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Significance of Underground Ibogaine Treatment Settings

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  • US and European Ibogaine Scenes Through the Year 2000
  • 1993
  • Transcript

    • 1. Significance of “Unofficial” Ibogaine Treatment Scenes
      • The existence of these scenes indicates demand for alternatives to existing treatment options.
      • Averse events including fatalities indicate the need for appropriate prospective medical evaluation of patients, monitoring within the treatment, and reliable formulations of ibogaine.
      • “ Anecdotal” or “case report” evidence suggests a possible neurobiological drug action.
      • All of the above strongly support the need for appropriate clinical trials to evaluate safety and efficacy in order to gain official approval
    • 2.  
    • 3. 1. Alper, K.R., Beal D., and Kaplan C.D. (2001). A Contemporary History of Ibogaine in the United States and Europe. In Ibogaine: Proceedings of the First International Conference (The Alkaloids Volume 56), pp. 249-281. Academic Press, San Diego, California. 2. Lotsof, H.S., and Alexander N.E. (2001). Case studies of ibogaine treatment: implications for patient management strategies. In Ibogaine: Proceedings of the First International Conference (The Alkaloids Volume 56), pp. 293-313. Academic Press, San Diego, California. 3. Alper, KR, Lotsof, HS, Frenken, GMN, Luciano, DJ, and Bastiaans, J. Treatment of Acute Opioid Withdrawal with Ibogaine. American Journal on Addictions 8: 234-242, 1999. 4. Frenken G. (2001). From the roots up: ibogaine and addict self-help. In Ibogaine: Proceedings of the First International Conference (The Alkaloids Volume 56), pp. 283-292, Academic Press, San Diego, California. 5. Mash, D.C., Kovera A. , Pablo J., Tyndale R., Ervin F.R., Kamlet J.D., and Hearn W.L. (2001). “Ibogaine in the Treatment of Heroin Withdrawal” Ibogaine: Proceedings of the First International Conference (The Alkaloids Volume 56), (K. Alper and S.D. Glick Eds.), pp. 155-171. Academic Press, San Diego, California. 6. Stolarof MJ. The Secret Chief. (1997) Multidisciplinary Association for Psychedelic Studies, Charlotte NC, 144 pages. 7. Kastelic , A. “Self-Help Use of ibogaine in Slovenia” Presented at the First International Conference on Ibogaine. New York, NY, Nov. 5 1999.
    • 4. Reports of Ibogaine Treatment in Humans
      • Case studies presented to NIDA in March 1995; 41 individuals receiving a total of 52 treatments
      • Published case reports (high degree of overlap with the above) describing a total of 56 treatments
      • Open label prospective study N=32 (Mash et al.)
    • 5. Published Ibogaine Case Studies
      • One paper describing 33 treatments for opioid dependence; complete resolution of withdrawal signs and absence of drug-seeking behavior in 25 (76%) 1 .
      • Total of 13 treatments, mainly for opioid dependence, in four additional papers 2,3,4,5 .
      • 1. Alper, KR, Lotsof, HS, Frenken, GMN, Luciano, DJ, and Bastiaans, J (1999). Treatment of Acute Opioid Withdrawal with Ibogaine. American Journal on Addictions 8: 234-242. 2. Cantor, M. (1990). ``Interviews: ibogaine treated addicts''. The Truth Seeker 117 (5 ) , 23-26. 3. Luciano, DJ. (1998). Observations on treatment with Ibogaine. American Journal on Addictions 7 , 89-90. 4. Sheppard, S.G. (1994). A preliminary investigation of ibogaine: case reports and recommendations for further study. J.Subst.Abuse Treat. 11 , 379-385. 5. Sisko, B. (1993). Interrupting drug dependency with ibogaine: a summary four case histories. Multidisciplinary Association For Psychedelic Studies (MAPS) Newsletter 4 : 15-24.
    • 6. Drug Abstinence Following Ibogaine Treatment (unpublished, presented to NIDA March 1995) Reported Time Interval of Post- treatment Drug Abstinence N (%) Alper, K.R. (2001). Ibogaine: A Review. In Ibogaine: Proceedings of the First International Conference (The Alkaloids Volume 56) , (K. R. Alper and S.D. Glick, Eds.), pp. 1-38. Academic Press, San Diego, California. <2 months 15 (29%) 2 to <6 months 15 (29%) 6 months to <1 year 7 (13%) ≥ 1 year 10 (19%) Not determined 5 (10%)
    • 7. Table 1 from : Alper, KR, Lotsof, HS, Frenken, GMN, Luciano, DJ, and Bastiaans, J. Treatment of Acute Opioid Withdrawal with Ibogaine. American Journal on Addictions 8: 234-242, 1999. Retrospective Case Series From Early1960’s U.S. and Late 1980’s-Early 1990’s Dutch Informal Scenes: Subjects
    • 8. Table 2 from : Alper, KR, Lotsof, HS, Frenken, GMN, Luciano, DJ, and Bastiaans, J. Treatment of Acute Opioid Withdrawal with Ibogaine. American Journal on Addictions 8: 234-242, 1999. Retrospective Case Series From Early1960’s U.S. and Late 1980’s-Early 1990’s Dutch Informal Scenes: Outcomes
    • 9. Prospective Open Label Study (Mash et al. 2001) 1
      • 32 patients treated for opioid (heroin or methadone) withdrawal.
      • Withdrawal Symptoms measured using the Objective Opiate Withdrawal Scale (OOWS)
      • Fixed dose of 800 mg ibogaine HCl given approximately 12 hours after the last opiate dose
      • OOWS significantly reduced at 12 and 24 hours post ibogaine administration; the level of discomfort at these acute relative to post-treatment time points was as low as the level seen 1 week later. Objective signs of opiate withdrawal rarely seen and none increased at later time points.
      • Decreased craving at <72 hours post-treatment; these reductions were maintained at 6 to 9 days post-treatment
      • Depression scores reduced relative to pre-treatment at 6 to 9 days and 1 month post-treatment
      • 1. Mash, D.C., Kovera A. , Pablo J., Tyndale R., Ervin F.R., Kamlet J.D., and Hearn W.L. (2001). “Ibogaine in the Treatment of Heroin Withdrawal” in Ibogaine: Proceedings of the First International Conference (The Alkaloids Volume 56), (K. Alper and S.D. Glick Eds.), pp. 155-171. Academic Press, San Diego, California.
    • 10. Disease-Specific Advocacy
    • 11. Examples of Disease Specific Advocacy
      • HIV: Aids Coalition to Unleash Power (ACT UP); Treatment Action Group (TAG)
      • Opiate Dependence: Dutch Junkiebond, Danish Drug Users Union
      • Psychiatric Disorders: National Alliance for the Mentally Ill (NAMI)
    • 12. Nico Adriaans organizer Dutch Addict Self-Help
    • 13.  
    • 14. Political Advocacy Graphics