For Heroin Addicts, A Bizarre Remedy

For Heroin Addicts, A Bizarre Remedy
Posted by FoM on November 28, 1999 at 10:59:23 PT
By Brendan I. Koerner 
Source: U.S. News Online
Howard Lotsof wasn't trying to end his addiction. A college dropout with a heroin habit and a taste for pharmacological adventure, he was simply curious about ibogaine, an alkaloid derived from a West African shrub. 
But a single dose of the drug sent him on a 36-hour psychedelic journey, filled with dreamlike visions and painful self-discovery that miraculously killed his craving for dope. "It wasn't until the next day when I walked out of my house, I realized, 'Gee, I'm clean, I'm not going through withdrawal,' " the Staten Island, N.Y., resident says, remembering his first ibogaine experience in 1962. "I used to think of [heroin] as my comfort, but 36 hours later I thought, 'Boy, that drug emulates death.' "Since then, Lotsof, the treatment's most zealous promoter, has administered the hallucinogen to dozens of addicts in the Netherlands and Panama. Clinics have popped up from Slovenia to St. Kitts–though not in the United States, where ibogaine is as illegal as any street narcotic. The drug has been linked to long-term brain damage and death. But serious medical interest persists, in part because the current pharmacological therapies are far from ideal. Methadone, the primary remedy for heroin addiction, must be taken every day for months, even years. And about 30 percent of methadone users relapse within 12 months of beginning therapy. Waking dream. Ibogaine is concocted from the bark of Tabernanthe iboga, a plant from the forests of Gabon. Initiates into the Bwiti religion are fed the drug to facilitate communication with the dead. In the United States, gonzo journalist Hunter S. Thompson suggested absurdly in Fear and Loathing: On the Campaign Trail '72 that presidential candidate Edmund Muskie's odd behavior was caused by ibogaine abuse.An ibogaine trip is compared with a waking dream, in which childhood memories flicker through the mind like movies. This hallucinatory phase, which lasts several hours, is followed by a period of introspection during which addicts say they confront the damage they have caused themselves and loved ones. After crashing from exhaustion, patients typically awaken famished, and without a yen to get high (although some later relapse).Tales of ibogaine's effectiveness are legion among addicts, but data are in short supply. "The whole trouble is that all these stories are just stories," says Stanley Glick, chairman of the department of pharmacology and neuroscience at Albany Medical College, who last month co-directed the First International Conference on Ibogaine at the New York University School of Medicine. "We need systematic clinical trials." An FDA-approved trial at the University of Miami commenced in 1993 but has been suspended due to a patent fight.However, recent work with rats and mice has shed light on ibogaine's neuronal mechanisms. Researchers believe the drug binds to the brain's NMDA receptor, blocking out the neurotransmitter glutamate. Glutamate transmission plays a key role in sensitizing addicts to drugs, and preventing that transmission may combat the hunger for cocaine, heroin, even alcohol. Though intrigued by ibogaine, the National Institute on Drug Abuse is currently funding only one researcher, Glick. In 1995, a panel of NIDA consultants, troubled by evidence that ibogaine causes seizures in monkeys and dogs, as well as by reports of deaths among native practitioners, recommended against developing the drug. "We then said we would fund pre-clinical and clinical trials that got meritorious scores through the peer-review process," says Frank Vocci, director of NIDA's Medications Development Division. "And that is still our position."But Glick says the drug's neurotoxicity can be avoided. He has a patent pending on an ibogaine derivative called 18-methoxycoronaridine that, unlike its sister compound, does not kill cells in the cerebellum, a part of the brain associated with repetitive behavior. Glick hopes this safety improvement will interest pharmaceutical manufacturers."There is a stigma, an enormous stigma, attached to addiction," says Lotsof, adding that drug companies view the nation's estimated 600,000 heroin addicts as problematic subjects. But he says such stereotypes should not be allowed to stall new cures, no matter how offbeat. Science & Ideas 12/6/99Related Web Sites:The Ibogaine Dossier Ibogaine Vault
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