Ibogaine is a naturally occurring psychoactive alkaloid found in the roots of the Tabernanthe Iboga plant from West Africa. It has been traditionally used for spiritual exploration and healing by the Bwiti culture for thousands of years. Howard S. Lotsof first discovered its ability to disrupt chemical dependency in the 1960s and has since advocated for its use in addiction treatment. Ibogaine works in two ways: by reducing withdrawal symptoms and cravings to sustain periods of abstinence, and by producing a subjective experience where one examines their life and choices. It is administered orally and its effects can last up to 36 hours over 3 stages. Side effects include coordination issues, hallucinations

1. IbogainePresented by Rachel Jordan

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

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

4. Ibogaine’s HistoryHoward S. Lotsof first discovered Ibogaine’s ability to disrupt chemical dependency in 1962-63Ever since, he has been researching everything about it and advocating for it’s use in treating addictionAs of March 2007, 12 people out of 3611 died in relation to Ibogaine treatment but also in relation to other factorsHas been used to treat chemical dependence for over 40 years and has a 65% abstinence rate over 10% with conventional drug treatment programsNo potential for abuse

5. Ibogaine’s action Has been shown to bind with multiple neurotransmitter sites within the CNS Increases serotonin and decreases/blocks dopamine Has been shown to act both as an antagonist and an agonist as well as directly and indirectly

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

7. Forms and DosageBotanical root barkTotal alkaloid extractPurified 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 effectCost is roughly $4700-$4900 for 5 day treatment program on Vancouver Island

8. Ibogaine AdministrationAn oral capsuleTakes approx. 45 minutes to take effect & decrease withdrawal symptomsShould 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 thereafterEffects occur in 3 stages and can last up to 36 hours

9. First StagePatient will usually want to lay prone & still as may experience motion related N&VSkin tends to become numbMay hear an initial buzzing or oscillating soundA period of dream-like visualization may last for 3 to 4 hours & ends abruptly should it occur at allMay 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 stageFollows visualization & has been described as one in which the patient principally experiences cognitive evaluation or a review of issues that are important to themThey 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 StageAlso known as Residual Stimulation stageIt tends to leave the patient exhausted & therefore is somewhat uncomfortableMay remain awake for two or more days but most patients will sleep within 24-48 hours of Ibogaine administrationUsually, there is a long term diminishment of the need for sleep over weeks or monthsSome patients may require or request sedation

12. Side EffectsCoordination disturbances (unstable gait and tendency to fall)Hallucination-like experiences Sleep disturbancesConcentration & speech troublesHeart rate & blood pressure changesNausea & vomitingDizziness Light sensitivityTirednessMuscles soreness

13. Post Ibogaine Treatment TherapyPatients are encouraged to attend NA or AA meetings for further supportMany are encouraged to have supports &/or resources in place before detox-ingOther additional treatment therapies

14. ContraindicationsHistory of heart attacks or cardiovascular disease/abnormalitiesConcurrent opiate/stimulant drug useActive psychological or neurological disordersBeck Depression Inventory score > 24 Active TB or pregnancyImpaired kidney, liver or GI function Concurrent drugs that may cause adverse ibogaine/drug interactions

15. PHN RoleKnow use/effects of Ibogaine in case a client inquires about it or presents themselves on itAdvocate for its use/funding in addictions treatment through a harm reduction, health promotion perspectiveEducate 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 & othersKnow 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. ReferencesIbogaine 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.htmlIbogaine Roots of Hope: CBS. Retrived from Veoh videos and internet television athttp://www.veoh.com/videos/v927524wxpsC5nkIbogaine 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/