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Ibogaine for Opioid Addiction

The Kentucky Ibogaine Initiative shared these statistics on a recent LinkedIn post:

Treatment Success Rates in Opioid Use Disorder

Abstinence 7%

Methadone 30-60%

Suboxone 30-50%

Naltrexone 20-30%

Ibogaine 80%

If you are unfamiliar with the Kentucky Ibogaine Initiative, they are a nonprofit dedicated to treatments for opioid addiction which is ravaging their state. Taken from their website: "Kentucky has the third highest age-adjusted drug overdose fatality rate in the United States, at 49.3 deaths per 100,000 people. Opioids were involved in approximately 81% of Kentucky resident overdose deaths in 2020.

Kentucky and the broader Appalachian region have been disproportionately impacted by addiction and its devastating consequences.

There is an urgent need for more effective interventions and treatments."

Ibogaine is the psychedelic medicine that is showing, through testimonials and studies, to be highly effective against opioid addiction as reflected in the above statistics, and the Kentucky Ibogaine Initiative is heavily involved in bringing this information to the public. Kentucky's legislation surprised us all when they created the Kentucky Opioid Abatement Advisory Commission (KYOAAC). Here is a synopsis of the purpose of this committee:

"The Kentucky Opioid Abatement Advisory Commission (KYOAAC) has been appointed with the distribution of half of the state's $842 million settlement from opioid distributors. The funds are to be used for interventional, therapeutic, and recovery services for the individuals, families, and communities who have been ravaged by the state's opioid addiction epidemic.

KYOAAC is considering funding to facilitate research into ibogaine therapy for the treatment of Opioid Use Disorder (OUD). To accomplish this, KYOAAC is considering the allocation of up to $42 million of the settlement funds to develop the first-ever double-blind, placebo-controlled clinical trials of ibogaine therapy for OUD. These trials, if successful, will lay the groundwork for larger Phase 3 clinical trials to make ibogaine therapy a legal prescription treatment for OUD, covered by insurance and public health care plans."

Yes, you read that correctly, opioid distributors had to pay the state of Kentucky $842 million dollars.

Back to the post that prompted this blog and the statistics reflected, it is important to note that the 30-60% efficacy of the medications in these stats does not remove addiction, it shifts the addiction to methadone or suboxone, which when those doses are missed, throws a client into withdrawal. The long-term effects of methadone on the body are significant and detrimental. Both medications, methadone and naltrexone target specific receptors by utilizing chemical compounds to mimick an antagonist reaction that blocks opioid impact. We cannot affect a receptor in the body with a medication in order to produce a specific outcome without affecting the other uses that same receptor has in the body (ladies, just consider our experiences with birth control); nor can we mimick an antagonistic reaction with chemicals without antagonizing other necessary actions within the body. Therefore, the body creates a new homeostasis with these medications that comes with uncomfortable side effects and accumulating systemic changes often resulting in new undesirable medical issues.

One of the less discussed problems I witnessed as a therapist when working with opioid recovery (I worked for a year in a methadone clinic, the goal was titration of methadone to full recovery) is that the body’s natural production of opioids/pain response/pain relief are halted when the external source is halted. This includes emotional pain, and yes, our body has a natural chemical response to manage emotional pain just like physical pain. The time-lapse for the body to bounce back to a natural homeostasis after opioid or opioid-antagonist medications are removed is incredibly difficult, lengthy, and exacerbated by the heavy guilt of addiction. While that difficulty is most apparent in the physical withdrawal, it is also happening in the context of emotional withdrawal, which is now unprotected, exposed and raw….like skin turned inside out. The body and mind, having no capacity to use any of its own once-innate pain relief, becomes highly activated, confused, reactive and fragile, for a very long duration, often up to a year. I do not care how tough, stoic, courageous, or willful you may think you are, that process is nothing short of a harrowing experience of disintegration. This is why the recidivism rate of opioid use disorder is so high. If you meet someone who managed recovery without any assistance, that person has a fortitude you may never have to tap into, if you are lucky, and they deserve accolades. From my vantage point, anyone who is in recovery deserves accolades, for which most never receive.

This is not to say that there is not a place for medications that are opioid-antagonists. I did bear witness to those clients that did successfully get off of opiates with methadone, and then fully off methadone, while I was working at the clinic. But the only 3 clients in that year I saw successfully recover were all clients that had become addicted due to a chronic medical issue. The rest of the clients holding deep traumatic wounds filled with emotional pain were not successful. Addiction is due to emotional trauma. Even for those who may have had a debilitating physical/medical issue that resulted in chronic pain likely became addicted not just due to the physical response, but also because it helped ease the grief around accepting their new relationship with their body.

This is why I suspect Ibogaine is pointing to these types of positive outcomes. If it works the same as the other psychedelic medicines are showing through research, it is not ‘blocking’ a physical reaction to an external input, it is ‘opening’ space to heal the deeper emotional trauma by repairing the damage that neural pathways have taken on with the chemicals released from chronic emotional injury, and the damage from chemicals in chronic opioid intake. As a therapist, I intend to learn all I can about Ibogaine and its potentiality in healing addiction, for opioids and other substances as well. I am thankful for the gatekeepers, those who are pointing the way to these new paths in healing such as Kentucky Ibogaine Initiative, and hopeful that others are as ready as I am to learn about this promising treatment.

-----Tracey K. Wyatt, LPC


Southeast Coalition of Psychedelic Practitioners

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