THE ENCOD BULLETIN ON DRUG POLICIES IN EUROPE
The European Ibogaine Forum took place in Vienna on September 8-10th 2017. The conference brought together many of the world’s leading clinicians, medical researchers, policy experts, and individuals experienced with ibogaine’s therapeutic benefits and cultural background. The forum was a non-profit event, organized and hosted by Entheo Science, and designed to complement the important work of ICEERS and GITA with raising awareness of ibogaine worldwide.
picture: All of Us!
Ibogaine is a naturally occurring psychoactive indole alkaloid derived from the roots of the African rain forest shrub Tabernanthe iboga. It is traditionally used by indigenous peoples of Western Africa (the Bwiti) in low doses to combat fatigue, hunger and thirst, and in higher doses as a sacrament in spiritual initiation ceremonies. The genesis of utilizing ibogaine to interrupt drug-dependence disorders began in 1962 with the anecdotal observations of Howard Lotsof who made the remarkable discovery that after a single ibogaine trip, his heroin addiction had been eradicated.
Unlike most entheogens – wherein the end-result tends to have a lot more to do with set, setting, and intent, rather than any specific mechanism of action brought about by the molecule itself – ibogaine can be fatal. Ibogaine is not suitable for all individuals. There can be a relatively narrow margin between what constitutes an effective, therapeutic dose, and a lethal one. Ibogaine potentiates other molecules. Despite decades of medical research and hundreds of monographs appearing in peer-reviewed medical journals, as of 2017 we still don’t understand exactly how it works or what the primary mechanism of action is. Ibogaine is unlike any other drug that has been discovered to date, it’s an extremely “dirty” molecule that affects pretty much every neurotransmitter system that we know about and directly and indirectly interacts with a wide spectrum of targets within the CNS.
Drug dependence results from interrelated neuroadaptations which underlie tolerance, sensitization, and withdrawal. Ibogaine is NOT a “cure” for drug addiction. It will not fix everything that’s wrong with your life, and somehow make it different. It does not work for everyone, and it can take multiple doses of ibogaine for even a highly motivated individual to break out of their cycle of drug dependence.
Having said all of the above, ibogaine is significantly more effective at interrupting substance abuse disorders and providing a complete reset, than anything else that presently exists. While many molecules can provide you with a perspective shift regarding whatever your situation happens to be, there are very few medications that have any efficacy whatsoever for stimulant abuse, and there is nothing else which has yet been discovered that can completely eradicate opioid dependence overnight.
When I was first treated with ibogaine during the 1990s by Dr. Deborah C. Mash, it was at the tail-end of 16 years of heroin use, and a decade+ of polysubstance abuse (speedballs). I was a “high functioning” addict and had access to significant resources throughout much of my addiction, by the time I did ibogaine, I had been through pretty much every available detox on the planet, ranging from UROD (Ultra Rapid Opiate Detox), Dr. Richard Resnick’s “black box” (NeuroElectric Therapy), methadone, Buprinex, tapering down using clonidine and Valium, the home version of UROD (naltrexone with a handful of Xanax and clonidine tossed into the mix), and of course the various unplanned detox’s in hotel rooms with Bacardi 151 and whatever I could get my hands on at the time. All of these attempts failed to produce any lasting results.
Upon actual administration of ibogaine, the entire process of withdrawal is over within about an hour. “Withdrawal” itself, is something of a misnomer, there is nothing except a sensation of heat in your solar plexus, which dissipates rapidly. It is unlike anything else I have ever experienced.
On a physical level what occurs amounts to a miracle – as far as opiate addiction is concerned – your habit is simply non-existent, your brain and body rebooted, and you are reset back to a pre-addictive modality. The only physical symptoms afterwards are a lack of energy, and occasional insomnia.
The apparent long-term ability of ibogaine to address a variety of these changes after single dose administration is thought to be due in part to its long-acting metabolite noribogaine. Unlike ibogaine which is cleared from the blood relatively rapidly, noribogaine remains in the system for a period of time ranging from weeks, to several months. This provides people with a window of opportunity during which they have the chance to establish or re-establish patterns of behavior which are conducive to maintaining a addiction-free existence.
In retrospect I can honestly say that without ibogaine it is extremely unlikely I would have ever gotten clean and stayed that way.
Medicalization of Ibogaine
Despite the renaissance of psychedelic research happening worldwide, the treatment for opioid addiction has seen remarkably little change in the last century, and we have, essentially, nothing that’s effective for stimulant abuse. Big Pharma has contributed significantly to first causing the opioid epidemic that has engulfed entire countries (to the point where as of 2017, the leading cause of death for Americans under the age of 50, is OD’ing on opioids) and then successfully monetizing a wider spectrum of maintenance medications which simply substitute one highly addictive molecule, with another equally — or more — addictive drug, that happens to be legal (Subutex and Suboxone). While America is at the heart of the opioid epidemic, its effects are being felt worldwide. In many countries throughout the world, opioid addiction and overdose deaths are at an all time high.
A strong running theme throughout the Vienna Ibogaine Conference was the medicalization of ibogaine. In most of the world ibogaine falls within the category of being an unregulated, experimental molecule. Unfortunately, as years go by, the ibogaine world is gradually getting smaller and smaller, as its use gets banned, country by country. At the present time ibogaine is illegal to possess or use within the United States, Belgium, Denmark, France, Hungary, Ireland, Switzerland, and Sweden. The most recent additions to the list of countries to join in banning ibogaine are the UK and Italy. Health Canada recently responded to multiple ibogaine-related incidents by making ibogaine a prescription medication in Canada.
While the individuals who work with ibogaine worldwide utilize a wide variety of paradigms and cultural contexts for providing ibogaine treatment, and many are averse to Western-style medicine and the entire medical establishment as a whole; the reality is, unless there is some sort of unified effort to work within the existing regulatory frameworks of countries where ibogaine use is presently legal, and do whatever is necessary to initiate clinical trials and support ibogaine research … then country by country, the ibogaine world will continue shrinking, and ibogaine treatment will be driven underground. This represents a tremendous and preventable loss for humanity as a whole.
Pivotal presentations on the topic of Medicalization for Ibogaine included:
Dr. Rick Doblin of MAPS, whose tireless and near-superhuman efforts at navigating the vast ocean of red-tape within the United States have resulted in successfully medicalizing MDMA.
Benjamin De Loenen, a talented film-maker and creator of the documentary Ibogaine: Rite of Passage, who then went on to become the founder and Executive Director of ICEERS, presented on Pathways to Ibogaine Regulation & Sustainability.
picture: left to right- Benjamin De Loenen and Dr. Anwar Jeewa
Bruno Rassmussen Chaves, M.D., who has treated over 1,000 patients with ibogaine in Brazil since 1994, primarily for stimulant abuse (cocaine and methamphetamine), shared his experiences providing legal ibogaine treatments in a medically-supervised environment. Bruno also touched upon Treating drug dependence with the aid of ibogaine: a qualitative study, a monograph that was published in 2016, which highlighted the fact that even individuals who relapsed and returned to drug use post-ibogaine treatment, experienced improved quality of life with significant harm reduction having occurred.
Kenneth R. Alper, M.D., an Associate Professor of Psychiatry and Neurology at New York University’s School of Medicine who is an author of over 70 peer-reviewed publications, books and book chapters, has spent decades publishing multidisciplinary monographs spanning neuropharmacology, toxicology and the medical ethnography of ibogaine, including a foundational paper published in the Journal of Ethnopharmacology that combined qualitative and quantitative methods to provide a comprehensive overview on the global use of ibogaine The ibogaine medical subculture. Ken presented an exceptional talk about his current findings and thoughts regarding ibogaine’s mechanism of action.
picture: Jeffrey D. Kamlet, MD
Additional highlights included: Dr. Jeffrey D. Kamlet’s presentation: From Womb to Tomb, which spanned a myriad spectrum of topics beginning with the Big Picture and narrowing down to focus on best practices for clinicians engaged in ibogaine treatment. Jeff was one of the primary MDs from Dr. Deborah Mash’s Healing Visions clinic in St. Kitts, he is recognized as one of the leading experts on safety in medically-supervised ibogaine treatment. He is a fellow of the American Society of Addiction Medicine, and has twice served as President of the Florida Society of Addiction Medicine.
Dr. Thomas Kingsley Brown gave a talk focusing on the recent publication of an observational study he co-authored with Kenneth Alper M.D.; Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes.
ENCOD’s Maja Kohek presented data from her collaborate work with ICEERS and other ibogaine researchers. The ibogaine experience: A qualitative study on the acute subjective effects of ibogaine, details the overall experience and points of commonality between 20 subjects who were dosed with ibogaine.
picture: Patrick Kroupa
Hattie Wells from The Beckley Foundation and I, gave a presentation which focused on our mutual work during the early 2000s and touched upon the first paper ever published on the growing topic of ibogaine microdosing.
Clare Wilkins, Dr. Anwar Jeewa, and Dr. José Carlos Bouso, also gave presentations which featured, or touched upon, ibogaine microdosing and presented a wide spectrum of variations for successful ibogaine detox treatment strategies.
picture: left to right- Dana Beal, Udi Bastiaans, Norma Alexander-Lotsof, and Paul Featherstone
Luminaries of the ibogaine world who were present included Norma Alexander-Lotsof, Howard Lotsof’s wife and collaborator; the legendary and indomitable Dana Beal, author of: The Ibogaine Story: the Staten Island Project, co-organizer of the first International Ibogaine conference at NYU in 1999, and organizer of annual ibogaine conferences that took place within the United States from 2003-2010 (among many other foundational contributions to the ibogaine movement); Boaz Wachtel, who was an ibogaine treatment provider from 1989 to 2009 and co-authored the first ibogaine treatment manual (with Howard Lotsof); and Dr. Udi Bastiaans who is the grandson of Jan Bastiaans, the first medical doctor that treated opioid addicts with the help of ibogaine, working with Howard Lotsof, his wife Norma, Bob Sisko and Boaz Wachtel.
The Vienna conference was extensive, featuring an opening night round-table on the future of ibogaine, three full days of presentations, followed by an open meeting focused on the GITA reboot. The full list of speakers who showed up from all over the world to share their experience, can be found here.
The European Ibogaine Conference was co-sponsored by ENCOD and made possible thanks to the personal efforts of: Joe Schraube, Tobias Enry, Jeremy Weate, and Dana Beal.
Videos of many conference presentations are available on Entheo Science’s YouTube channel, with more being added as they’re edited and released online. All images are used by permission, and © 2017, Jeremy Weate.
Patrick K. Kroupa