Ibogaine: Isreali MAPS
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Transcript of Ibogaine: Isreali MAPS
Exploratory Outcome Study of Ibogaine-Assisted Therapy in 20 Chemically-Dependent Persons
Valerie MojeikoMultidisciplinary Association for
Psychedelic Studies (MAPS) www.maps.org
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Tabernanthe Iboga
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Howard Lotsof
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Subjective Effects
• Psychedelic that produces a dreamlike state• Review of memories• Experience lasts several days• Many find it unpleasant, not a recreational drug• Some experience psychological material related to
addiction• Greatly reduces physical and psychological
withdrawal symptoms from heroin, methadone, other drugs
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Neurotransmitter Activities
• Novel mechanism of action• Complex interactions between multiple
neurotransmitter systems• Mu-opiod agonist; NMDA antagonist; kappa opioid
agonist; serotonin 5ht2a agonist; serotonin uptake inhibitor; 5ht3 agonist; dopamine uptake inhibitor; sigma opioid receptor agonist…
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Where do addicts take ibogaine?
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Hotel Rooms
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At Home
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Iboga Therapy House, Canada
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Bwiti-Inspired
Bwiti
Tribal
Hotel Rooms At Home
Underground
Harm Reduction Model Applied for grant
Govt is supportive No regulations on ibogaine in Canada
Iboga Therapy House Others
Clinics
Medical/Therapeutic
Ibogaine Treatment Options
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Existing treatment facilities providing detoxification--not collecting information…
• How well does it work? How safe is it?
• What percentage of people benefit and to what degree?
• How can these treatments be improved?
• Should formal studies be conducted?
MAPS’ Role: Evaluating program, providing feedback, and collecting data for research
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Preliminary Data: June 2004: Iboga Therapy House: 2wks-1yr after tx (avg. 6 months)
• 20 subjects• 6 of 7 treated for
Cocaine/Crack abstinent (86%)
• 3 of 8 treated for opiates abstinent (38%)
• 4/5 treated for other substances abstinent (80%)
0
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COC Opiate Alcohol Pot Meth Comb.
AbstinentUsing
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Exploratory Outcome Study
• Seeking to obtain basic preliminary data • Not a controlled study, but is representative
since including 20 Subjects treated consecutively
• One-year series of questionnaires and interviews from 20 subjects verified by interview with significant others
• Harm reduction model: looking at abstinence as well as non-abstinence outcomes, trying to differentiate between abuse and controlled use
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ASI-Addiction Severity Index
• Semi-structured 1 hour interview
• Scores on 7 subscales: medical status, employment and support, drug use, alcohol use, legal status, family/social status, and psychiatric status
• Been used extensively on a wide variety of outcome studies
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Peak Experience Profile (PEP)
• Measures the psychedelic experience
• 180 items; one composite score; 16 subscores
• Scores for peaks (highs) and nadirs (lows)
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Measures
• Addiction Severity Index (primary variable)
• Peak Experience Profile• Beck Depression and Anxiety
Inventories• Subjective and Objective Opiate
Withdrawal Scales (SOWS/OOWS)• Pain and Craving Scales
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Process
• All interviews are conducted by evaluation coordinator
• Baseline in person; follow-up by phone
• Each interview takes about an hour or two
• Valerie organizes and analyzes data
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i P W2
1 2 3 4 5 6 7 8 9 10
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ASI X X X X X X X X X X X X XBDI/BAI X X X X X X X X X X X X X XPEP XO/SOWS X X XPain/Cra X X X X X X X X X X X X X X XSO check
X X X X X X X X X X X X X X X
Schedule for Outcome Measures
i=Intake; P=Post-treatment; W2=Week 2; 1-12=Months 1-12
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Challenges
• No drug testing
• Difficulty of remaining in contact during follow-up
• Check-in with significant other addresses these concerns
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Progress
• End of protocol design and training phase• Began study at Ibogaine Association; ended
prematurely• Assisting Iboga Therapy House in obtaining
grant from Health Canada• Partial funding obtained from private donors
for study, Iboga Therapy House seeking additional funding for operating costs
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Goals• Obtain basic information about outcomes in
underground clinics• Provide feedback to improve services; help
win funding from Canadian government; increase safety
• Ideally lead to placebo-controlled double-blind studies
• Ibogaine available to drug addicts in a safe, supportive, and humane setting