Powerful psychedelics are gaining renewed attention as a treatment for opioid addiction
The pharmaceutical company Atai life sciences is spending millions on research into the complex, and congressional lawmakers from both parties have pushed the administration to promote ibogaine research into substance abuse, post-traumatic stress disorder and other mental health problems.
For Dr. Deborah Mash, professor of neurology at the University of California University of Miami who started studying ibogaine the rising interest in the early 1990s confirms her belief that the drug could help alleviate the opioid crisis. “Ibogaine is not a miracle cure, and it won’t work for everyone, but it is the most powerful addiction interrupter I have ever seen,” she said.
Researchers have also studied ibogaine’s ability to treat other difficult mental health conditions. A small study published earlier this year, the journal Nature Medicine found that military veterans with traumatic brain injuries who underwent a single ibogaine therapy session experienced marked improvements in disability, psychiatric symptoms and cognition.
No adverse side effects were reported among the 30 study participants, who were followed for one month. There was no control group.
Dr. Nolan Williams, lead author of the study, said the results were especially notable given the lack of therapeutic options for traumatic brain injury.
“These are the most dramatic drug effects I have ever recorded in an observational study,” said Dr. Williams, director of the Brain Stimulation Laboratory at Stanford University.
He and other researchers are quick to recognize the limitations of existing science on ibogaine therapy. “Without the green light to conduct studies from the FDA, you simply can’t do the kind of randomized trials that are the gold standard for clinical trials,” said Dr. Williams.
Ibogaine is known to cause arrhythmia, or irregular heartbeat, which in severe cases can lead to fatal cardiac arrest.
Other researchers are more skeptical about its potential as a widely accessible anti-addiction therapy. William Stoops, a professor of behavioral sciences at the University of Kentucky who specializes in substance use disorders, said ibogaine’s heart risks make it a poor candidate for regulator consideration.
Even if ibogaine were to win approval from the Food and Drug Administration, the poor health of many long-term opioid users, many of whom have cardiovascular problems, would make them ineligible for treatment, said Dr. Stoops. And the high cost of providing ibogaine under medical supervision would further shrink the pool of potential patients, he added. “Access would be so limited that how many people would benefit?” he asked.
The National Institute on Drug Abuse, part of the National Institutes of Health, has already begun funding studies (those are not studies involving humans) with ibogaine analogues, chemically related compounds that could provide the therapeutic benefits without the health risks. The agency’s director, Dr. Nora Volkow, said she had long been intrigued by ibogaine’s anti-addiction potential — and wary of its heart risks.
But existing treatments for opioid use disorders, such as methadone and buprenorphine, are imperfect, she noted, and half of all patients stop taking them after six months.
“In addition to existing effective medications, there is a need for treatment options that differ from the ones we currently have,” said Dr. Volkow. “We need to break the mold of how we do things and examine what the science shows us.”
The FDA said it could not comment on whether it would support ibogaine studies in the future, noting that federal law prohibits the agency from commenting on future studies. experimental drug applications.