Exploratory Outcome Study of Ibogaine-Assisted Therapy in 20 Chemically-Dependent Persons

Valerie MojeikoMultidisciplinary Association for

Psychedelic Studies (MAPS) www.maps.org

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Tabernanthe Iboga

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Howard Lotsof

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Subjective Effects

• Psychedelic that produces a dreamlike state• Review of memories• Experience lasts several days• Many find it unpleasant, not a recreational drug• Some experience psychological material related to

addiction• Greatly reduces physical and psychological

withdrawal symptoms from heroin, methadone, other drugs

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Neurotransmitter Activities

• Novel mechanism of action• Complex interactions between multiple

neurotransmitter systems• Mu-opiod agonist; NMDA antagonist; kappa opioid

agonist; serotonin 5ht2a agonist; serotonin uptake inhibitor; 5ht3 agonist; dopamine uptake inhibitor; sigma opioid receptor agonist…

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Where do addicts take ibogaine?

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Hotel Rooms

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At Home

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Iboga Therapy House, Canada

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Bwiti-Inspired

Bwiti

Tribal

Hotel Rooms At Home

Underground

Harm Reduction Model Applied for grant

Govt is supportive No regulations on ibogaine in Canada

Iboga Therapy House Others

Clinics

Medical/Therapeutic

Ibogaine Treatment Options

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Existing treatment facilities providing detoxification--not collecting information…

• How well does it work? How safe is it?

• What percentage of people benefit and to what degree?

• How can these treatments be improved?

• Should formal studies be conducted?

MAPS’ Role: Evaluating program, providing feedback, and collecting data for research

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Preliminary Data: June 2004: Iboga Therapy House: 2wks-1yr after tx (avg. 6 months)

• 20 subjects• 6 of 7 treated for

Cocaine/Crack abstinent (86%)

• 3 of 8 treated for opiates abstinent (38%)

• 4/5 treated for other substances abstinent (80%)

0

1

2

3

4

5

6

COC Opiate Alcohol Pot Meth Comb.

AbstinentUsing

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Exploratory Outcome Study

• Seeking to obtain basic preliminary data • Not a controlled study, but is representative

since including 20 Subjects treated consecutively

• One-year series of questionnaires and interviews from 20 subjects verified by interview with significant others

• Harm reduction model: looking at abstinence as well as non-abstinence outcomes, trying to differentiate between abuse and controlled use

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ASI-Addiction Severity Index

• Semi-structured 1 hour interview

• Scores on 7 subscales: medical status, employment and support, drug use, alcohol use, legal status, family/social status, and psychiatric status

• Been used extensively on a wide variety of outcome studies

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Peak Experience Profile (PEP)

• Measures the psychedelic experience

• 180 items; one composite score; 16 subscores

• Scores for peaks (highs) and nadirs (lows)

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Measures

• Addiction Severity Index (primary variable)

• Peak Experience Profile• Beck Depression and Anxiety

Inventories• Subjective and Objective Opiate

Withdrawal Scales (SOWS/OOWS)• Pain and Craving Scales

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Process

• All interviews are conducted by evaluation coordinator

• Baseline in person; follow-up by phone

• Each interview takes about an hour or two

• Valerie organizes and analyzes data

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i P W2

1 2 3 4 5 6 7 8 9 10

11

12

ASI X X X X X X X X X X X X XBDI/BAI X X X X X X X X X X X X X XPEP XO/SOWS X X XPain/Cra X X X X X X X X X X X X X X XSO check

X X X X X X X X X X X X X X X

Schedule for Outcome Measures

i=Intake; P=Post-treatment; W2=Week 2; 1-12=Months 1-12

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Challenges

• No drug testing

• Difficulty of remaining in contact during follow-up

• Check-in with significant other addresses these concerns

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Progress

• End of protocol design and training phase• Began study at Ibogaine Association; ended

prematurely• Assisting Iboga Therapy House in obtaining

grant from Health Canada• Partial funding obtained from private donors

for study, Iboga Therapy House seeking additional funding for operating costs

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Goals• Obtain basic information about outcomes in

underground clinics• Provide feedback to improve services; help

win funding from Canadian government; increase safety

• Ideally lead to placebo-controlled double-blind studies

• Ibogaine available to drug addicts in a safe, supportive, and humane setting