Treatment of Acute Opioid Withdrawal with Ibogaine

TLDR

Ibogaine, an alkaloid, is proposed to alleviate acute opioid withdrawal. The study reviewed 33 non‑medical, open‑label ibogaine detoxifications in patients averaging 0.64 g/day of heroin, mostly intravenously. In 25 of 33 patients, opioid withdrawal resolved within 24 h and remained absent for 72 h, while the remaining patients exhibited varied outcomes—including drug seeking with or without withdrawal, abstinence with mild withdrawal, and one possible fatality—indicating promising but variable efficacy that warrants controlled trials.

Abstract

Ibogaine is an alkaloid with putative effect in acute opioid withdrawal. Thirty‐three cases of treatments for the indication of opioid detoxification performed in non‐medical settings under open label conditions are summarized involving an average daily use of heroin of .64 ± .50 grams, primarily by the intravenous route. Resolution of the signs of opioid withdrawal without further drug seeking behavior was observed within 24 hours in 25 patients and was sustained throughout the 72‐hour period of posttreat‐ment observation. Other outcomes included drug seeking behavior without withdrawal signs (4 patients), drug abstinence with attenuated withdrawal signs (2 patients), drug seeking behavior with continued withdrawal signs (1 patient), and one fatality possibly involving surreptitious heroin use. The reported effectiveness of ibogaine in this series suggests the need for systematic investigation in a conventional clinical research setting.