Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes.

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.

In the evidence

This study is part of the evidence base for 2 syntheses in the library. Here is how each one recorded it.

• State of the evidence: Ibogaine for addiction ↑Supports

  Ibogaine treatment reduced opioid withdrawal scores and was associated with improved drug use, legal, and family/social outcomes over 12 months, with 50% reporting no opioid use at one month.

  Synthesized October 22, 2026

• State of the evidence: Ibogaine ↑Supports

  Ibogaine treatment (mean total dose 1,540 ± 920 mg HCl) reduced SOWS withdrawal scores from 31.0 to 14.0 posttreatment, with 50% reporting no opioid use at 1 month and improved Addiction Severity Index Drug Use, Legal, and Family/Social scores sustained to 12 months.

  Synthesized September 20, 2026

Comparable studies

Other observational and cohort studies on ibogaine for addiction, most cited first.