In any treatment offered for substance use disorders, there are a large number of variables that make it difficult to predict the success of treatment. This is partially because people’s needs and goals when entering treatment vary dramatically based on their personality, age, gender, employment status, and other social factors. However, in order to consider the efficacy of ibogaine-assisted detoxification, there are a few efforts have been made to quantify treatment outcomes.
Ibogaine Efficacy Research
Two studies being conducted by the Multidisciplinary Association for Psychedelic Studies (MAPS), attempt to track the long-term efficacy of ibogaine-assisted detox for opiate dependence. The studies, in Mexico and New Zealand, have reported preliminary results of 20% and 50% respectively, for clients remaining free from their primary substance of abuse for at least 12 months. Factors influencing this range were suggested to be the ease of follow-up in the New Zealand study become of closer proximity, as well as other factors such as plans for continuing care.1
Another study recently completed in Brazil shows a 61% rate of long-term total abstinence from alcohol, cannabis, cocaine and/or crack in a total of 75 people who completed a combination of ibogaine therapy and psychotherapy.2 There were several important distinctions in the treatment offered. For example, participants were encouraged to be abstinent, either at home or in inpatient care, for 30-60 days prior to ibogaine administration, and also had access to an extended stay inpatient treatment environment after treatment. Also, several of the participants underwent multiple treatments during the course of the study.
Comparisons with Conventional Detox
It is difficult to compare these results to conventional substance use disorder treatment programs for several reasons. Firstly, conventional inpatient treatment usually describes programs between 30 to 90 days in length. Programs that manage the initial withdrawal symptoms are generally described as detoxification programs, which usually last between 3 to 7 days. Ibogaine therapy programs usually last between five days and two weeks, and in several ways resemble conventional detox services, particularly the time-frame and the support for acute withdrawal symptoms.
Secondly, conventional detoxification programs in the United States have a completion rate of only 78% for three day to seven day programs, including those who were transferred for further treatment. Short-term inpatient treatment programs are completed, or lead to further treatment, in 74% of cases.3 The ibogaine-assisted detox studies above saw participants drop out of study follow-up, but everyone enrolled completed treatment.
In conventional studies, success rates for those who do complete treatment are never measured by strict abstinence as in the ibogaine studies mentioned above. The rates are based more generally on reduction of use and the negative consequences associated with it, such as the improvement of health, familial, social and economic situations. By those indicators, NIDA has compiled research statistics on the success of treatment for substance use disorders, and describes relapse rates following treatment ranging between 40 and 60%,4 where relapse is a worsening of symptoms related to substance use disorders.
NIDA’s first large-scale study on the treatment of prescription pain medication showed that 49% of participants saw an improvement during a 12-week or longer Suboxone treatment. The success rate dropped to 8.6% once Suboxone was discontinued,5 which again, does not mention levels of abstinence. Most conventional detox-only programs report negligible results without following through with a comprehensive treatment program, and that, again, is only considering an improvement in substance use disorder related symptoms. Sustained abstinence after attending only a conventional detox program is practically non-existent.
While the above is an attempt to connect the dots between two separate bodies of research, it is primarily a call for further research to be done. GITA sees great value in and supports the diversity of treatment options that are able to help people to reach their recovery goals.
When ibogaine is administered in programs of similar length to conventional detox, and even without long-term case management, ibogaine-assisted detox seems to lead to total abstinence from substances more often than most conventional treatment programs. And while many of the participants who were listed as “unsuccessful” on the MAPS’ studies, based on the criteria of a year of abstinence, most reported across-the-board improvements in the indicators used by NIDA and other agencies to calculate success.
While more research and comparative analysis is needed, the data above suggests that ibogaine can be highly effective, not only in detoxification, but also in treating the underlying causes of substance use disorders.
GITA is collaborating with the International Center for Ethnobotanical Education Research and Service (ICEERS) in order to design a long-term multi-site study that will observe a much larger sample of ibogaine therapy clients in order to provide more a thorough picture of ibogaine’s efficacy, as well as the efficacy of different ibogaine therapy protocols.
Schenberg Eduardo Ekman, Maria Angélica de Castro Comis, et al. Treating drug dependence with the aid of ibogaine: A retrospective study. Journal of Psychopharmacology. September 2014. ↩
Department of Health and Human Services. Substance Abuse and Mental Health Services Administration (SAMHSA). Treatment Episode Data Set (TEDS): Discharges from Substance Abuse Treatment Services. 2006. Read full text. http://wwwdasis.samhsa.gov/teds06/TEDSD2k6_508.pdf ↩
Principles of Drug Addiction Treatment: A Research-Based Guide. “How effective is drug addiction treatment?” Third Edition. NIDA. December, 2012. ↩
Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence: A 2-Phase Randomized Controlled Trial. Weiss, Roger D. et al. JAMA Psychiatry. December, 2011. ↩