract

Ibogaine is an alkaloid with putative effect in acute opioid withdrawal. Thirty-three cases of treatments for the indication of opioid detoxification performed in non-medical settings under open label conditions are summarized involving an average daily use of heroin of .64 +/- .50 grams, primarily by the intravenous route. Resolution of the signs of opioid withdrawal without further drug seeking behavior was observed within 24 hours in 25 patients and was sustained throughout the 72-hour period of posttreatment observation. Other outcomes included drug seeking behavior without withdrawal signs (4 patients), drug abstinence with attenuated withdrawal signs (2 patients), drug seeking behavior with continued withdrawal signs (1 patient), and one fatality possibly involving surreptitious heroin use. The reported effectiveness of ibogaine in this series suggests the need for systematic investigation in a conventional clinical research setting.

Topics

Forensic Toxicology and Drug Analysis Neurotransmitter Receptor Influence on Behavior Opioid Use Disorder Treatment

Categories

Cellular and Molecular Neuroscience Life Sciences Neuroscience

Tags

Abstinence Alternative medicine Anesthesia Detoxification (alternative medicine) Drug Drug withdrawal Heroin Internal medicine Medicine Morphine Opioid Pathology Pharmacology Psychiatry Receptor