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Ibogaine: An Alternative Universe of Drug Treatment: Part One

By Spero Alexio and Dr. Stephen Grinstead

My Ibogaine Journey Began In January 2015 In Las Vegas, Nevada

As I sat across from the three new members of the SMART Recovery meeting, I thought to myself “how on earth is this possible”. I had been facilitating SMART groups, a science-based alternative to 12-Step meetings, for about a year. These three young people showed up together and were all former opiate addicts who had repeatedly failed in traditional addiction treatment. Desperate for a solution to their drug problem they had travelled to Mexico, detoxed with a plant hallucinogen called Ibogaine, and were now continuing their recovery in the United States.

For many years, my psychotherapy practice had been dedicated to doing creative, highly personalized counseling with individuals who did not do well with conventional addiction treatment approaches and were searching for an alternative method. I volunteered my services as a psychotherapist to lead SMART Recovery- a secular support group whose emphasis is on cognitive behavioral therapy and self-actualization. S.M.A.R.T. is an acronym for Self-Management And Recovery Training. 

SMART meetings are open to the public and like AA and other self-help groups rely on donations from attendees. Where it differed from 12 step groups was how SMART encouraged its members to take full responsibility for their recovery. There are no sponsors, phone lists or reliance on a Higher Power.  As such, there are less directives and a greater emphasis on discovering “what works for you”. I led the meeting as a public service, expecting nothing in return. 

These three group members who had detoxed with Ibogaine were vibrant- almost glowing, fully engaged in the group process, and surprisingly hopeful about their futures. Most apparent was their relief at being free from the grip of addictive illness. However, their level of “wellness” seemed incongruous with anyone who had recently detoxed from heroin or powerful Opioid pain medications like Oxycontin. They spoke with reverence how this sacred plant not only detoxed them from opiates but also showed them aspects of their lives that had contributed to their addiction. The hallucinogen had allowed them to view their lives in a detached way as if viewing a film or as they reported seeing snapshots of significant people and situations. Something cathartic had happened that words could not completely express.

These three young people who attended my SMART Recovery meeting talked about working with a shaman in Mexico after their Ibogaine detox. They shared how they were now integrating the visions they experienced with Ibogaine. They believed that their lives now had meaning and a sense of purpose but were not yet sure what that purpose was…  Most remarkable was that they reported no thoughts or urges to use opiates again.

I was intrigued by the possibility of a profoundly different approach to opioid addiction yet remained highly skeptical. A plant medicine called Ibogaine? A “cure” that was only available outside the US?  Shamans, sacred ceremonies, and a mystical trip through the traumatic experiences that had contributed to their addiction?

My only frame of reference was the Carlos Castaneda books, “The Teachings of Don Juan” and “Journey to Ixtlan” that I read in High School… a lifetime ago. I wondered about the treatment potential of Ibogaine, especially for people who had failed with other approaches. It was so radically different. It felt like I had encountered an alternative universe of drug treatment.  If so, the healing power of this plant was unlike anything I had seen in 20 years of working as a psychotherapist.

A Brief History of Addiction Treatment

The history of substance use disorder treatment is comprised of a variety of approaches and methods that have come and gone over the past decades, similar to fashion trends. New approaches often face skepticism, opposition, and negative controversy until they are either validated by research or rejected as ineffective.  

In the 1880s Sigmund Freud claimed that cocaine showed promise as a treatment for alcoholism and morphine addiction. Freud self-administered cocaine and enthusiastically proclaimed it a “magical drug”. (1) Eventually cocaine’s addictive qualities outweighed any real or imagined benefits and Freud had to cease recommending the drug.  This pattern of switching one drug for another continues to this day.

In 1901, Charles B. Towns opened a substance abuse hospital in New York City which treated affluent alcoholics with a novel approach called The Belladonna Treatment. Interestingly, the primary ingredient in this treatment was a plant hallucinogen called Deadly Nightshade. Taken in small doses, the active ingredients of Nightshade act as sedative and generally produce pleasing hallucinations. Bill Wilson, who later developed Alcoholics Anonymous, was treated at Charles B. Towns Hospital. (2)

Bill Wilson, a failed Wall Street speculator, helped formulate Alcoholics Anonymous in 1935. There was great skepticism that a layperson could create an effective treatment for alcoholism when medical professionals had failed terribly. By the early 1950s, AA had become a worldwide phenomenon and was more widely accepted in hospitals and treatment programs than any other modality. (3) A lesser-known fact is that Wilson later experimented with LSD under the supervision of Betty Eisner, an American psychologist known for her groundbreaking use of LSD and other psychedelic drugs as adjuncts to psychotherapy. (4)

In the 1960s a psychiatrist named Dr. Aaron T. Beck pioneered a form of talk therapy currently known as Cognitive Behavior Therapy (CBT). This treatment involves identifying and challenging unhelpful thoughts and helping people learn how to modify their thinking patterns and behaviors. (5) One study found that 60 percent of people who are treated with cognitive behavioral therapy for a substance use problem are able to maintain their recovery for at least a year. (6)

Harm Reduction, MAT and Cannabis

M.A.T. (Medicated Assisted Treatment) is gaining support from many professionals treating substance use disorders and the Harm Reduction Community. There are three drugs approved by the FDA for the treatment of opioid dependence: buprenorphine, methadone, and naltrexone. Medication management needs to be accompanied by Cognitive Behavioral Therapy or counseling in conjunction with social support to achieve the best outcomes. (7)

Dr. Andrew Tatarsky at The Center For Optimal Living in New York City expanded the Harm Reduction paradigm to include a more nuanced continuum of treatment options. It is a multifaceted approach that brings together psychodynamic, relational, cognitive, behavioral, motivational, stages of change, and mindfulness-based therapies in a harm reduction frame.

Cannabis /Marijuana has been heralded by some as a natural treatment for substance use issues and is sometimes used as a Harm Reduction tool for former addicts.  There are frequent anecdotal claims that Cannabis has been used successfully to detox/transition people off everything from alcohol to opiates/Opioids.

CBD Oil for P.A.W.S.

In the Spring of 2021, Chuck Romanoli of Country Roads Cannabis in West Virginia will be offering a CBD Oil specifically designed to counter the effects of P.A.W.S (Post Acute Withdrawal Syndrome). Their latest product does not contain the psychoactive effects of THC. (8) The World Health Organization has stated “In humans, CBD exhibits no effects indicative of any abuse or dependence potential….” To date, there is no credible evidence of public health related problems associated with the use of pure CBD.” (9)

About Ibogaine and How It Works

Ibogaine is part of a new wave of addiction treatment called “Psychedelic Assisted Therapy” and also involves Psylocibin, Ayahuasca, 5-MeO-DMT and synthetic hallucinogens like Ketamine and MDMA. Unfortunately, the Ibogaine approach like many other new treatment proposals has its critics.

Ibogaine is an isolated active alkaloid from the root bark of a central West African shrub (Tabernanthe Iboga). It has been used by traditional communities for ritualistic and healing purposes for centuries. Ibogaine treatment for opioid addiction involves the ingestion of a flood dose of ibogaine, hydrochloride (HCL), in the form of capsules.

Ibogaine detoxes the body, eliminating cravings and withdrawal symptoms by latching on to neuroreceptor sites previously occupied by Opioids/Opiates and balancing the neurotransmitter levels damages from prolonged drug use. At the same time, Ibogaine produces powerful psychoactive effects, sometimes described as a “waking dream state”. The psychedelic component of Ibogaine is known to bring on a profound shift of perspective where individuals have deeply existential and personally meaningful experiences. Some people report that they were confronted by an “Iboga God”, a strong male entity that, in effect, reads them the riot act.

This is a powerful plant hallucinogen not to be trifled with. Intention, preparation, and screening play a significant role. A thorough medical and psychological assessment must be completed before anyone begins an Ibogaine detox protocol.  People with pre-existing cardiac conditions and certain psychiatric disorders are not candidates for treatment. Proper medical supervision during the Ibogaine detox is essential to successful treatment.

Each new evolution and direction in treatment has adherents who claim their approach is “the best”, but if this brief history illustrates anything, it is that “one treatment approach most definitely doesn’t fit all”. The question is not what’s the best treatment for substance use disorders; rather it is what will work best for each individual!  We need to meet each person where they are and discover what is the most effective course of treatment.

January 2021 In The Unites States of America

As the Covid-19 virus has paralyzed the United States and dominated the country’s attention, opioid use has accelerated at an alarming rate. Fentanyl, a synthetic opioid pain reliever, 50 to 100 times more powerful than heroin, is flooding illegal drug markets and spiking overdose deaths.  Never has the ineffectiveness of addiction treatment in America been more apparent. Young people cycle in and out of rehabs, sometimes attending multiple rehabs before they are 21 years old. Even the “best” addiction treatment facilities do not have appreciably better outcomes. When someone relapses, the common response of treatment professionals is often to blame the patient, claiming they gave him or her all the “recovery tools” needed to be successful. Overdose deaths continue at a record pace…

Against this backdrop of futility, word is spreading about a miracle treatment that was historically only available in Mexico and other countries outside the borders of the United States. The changes brought about by Ibogaine are so remarkable that many began to proclaim that it was an “addiction cure”. This is simply not true. However, success rates can be greatly improved with continuing care that both complements and expands upon the original Ibogaine experience.  As the years have gone by, I’ve counseled many people who have detoxed with Ibogaine and developed treatment protocols specifically for these individuals.

Although skeptical at first, I am now convinced there is no better way to detox from opiates and opioids. My enthusiasm for this treatment is so great that I will be doing a cross country speaking tour once it is safe to travel again. In the meantime, “The Ibogaine Tour” will be virtual. The first destination is Recovery View’s podcast on January 17th 2021. All aboard!

12/21/20 Spero Alexio Interview with Business Talk Radio NYC

In part two of Ibogaine: An Alternative Universe of Drug Treatment:

  • What are the elements of Ibogaine continuing care?
  • Where is Ibogaine treatment available outside the United States?
  • How do you choose an Ibogaine provider?
  • What kind of person is attracted to Ibogaine treatment?
  • Preparation and Integration.
  • The Ibogaine Tour

 

References

 1- Grinspoon, L., Bakalar, J. (1981). Coca and Cocaine as Medicines: An Historical Review. Journal of Ethnopharmacology, 3(2-3), 149-159.

2- Markel, H. (2010). An Alcoholic’s Savior: God, Belladonna or Both? The New York Times.

3- Dossett, W. (2013). Addiction, Spirituality, and 12-Step Programs. International Social Work 56, 369-383.

4-  Lattin, D. (2012). Distilled Spirits. University of California Press         

5- https://beckinstitute.org/get-informed/what-is-cognitive-therapy/

6- Rawson RA, Huber A, McCann M, et al. A comparison of contingency management and cognitive-behavioral approaches during methadone maintenance treatment for cocaine dependence. Arch Gen Psychiatry. 2002;59(9):817-824. doi:10.1001/archpsyc.59.9.817

 7- https://store.samhsa.gov/product/TIP-63-Medications-for-Opioid-Use-Disorder-Full-Document/PEP20-02-01-006

8- https://www.countryroadscanna.com/

9- https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf

 

About the Authors

Spero Alexio,  PsyM, MSW, CRPS

Spero Alexio is a writer and clinically trained psychotherapist with a virtual counseling practice located in Las Vegas, Nevada. He is considered both an expert in the dynamics of relapse and a pioneer in non-traditional drug treatment. He developed Qtherapy, a form of exposure therapy that neutralizes the cues associated with addictive behavior. Mr. Alexio also provides aftercare for individuals who have detoxed with Ibogaine and other plant medicines.

Email: sperogalexio@yahoo.com

Phone: (702) 204-9472

Website: https://www.psychologytoday.com/us/therapists/spero-alexio-las-vegas-nv/437458

 

Dr. Stephen Grinstead, Dr.AD, LMFT, ACRPS

Dr. Grinstead has a Bachelors Degree in Behavioral Science, a Masters Degree in Counseling Psychology and a Doctorate in Addictive Disorders (Dr. AD).  He is a California Licensed Marriage and Family Therapist, (LMFT) a past California Certified Alcohol and Drug Counselor (CADC-II), and an Advanced Relapse Prevention Specialist (ACRPS). He served on the faculty of UC Santa Cruz Extension Alcohol and Drug Studies Program and also taught at Santa Clara University, UC Berkeley Extension and Stanford University Medical School and served on the faculty of University of Utah’s School on Alcoholism and Other Drug Dependencies as well as serving as an Adjunct Professor at Alliant University teaching Masters Level and Psy.D. Students the Treating the Addicted Family System course for the Marriage and Family Therapy track for five years. Dr. Grinstead is also author of the book Thank You Adversity For Yet Another Test: A Body Mind Spirit Approach for Relieving Chronic Pain Suffering.

Website: www.drstevegrinstead.com – Email: drgrinstead@yahoo.com

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