Bad Science on “Homeland”

Bad Science on "Homeland"

Bad Science on “Homeland”

I’d like to announce my willingness to serve as a media consultant on topics relating to opioid addiction. I’m prompted to do this after another bit of bad science on TV.

There I was, catching up on recorded episodes of “Homeland,” one of my favorites. One of the main characters, Brody, was on the run since he was suspected of planting the bomb that blew up the CIA. He survived an abdominal gunshot wound, and then was imprisoned in a weird high rise for the homeless in Venezuela by a mysterious group of people who may or may not have his best interests at heart. To treat both his physical and mental pain, he was encouraged to shoot up opioids, and he became addicted.

Saul, acting head of the CIA, flies to Venezuela to fetch Brody back to the U.S. for a top secret mission. He found Brody, strung out of opioids, living in squalor, and in terrible shape. He’s so appalled by the smell in Brody’s cell that he does the male equivalent of a pearl clutch…he puts a handkerchief to his nose. Brody is transported back to the states, where he goes into terrible opioid withdrawal. He’s screaming, groaning, and stewing in secretions.

Saul needs him to be well in order to take part in a clandestine mission in Iran. Saul asks his staff if there’s any way to get Brody back into shape and out of withdrawal faster. One of the team mentions methadone, and Saul says something like no, we need for him to be functional.

No one mentions buprenorphine.

Shifty CIA operative Dar Adal pipes up that ibogaine will cure Brody but will have bad side effects like hallucinations. A sidekick adds, “Yes, violent, mind-bending hallucinations.” Adal then mysterious says (everything he says is mysterious) “Take my word for it.”

So they give poor Brody ibogaine, and he has violent, mind-bending hallucinations. He screams. He cries. He has terrifying hallucinations of his old war buddy, now dead. At one point presses his face to the window of his cell, screaming, “What did you give me??”

I guess such histrionics make better TV than seeing Brody look normal after several days of methadone or buprenorphine.

After the agony of the ibogaine, Brody is well enough to start running and getting back into shape.

Now for the truth: 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 has effects on 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. 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. (See my blog post of June 1, 2013) Ibogaine’s supporters claim this drug can cure addiction to alcohol, cocaine, opioids, and nicotine.

In other words, there are case reports of possible benefits of ibogaine, but it is not at present an evidence-based treatment for opioid addiction.

I’m really getting annoyed with Homeland. It was my favorite show in the past, but started to drag this season. (Don’t get me started on the booooring Dana storyline.) Now it has me snorting in disgust at bad science.

Thin ice, Homeland…you are on thin ice with me. If you need a medical consultant, I’m available.

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2 responses to this post.

  1. Posted by Sean McKinnon on December 8, 2013 at 8:09 pm

    I would have an issue the “no, we need him to be functional” comment in regards to the suggestion of methadone treatment. Methadone is the “gold standard” treatment for opioid addiction and does not impair normal functioning, I’m fact in most cases it allows to people to BEGIN to function again after having not been normally functional due to short acting opioids for a long time.

    There was also an episode of SVU where “Dr. George Haung” the units FBI psychiatrist proposes treating an opioid addict with Ibogaine.

    Reply

  2. I missed that episode. I have only seen where Brody’s side kick who is also a CIA agent gets bamboozle by the CIA to answer questions for The Congregational Hearing. She is also a person who has bipolar which she seem to have acted fairly well.

    I also saw the episode where Brody gets hung after he killed the big bad guy from Iran security.

    They mention on those episodes about Brody’s Opiate Addiction, but I didn’t see the episode. Although I know that withdraws are not fun, the media does have a tendency of exaggerating the conditions. The “Man with the Golden Arm” and I think the “Story of Gene Krupa” (some hot drummer from the 50’s who smoke marijuana went though withdraw while he was arrested. Withdrawal form marijuana, you would think that people in the movie business would get it right.

    They wouldn’t hire you as a consultant unless you can make the condition a lot more dramatic and much more awful. Regular treatment would be too boring for them.

    Reply

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