Ibogaine: Treatment Acceptability


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  • Presented May 5, 2003, NYC Iboga and Ibogaine Forum.
  • The principal source of ibogaine is in the bark of the root of Tabernanthe iboga.
  • Based on the writing of Link BG & Phelen JC, “On Stigma and Public Health Implications. Columbia University, 2001. <http://www.stigmaconference.nih.gov/papers.html>
  • Ibogaine: Treatment Acceptability

    1. 1. Patient Medication Acceptability and Treatment Options: <ul><li>Ibogaine </li></ul><ul><li>Methadone </li></ul><ul><li>Buprenorphine </li></ul>Howard S. Lotsof DORA WEINER FOUNDATION
    2. 2. Background: Drug Control <ul><li>• 1906 Pure Food and Drug Act </li></ul><ul><li>• 1914 Harrison Narcotic Act </li></ul><ul><li>• 1970 Controlled Substances Act </li></ul>
    3. 3. Background: Methadone <ul><li>• 1937 synthesized by Max Bockmühl and Gustav Ehrhart, I.G. Farbenindustries. Patent issued 1941 </li></ul><ul><li>• 1950 use in treatment of opioid abstinence syndrome established in US </li></ul><ul><li>• 1964 use in opioid maintenance therapy </li></ul>
    4. 4. Methadone molecule
    5. 5. Methadone powder
    6. 6. Methadone diskets
    7. 7. Methadone liquid
    8. 8. Background: Buprenorphine <ul><li>• 1965 synthesized by KW Bentley at Rickitt & sons, UK. </li></ul><ul><li>• 1975 - 1978 DR Jazinski et al. Indicate utility in treating opiate addiction </li></ul><ul><li>• 1977 - 2003 John Lewis champions analgesic and antiaddictive development </li></ul><ul><li>• 2000 Drug Addiction Treatment Act authorizes use in opioid maintenance therapy </li></ul><ul><li>• 2002 FDA approves that use to Reckitt Benckiser </li></ul>
    9. 9. Buprenorphine molecule
    10. 10. Buprenorphine products manufacturer, Reckitt Benckiser will not make current product photographs available
    11. 11. Background: Ibogaine An experimental medication <ul><li>• Botanical source Tabernanthe iboga. Used for 100s of years in African medicine and religion </li></ul><ul><li>• 1901 ibogaine isolated by Dybowski and Landrin </li></ul><ul><li>• 1958 molecular structure determined Bartlett et al. </li></ul><ul><li>• 1962 Lotsof discovers Antiaddictive effects </li></ul><ul><li>• 1993 - 2003 Mash & Glick develop second generation ibogaine-like drugs </li></ul>
    12. 12. Ibogaine molecule
    13. 13. Noribogaine Liver transforms ibogaine into noribogaine
    14. 14. 18-methoxycoronaridine molecule 18-MC Synthetic molecule
    15. 15. Tabernanthe iboga shrub
    16. 16. Roots bark contain ibogaine
    17. 17. Pharmaceutical ibogaine experimental medication
    18. 18. Discovery of antiaddctive effects <ul><li>Methadone </li></ul><ul><li>NYC </li></ul><ul><li>1964 </li></ul><ul><li>Doctors administer to drugs users </li></ul><ul><li>Ibogaine </li></ul><ul><li>NYC </li></ul><ul><li>1962 </li></ul><ul><li>Drug users administer to drug users </li></ul>Buprenorphine Lexington, KY 1975 Pharmaceutical industry/gov. Development
    19. 19. Methadone <ul><li>The golden age of Dole and Nyswander </li></ul><ul><li>1966 - 1973 </li></ul>
    20. 20. Drs. Dole and Nyswander ca 1976
    21. 21. Early generation methadone patients <ul><li>The program was administered or controlled by doctors in a medical research environment even at the clinic level. </li></ul><ul><li>Nurses, counselors and patients believed in opioid maintenance therapy and collaborated to make it work. Patients and staff were a team. </li></ul><ul><li>There was no “us” and “them”. Patients were treated like any other medical patients. </li></ul>
    22. 22. Early generation ibogaine patients <ul><li>A full collaboration between academic researchers, pharmaceutical developers and user self-help groups with mutual respect. </li></ul><ul><li>Equal status between the parties. Users, doctors and drug developers worked together to define the ideal administration paradigm. </li></ul><ul><li>There was no “us” and “them”. Patients were treated just like any other medical patients, except when they were treated like doctors. </li></ul>
    23. 23. Later generation ibogaine patients <ul><li>Drug users are no longer involved as equal participants in ibogaine development. </li></ul><ul><li>Drug users and self-help groups, no longer affiliated with medical academics or drug developers, lost a level of authority and control. </li></ul><ul><li>Ibogaine patients are not dependent on clinic administered drugs. Ibogaine providers generally leave the field rather than control or abuse patients. This could change in the future. </li></ul>
    24. 24. Later Generation Methadone Patients What’s wrong with methadone today ? <ul><li>Nothing is wrong with methadone. </li></ul><ul><li>Almost something is wrong with many clinics that administer and provide it to patients. </li></ul><ul><li>Medical decisions are often not made by medical doctors. </li></ul><ul><li>Many clinics practice control of patients rather than providing them with ethical medical care. </li></ul>
    25. 25. Buprenorphine patients <ul><li>Buprenorphine patients never shared an important role in the development of the drug. </li></ul><ul><li>The manufacturer and the US government appear to desire that stigma associated with chemical dependence not be attached to buprenorphine. </li></ul><ul><li>Whether this early generation or later generations of buphrenorphine patients are well treated by the medical community and society will have to be seen. </li></ul>
    26. 26. Two important issues in chemical dependence treatment <ul><li>Stigma </li></ul><ul><li>Discrimination </li></ul>
    27. 27. Stigma Focuses attention on the victim
    28. 28. Discrimination: Focuses attention on those who produce rejection and exclusion
    29. 29. The ibogaine advantage Ibogaine removes the stigmatized condition.
    30. 30. Why ibogaine is not available? <ul><li>Industry deems ibogaine not to be profitable. </li></ul><ul><li>Government, industry and academia chose to place their interest in the development of opiate drugs with which they are familiar. </li></ul><ul><li>3. Ibogaine represents a new scientific paradigm to the understanding of addiction. </li></ul>
    31. 31. Ibogaine availability proximate to United States <ul><li>St Kitts West Indies </li></ul><ul><li>Vancouver, BC, Canada </li></ul><ul><li>Rosarito, Baja, Mexico </li></ul>
    32. 32. Ibogaine availability
    33. 33. Ibogaine resources The Ibogaine Dossier An internet library http://www.ibogaine.org http://www.ibogaine.desk.nl
    34. 34. Manual for Ibogaine Therapy Second Revision Release date Friday, May 9, 2003 http://www.ibogaine.org/manual.html