1. Ibogaine Presented by Rachel Jordan

2. What is Ibogaine? A naturally occurring psychoactive plant alkaloid It is sourced from the roots of the plant TabernantheIboga that grows in the forests of West Africa TabernantheIboga plant

3. Ibogaine’s History Traditionally used for thousands of years as a catalyst for spiritual exploration and healing by the African Bwiti culture.

4. Ibogaine’s History Howard S. Lotsof first discovered Ibogaine’s ability to disrupt chemical dependency in 1962-63 Ever since, he has been researching everything about it and advocating for it’s use in treating addiction As of March 2007, 12 people out of 3611 died in relation to Ibogaine treatment but also in relation to other factors Has been used to treat chemical dependence for over 40 years and has a 65% abstinence rate over 10% with conventional drug treatment programs No potential for abuse

6. Ibogaine’s Effects Works in two ways: Reduction of withdrawal symptoms & cravings & sustained periods of abstinence or reduced use Produces a subjective experience where the person may undergo processes where their life & choices are examined & reassessed

7. Forms and Dosage Botanical root bark Total alkaloid extract Purified Ibogaine HCl (99.4% purity) Doses are determined on an individual patient basis and are based on kg as well as addiction severity. Normal dosing is usually 15-20mg/kg for full therapeutic effect Cost is roughly $4700-$4900 for 5 day treatment program on Vancouver Island

8. Ibogaine Administration An oral capsule Takes approx. 45 minutes to take effect & decrease withdrawal symptoms Should be taken in place of next narcotic dose Blood pressure & pulse should be checked every 30 min for first 4-8 hours & then if stable, every hour thereafter Effects occur in 3 stages and can last up to 36 hours

9. First Stage Patient will usually want to lay prone & still as may experience motion related N&V Skin tends to become numb May hear an initial buzzing or oscillating sound A period of dream-like visualization may last for 3 to 4 hours & ends abruptly should it occur at all May experience random flashes of light that appear everywhere with eyes open & may last for hours or days. Visualization on the other hand is most common with eyes closed.

10. Second stage Follows visualization & has been described as one in which the patient principally experiences cognitive evaluation or a review of issues that are important to them They may cover every possible scenario from early childhood experiences to current health issues & may last for as few as 8 hours or for 20 hours or longer.

11. Third Stage Also known as Residual Stimulation stage It tends to leave the patient exhausted & therefore is somewhat uncomfortable May remain awake for two or more days but most patients will sleep within 24-48 hours of Ibogaine administration Usually, there is a long term diminishment of the need for sleep over weeks or months Some patients may require or request sedation

12. Side Effects Coordination disturbances (unstable gait and tendency to fall) Hallucination-like experiences Sleep disturbances Concentration & speech troubles Heart rate & blood pressure changes Nausea & vomiting Dizziness Light sensitivity Tiredness Muscles soreness

13. Post Ibogaine Treatment Therapy Patients are encouraged to attend NA or AA meetings for further support Many are encouraged to have supports &/or resources in place before detox-ing Other additional treatment therapies

14. Contraindications History of heart attacks or cardiovascular disease/abnormalities Concurrent opiate/stimulant drug use Active psychological or neurological disorders Beck Depression Inventory score > 24 Active TB or pregnancy Impaired kidney, liver or GI function Concurrent drugs that may cause adverse ibogaine/drug interactions

15. PHN Role Know use/effects of Ibogaine in case a client inquires about it or presents themselves on it Advocate for its use/funding in addictions treatment through a harm reduction, health promotion perspective Educate the public and patients on benefits & risks of Ibogaine compared to conventional treatments so they can make the best choice possible & can advocate for themselves & others Know difference b/w opioid withdrawal & Ibogaine’s effects

16. Q & A !! Where does Ibogaine originate from? Who qualifies for Ibogaine treatment? How long does the therapy typically last? What are the two main ways that Ibogaine works on treating chemical dependence? How many different forms are there? How is it typically taken? What should a nurse do while taking care of a person on Ibogaine?

17. References Ibogaine Association. (2006). Retrieved February 27, 2008 from http://www.ibogaine-therapy.net/ Ibogaine Research Project. (2005). Retrieved February 27, 2008 from http://www.ibogaine-research.org/Ibogaine-Research-Project/Ibogaine.html Ibogaine Roots of Hope: CBS. Retrived from Veoh videos and internet television athttp://www.veoh.com/videos/v927524wxpsC5nk Ibogaine Therapy House. (2008). Retrieved February 27, 2008 from http://www.ibogatherapyhouse.net/cms/content/view/22/37/ Multidisciplinary Association for Psychedelic Studies. (2007). Ibogaine studies and research projects. Retrieved February 27, 2008 from http://www.maps.org/ibogaine/ Roslin, A. (2007, Oct. 25). THE QUEST FOR THE ULTIMATE CURE FOR ADDICTION.The Georgia Straight. Retrieved February 27th, 2008 from http://www.mapinc.org/drugnews/v07/n1235/a06.html. The Ibogaine Dossier. (1999). Retrieved February 27, 2008 from http://www.ibogaine.org/index.html/