CThis plant, classified as a narcotic, is prohibited in France and the United States. Elsewhere, research and treatment centers have been authorized. In 1962, a young drug addict, Howard Lotsof, experimented with six companions with a new hallucinogenic substance that a chemist friend told him about: ibogaine. Against all expectations, after 36 hours of experience, the young American and his friends, all addicted to heroin or cocaine, freed themselves from their addiction. A final weaning for Howard Lotsof and at least six months for the others, a period during which they remained in contact.
Chance or big discovery?
From the 1980s until his death in 2010, Howard Lotsof did not stop trying to convince scientists, laboratories, politicians and civil society to treat drug addicts with ibogaine. This molecule from the alkaloid family is extracted from iboga (Tabernanthe iboga), a shrub endemic to equatorial central Africa. The bark of its root contains a dozen very active alkaloids used in traditional medicine and Bwiti initiation ceremonies in Gabon.
“When I heard about ibogaine, I became very curious, and skeptical. And the more I experimented, the more interesting it became, ”says Stanley Glick, professor and research director at the Center for Neuropharmacology and Neuroscience at Albany Medical College in New York. By experimenting with the molecule on rats addicted to cocaine and morphine, Stanley Glick proved in 1991 that ibogaine reduced the self-administration of these substances just two days after treatment.
Since then, research, mainly American, carried out on animals and on human cell cultures have clarified its effects. Ibogaine is a tryptamine, close to psilocin and psilocybin (substances present in hallucinogenic mushrooms), psychostimulant and hallucinogenic in high doses. This molecule interacts with neurotransmitters, mainly serotonin and glutamate, and blocks opioid receptors. It is an NMDA receptor antagonist (activated by glutamate) which would explain its anti-addictive properties.
“It is effective in opiate withdrawal almost most of the time. Some patients have lingering effects afterwards. But, there was never a double-blind study, which is necessary to define actual success rates,” says Deborah Mash, professor of neurology and molecular and cellular pharmacology at Miami Medical University.
The latest studies have highlighted important new properties: iboga has stimulating effects on energy metabolism and, according to Professor Dorit Ron in Israel, ibogaine stimulates the synthesis and release of neurotrophin, which helps the nerve pathways to regenerate and the brain to reorganize.
Testimonies confirm its effectiveness: "My life completely changed, twelve hours after my treatment with ibogaine I was weaned of seventeen years of addiction. It was incredible, I can not explain it, "says Roberto, 45, an Italian who lived in New York and had a daily consumption of heroin, cocaine and methadone, clean for seven years. "I was weaned from three years of cocaine addiction in a weekend in 2004, since I have never relapsed," says Eric, a French 37 years. "My weaning was immediate. While I was unimaginable not to take doses because I was several grams per day, "says Nicolas, former addict to cocaine, weaned for three years.
But the failures also exist: "For me, it did not work," says Daniel, who has been dependent on heroin, cocaine and "all kinds of drugs" for more than 30 years. "I was taking industrial doses and I hit the bottom with methadone, the drug that doctors seem to give you as a solution ..." Daniel says ironically, who took methadone two weeks after treatment.
Although today the main actions of ibogaine have been identified, its very complex pharmacodynamic functioning has not been fully explained. But the big taboo that iboga and ibogaine raise is actually that of their hallucinogenic properties. "The iboga does not enter the huts, it does not have the profile of psychotropic drugs. It is not a recreational substance, and its actions are different and more complicated than those of most hallucinogens, "said Yann Guignon, consultant in intercultural mediation and sustainable development in Gabon. In addition, "ibogaine became known in an unusual way, it was not discovered by a scientist; that is why, from the beginning, it has been met with skepticism by the scientific community. His story in Africa has also given him a mystical dimension that people do not take seriously. And because it has hallucinogenic effects, people think it will never be an approved drug, "says Glick.
"Iboga is part of a whole, it opened my consciousness, cleansed the mind and body," adds Eric. Beyond physiological withdrawal, many witnesses insist on the visions they had during treatment. Charles Kaplan, former director of the Addiction Research Institute in Rotterdam, relates them to the psychiatric aspect: "There is a psychosocial effect. These effects are very close to what psychoanalysts call "abreaction". They bring to the surface the lost memories and emotional experiences of addiction processes that can be worked with therapists. "
Deborah Mash explains that ibogaine is "a psychoactive molecule, but not a hallucinogen like LSD. She puts on a waking dream for thirty-six hours and, during this state of altered consciousness, the patient relives the experiences of his childhood and discovers the roots of his addiction. "It's like doing ten years of psychoanalysis in three days," Howard Lotsof often said.
This subjective process, which can not be measured scientifically, actually contributes to fueling fears and reservations about iboga or ibogaine treatments. For Atome Ribenga, a Gabonese traditional practitioner, the notion of "hallucinogen" refers to visions or auditions of totally unreal things, whereas these visions are revealing of realities, even if they are symbolic, for the one who lives them in the initiation.
Patients are then invited to verbalize their experience for therapeutic support. “After six months of well-being, I had a breakdown because, in reality, iboga heals you and gives you the chance to say to yourself: ‘OK, you can get back into life if you want to,’” confides Roberto. According to the scientific and sociological literature on iboga, relapses often occur six months after treatment, following a lack of therapeutic follow-up or due to an unfavorable social environment – frequenting the addiction community arouses new temptations.
Although iboga and ibogaine have been classified as drugs in the United States since 1967, they have been authorized by the National Institute on Drug Abuse (NIDA) to be prescribed as part of a treatment protocol for man in the early 1990 years. After a meeting with Howard Lotsof and anecdotal evidence from the Addiction Research Institute in the Netherlands and a clinic in Panama at that time, Deborah Mash, skeptical and impressed, was allowed to conduct the first clinical trials in the United States. United States for phase I. But in 1995, following a presentation to representatives of pharmaceutical companies, NIDA has decided to stop its funding.
"The opinion of the pharmaceutical industry was generally critical and had a significant influence in the decision to no longer fund trials. NIDA has stopped its ibogaine project, but continues to support preclinical research on iboga alkaloids, "says Kenneth Alper, a professor of psychiatry and neurology at the University of Medicine in New York. How to explain such resistance? "Most pharmaceutical companies do not want to have anything to do with ibogaine, nor with addiction treatments in general. Most companies mistakenly believe that they can not make a lot of money in the treatment of addiction. Plus, they think it could be a bad thing for them because people stigmatize addiction and think it does not deserve to be treated like other diseases, "says Glick.
To treat a disease in one or two treatments is much less profitable than a treatment for life. It was with private funds that Deborah Mash was able to continue her research, between her laboratory in Miami and a detox clinic on the islands of St. Christopher in the Caribbean.
Today, the international community diverges on the status of research on iboga and ibogaine. While most countries do not have legislation, the United States, Belgium, Poland, Denmark, Switzerland and, since 2007, France have classified these two substances as drugs. The French Agency for the Safety of Health Products (Afssaps) also noted that iboga tended "to develop within the framework of sectarian activities through seminars on "self-revaluation" and "inner journeys"". It noted that the plant was the subject of "active promotion" on the Internet.
Interested in scientific and empirical observations, other governments have initiated research programs or licensed ibogaine clinics. In Israel and India, clinical trials are conducted with the agreement of ministries of health; in Brazil, Mexico, Panama and the Caribbean, formal care centers have been established; in Slovenia, a multidisciplinary research center has been working since 2005, and since 2009, New Zealand has authorized the prescription of ibogaine.
In Gabon, after having long remained in the secrecy of the initiates, iboga was declared "national heritage and strategic reserve" in 2000. For Bernadette Rebienot, president of the Union of Traditional Health Practitioners in Gabon, "treatment with ibogaine removes the initiatory part of iboga, so we are not really at the source. In the West, researchers think they know iboga, but they make me laugh ... We have known it since the beginning of time. We need collaboration between us, it is complementary and it is for the good of humanity ", warns langanga (" traditional practitioner "), who pleads with the World Health Organization (WHO) for the recognition of the traditional pharmacopoeia.
In Slovenia, "The Institute for Anthropological Medicine [IMO] aspires to restore the quality and reputation of traditional healing and natural remedies through the scientific evaluation of these methods, their effectiveness and their safety" explains Roman Paskulin, addictologist and director of the IMO. We offer our advice on reducing the risk of ibogaine treatments, but do not provide care at this time. The goal is to develop a holistic approach to health in its physical, mental and social dimensions, bringing together universities of medicine, humanities and biotechnology, with the support of the Ministry of Health and the Office of Health. drug addicts.
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