Saturday, October 15, 2016

Why Is Ibogaine Illegal? Schedule One No Less?

Ibogaine is an African plant with hallucinogenic properties. I recently read about it in the excellent book Illegal Drugs by Paul Gahlinger. What’s especially galling about the Schedule I status of Ibogaine is that it shows some promise in the treatment of addiction. It’s potentially the solution to the drug problem, but it’s treated like it’s just another habit-forming substance.

After a dose of about 150 milligrams of the powdered root bark, the user might experience an increased sense of colors, similar to the effects of mescaline. With 300 milligrams, there is a slight nausea, dizziness, and a lack of muscular control or coordination. At one gram, there are hallucinations, which can last for days. The elimination half-life— the time it takes for half of the ibogaine to leave the body— is about 38 hours, suggesting that some effects can persist for a week or longer with a large dose.
Since ibogaine has a chemical structure similar to LSD (the ibogaine molecule contains the indole ring characteristic of many hallucinogens; see Chapter 6), the U.S. federal government classified ibogaine among substances analogous to LSD, and therefore made it illegal. Unlike LSD, however, ibogaine was never a recreational drug and it also shows promise as an anti-addictive medication. As research progresses, ibogaine may be rescheduled and marketed as a pharmaceutical.

So it never became a party drug. It’s not “fun.” Maybe it would if it were fully legalized, but it's hard to say. Some tribal medicines (ayahuasca, mescaline) never really caught on as recreational party drugs, and it seems like ibogaine could be in this category. 

Soon after its discovery, Europeans began to experiment with ibogaine and found that it was effective in curing addiction to opiates, cocaine, alcohol, amphetamines, and nicotine. Self-help groups claimed that ibogaine reduces withdrawal symptoms and helps addicts stay away from other drugs. Some addicts claim that even a single dose has reduced drug cravings for periods up to six months.

Even granting that we should probably doubt 19th century medicine, this is kind of promising and should be explored further.

One of the first to explore this use was Howard Lotsof, a non-scientist businessman who discovered that he and his friends stopped abusing drugs after experimenting with ibogaine. In the 1960s, he founded a New York corporation, NDA International, Inc., to market Endabuse. He went on to develop a formal detoxification program and took out several patents, beginning in 1985 with his “Rapid method for interrupting the narcotic addiction syndrome.” In this program, one gram of ibogaine hydrochloride is taken by mouth, with effects lasting for about 30 hours. Following just this single treatment, it is claimed that the addict will no longer want to take heroin and show no perceptible signs of physical withdrawal.

Again, even with the possibility that this is pure snake-oil, testimonials are a good place to start. If this can help people kick their opioid, alcohol, or cocaine addictions, it is well worth exploring. No such exploration is possible with the Schedule I status, which severely restricts the ability of researchers to acquire the drug for legitimate medical trials. 

The effects of ibogaine are felt about 15 to 20 minutes after ingestion. A buzzing sound is often heard, perhaps in waves, and the skin may feel numb. After 25 to 30 minutes, objects appear to vibrate. There may be nausea. After about an hour, the first visions appear. Then peak intoxication follows, lasting two to four hours, during which the user can experience difficulty walking, dizziness, pain with bright lights, and out-of-body sensations. There may also be tremors, abnormal breathing, spasms in the legs, and seizures. Some users have diarrhea, teary eyes, salivation, and a runny nose.

To reiterate, this sounds like other kinds of tribal medicine (mescaline and ayahuasca for example). No fun, but definitely mind altering. 

Then there's this:

There is no documented withdrawal syndrome.

This helps us rule out the possibility of problematic habit-forming.

From the section titled “What to Do if There Is An Overdose?”

Ibogaine appears to be safe even in amounts that vastly exceed the normal dose. The greatest danger is in the paralysis that accompanies very high doses, but this is not properly considered an overdose, and resolves without adverse effects. There are unsubstantiated reports that excessive amounts of iboga ingestion have resulted in seizures, paralysis, and death by respiratory arrest.

The major concern is probably anxiety and apprehension from the long-lasting effects. An overdose should be managed by support in a manner similar to the treatment of hallucinogens (see LSD). For suspected overdose, atropine has been used to suppress all signs of ibogaine intoxication.

So basically there’s nothing to worry about except for the possibility of the user freaking out a little. This can be managed with a bit of reassurance, or possibly atropine for very extreme cases. With almost no deaths  or even significant side effects observed in all the world’s literature, this appears to be a pretty safe drug. 

For a more thorough literature review than I am willing to write here, please see this article at Erowid. Even if the anti-addictive powers of ibogaine turn out to be complete bunk, it's still very much worth exploring the possibility. 

Hopefully ibogaine is descheduled or *at least* put on a less restrictive schedule, given its impressive safety profile and promise as a treatment for addictions that are actually harmful. Hopefully the DEA stops preemptively banning anything that looks like it might be fun. I really don't understand what makes these drug warriors tick. They don't seem to care that their policies don't make sense. They aren't taking the entirety of American drug policy as a portfolio; it's as if they're doing a bunch of one-offs without considering the overall effect. Banning some substances might mean other, more dangerous substances become more attractive or relatively cost-effective. Lawmakers and the DEA need to consider these overall effects of drug policy. They need to stop treating bans on particular substances as if they are isolated decisions, as if they don't affect the outcomes of *other* decisions to ban other substances. Maybe if ibogaine were the only drug in the world, it might make sense to ban it. (I said "maybe"; I certainly don't think it would make sense.) But its ban needs to be assessed in context. The world also contains many potentially harmful substances: alcohol, tobacco, cocaine, heroin. If freely available ibogaine would reduce the use of these substances, then surely it should be freely available. 

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