Case Report of Death from Ibogaine Ingestion

IBOGAINE

IBOGAINE

In the latest issue of the American Journal on Addictions (Volume 22 (3) May/June 2013, p. 302) was a one-page case report of a death due to ibogaine, ingested for the purpose of curing heroin addiction.

Ibogaine is a hallucinogenic psychoactive substance found in some species of plants that grow in Africa. It’s been used in religious ceremonies, chewed to give a mild stimulant effect. With increased doses, this substance has hallucinogenic effects. Ibogaine is a sloppy drug, affecting at least three types of brain receptors. Ibogaine’s metabolite, noribogaine, has serotonin reuptake inhibition properties, like found in many antidepressants. It also has a weak opioid effect on the mu opioid receptors and a stronger effect at the kappa opioid receptors, causing less dopamine to be released. It also has effects on at least two other receptor types.

Limited studies show that since the drug does block the release of dopamine, it may have some benefit in the treatment of addiction to these drugs. Both animal studies and case reports suggest ibogaine may reduce withdrawal symptoms of opioid addiction and craving for cocaine. But so far there have been no good scientific trials of the drug. This drug has been outlawed in the U.S. and in most European countries due to concerns about the drug’s side effects and case reports of death. Ibogaine’s supporters claim this drug can cure addiction to alcohol, cocaine, opioids, and nicotine.

In this case report, the decedent was a 25-year old male with heroin addiction and a history of supraventricular tachycardia, meaning he had an underlying heart problem that caused episodes of rapid heart rate. This man took ibogaine 2.5 grams over 3 hours, and then had hallucinations, difficulty with balance, fever, and muscle spasms. He improved over the first day, but by the next day he developed problems breathing and had a respiratory arrest. Despite cardiopulmonary resuscitation, he remained in a deep coma and died after two days of multi-organ failure.

This death was of course a tragedy, but I’m not sure this case and other similar cases mean ibogaine won’t ever have a place in the treatment of opioid addiction. It surely gives us information that patients with underlying heart disorders are at increased risk of death from ibogaine.

I still think there’s a need for further (careful) research on ibogaine. This can’t be done at present in the U.S. or Europe, but perhaps other counties can do necessary trials.

Yes, this is a medication that can kill, but then, addiction kills, too. And many medications routinely used in the medical treatment of various illnesses can be deadly at the wrong doses or in the wrong patients. For all medical treatments, the risks have to be weighed against the benefits. Right now, we don’t have a full idea of the benefits or the risks of ibogaine.

Like many treatments for addiction, there are also people who make unsubstantiated claims in favor of ibogaine, and sell it via the internet or in countries where it isn’t outlawed, as a miracle cure for opioid addiction. The evidence for this claim is lacking, to put it mildly. This case report reminds us that ibogaine can be deadly. Until/unless we have more knowledge about the risks/benefits of ibogaine, evidence-based treatment of opioid addiction with methadone and buprenorphine are much better options and should be recommended.

For further information of the state of ibogaine research, here’s a great reference:

http://www.ibogaine-research.org/Ibogaine-Research-Project/Areas/Media/JAMA.htm

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9 responses to this post.

  1. could you post a better link to the article from the journal please?
    I would also like to comment on tagging Ibogaine as sloppy. I feel there is much more to the significance of this African root that would redeem itself away from the term sloppy. As I seek the referenced article, I wonder the circumstances of this persons ingestion of Ibogaine. Was he alone? or was he in one of the many legal Ibogaine clinics in a country where Ibogaine is not classified as schedule 1?

    I believe most any clinic would have redirected this person during the prescreening process with such a heart abnormality.

    Too many sloppy articles on Ibogaine prevent this mysterious and complicated substance from reaching the people who may best heal and learn from it. It is a blessing for many people healing from not just opiate addiction, but trauma such as rape, and war.

    The evidence is not lacking, the evidence is shuffled behind misinformation and misunderstanding.

    Reply

    • I used the term “sloppy” when perhaps a more precise term would have been “relatively non-selective.” By that I mean ibogaine doesn’t just act on one set of receptors, like the opioids. Rather it acts on four of five types of receptors.

      Don’t know what you mean about the link – it works fine on my computer.

      I’d be interested in reading the studies you say exist; can you give references?

      Reply

      • I understand that mapping a consistent and reliable process of how and where Ibogaine functions in the brain alone can be frustrating for doctors in any field. People in these fields want specific monitoring for creating protocol. Ibogaine functions and reacts with the body and brain differently from person to person. Yet, It does function often with a manner suggesting repair . So, yes, “relatively non-selective” That alone can make a frustrating substance to narrowly study…
        I say this from observation and opinion weighing much more in favor over actual clinical study.

        As far as the link, I am referring to the journal study provided in the beginning of your article. The actual ink that you provide at the end functions and I agree, is awesome.

        The studies I refer to are from personal experience and observation. I have been involved in and around various aspect of the ibogaine communities around and have seen Iboga and Ibogaine provide the ability to interrupt many forms of problematic habits, both substance and emotion. Sooooo… many of the forms of “proof” are both without the bias of skepticism and the desire to provide people with release from addiction and liberation from unhealthy lifestyles..

        Ibogaine is no silver bullet, Howard Lotsof, who is credited as spearheading the Ibogaine movement in the US.. even he “relapsed” into using heroin again. It is no silver bullet. It does require the “addict” to participate in their own “recovery” and healing.
        I think we have been allowed only a small glimpse into how Iboga works, or can work. The link you provide at the end gives the same references I would have provided as suggesting Ibogaine is a viable means of interrupting addictions and relieving opiate withdrawal. Dr. Alper.. Dr Deborah Mash.. etc
        Don’t get me wrong, I am thankful to see another article about Ibogaine make its way into the public forum. It was just the fact that I think it alludes to a recent death from Ibogaine when I cannot find one.

      • This was a recent issue, and I can’t provide a link. I suspect you would need a subscription. However, there is an address for correspondence, if you want to contact the doctor who submitted the article: Dr. Jalal, St. John Hospital and Medical Center, 22101 Moross Rd, Detroit, MI 48326.

        This patient was not at a clinic. He must have ordered it from some source, I suspect the internet. It says the patient’s mother supervised administration. The ingested substance was sent to Poison Control and was confirmed to be ibogaine.

        I did find this link to an older article, about ibogaine deaths: http://wiki.dmt-nexus.me/w/images/d/d8/Fatalities_after_ibogaine_use.pdf

  2. This is not the first time that patients have died from Ibogain treatment. Previous deaths I have known where not directly caused by the Ibogain treatment. Well, actually I think one died because he/she was not straight with the doctor about their medical condition, and I think one of the deaths was from a heart attack. But don’t quote or certified me with that information. It is likely to be wrong because I do not quite remember. Another one I think died away from the site. He or she brought with them a good supply of heroin and hidden it well from the doctors (we junkies are very creative (not always in our best interest). I believe this person did her/his usual dose of heroin which I believe was quite high. I believe the person had not done heroin for about a week and her/his usual dose kill’em.

    My friend Howard S. Lotsof, a junky (who died recently) who first discovered that after using Ibogain recreationally, Voila!!! The next day he was not suffering from withdrawals. He continuo to do whatever he could do to have Ibogain becomes a treatment modality.
    For decades he tried the medical field to pay attention. But the prejudice of “Spirituality” and religion indoctrinators believe that this use of other drug to cure a drug problem was not appropriate, etc. etc. Lotsof did do a 3 person case study in which he found that all three persons had a drop on their Hepatitis C viral load. I had the paper and read it was well written well-presented whoever in the research industry coached them to do the study apparently did a good job. I am not sure whether the paper was published. He did paid quite a bit for Ibogain Research back in the days.

    Dr. Jeffery Kamlet, down here in Miami, does real good work with it. There are a couple of people in Gainesville, Florida who are not doctors. They do no attempt at curing anything or anyone. There work is “strictly spiritual” and they do weekly

    If I remember correctly, our friend Timothy Leary and Al Port where the two Harvard Research Psychologist who went hippy and started the LSD revolution of Sex, Drugs and Rock & Roll where consumers of their own research substance, as I remember correctly LSD was being use to sober up Alcoholics. Apparently Hallucinogenic has that effect on substance use disorder and withdrawals.

    If I remember correctly the reason that medical clinical trial are done is to stablish not only efficacy but safety patter meters.

    Reply

  3. Posted by David on June 4, 2013 at 7:45 pm

    Ibogaine is usually very safe, and just because there are a few deaths reported, that should not be used as an excuse to deny this wonderful medicine to addicts. MOST people have a favorable experience with ibogaine, and anybody who researches it online will learn that. Besides helping addicts, ibogaine also helps non-addicts in many cases. Having an article critical of ibogaine on an opioid treatment website seems suspicious to me…

    Reply

    • Suspicious??? To tell people ibogaine has caused the death of some patients who take it for opioid addiction?? It would seem suspicious if I didn’t talk about the possible downside of this potential medication. Ibogaine is not an evidence-based treatment. There’s anecdotal data, meaning case studies of addicts who have benefitted. This type of information is helpful, and often points researchers to a potential new treatment. But because ibogaine is illegal in the U.S. and Europe – because of past deaths – no large-scale studies can be done to see if it works and what benefits exist.

      Reply

  4. Posted by mark on June 15, 2013 at 10:56 pm

    Its suspicious to me too. Thousands and thousands of deaths from methadone and you bash a drug that will put you out of business. Hmmm

    Reply

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