Ibogaine & Baclofen – A Magic Pill for Addiction?

AiR member 123peace wrote in on the topic of MAT drug Ibogaine…

"I have been reading and hearing more and more about Ibogaine. It is illegal in the US, however, there are clinics in Canada and Mexico. The success rate for overcoming addiction is high (however there are risks). Addicts have stated that after 4 days they were back to normal – really normal.

Whatever reason the US has for not permitting – should be looked at twice. It seems that because of the success rate – it is definitely worth trying and a much easier and quicker way to eliminate addiction."

There is a persistent lack of simple answers to drug addiction. This lends itself to seeking alternative medicines and new practices for detoxification, cravings, and a return to normalcy.

Addiction recovery, however, is anything but simple. Recovery (which I define as being free from drugs of abuse, and living a healthy lifestyle) is best addressed at several levels: the biological, the mental, and the social. See this recent post addressing wellness and recovery.

There are a number of non-FDA-approved drugs being used to help people detox. Two that come up a lot are Ibogaine for opiates and Baclofen for alcohol.

Both of these drugs are supposed to help with that critical early period of detox and the return of cravings that can lead to relapse.

Baclofen and Ibogaine: the research is insufficient

These drugs lack study, and for this reason I suggest caution. It’s true that in the US we have a system that is slow and cumbersome when it comes to approving drugs. At no time was this more true than in the early years of the AIDS epidemic. Early AIDS sufferers were desperate for answers, and groups like ACTup pushed successfully for the speedier advance of drugs to market. In the meantime, people tried anything they could find to treat their illness.

Historically, funding for substance abuse research is limited, compared to other illnesses. Research, however, is the answer. Rigorous study with careful design and control groups is critically important.

People with addiction issues, and their families, are aching for more solutions. It is in this vacuum that drugs with some anecdotal evidence gain promise.

I don’t have experience with either Ibogaine or Baclofen. Here are links on each so that you can read up on them.

Ibogaine: An article from thefix.com

Baclofen: An article from thefix.com, and an informational page from American Addiction Centers 

That critical period of withdrawal and the cravings that follow are being addressed by drugs that are already on the market: methadone and buprenorphine (suboxone, subutex). There is also naltrexone (vititrol) but this drug works differently than the first two by blocking the effects of opiates and thus deterring one's desire to use. For alcohol, there is Acamprosate (campral®) and Disulfiram.

My comments about these FDA-approved drugs, even if we could put Ibogaine and Baclofen in the same “evidence base,” are the same.

Getting support for the biological piece of addiction is a partial solution only. 

MAT (medication-assisted treatment) reduces withdrawal symptoms and helps with cravings. This is very important, but typically insufficient for recovery as I define it.  The fact that we are even talking about drug solutions for addictions is partly a response to the lack of supportive, comprehensive, long-term treatment for addiction. It is also a response to how deadly opiate addiction has become.

What ought to be one wheel on the car — the pharmaceutical intervention — has become the whole mainframe. I was just on another webinar yesterday listening to 5 treatment programs talk about their success expanding their MAT treatments. The word psychotherapy was never mentioned, not once. Not to say these organizations aren’t providing behavioral interventions, but the pairing of the two is fast disappearing from our conversation of MAT. The same is true of an 80-page compendium of a recent professional conference on MAT.  I did a search and found the word "therapy" mentioned 6 times, all by one presenter, in one paragraph. That was it!

Can a medication alone deliver quality recovery?

I would lump Ibogaine and Baclofen in with these FDA-approved drugs to make this overarching point: a drug alone is not enough to get and maintain a quality recovery.

It’s a start – it's harm reduction. Harm reduction is, by the way, how the outcomes of methadone and buprenorphine are measured: lower death, lower use of opiates. Pot smoking or shooting cocaine (as one mom told me last night her son had started doing, now that he’s on Vivitrol) are not measured or considered. Neither are improved coping skills, hopefulness, or other measures of wellness.

I’ve been on methadone, naltrexone, and antabuse in my past, without the proper accompanying psycho-social care. I can tell you I wanted to snort the little specks I found in the carpet. I was out of my mind for something to alter my mood. Nothing had changed in my world, except that I was now unable to use opiates or drink. I smoked pot, snorted coke, and did even drink. I turned blotchy red and threw up, but this didn’t deter me. Eventually, I left the methadone clinic and other addiction drugs behind and went back to using. 

Here’s a quote from the Ibogaine article I’ve linked to above. It says it well:

A cautionary footnote: Even with ibogaine as a transformative agent, as the interviews indicate, there’s no escaping the inner work to be done after treatment. No substance will completely clear all the damage, the wreckage, the peer influences, the long-term patterns of thought, action and behavior that dominate an addict’s life experience and deprive one of health, meaning, satisfaction and abundance. If, however, addict or not, you’re ready to take a deep look at yourself, however difficult or painful that might be, if you’re willing to open the window of opportunity …. and completely re-order your life in recovery, then ibogaine (substitute any of the drugs mentioned in this piece) will give you the chance. 

Thank you for writing in and sparking this conversation. Do other members have personal experience to share?