Drug for cold turkey.

The Journal of Ethnopharmacology has a survey of a subculture that could turn addiction therapy on its ear – an informal alliance of people using the psychedelic drug ibogaine to break free from opiate addiction:

The clinical focus on the treatment of opioid withdrawal distinguishes the ibogaine subculture from subcultures associated with psychedelic or other illegal drugs. The reason for taking ibogaine was more frequently to alleviate the symptoms of opioid withdrawal than to pursue spiritual or psychological goals. In the US, the expansion of the ibogaine subculture coincides temporally with a substantial increase in the public health impact of opioid use disorders (Compton and Volkow, 2006). The incidence of opioid-related deaths in the US doubled between 1999 and 2004 (Fingerhut, 2007), with methadone and oxycodone accounting for most of this increase. In contrast to trends regarding opioids, there was no increase in use of hallucinogen and MDMA among young adults in the US between 2002 and 2005 (Substance Abuse and Mental Health Services Administration, 2006), suggesting that the recent expansion of the ibogaine subculture is not an epiphenomenon of popular interest in psychedelic drugs and the availability of psychoactive substances on the Internet (Schifano et al., 2006).

Frank Vocci, who oversaw NIDA’s ibogaine project as the head of Medications Development (Vastag, 2005), characterized the ibogaine subculture as a “vast uncontrolled experiment”. The term has significant literal merit. The data on iboga alkaloids collectively subsumes significant elements of a drug development process in various stages of completion, including substantial preclinical and open label study evidence, preclinical toxicological studies, and some initial Phase I safety and pharmacokinetic data.

Reports of efficacy of ibogaine in opioid withdrawal may be valid irrespective of the methodological limitations associated or craving, the clinical expression of acute opioid withdrawal occurs within a limited time frame, is easily operationalized, tends to be robust, and can be assessed accurately by typically experienced lay providers. It appears unlikely that suggestion or placebo could solely mediate the effect attributed to ibogaine in acute opioid withdrawal.

In other words, there’s something unique to ibogaine apart from other psychedelic drugs that makes it effective in kicking heroin and oxycodone, and people are figuring this out in increasing numbers without the medical establishment’s help.

There’s a subscriber-only summary of Dr. Alper’s findings at Science News.