Author: Charles Frank

The psychedelic ibogaine can treat addiction The race is on to cash in Drugs

On a rainy October night outside his home in Libreville, Gabon, Christophe Bibang explained how many Gabonese, especially those who practice Bwiti, are experiencing a shift in their relationship with iboga. Recently, more people are buying iboga root – either lengths of bark or in powdered form – in big cities for use in urban Bwiti temples. Keep reading to learn more about the use of ibogaine treatment for addiction.

1. Over the past decade, ibogaine’s popularity has incentivized poachers to target shrubs in Gabon, one of the few places Tabernanthe iboga, the plant ibogaine is most commonly derived from, naturally propagates.
2. Ibogaine is one of the most promising psychedelics for addiction.
3. “I’ve viewed it a little skeptically … but the stories with ibogaine keep surfacing and [keep] being very similar.

In May, support ibogaine’s efficacy, the company’s hope is that an ibogaine capsule would be used at detox centers in the U.S. “I’m a hardcore neuropharmacologist and physician by training,” says Dr. Srinivas Rao, co-founder and chief scientific officer at ATAI. “I’ve viewed it a little skeptically … but the stories with ibogaine keep surfacing and [keep] being very similar. People seem to get a lot out of this experience.” ATAI is also pursuing noribogaine—the substance ibogaine breaks down to in the body—as a possible addiction treatment.

He vows to raise funds to open a chain ibogaine therapy clinics in Mexico with more comprehensive medical and emotional support during treatment, as well as after care. He also plans to open a second clinic in Cancun next month, with hopes of scaling up to treating 300 people a day. She spent five weeks at the clinic, where, not unlike upscale in-patient substance use disorder treatment centers in the United States, she was offered psychotherapy sessions, acupuncture, and lounge chairs overlooking the beach. But the main attraction was the powerful psychedelic, an experience Smith, now an in-home caretaker in Arizona, believes saved her life. “It’s like I was put back to the day before I ever used a drug,” she said.

Psychedelic Inspires New Treatments for Addiction and Depression

“Their improvement [was] way above what we would see with typical currently approved treatments,” Davis says. Once dismissed as a fringe, counterculture vice, psychedelics are rapidly approaching acceptance in mainstream medicine. These drugs uniquely change the brain, and a person’s awareness of experiences, in the span of just a few hours. This fast-acting shift could be useful in mental-health treatments, and research is already supporting this notion. Just one dose of psilocybin, the active ingredient in magic mushrooms, was recently shown to ease depression and anxiety in cancer patients—an outcome that lasted for years after their trip. Researchers are recognizing that psychedelics can provide a radical new approach to mental-health treatments at a time when innovation is desperately needed.

Shoichet has submitted the structures of both new molecules to Sigma Aldrich, the chemical manufacturing company, aiming to make them available for further testing by other scientists, while he continues to hunt for more precise molecules. “All of a sudden, they popped — that’s when these drugs looked a lot more potent than even paroxetine [Paxil],” Shoichet said. With this sort of potency, we hope to have a better therapeutic window without side effects.

In the past year, the FDA has paused clinical trials for other synthetic compounds, including one called 18-MC, over safety concerns. Over the past decade, ibogaine’s popularity has incentivized poachers to target shrubs in Gabon, one of the few places Tabernanthe iboga, the plant ibogaine is most commonly derived from, naturally propagates. Consumed in small doses, iboga root bark acts as a stimulant, often brewed into palm wine or chewed to curb hunger and fatigue. In larger doses, iboga has powerful psychoactive effects, which have been harnessed for centuries by the Fang, Mitsogo and Punu people of the Congo Basin, as part of the Bwiti religion. The ongoing poaching is depleting natural reserves of iboga in Gabon’s forests and cutting Gabonese people out of an industry that would not exist without their Indigenous knowledge.

The drugs inhibited SERT in a similar way to ibogaine, but unlike the psychedelic, their effect was potent and selective, with no spillover impacts on a panel of hundreds of other receptors and transporters. On his plot of land outside the city, Bibang is cultivating 20 iboga plants. For now, he sells the plants to people who want to plant their own backyard iboga shrubs. But he also recognizes the global interest in iboga and what doors that could open for plant experts like him. “It was horrific, it was the worst thing in the world, what I saw,” said Smith (whose name has been changed to protect her identity) referring to her experience on ibogaine.

The psychedelic ibogaine can treat addiction. The race is on to cash in

Preakuammicine is highly unstable and therefore reduced to stemmadenine by oxidation-reduction reactions (REDOX 1 and REDOX 2). Stemmadine is acylated by stemmadine Ο-acetyltransferase (SAT) to yield stemmadine acetate. Through oxidation by precondylocarpine acetate synthase (PAS) and reduction by dihydroprecondylocarpine acetate synthase (DPAS), an enamine intermediate is formed. The intermediate undergoes fragmentation to produce an iminium that tautomerizes to yield dehydrosecodine. Coronaridine synthase (CorS) catalyzes the isomerization of dehydrosecodine and an unusual cycloaddition is completed. The iminium is reduced by DPAS and NADPH to form (-)-coronaridine.

MindMed, a U.S.-based company aiming to develop medicines based on psychedelics, is pursuing a synthetic derivative of ibogaine called 18-MC for opioid addiction. MindMed’s Phase 1 trial in Australia has so far found no adverse cardiovascular effects with 18-MC. Phase 2 trials, to test if 18-MC lessens opioid withdrawal, are expected to begin this year. In 2017, Davis published a study in the Journal of Psychedelic Studies in which he surveyed 88 people—most of whom had been using opioids daily for at least four years—who had visited an ibogaine clinic in Mexico from 2012 to 2015.

IBOGA – Uses, Side Effects, and More

With treatment, it’s possible to get on a road to a happy and healthy life. There’s some recent evidence—in rats—that ibogaine may increase neurotrophic factors in the brain, which are proteins that encourage neuron growth and plasticity (the ability of the brain to change even in adulthood). These appear to be key in helping the brain remodel to overcome an assault like a substance-use disorder. But since other psychedelics also increase neural plasticity, something more is likely going on. This is converted using N-iodosuccinamide and then fluoride to form 2-(2-iodo-1H-indol-3-yl)ethanol. This is treated with iodine, triphenyl phosphine, and imidazole to form 2-iodo-3-(2-iodoethyl)-1H-indole.

Some people stop using drugs completely and stay sober for years. Because of a lack of controlled ibogaine trials, it’s difficult to quantify the risks, but the threats to cardiovascular health are particularly concerning. The drug may block certain channels in the heart and slow down heart rate, which can cause fatal arrhythmias. In one observational study published in 2018, researchers followed 15 people as they received ibogaine treatment for opioid dependence in New Zealand, where ibogaine is legal by prescription, and interviewed them for a year after.

Targeted Molecules Are More Powerful Than SSRI Antidepressants and Avoid Ibogaine’s Dangerous Side Effects

But case studies in which ibogaine had helped heroin users successfully detox—including Lotsof’s New York City group and another from the Netherlands in the early ’90s—were promising enough that one U.S. government agency took notice. The popularity of ibogaine treatment has also caught the interest of researchers and drug developers, posing ethical questions regarding who has a right to profit off of Indigenous knowledge. Psychedelic therapies are expected to grow into a nearly $11bn industry in the next five years.

A simple internet search for ibogaine therapy in Mexico will reveal plenty of options – mostly unregulated, with some existing only on social media. Some are run solely by people who have used ibogaine to get clean and want to help others do the same. They are generally more affordable than traditional rehab clinics in the US (Smith paid $12,000) and offer opioid users another option when rehabilitation and 12-step programs have failed. With ayahuasca and psychedelics other than ibogaine, the focus is on psychotherapy. The trips can give people insight into the issues that underlie their addictive behaviors and help them use that insight to get sober. While it does prompt psychological insights similar to those produced by other psychedelics, it is the only one that also has a physical effect that stifles symptoms of opioid withdrawal.

It hasn’t been approved by the Food and Drug Administration (FDA) for any addictive disorder and it is classified as a schedule I drug in the United States. Schedule I drugs are substances with a high potential for abuse. In 1991, the National Institute on Drug Abuse (NIDA) decided to fund animal research into ibogaine; the resulting studies (and later ones) in rodents found that ibogaine reduced how much heroin, morphine, cocaine and alcohol the animals consumed. Food and Drug Administration (FDA) to greenlight a clinical trial of ibogaine in humans for cocaine dependence, but it fell apart in early stages because of a lack of funding and contractual disputes.

“They use ibogaine to offset or temporarily eliminate the symptoms of withdrawal, largely from opioids, and they are not in the business of healing. It is a psychedelic version of what we call the treatment model, where people have to come back,” he said. More Americans died from drug overdoses last year than ever before, aggravated by the COVID-19 pandemic.

NIDA abandoned its interest in ibogaine, citing safety as one concern. There still has been no completed clinical trial in the U.S. to test ibogaine in people. Some people swear by ibogaine for treating addiction, but it isn’t a very good drug. It has bad side effects, and it’s not approved for use in the U.S. Scientists in various parts of the world are working to develop synthetic compounds based on ibogaine that can be turned into pharmaceuticals that provide the same benefits without the risks.