Evidence of Efficacy
Ibogaine shows promise as a tool in treating drug craving and opioid withdrawal syndrome. There are currently no efficient treatments to combat drug craving. Additionally, other than opioid substitution therapies, there is a lack of pharmaceuticals that can eliminate the opioid withdrawal syndrome and help opioid-dependent patients to give up the use of opiates such as morphine, heroin, methadone and oxycontin. Furthermore, standard pharmacological and psychological approaches used in the treatment of addiction have very limited success. It seems necessary to investigate new and potentially more efficient tools for this growing individual and social problem.
Animal studies have found consistent decreases in drug self-administration after treatment with this alkaloid. Preclinical studies show that iboga alkaloids produce significant attenuation of opioid withdrawal signs in different animal species, and reduce self-administration of cocaine, amphetamine, methamphetamine, alcohol, and nicotine (1).
In humans, one paper describing 33 treatments for opioid dependence showed complete resolution of withdrawal signs in 29 (88%) (2). An open label prospective study showed resolution of withdrawal signs and symptoms at 24 hours (3). No controlled clinical trials have been conducted to assess clinical efficacy.
Anecdotal evidence suggests that a single administration of ibogaine is capable of alleviating drug craving and relapse of drug use for a period of time of weeks to months. The only follow-up study done until now showed that 67% of the 21 participants ended the use of either all or the primary and secondary drugs of abuse after ibogaine treatment. Thirty-three percent of them did not end the use of their primary or secondary drugs of abuse, but decreased the amount of drug use. The overall average drug free period (from primary and secondary drugs of abuse) of all participants was 21.8 months. The median was, however, lower - 6 months. (4).
Informal addiction treatments with ibogaine have spread throughout the world during the last three decades. These are typically performed in private clinics with medical backup and underground settings (such as private houses, apartments or even hotel rooms) outside of medical facilities by providers that often lack medical training. Until 2006 a total of 3414 reported ibogaine treatments had taken place all over the world, a fourfold increase relative to 5 years earlier. Sixty-eight percent of these users took ibogaine with the intention of treating a substance-related disorder, mainly opioid withdrawal (5). This fast increase in ibogaine’s popularity in unofficial contexts, mostly spread by word of mouth, suggests efficacy as an addiction treatment tool.