Transcript Exploratory Outcome Study of Ibogaine Therapy in Subjects with

Exploring Ibogaine’s Potential in
the Treatment of Addiction
Multidisciplinary Association
for Psychedelic Studies (MAPS)
www.maps.org
Presented by: Valerie Mojeiko
Tabernanthe Iboga
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…Originally used by the
Bwiti…
Shaman -->
<--His Wife
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…in Rite of Passage
Rituals…
Bwiti people
participating
a ritual
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…until Howard Lotsof…
…Serendipitously
discovered
ibogaine’s
ability to
reduce or
eliminate
withdrawal
symptoms from
opiates…
…and found
a place
for
ibogaine
in Western
culture.
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Psychedelics and Addiction
(where this fits in)
In the 1970s… …Stan Grof, Bill
Richards, Walter
Pahnke, and others
published research
using LSD to treat
alcoholics and heroin …With promising
addicts…
results.
Learned: Multiple sessions may
be more effective than singledose administration
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Ibogaine’s Effects
Psychedelic
Unpleasant for many
(not recreational)
Produces a DREAMLIKE state
VERY Long-lasting
The “trip” may be related to the addiction
Greatly reduces physical and
psychological withdrawal symptoms
from heroin, methadone, other drugs
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Iboga Therapy House
Ibogaine Detoxification Facility in Vancouver, Canada
•MAPS awarded $5000 grant to set up North America’s
first legal ibogaine detoxification facility
•Future Site of MAPS-Sponsored Research
•Will provide treatment to addicts from Canada and the
US for a modest fee
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Iboga Therapy House
Therapeutic Procedures
1. Prescreening Process: Application,
Physical Exam, Drug Test
2. Enter Facility
3. Supervision Period: 12-24 hours
4. Ibogaine Experience: 1-2 days
5. Integration Period and Therapy: 2-3
days
6. Leave Facility
7. Follow-up: One year
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Program Evaluation and Outcome
Study
• How well does ibogaine 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%)
6
5
4
Abstinent
Using
3
2
1
0
COC
Opiate Alcohol
Pot
Meth Comb.
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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: measuring
abstinence as well as non-abstinence
outcomes, striving to differentiate between
abuse and controlled use
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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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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)
Sense that the
• Measures the psychedelic
experience
experience
cannot be
described
in
Experience
explosive
• 180 of
items;
one ecstasy.
composite
score; adequately
16
words.
subscores
Experience of the insight that "all is One".
• Scores for peaks (highs) and nadirs
With open (lows)
eyes seeing objects around you turned into great
works of art.
Experience of unbearable tortures that will
never end.
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Schedule for Outcome Measures
i
P W 1 2 3 4 5 6 7 8 9 1 1 1
2
0 1 2
ASI
X
X X X X X X X X X X X X
BDI/BAI
X
X X X X X X X X X X X X X
PEP
X
O/SOWS X X X
Pain/Cra
X X X X X X X X X X X X X X X
SO
check
X X X X X X X X X X X X X X X
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 and gift certificates
address these concerns
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Progress
• End of protocol design and training
phase
• Has been submitted for IRB approval
• 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 doubleblind studies
Ibogaine available to drug addicts in a safe,
supportive, and humane setting
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End
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