Exploring Ibogaine’s Potential in the Treatment of Addiction

1. Exploring Ibogaine’s Potential in the Treatment of Addiction Multidisciplinary Association for Psychedelic Studies (MAPS) www.maps.org Presented by: Valerie Mojeiko

2. Tabernanthe Iboga Ibogaine Outcome Study, V. Mojeiko

3. …Originally used by the Bwiti… Shaman --> <--His Wife Ibogaine Outcome Study, V. Mojeiko

4. …in Rite of Passage Rituals… Bwiti people participating a ritual Ibogaine Outcome Study, V. Mojeiko

5. …until Howard Lotsof… …Serendipitously discovered ibogaine’s ability to reduce or eliminate withdrawal symptoms from opiates… …and found a place for ibogaine in Western culture. Ibogaine Outcome Study, V. Mojeiko

6. Psychedelics and Addiction(where this fits in) …Stan Grof, Bill Richards, Walter Pahnke, and others published research using LSD to treat alcoholics and heroin addicts… In the 1970s… …With promising results. Learned: Multiple sessions may be more effective than single-dose administration Ibogaine Outcome Study, V. Mojeiko

7. Ibogaine’s Effects Psychedelic Unpleasant for many (not recreational) Produces a DREAMLIKE state VERY Long-lasting The “trip” may be related to the addiction Greatly reduces physical and psychological withdrawal symptoms from heroin, methadone, other drugs Ibogaine Outcome Study, V. Mojeiko

8. Iboga Therapy House Ibogaine Detoxification Facility in Vancouver, Canada • MAPS awarded $5000 grant to set up North America’s first legal ibogaine detoxification facility • Future Site of MAPS-Sponsored Research • Will provide treatment to addicts from Canada and the US for a modest fee Ibogaine Outcome Study, V. Mojeiko

9. Iboga Therapy House Therapeutic Procedures Prescreening Process: Application, Physical Exam, Drug Test Enter Facility Supervision Period: 12-24 hours Ibogaine Experience: 1-2 days Integration Period and Therapy: 2-3 days Leave Facility Follow-up: One year Ibogaine Outcome Study, V. Mojeiko

10. Program Evaluation and Outcome Study • How well does ibogaine work? How safe is it? • What percentage of people benefit and to what degree? • How can these treatments be improved? • Should formal studies be conducted? MAPS’ Role: Evaluating program, providing feedback, and collecting data for research Ibogaine Outcome Study, V. Mojeiko

11. Preliminary Data: June 2004: Iboga Therapy House: 2wks-1yr after tx (avg. 6 months) • 20 subjects • 6 of 7 treated for Cocaine/Crack abstinent (86%) • 3 of 8 treated for opiates abstinent (38%) • 4/5 treated for other substances abstinent (80%) Ibogaine Outcome Study, V. Mojeiko

12. Exploratory Outcome Study • Seeking to obtain basic preliminary data • Not a controlled study, but is representative since including 20 Subjects treated consecutively • One-year series of questionnaires and interviews from 20 subjects verified by interview with significant others • Harm reduction model: measuring abstinence as well as non-abstinence outcomes, striving to differentiate between abuse and controlled use Ibogaine Outcome Study, V. Mojeiko

13. Measures • Addiction Severity Index (primary variable) • Peak Experience Profile • Beck Depression and Anxiety Inventories • Subjective and Objective Opiate Withdrawal Scales (SOWS/OOWS) • Pain and Craving Scales Ibogaine Outcome Study, V. Mojeiko

14. ASI-Addiction Severity Index • Semi-structured 1 hour interview • Scores on 7 subscales: medical status, employment and support, drug use, alcohol use, legal status, family/social status, and psychiatric status • Been used extensively on a wide variety of outcome studies Ibogaine Outcome Study, V. Mojeiko

15. Peak Experience Profile (PEP) • Measures the psychedelic experience • 180 items; one composite score; 16 subscores • Scores for peaks (highs) and nadirs (lows) Sense that the experience cannot be described adequately in words. Experience of explosive ecstasy. Experience of the insight that "all is One". With open eyes seeing objects around you turned into great works of art. Experience of unbearable tortures that will never end. Ibogaine Outcome Study, V. Mojeiko

16. Schedule for Outcome Measures i=Intake; P=Post-treatment; W2=Week 2; 1-12=Months 1-12 Ibogaine Outcome Study, V. Mojeiko

17. Challenges • No drug testing • Difficulty of remaining in contact during follow-up • Check-in with significant other and gift certificates address these concerns Ibogaine Outcome Study, V. Mojeiko

18. Progress • End of protocol design and training phase • Has been submitted for IRB approval • Partial funding obtained from private donors for study, Iboga Therapy House seeking additional funding for operating costs Ibogaine Outcome Study, V. Mojeiko

19. Goals • Obtain basic information about outcomes in underground clinics • Provide feedback to improve services; help win funding from Canadian government; increase safety • Ideally lead to placebo-controlled double-blind studies • Ibogaine available to drug addicts in a safe, supportive, and humane setting Ibogaine Outcome Study, V. Mojeiko

20. End Ibogaine Outcome Study, V. Mojeiko