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IBOGAINE THERAPY
INFORMATION FOR
CLINICIANS
Ibogaine Aotearoa Charitable Trust I.ACT
I.ACT Information and Guide Lines Des...
Ibogaine Therapy Information For Clinicians | 2013
Page | 1
Procedures and Steps in the Treatment of Opioid Cessation with...
Ibogaine Therapy Information For Clinicians | 2013
Page | 2
Exclusion Criteria
• heart, kidney, gastro-intestinal disease ...
Ibogaine Therapy Information For Clinicians | 2013
Page | 3
Clinician considerations to support client.
whanau inclusive p...
Ibogaine Therapy Information For Clinicians | 2013
Page | 4
the first 48 hours post administration of ibogaine personal vi...
Ibogaine Therapy Information For Clinicians | 2013
Page | 5
their code of ethics.3
And is also a current board member of t...
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2013 Guidelines for Clinician's working with Clients wishing ot cease opioid dependence with Ibogaine Therapy

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2013 Guidelines for Clinician's working with Clients wishing to cease opioid dependence with Ibogaine Therapy.
Ibogaine Aotearoa Charitable Trust

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Transcript of "2013 Guidelines for Clinician's working with Clients wishing ot cease opioid dependence with Ibogaine Therapy"

  1. 1. IBOGAINE THERAPY INFORMATION FOR CLINICIANS Ibogaine Aotearoa Charitable Trust I.ACT I.ACT Information and Guide Lines Designed for Clinicians at Community Alcohol and Drug Services 2013
  2. 2. Ibogaine Therapy Information For Clinicians | 2013 Page | 1 Procedures and Steps in the Treatment of Opioid Cessation with Ibogaine This document is specifically designed for clinicians working at Community Alcohol and Other Drug Services (CADS) who have a client that is wishing to undergo Ibogaine Therapy to cease their dependence on opioids. In February 2010 Medsafe reclassified Ibogaine hcl as a non-approved prescription medication to be used in the treatment of chemical dependence on substances, primarily opioids.1 In September of 2009 Tanea Paterson founded Ibogaine Aotearoa Charitable Trust I.ACT (Trust Number 2553458) with the view to bringing the option of ibogaine to consumers wishing to cease their dependence on substances in a safe and therapeutic way and to develop and implement a ‘best practise’ model for Aotearoa/NZ and further afield. This document represents the culmination of work from Tanea’s own experiences as a former methadone dependent person and ibogaine client, an ibogaine therapy provider and a DAPAANZ registered addiction practitioner along with the trustees of I.ACT which include psychiatric nurses, a medical anthropologist and a school principal. The document has been developed for clinicians working in the fields of addiction and psychological health. It is a guide to the procedures and steps that Tanea and the trustees of I.ACT have developed and outlines protocols conducive to ethical and safety standards considered appropriate with such an experimental medicine. The I.ACT Client Information Sheet is attached and may be copied and distributed to any client or treatment professionalenquiring about ibogaine. Inclusion and Exclusion Criteria Inclusion Criteria TangataWhaiora, the Person Seeking Help Has a desire to cease dependence on opioids, is motivated to change and who understands that ibogaine therapy alone is not a ‘cure’ signs an informed consent and must understand the risks and benefits of ibogaine therapy is willing to be a part of a process including adhering to provider and clinicians requests to attend appointments and do the appropriate medical testing and comprehensive assessment honestly takesresponsibility of engaging with any services that they have been referred to and continue with ongoing self-care. understands that the provider obligations will end at 6 weeks post ibogaine therapy unless prior formal arrangement has been made for extended support. is self-funded or willing to seek out funding privately for their tx 1 See section 10 General Business, Minutes of the November 2009 Medicines Classification Committee Meetinghttp://www.medsafe.govt.nz/profs/class/mccmin03nov2009.htm
  3. 3. Ibogaine Therapy Information For Clinicians | 2013 Page | 2 Exclusion Criteria • heart, kidney, gastro-intestinal disease or cancer will be excluded • liver disease must be investigated (often clients are hep c positive, however this does not always exclude them) • history of active neurological or psychiatric disorders, such as cerebellar dysfunction, epilepsy, psychosis, bipolar illness, schizophrenia, organic brain disease or dementia that require ongoing treatment. • currently pregnant or breastfeeding • inadequate home environment to return to i.e. living alone with no support, living situation indicative of continued drug use (partner/whanau/flatmates still in active use) In this case extra support plans and risk management plans must be put in place prior to tx. Residential care post ibogaine tx should be discussed in this case • currently taking prescribed and non-prescribedmedication(supplements and/or street drugs) contraindicated with ibogaine. Discuss on a case by case basis Medication considerations • doses of methadone over 60 mgs must reduce to <60 mg’s prior to tx and where possible switch to short acting opiate (SAO) • the lower the opiate dose the easier the tx and recovery, risks and benefits must be weighed up (risk of being unstable and client ‘topping up’ for example) • buprenorphineclients must switch to SAO for no less than two weeks prior to ibogaine tx and for methadone for no less than one week. Dosage to be determined by the Dr(generally 1:4 ratio) • last dose of methadone (if no SAO) on the day prior to therapy in the am, () • exclusion for medications contraindicated with ibogaine, primarily anticonvulsants, anti-epileptic drugs, antidepressants, neuroleptics etc. • if uncertain whether medications have contraindications seek further investigation NB – Due to popularity and a deficit in medical knowledge/contraindications around ‘synthetic cannabinoids’ and ‘herbal highs’ clients who present that use these substances will be excluded until they can prove abstinence or until more research has been released on the safety of these products. Cannabis is not included in this as it has been shown to have no negative interactions with ibogaine.
  4. 4. Ibogaine Therapy Information For Clinicians | 2013 Page | 3 Clinician considerations to support client. whanau inclusive practice • risk management plans • relapse prevention plan • assertiveness and stress management • diet and lifestyle advice or referral to natural health provider or Hep C support services • advice and support about reducing their methadone and other medications where necessary Ibogaine Therapy for Opioid Cessation Process with Ibogaine Aotearoa Charitable Trust 1. If a client presents as interested in ibogaine therapy please contact the provider for more informationtanea.nz@gmail.com and/or www.ibogaine.org.nz 2. Once inclusion is established and medical and psychological tests have been sighted the planning process begins. 3. Clinician to have at least one consult with the ibogaine provider to develop consistent and holistic aftercare plans, with client consent and/or client attendance on a 1:2 basis. 4. The client will be provided with an information sheet, which includes the treatment contract and consent form. They will have the opportunity to ask any questions about ibogaine and the therapeutic process prior to therapy. An early leave form is to be sighted and signed in cases where a person choses to leave during the treatment process against the providers advice. 5. Ibogaine tx for methadone cessation costs from $5,500-$6500nzd. Price structure varies depending on amount of ibogaine needed and the number of days required for 24hr care, minimum being 72 hrs post first administration of ibogaine hcl. Prices include accommodation, food, supplements, prescription fees, related costs such as communication and travel. This also includes pre tx assessment work, referrals and six weeks post tx after care support. 6. The client will receive the amount of ibogaine hcl that is determined by the therapy provider with considerations on their body weight, the level and longevity of drug use, physical considerations and sensitivity to ibogaine (decided post 200mg test dose administration). The dose may be adjusted by the provider during the process if necessary. 7. During the time that the client is in the care of the provider they will not be left alone at any time, exception being personal grooming and toileting.The client will have a sitter present for a minimum of 72 hrs post first ibogaine hcl administration. 8. At any time pre and post ibogaine therapy should they request a whanau member or support person to be with them a prearranged (safe) person will be contacted. During
  5. 5. Ibogaine Therapy Information For Clinicians | 2013 Page | 4 the first 48 hours post administration of ibogaine personal visits will be restricted for the client’s physical and psychological safety unless deemed as beneficial for the client. 9. Post treatment the client should have at least three weeks off work, preferably longer if job is very physical.The provider/s will remain in a support person/counsellor role for 6 weeks post tx and will refer the clients to any other necessary after care supports. Excerpt from the Ibogaine Dossier2 on the Effects of Ingesting Ibogaine Once ibogaine has been administered, effects follow. The patient will usually want to lay prone and should be encouraged to remain still as nausea and vomiting as well as, being systemic have been seen to be motion related. The skin tends to become numb. Patients will report an initial buzzing or oscillating sound. A period of dream-like visualization lasting for 3 to 4 hours in most but, not all patients is considered to be the first prominent stage of ibogaine effects. This stage ends abruptly should it occur at all. Another aspect of ibogaine effect that is common are random flashes of light that appear everywhere with eyes open. This may last for hours or days. Visualization on the other hand is most common with eyes closed. The second stage that follows visualization has been described as one in which the subject principally experiences cognitive evaluation or a review of issues that are important to the subject. These may cover every possible scenario from early childhood experiences to current health issues. This period may last for as few as 8 hours or for 20 hours or longer. The third or final stage of ibogaine effects is that of residual stimulation. This stage, because it tends to leave the subject/patient exhausted is somewhat uncomfortable. Subjects may remain awake for two or more days. Usually, there is a long term long term diminishment of the need for sleep over weeks or months. Some patients may require or request sedation. Sedatives that have been used include benzodiazepines and melatonin. The above summarizes the experience of a person who has ingested ibogaine for your information. It is a brief description of what may happen and is intended as a general guide only as each person has a unique and personal experience during their therapy. Tanea Paterson can be contacted by email tanea.nz@gmail.com to meet with both clinician and/or client by appointment to answer specific questions pertaining to the process of ibogaine therapy. She is a current member of DAPAANZ and abides by 2 http://www.ibogaine.desk.nl/manual.html
  6. 6. Ibogaine Therapy Information For Clinicians | 2013 Page | 5 their code of ethics.3 And is also a current board member of the Global Ibogaine Therapist Alliance GITA4 . Tanea Paterson Ibogaine Aotearoa Charitable Trust (I.ACT) Director/Provider DAPAANZ Registered Addictions Practitioner Otepoti/Dunedin 0273013748 www.ibogaine.org.nz 3 http://www.dapaanz.org.nz/code-of-ethics/ 4 http://ibogainealliance.org/about-us

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