Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes.
Thomas Kingsley Brown, Kenneth Alper
The American Journal of Drug and Alcohol Abuse 2018 DOI: 10.1080/00952990.2017.1320802 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study Peer reviewed |
|---|---|
| Sample size | 30 |
| Population | Adults with DSM-IV opioid dependence |
| Intervention | Ibogaine HCl |
| Dose | mean total dose of 1,540 ± 920 mg ibogaine HCl |
| Duration | Detoxification and follow-up at 1, 3, 6, 9, and 12 months |
| Topics | Addiction Ibogaine |
| Keywords | 18-methoxycoronaridine Oxycodone Ibogaine therapy Plant alkaloid Heroin addiction Prescription opioid addiction Addiction recovery Withdrawal symptoms Drug use improvements Social well-being improvements Path to recovery |
| Citations | 156 |
| Key findings | Ibogaine treatment was associated with a significant reduction in opioid withdrawal symptoms and sustained improvements in drug use, legal, and social outcomes over 12 months. |
Abstract
Ibogaine is a monoterpene indole alkaloid used in medical and nonmedical settings for the treatment of opioid use disorder. Its mechanism of action is apparently novel. There are no published prospective studies of drug use outcomes with ibogaine. To study outcomes following opioid detoxification with ibogaine. In this observational study, 30 subjects with DSM-IV Opioid Dependence (25 males, 5 females) received a mean total dose of 1,540 ± 920 mg ibogaine HCl. Subjects used oxycodone (n = 21; 70%) and/or heroin (n = 18; 60%) in respective amounts of 250 ± 180 mg/day and 1.3 ± 0.94 g/day, and averaged 3.1 ± 2.6 previous episodes of treatment for opioid dependence. Detoxification and follow-up outcomes at 1, 3, 6, 9, and 12 months were evaluated utilizing the Subjective Opioid Withdrawal Scale (SOWS) and Addiction Severity Index Composite (ASIC) scores, respectively. SOWS scores decreased from 31.0 ± 11.6 pretreatment to 14.0 ± 9.8 at 76.5 ± 30 hours posttreatment (t = 7.07, df = 26, p < 0.001). At 1-month posttreatment follow-up, 15 subjects (50%) reported no opioid use during the previous 30 days. ASIC Drug Use and Legal and Family/Social Status scores were improved relative to pretreatment baseline at all posttreatment time points (p < .001). Improvement in Drug Use scores was maximal at 1 month, and subsequently sustained from 3 to 12 months at levels that did not reach equivalence to the effect at 1 month. Ibogaine was associated with substantive effects on opioid withdrawal symptoms and drug use in subjects for whom other treatments had been unsuccessful, and may provide a useful prototype for discovery and development of innovative pharmacotherapy of addiction.