This Psychedelic Drug Targets Addiction and Depression
Researchers are rediscovering ibogaine's therapeutic effects.
As Americans struggle to find new ways of addressing addiction in the midst of an increasingly apparent opioid crisis , popular attention has turned to ibogaine. A relatively obscure psychedelic, ibogaine has been known in limited circles for its potential to disrupt addictions since the 1960s. No one claims it eliminates addictive behavior outright, but one dose of the potent hallucinogen can reportedly immediately cut cravings, especially for opioids, and keep them suppressed for weeks. And this could afford people with addiction problems a better chance to get a handle on broader, core addictive triggers.
This potential has prompted a surge of research on the compound and substances derived from it in recent years. Studies worldwide have largely confirmed that it may be a far more effective tool for recovery for many individuals than existing treatment programs that have high dropout and relapse rates, or that just swap one addiction for another—like methadone. Buzz about the substance has also prompted numerous pop culture depictions of its addiction usage, whether on shows like Homeland and Law and Order: SVU or in tabloid stories about celebrities like Scott Disick, of Kardashian notoriety, seeking it out as part of their own recovery journeys.
Yet for all the scientific and popular focus on its anti-addiction potential, ibogaine has long been used for other purposes. As with many psychedelics, it has a deep history in the areas where it was originally located as a psycho-spiritual tool with a wide array of usages. And when it was introduced to the West, it was used as a stimulant and experimental antidepressive for decades before anyone stumbled upon its anti-addictive potential.
As psychedelic science has sprung back from the grave in recent years, researchers have probed multiple potential therapeutic uses for other substances, like psilocybin, even if some threads seem more promising than others. So why does modern research and popular coverage of ibogaine seem to focus solely on its potential for addiction treatment, without even mentioning other therapeutic uses?
Ibogaine is a naturally occurring compound in plants from the Apocynaceae family and is best known via the iboga plant of west central Africa. French explorers first recorded its usage amongst peoples in modern Gabon in the mid-19th century, although locals have used it in rituals for centuries. To this day, up to 300,000 Gabonese use ground iboga as part of Bwiti, a malleable set of socio-spiritual practices.
"It's used as a right of passage, a socially binding ritual, and for what we would describe as forms of mental illness," says Dimitri Mungianis, an American who considers himself a Bwiti spiritual practitioner and believes in the value of iboga and ibogaine for a variety of therapeutic uses. "They won't touch anybody we would describe as schizophrenic," but they do use it to treat what we would call anxiety or depression—what they would call spells or curses.
As early as the 1930s, French pharmacists developed ibogaine as a drug. They sold it as Lambaréné, a stimulant—in low doses, the substance's hallucinogenic potential can be negligible, but it knocks back fatigue. Lambaréné stayed on the shelves until France declared it illegal in the 1960s. Meanwhile therapists, especially in the '50s and '60s, probed the substance as a possible antidepressive tool. Around the same time, researchers also explored its potential to modulate the analgesic effects of the opioid morphine for pain management.
Scientists toggled their attention to ibogaine's anti-addiction uses thanks to a heroin user, Howard Lotsof, who at the age of 19 in 1962 procured some ground iboga, which he wanted to test out as a new high. This may seem odd, given that many proponents of ibogaine as a tool in addiction treatment say that the the intensity of the trip means it doesn't have real recreational or abusive potential. To wit—although it's a bit different for everyone—ibogaine can cause intense hallucinations for over a day, prevent sleep, and lead to intense nausea and a strong buzzing in the ears. However according to Mungainis, "what's been kept under wraps is that small amounts of iboga are fun. You can dance on it. You can fuck on it. You can have a good time riding the subways… It's used for fun in Gabon—people mix it with pot and smoke weed."
It's unclear if Lotsof, who died in 2010, was copying earlier recreational users, or how widely known this would have been. Iboga was not easy to procure at the time, even though it was not listed as a schedule-controlled substance in the United States until 1970. Regardless, Lotsof took it, had a powerful trip, and saw his heroin cravings drop off. He got a friend who also struggled with addiction to try iboga as well, and realized many of them had similar reactions. From then on, he became an advocate for research into ibogaine as an anti-addiction tool. By the 1990s, he'd attracted a fair amount of academic attention, with numerous studies on ibogaine's mechanics and in animal populations bearing out his intuition. The substance, it seemed, interacted with receptors involved in addiction pathways in a unique manner that prevented the sensation of cravings.
Although researchers at times still make reference to ibogaine or its derivatives' potential in treating depression or other disorders, from 1962 on, science has overwhelmingly focused on its addiction-disruption powers. So have the people who make up the psychedelic underground, although some of the spa-like centers that popped up in the '90s and early 2000s still advertise ibogaine as a psycho-spiritual tool—and some individuals seek these centers to manage anything from anxiety to eating disorders. However even those seeking it in unregulated settings for alternative uses likely first encounter it through addiction treatment. Mungianis suspects the focus in ibogaine research is so squarely on addiction because of the power of Lotsof's narrative and the importance of finding alternatives to existing treatments in the current climate.
However, Deborah Mash, professor of neurology and molecular and cellular pharmacology of the University of Miami, who has studied ibogaine and its potential uses since the 1990s, believes it's more to do with the substance's trickiness. Ibogaine has been implicated in the death of a number of people using it for addiction or other psychological needs in underground contexts. But it's not considered randomly dangerous so much as it's highly reactive with cardiac disorders, certain mental conditions, and other drugs.
As such, researchers think underground or personal ibogaine usage is especially dangerous, as those administering it may not know what to look out for. Even Mungianis, who loathes the idea of proscribing the use of ibogaine as a controlled pharmaceutical, acknowledges that self-administration is risky due to problems procuring pure products and using them safely, although he believes that society's focus should be on raising awareness about and creating support structures for harm-reduction and safe usage.
Ibogaine is also still hard to procure. "It's a difficult molecule to extract, and there can be impurities in it," Mash says. "And it's very expensive to make it by the synthetic route." Leaning on iboga as a source could also lead to exploitation in Gabon and the over-extraction of a sensitive resource, Mungianis says.
Mash acknowledges that there could be other therapeutic uses for ibogaine. She has superficially noted the potential for noribogaine (what ibogaine turns into once our bodies metabolize it) to reduce depression. But there are many other drugs on the market, and revolutionary psychedelic treatments being explored, to address these other issues. And other psychedelics with equal or greater potential do not carry nearly as many potential risks, expenses, or limitations. However, Mash stresses, ibogaine could present a potential breakthrough in addressing addiction.
This equation may change in the future. As Mash points out, we don't have a full understanding of ibogaine or its parallels or derivatives yet, and as we learn more we may find additional uses for which it is especially effective. We could also mitigate some of its costs and risks.
However our understanding of the substance has long been stunted by a lack of research dollars available for even ibogaine-as-addiction-treatment research. Lotsof and Mash both tried to get it moving through FDA trials in the '90s, but couldn't put together the millions upon millions required for the process. Other psychedelics like MDMA and psilocybin have managed to find strong support bases that ibogaine never could. Mash hopes to change that, though. This year she's leading a renewed push to fund studies and FDA trials for ibogaine and noribogaine.
"Once scientists have the ability to study the drug and we're able to work with human subjects" for addiction treatments we have evidence for and a strong reason to pursue, she says, "we're going to learn a lot more about it. We're going to learn about other [uses] that maybe we never thought about. But we've got to get into structured clinical trials before we can identify those."
"And," she adds with conviction, "I'm going to make that happen."
Correction: A previous version of this article states that Mungianis "and helps people access ground iboga." While he doesn't directly help people access it, he believes in the value of iboga and ibogaine for a variety of therapeutic uses.
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