Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — Written by Jennifer Huizen on May 14, 2021
Some anecdotal and early research evidence suggests that ibogaine, a compound derived from a shrub in western Central African, may help reduce symptoms of drug and alcohol withdrawal, ease cravings, and lower the risk of recurrent use.
Although some expertsTrusted Source acknowledge that ibogaine could be an excellent alternative treatment, the Drug Enforcement Agency (DEA) recognizes it as a Schedule I substance. This classification means that it is illegal and currently has no approved medical use in the United States.
This article explains more about ibogaine, including what the research says so far about using it to treat addiction and the potential risks. It also lists some other psychedelic compounds that may be useful in addiction treatment.
What is ibogaine?
Ibogaine is a type of compound called an alkaloid. It is the most abundantTrusted Source alkaloid that Tabernanthe iboga, a mid-sized shrub native to western Central Africa, produces.
The Bwiti religion uses different parts of T. iboga for certain healing and religious purposes. For example, as well as having hallucinogenic effects, the roots and root bark of the shrub can be effective in:
- restoring good health
- increasing sexual arousal or behavior
- reducing fever
The leaves of T.iboga also act as an aphrodisiac. In addition, their anesthetic properties mean that they can numb pain.
Research suggests that in small doses, ibogaine usually acts as a mild stimulant. However, larger quantities can cause hallucinations and induce a profound psychedelic state. This state may significantly reduce symptoms of opioid withdrawal and block substance cravings.
In the 1980s, ibogaine became popular in Europe and the U.S. as a nonaddictive treatment option for drug dependency. Since then, some research indicates that ibogaine may also be useful for the treatment of neuropsychiatric conditions, alcohol use disorder, and depression.
Using ibogaine to treat addiction
Despite the classification of ibogaine as a Schedule I drug, researchers renewed their investigations of the substance as a treatment for addiction in the late 1990s.
However, according to a 2020 article in NatureTrusted Source, scientists have not yet tested ibogaine in placebo-controlled, double-blind clinical trials. Instead, they have only looked at ibogaine’s potential benefits in open-label studies, in which all the participants were aware of which form of treatment they were taking.
Anecdotal reports around ibogaine’s medical uses also indicate that it has promise as a treatment, but these reports are usually based on hearsay, observations, or historical accounts, as opposed to scientific research and trials.
Other major issuesTrusted Source may prevent ibogaine from therapeutic use, even if researchers establish its medical properties. For instance, it is hard to gather large quantities of ibogaine because humans have overexploited T. iboga. There are currently only three ways to make synthetic ibogaine, all of which involve numerous steps and produce extremely low yields.
The safety profile of ibogaine is also currently unacceptable. The compound tends to accumulate in fatty tissues and can block potassium channels, causing heart problems. Furthermore, several people have died from ibogaine toxicity. Ibogaine can also cause hallucinations that can be severe and last longer than 24 hoursTrusted Source.
Successes
Researchers around the world continue to explore ibogaine’s potential medical uses — in particular, its use as a treatment for addiction and neuropsychiatric conditions. Thousands of studies have investigated the different properties of ibogaine, its potential uses, and its effectiveness. Currently, Brazil, South Africa, and New Zealand classify ibogaine as a pharmaceutical substance that licensed medical professionals can use.
Some researchTrusted Source suggests that ibogaine somehow changes addiction-related or promoting pathways between nerve cells in the brain. It may also affect signaling in brain regions that play a role in the behavioral effects of drugs that are addictive.
Hallucinogens such as ibogaine may also activate the 5-HT2A serotonin receptor (HTR2A). Serotonin is a brain hormone that helps improve mood, happiness, and feelings of well-being.
In a 2014 study in Brazil, researchers recruited 75 participants who previously used cannabis, cocaine, crack cocaine, or alcohol. The participants who received one ibogaine treatment reported abstaining from drug use for a median of 5.5 months. Those who received multiple ibogaine treatments abstained for a median of 8.4 months.
The Multidisciplinary Association for Psychedelic Studies (MAPS) also helped fund two observational studies in 2017 that supported the use of ibogaine as a treatment for addiction to drugs.
In the first of these studies, which took place in Mexico, ibogaine use improved symptoms of opioid withdrawal and reduced subsequent drug use in people who had found other treatment options ineffective.
In the other study, researchers in New Zealand concluded that a single treatment with ibogaine reduced symptoms of opioid withdrawal in people dependent on opioids over 12 months. It also helped people stop taking opioids or maintain a reduced use. However, one person in the study died during treatment.
Some researchersTrusted Source are currently trying to modify psychedelic compounds such as ibogaine to make them safer by reducing their ability to cause hallucinations.
In 2012, the National Institute on Drug Abuse pledged $6.5 million to develop a nonpsychoactive version of ibogaine called 18-methoxycoronaridine (18-MC). Currently, researchers have completed a phase 1 human clinical trial of 18-MC, and there are plans for phase 2a clinical trials.
Risks
The DEA classifies ibogaine as a Schedule I controlled substance. According to this classification, ibogaine:
- has no currently accepted medical use
- lacks evidence to show that it is safe for use under medical supervision
- has a high risk of abuse and addiction
- can be a dangerous substance
Furthermore, ibogaine can be toxic, with the potential to cause paralysis, convulsions, and death from respiratory failure or heart failure.
According to MAPS, 30 people have died due to ingesting ibogaine in peer-reviewed scientific works. However, the association claims that researchers could have avoided most of these deaths by taking preventive steps, such as screening properly for medical conditions, monitoring electrolyte levels, and monitoring cardiac health.