Psychoactive plant derivatives (ayahuasca, ibogaine, kratom) and their application in opioid withdrawal and use disorder - a narrative review.
Alexandra Arenson, Cynthia I Campbell, Ilan Remler
Journal of Addictive Diseases 2024 DOI: 10.1080/10550887.2023.2195777 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Narrative review Longitudinal Peer reviewed |
|---|---|
| Interventions | Ayahuasca Ibogaine Kratom |
| Topics | Addiction Ayahuasca Ibogaine Psychedelic-assisted therapy |
| Keywords | Opioid withdrawal Kratom Opioid addiction treatment Plant medicine Natural remedies Alternative therapy |
| Citations | 8 |
| Key findings | Ayahuasca, ibogaine, and kratom may have efficacy in treating opioid withdrawal and opioid use disorder through pharmacodynamic effects, rituals, and neuroplasticity, but evidence is limited to small observational and animal studies. |
Abstract
The opioid epidemic and limited access to treatment for opioid withdrawal (OW) and opioid use disorder (OUD) has led individuals to seek alternative treatments. This narrative review aims to educate clinicians on the mechanisms of action, toxicity, and applications of psychoactive plant-based substances patients may be using to self-treat OUD and OW. We specifically discuss ayahuasca, ibogaine, and kratom as they have the most evidence for applications in OUD and OW from the last decade (2012-2022). Evidence suggests these substances may have efficacy in treating OW and OUD through several therapeutic mechanisms including their unique pharmacodynamic effects, rituals performed around ingestion, and increased neuroplasticity. The current evidence for their therapeutic application in OUD and OW is primarily based on small observational studies or animal studies. High-quality, longitudinal studies are needed to clarify safety and efficacy of these substances in treatment of OW and OUD.