Ibogaine Use in Addiction Treatment: An Overview

What Is ibogaine?

A shrub found in Central West Africa, Tabernanthe iboga plays a pivotal role in the region's Bwiti culture. The shrub's bark is known to have powerful psychoactive effects, and as such is used in a multitude of different ceremonies, including rites of passage and healing rituals. This is, in large part, because it contains ibogaine, a psychedelic chemical also found in several plants from the dogbane family.

In 1962, scientist Howard Lotsof and six friends — all of whom were struggling with heroin addiction — ingested ibogaine powder, which at the time had been marketed as a neuromuscular stimulant in France since 1939. After an intense hallucinogenic experience with the extract, five of the six individuals immediately quit using heroin. From that day forward, Lotsof became a leading advocate of ibogaine's potential in treating addiction.

Today, ibogaine is a highly regulated substance in most Western countries. In the United States, it is an illegal Schedule 1 Drug, and is not approved for any therapeutic or clinical usage. Canada added ibogaine to the Prescription Drug List in 2017, meaning that while it is still tightly controlled, it can be legally obtained via a prescription. Ibogaine is also illegal in the United Kingdom and other European countries, with the exception of Portugal, where it is decriminalized, and Denmark, where it is a controlled substance. The only countries it is fully legal to possess ibogaine in are New Zealand and Uruguay.

How does ibogaine affect the brain?

Ibogaine is somewhat unique in that its precise effects are dependent on dosage. In lower quantities, it acts primarily as a stimulant, and its hallucinogenic effects are mostly or entirely absent. A large dose of the drug puts the user into an almost dreamlike state that lasts a full day or more.

Typically, the effects of ibogaine begin one to three hours after initial ingestion. Users have reported visualizing past memories, floating or conversing with a transcendent being or beings. This is known as the acute phase and lasts up to eight hours.

The acute phase is followed by the evaluative phase, which lasts eight to 20 hours. This phase is marked by deep reflection and introspection. Finally, the residual stimulation phase, which can last up to 72 hours, frequently involves increased arousal, vigilance and a reduced need for sleep. After using ibogaine, one typically experiences heightened introspection lasting up to several weeks.

Of course, it can have negative side effects. Ibogaine is known to cause ataxia, dry mouth, nausea, vomiting and, in severe cases, cardiac arrest.

Ibogaine is also unique for the complex manner in which it interacts with the brain, simultaneously affecting multiple neurotransmitters. Researchers are still attempting to definitively explain these interactions. Similarly, they do not yet fully understand the precise mechanisms by which ibogaine interrupts addiction.

What's currently known about ibogaine is that it influences the body's serotonin system, reduces dopamine levels and increases the breakdown of dopamine by the body. It also interacts with acetylcholine, a neurotransmitter primarily associated with autonomic muscle contractions, heart rate, blood vessel dilation and bodily secretions. Some evidence suggests that ibogaine may increase neuroplasticity and effectively "reset" neuroreceptors to a pre-addiction state.

Human clinical trials of ibogaine for addiction treatment are currently underway in Spain, the UK and the University of São Paulo. There is also a clinical study planned in Canada.

What type of addictions does ibogaine treat?

The bulk of the current research around the clinical applications of ibogaine pertains to opioids. Multiple observational studies have demonstrated its effectiveness in reducing both cravings and withdrawal symptoms. Similar effects have been observed with cocaine, and research suggests that ibogaine may actually block cocaine molecules from bonding with serotonin transmitters.

A 2005 study also found that ibogaine could be effective in treating alcoholism.

Further research into ibogaine is necessary before it can definitively be declared as a treatment for addiction. However, results of these studies show its promise. And in that promise could be a significant investment opportunity.

What is the current availability of ibogaine treatments?

At the moment, ibogaine is relatively hard to come by. Although numerous prior to 2017, since ibogaine was added to Canada's Prescription Drug List ibogaine clinics have become functionally nonexistent. Ibogaine's status as a Schedule 1 Substance in the US means that in addition to being impossible to acquire legally for clinical use, it's also difficult to obtain for research purposes.

That doesn't mean investors should turn a blind eye, however.

It is estimated that the global drug addiction treatment market will reach US$37.7 billion by 2027. The global opioid use disorder market, meanwhile, was worth US$2.52 billion in 2020. Moreover, there are still multiple highly successful companies and promising startups working with ibogaine and ibogaine derivatives.

For instance, Massachusetts-based startup Delix Therapeutics announced plans in December to work with the National Institute on Drug Abuse to test its own non-psychedelic version of ibogaine for a range of substance use disorders.

Meanwhile, New York based MindMed (NASDAQ:MNMD) has developed a non-hallucinogenic version of ibogaine that recently entered Phase II clinical trials. Atai Life Sciences (NASDAQ: ATAI) subsidiary DemeRx, headquartered in Florida, is currently developing two ibogaine and noribogaine derivatives for opioid dependence.

In Canada, Universal Ibogaine (TSXV:IBO) has plans to operate a seven-day ibogaine treatment program across an international network of clinics. The company recently secured C$6 million in financing to work towards developing a new innovative addiction treatment model.

According to Universal Ibogaine CEO Nick Karos, the financing has allowed the company to acquire the Kelburn Treatment Center and invest in a clinical trial program with the goal of demonstrating the safety and efficacy of its ibogaine treatment protocol so it can begin treating patients with ibogaine in Canada.