Essay On Drug Addiction Wikipedia France

Anthony Malcolm Daniels[1] (born 11 October 1949), who generally uses the pen name Theodore Dalrymple, is an English writer and retired prison doctor and psychiatrist. He worked in a number of Sub-Saharan African countries as well as in the east end of London. Before his retirement in 2005, he worked in City Hospital, Birmingham[2] and Winson Green Prison in inner-city Birmingham, England.

Daniels is a contributing editor to City Journal, published by the Manhattan Institute, where he is the Dietrich Weismann Fellow.[3] In addition to City Journal, his work has appeared in The British Medical Journal, The Times, The Observer, The Daily Telegraph, The Spectator, The Salisbury Review, National Review, and Axess magasin. He is the author of a number of books, including Life at the Bottom: The Worldview That Makes the Underclass, Our Culture, What's Left of It, and Spoilt Rotten: The Toxic Cult of Sentimentality.

In his writing, Daniels frequently argues that the socially liberal and progressive views prevalent within Western intellectual circles minimise the responsibility of individuals for their own actions and undermine traditional mores, contributing to the formation within prosperous countries of an underclass afflicted by endemic violence, criminality, sexually transmitted diseases, welfare dependency, and drug abuse. Much of Dalrymple's writing is based on his experience of working with criminals and the mentally ill.

Daniels has been described as a pessimist. In 2010, Daniel Hannan wrote that Dalrymple's work "takes pessimism about human nature to a new level. Yet its tone is never patronising, shrill or hectoring. Once you get past the initial shock of reading about battered wives, petty crooks and junkies from a non-Left perspective, you find humanity and pathos".[4]

In 2011, Dalrymple received the 2011 Freedom Prize from the Flemish think tankLibera!.[5]

Life[edit]

Daniels was born in Kensington, London.[6] His father was a Communist businessman of Russian ancestry, while his Jewish mother was born in Germany.[7] She came to England as a refugee from the Nazi regime.[8]

His work as a doctor took him to Southern Rhodesia (now Zimbabwe), Tanzania, South Africa, and the Gilbert Islands (now Kiribati).[9] He returned to the United Kingdom in 1990, where he worked in London and Birmingham.[10]

In 1991, he made an extended appearance on British television under the name Theodore Dalrymple. On 23 February, he took part in an After Dark discussion called "Prisons: No Way Out" alongside former gangster Tony Lambrianou, Taki Theodoracopolous, and others.[11]

In 2005 he retired early as a consultant psychiatrist.[12] He has a house in Bridgnorth, Shropshire, and also a house in France.[13]

Regarding his pseudonym "Theodore Dalrymple", he wrote that he "chose a name that sounded suitably dyspeptic, that of a gouty old man looking out of the window of his London club, port in hand, lamenting the degenerating state of the world".[14]

He is an atheist, but has criticised anti-theism and says that "to regret religion [...] is to regret our civilisation and its monuments, its achievements, and its legacy".[15] Raised in a non-religious Jewish home, he began doubting the existence of a God at age nine. He became an atheist in response to a moment in a school assembly.[15]

Daniels has also used other pen names, notably "Edward Theberton" and "Thursday Msigwa". As "Edward Theberton", he has written articles for The Spectator from countries in Africa, including Mozambique.[16] He used the name "Thursday Msigwa" when he wrote Filosofa's Republic, a satire of Tanzania under Julius Nyerere.[17] He may also have used another pen name, in addition to his bona fide name.[14]

Writing[edit]

Daniels began sending unsolicited articles to The Spectator in the early 1980s; his first published work, entitled A Bit of a Myth appeared in the magazine in August 1983 under the name A.M. Daniels.[9]Charles Moore wrote in 2004 that "Theodore Dalrymple, then writing under a different pseudonym, is the only writer I have ever chosen to publish on the basis of unsolicited articles".[18] Between 1984 and 1991 Daniels published articles in The Spectator under the pseudonym Edward Theberton.

Daniels has written extensively on culture, art, politics, education, and medicine – often drawing on his experiences as a doctor and psychiatrist in Africa and the United Kingdom. The historian Noel Malcolm has described Daniels's written accounts of his experiences working at a prison and a public hospital in Birmingham as "journalistic gold",[19] and Charles Moore observed that "it was only when he returned to Britain that he found what he considered to be true barbarism – the cheerless, self-pitying hedonism and brutality of the dependency culture. Now he is its unmatched chronicler."[18]Daniel Hannan wrote in 2011 that Dalrymple "writes about Koestler's essays and Ethiopian religious art and Nietzschean eternal recurrence – subjects which, in Britain, are generally reserved for the reliably Left-of-Centre figures who appear on Start the Week and Newsnight Review. It is Theodore's misfortune to occupy a place beyond the mental co-ordinates of most commissioning editors."[5]

Life at the Bottom: The Worldview That Makes the Underclass, a collection of essays was published in book form in 2001. The essays, which the Manhattan Institute had first begun publishing in City Journal in 1994, deal with themes such as personal responsibility, the mentality of society as a whole, and the troubles of the underclass. As part of his research for the book, Dalrymple interviewed over 10,000 people who had attempted suicide.

Our Culture, What's Left of It: The Mandarins and the Masses, published in 2005, is another collection of essays in which he contends that the middle class's abandonment of traditional cultural and behavioural aspirations has, by example, fostered routine incivility and militant ignorance among the poor. He examines diverse themes and figures in the book including Shakespeare, Marx, Virginia Woolf, food deserts and volitional underclass malnutrition, recreational vulgarity, and the legalisation of drugs. One of the essays in the book, "When Islam Breaks Down", was named one of the most important essays of 2004 by David Brooks in the New York Times.[20]

In 2009, Dalrymple's British publisher Monday Books announced it was to publish two books. The first, Not With a Bang But A Whimper, appeared in August 2009. It is different from the United States book of the same name, though some of the author's essays appear in both books. In October 2009, Monday Books published Second Opinion, a further collection of Dalrymple essays, this time dealing exclusively with his work in a British hospital and prison.[21]

With Gibson Square Dalrymple then published his most successful book Spoilt Rotten: The Toxic Cult of Sentimentality (2010), which analyses how sentimentality has become culturally entrenched in British society with seriously harmful effects. In 2011, he published Litter: What Remains of Our Culture, followed by The Pleasure of Thinking (2012), Threats of Pain and Ruin (2014), and others.

Dalrymple was a judge for the 2013 Hippocrates Prize for Poetry and Medicine.

Themes[edit]

Daniels's writing has some recurring themes.[22]

  • The cause of much contemporary misery in Western countries – criminality, domestic violence, drug addiction, aggressive youths, hooliganism, broken families – is the nihilistic, decadent and/or self-destructive behaviour of people who do not know how to live. Both the smoothing over of this behaviour, and the medicalisation of the problems that emerge as a corollary of this behaviour, are forms of indifference. Someone has to tell those people, patiently and with understanding for the particulars of the case, that they have to live differently.[23]
  • Poverty does not explain aggressive, criminal and self-destructive behaviour. In an African slum you will find among the very poor, living in dreadful circumstances, dignity and decency in abundance, which are painfully lacking in an average English suburb, although its inhabitants are much wealthier.[24]
  • An attitude characterised by gratefulness and having obligations towards others has been replaced – with awful consequences – by an awareness of "rights" and a sense of entitlement, without responsibilities. This leads to resentment as the rights become violated by parents, authorities, bureaucracies and others in general.[25]
  • One of the things that make Islam attractive to young westernised Muslim men is the opportunity it gives them to dominate women.[26]
  • Technocratic or bureaucratic solutions to the problems of mankind produce disasters in cases where the nature of man is the root cause of those problems.
  • It is a myth, when going "cold turkey" from an opiate such as heroin, that the withdrawal symptoms are virtually unbearable; they are in fact hardly worse than flu.[27][28]
  • Criminality is much more often the cause of drug addiction than its consequence.
  • Sentimentality, which is becoming entrenched in British society, is "the progenitor, the godparent, the midwife of brutality".[29]
  • High culture and refined aesthetic tastes are worth defending, and despite the protestations of non-judgmentalists who say all expression is equal, they are superior to popular culture.[30][31][32]
  • The ideology of the Welfare State is used to diminish personal responsibility. Erosion of personal responsibility makes people dependent on institutions and favours the existence of a threatening and vulnerable underclass.
  • Moral relativism can easily be a trick of an egotistical mind to silence the voice of conscience.[33]
  • Multiculturalism and cultural relativism are at odds with common sense.[34]
  • The decline of civilised behaviour – self-restraint, modesty, zeal, humility, irony, detachment – ruins social and personal life.[35]
  • The root cause of our contemporary cultural poverty is intellectual dishonesty. First, the intellectuals (more specifically, left-wing ones) have destroyed the foundation of culture, and second, they refuse to acknowledge it by resorting to the caves of political correctness.

Bibliography[edit]

References[edit]

  1. ^https://beta.companieshouse.gov.uk/officers/JmqpqdJ2FBNeLlX4CY-_kO9u_MQ/appointments
  2. ^"NEJM paper". Nejm.org. Retrieved 2014-04-15. 
  3. ^"City Journal: Theodore Dalrymple". Manhattan Institute. Retrieved 31 December 2010. 
  4. ^Daniel Hannan (24 February 2010). "Are conservatives jollier than Lefties?". The Daily Telegraph. Retrieved 5 May 2011. 
  5. ^ abDaniel Hannan (4 May 2011). "In praise of Flanders, Right-wing intellectuals and Theodore Dalrymple". The Daily Telegraph. Archived from the original on 7 May 2011. Retrieved 5 May 2011. 
  6. ^http://search.findmypast.co.uk/results/world-records/england-and-wales-births-1837-2006?firstname=anthony%20m&lastname=daniels&eventyear=1949&eventyear_offset=2&county=london
  7. ^Theodore Dalrymple (2013). The New Vichy Syndrome: Why European Intellectuals Surrender to Barbarism. Encounter Books. p. ii. 
  8. ^Theodore Dalrymple (2005). Our Culture, What's Left of It. Ivan R. Dee. p. 158. 
  9. ^ abA bit of a myth, A.M. Daniels, The Spectator, 26 August 1983
  10. ^The doctor is in, The New Criterion, May 17, 2004
  11. ^"PRISONS - WHICH WAY OUT?". BFI. Retrieved 17 June 2014. 
  12. ^A doctor's farewell, The Spectator, 22 January 2005
  13. ^Minutes of the Extraordinary Meeting of Bridgnorth Town Council held in the Mayor's Parlour, College House on Monday, 28 October 2013 at 7.15pm
  14. ^ abDalrymple, Theodore (16 February 2008). "Where nobody knows your name". Globe and Mail. Retrieved 18 Sep 2013. 
  15. ^ abDalrymple, Theodore. "What the New Atheists Don't See". City Journal. Retrieved 5 January 2009. 
  16. ^Black Marx, Edward Theberton, The Spectator, 4 July 1986, Page 13
  17. ^Political Violence, Paul Hollander, Palgrave Macmillan, 2008
  18. ^ abCharles Moore (15 May 2004). "What's wrong with Britain? Less than the Jeremiahs allow". The Daily Telegraph. Retrieved 31 December 2010. 
  19. ^Noel Malcolm (15 August 2010). "Spoilt Rotten! by Theodore Dalrymple: review". The Sunday Telegraph. Retrieved 23 October 2010. 
  20. ^David Brooks (25 December 2004). "The Hookie Awards". The New York Times. Retrieved 18 August 2015. 
  21. ^The publisher made extracts from both works available free of charge on its Web site Not With A Bang But A WhimperSecond Opinion
  22. ^A good number of Daniels's themes are discussed in the interview by Paul Belien with Daniels: 'Dalrymple on Decadence, Europe, America and Islam', in: The Brussels Journal, the Voice of Conservatism in Europe, 17 September 2006.
  23. ^Life at the bottom. The Worldview that makes the Underclass (passim).
  24. ^Theodore Dalrymple (Spring 1999). "What is Poverty?". City Journal. Retrieved 12 August 2009. 
  25. ^'The Law of Conservation of Righteous Indignation, and its Connection to the Expansion of Human Rights', in: In Praise of Prejudice. The Necessity of Preconceived Ideas, p. 68 (chapter 17).
  26. ^In The Gelded Age. A review of America Alone: The End of the World as We Know It, by Mark Steyn (Website The Claremont Institute, 9 April 2007), Dalrymple wrote: "The principal immediate attraction of Islam to young Muslims brought up in the West is actually the control and oppression of women". A similar idea is expressed in The Suicide Bombers Among Us (City Journal, Autumn 2005). In that piece Dalrymple wrote: "However secular the tastes of the young Muslim men, they strongly wish to maintain the male dominance they have inherited from their parents".
  27. ^Theodore Dalrymple (9 April 1999). "Cold turkey is no worse than flu". New Statesman. Archived from the original on 23 June 2015. Retrieved 22 June 2015. 
  28. ^Theodore Dalrymple (7 February 2003). "Addicted to lies: junking heroin is no worse than flu". The Times. Retrieved 31 October 2009. 
  29. ^Dalrymple 2010, p. 50
  30. ^"The Baroque is superior to Rock: high culture is no bulwark against barbarism – but Baroque does not make those already predisposed to violence even more violent". Social Affairs Unit. 10 October 2005. Retrieved 21 April 2009. 
  31. ^Theodore Dalrymple (Winter 1998). "Poetry and Self-Pity". City Journal. Retrieved 11 May 2007. 
  32. ^Theodore Dalrymple (Winter 1998). "Trash, Violence, and Versace: But Is It Art?". City Journal. Retrieved 12 June 2008. 
  33. ^'The Uses of Metaphysical Skepticism', in: In Praise of Prejudice. The Necessity of Preconceived Ideas, p. 6 (chapter 2).
  34. ^Theodore Dalrymple (Summer 2004). "Multiculturalism Starts Losing Its Luster". City Journal. Retrieved 12 July 2009. 
  35. ^Theodore Dalrymple (Summer 1999). "All Our Pomp of Yesterday". City Journal. Retrieved 12 June 2008. 

External links[edit]

Clinical data
Routes of
administration
by mouth
ATC code
Legal status
Legal status
  • AU:S4 (Prescription only)
  • CA: Unscheduled
  • NZ: Prescription only [1]
  • UK: Unscheduled
  • US:Schedule I
  • UN: Unscheduled
Identifiers
CAS Number
PubChemCID
ChemSpider
UNII
ChEMBL
ECHA InfoCard100.001.363
Chemical and physical data
FormulaC20H26N2O
Molar mass310.44 g·mol−1
3D model (JSmol)
Melting point152 to 153 °C (306 to 307 °F)

SMILES

  • CC[C@H]([C@@H]1[N@](C2)CC3)C[C@@H]2C[C@H]1C(N4)=C3C5=C4C=CC(OC)=C5

InChI

  • InChI=1S/C20H26N2O/c1-3-13-8-12-9-17-19-15(6-7-22(11-12)20(13)17)16-10-14(23-2)4-5-18(16)21-19/h4-5,10,12-13,17,20-21H,3,6-9,11H2,1-2H3/t12-,13+,17+,20+/m1/s1 Y
  • Key:HSIBGVUMFOSJPD-CFDPKNGZSA-N Y
  (verify)

Ibogaine is a naturally occurring psychoactive substance found in plants in the Apocynaceae family such as Tabernanthe iboga, Voacanga africana and Tabernaemontana undulata.[2] It is a psychedelic with dissociative properties.

Ibogaine is not currently approved for any medical uses in the United States.[2] Preliminary research indicates that it may help with drug addiction;[2] however, there is a lack of data in humans.[3] Its use has been associated with serious side effects and death.[2] It is used as an alternative medicine treatment for drug addiction in some countries. Its prohibition in other countries has slowed scientific research.[4] Ibogaine is also used to facilitate psychological introspection and spiritual exploration. Derivatives of ibogaine that lack the substance's psychedelic properties are under development.[5]

Ibogaine-containing preparations are used for medicinal and ritual purposes within African spiritual traditions of the Bwiti, who claim to have learned it from the Pygmy peoples. Although it was first commonly advertised as having anti-addictive properties in 1962 by Howard Lotsof, its Western use predates that by at least a century. In France it was marketed as Lambarène and used as a stimulant. Additionally, the U.S. Central Intelligence Agency (CIA) studied the effects of ibogaine in the 1950s.[6]

Ibogaine is an indole alkaloid that is obtained either by extraction from the iboga plant or by semi-synthesis from the precursor compound voacangine,[7][8] another plant alkaloid. The total synthesis of ibogaine was described in 1956.[9] Structural elucidation by X-ray crystallography was completed in 1960.[10][11]

Psychoactive effects[edit]

Ibogaine is a psychedelic.[12] The experience of Ibogaine is broken down in two phases, the visionary phase and the introspection phase. The visionary phase has been described as oneirogenic, referring to the dreamlike nature of its psychedelic effects, and lasts for 4 to 6 hours. The second phase, the introspection phase, is responsible for the psychotherapeutic effects. It can allow people to conquer their fears and negative emotions. Ibogaine catalyzes an altered state of consciousness reminiscent of dreaming while fully conscious and aware so that memories, life experiences, and issues of trauma can be processed.[13]

Uses[edit]

Medical[edit]

See also: Ibogaine § Research

Ibogaine is not currently approved for any medical uses.[2] Clinical studies of ibogaine to treat drug addiction began in the early 1990s, but concerns about cardiotoxicity led to termination of those studies.[3] There is currently insufficient data to determine whether it is useful in treating addiction. Nonetheless, some alternative medicine clinics administer ibogaine for this purpose, in what has been called a "vast, uncontrolled experiment."[14]

Religious[edit]

In Bwiti religious ceremonies, the root bark is pulverized and swallowed in large amounts to produce intense psychoactive effects.[15]

Adverse effects[edit]

Immediate[edit]

One of the first noticeable effects of large-dose ibogaine ingestion is ataxia, a difficulty in coordinating muscle motion which makes standing and walking difficult without assistance. Xerostomia (dry mouth), nausea, and vomiting may follow. These symptoms may be long in duration, ranging from 4 to 24 hours in some cases. Ibogaine is sometimes administered per rectum to avoid nausea and vomiting.

Cardiovascular[edit]

Ibogaine causes long QT syndrome at therapeutic doses, apparently by blocking hERG potassium channels in the heart.[2][16]

Neurotoxicity[edit]

Work in the laboratory of Mark Molliver at Johns Hopkins indicated degeneration of cerebellar Purkinje cells observed in rats given substantially larger dosages of ibogaine than those used to study drug self-administration and withdrawal.[17] However, subsequent research found no evidence of neurotoxicity in the primate[18] or mouse[19] at dosages that produced cerebellar degeneration in the rat, and it has been suggested that cerebellar degeneration might be a phenomenon limited to a single species.[20] The FDA was aware of Molliver’s work at the time it approved a Phase 1 study in which humans received ibogaine in 1993.[21] Neuropathological examination revealed no evidence of degenerative changes in a woman who had received four separate doses of ibogaine ranging between 10 and 30 mg⁄ kg over a 15-month interval prior to her death due to a mesenteric artery thrombosis with small bowel infarction 25 days after her last ingestion of ibogaine.[18] A published series of fatalities temporally associated with the ingestion of ibogaine found no evidence suggesting a characteristic syndrome of neurotoxicity.[22]

Interactions[edit]

Adverse interactions may occur between ibogaine and psychiatric medications. Some studies also suggest the possibility of adverse interaction with heart conditions.[16][2][22]

Because ibogaine is one of the many drugs that are partly metabolized by the cytochrome P450 complex, caution must be exercised to avoid foods or drugs that are similarly metabolized by CP450, in particular foods containing bergamottin or bergamot oil, such as grapefruit juice.[23]

Pharmacology[edit]

Pharmacodynamics[edit]

SiteIbogaineNoribogaine
MOR2,000–100,000700–3,000
DOR>100,0005,000–25,000
KOR2,000–4,000600–1,000
5-HT2A16,000>100,000
5-HT2C>10,000>10,000
5-HT32,600>100,000
σ12,500–9,00011,000–15,000
σ290–4005,000–19,000
NMDA1,000–3,0006,000–15,000
nACh201,500
SERT50040
DAT2,0002,000
Values are Ki (nM). The smaller the value, the
more strongly the drug binds to the site.

Ibogaine affects many different neurotransmitter systems simultaneously.[26][21]

Noribogaine is most potent as a serotonin reuptake inhibitor. It acts as a moderate κ-opioid receptor agonist[27] and weak µ-opioid receptor agonist[28] or weak partial agonist.[29] It is possible that the action of ibogaine at the kappa opioid receptor may indeed contribute significantly to the psychoactive effects attributed to ibogaine ingestion; Salvia divinorum, another plant recognized for its strong hallucinogenic properties, contains the chemical salvinorin A which is a highly selective kappa opioid agonist. Noribogaine is more potent than ibogaine in rat drug discrimination assays when tested for the subjective effects of ibogaine.[30]

Pharmacokinetics[edit]

Ibogaine is metabolized in the human body by cytochrome P450 2D6 into noribogaine (12-hydroxyibogamine). Both ibogaine and noribogaine have a plasma half-life of around two hours in the rat,[31] although the half-life of noribogaine is slightly longer than that of the parent compound. It is proposed that ibogaine is deposited in fat and metabolized into noribogaine as it is released.[32] After ibogaine ingestion in humans, noribogaine shows higher plasma levels than ibogaine and is detected for a longer period of time than ibogaine.[33]

Chemistry[edit]

Ibogaine is a tryptamine. It has two separate chiral centers, meaning that there are four different stereoisomers of ibogaine. These four isomers are difficult to resolve.[34]

Synthesis[edit]

One recent total synthesis[35] of ibogaine and related drugs starts with 2-iodo-4-methoxyaniline which is reacted with triethyl((4-(triethylsilyl)but-3-yn-1-yl)oxy)silane using palladium acetate in DMF to form 2-(triethylsilyl)-3-(2-((triethylsilyl)oxy)ethyl)-1H-indole. This is converted using N-iodosuccinamide and then fluoride to form 2-(2-iodo-1H-indol-3-yl)ethanol. This is treated with iodine, triphenyl phosphine and imidazole to form 2-iodo-3-(2-iodoethyl)-1H-indole. Then using 7-ethyl-2-azabicyclo[2.2.2]oct-5-ene and cesiumcarbonate in acetonitrile the ibogaine precursor 7-ethyl-2-(2-(2-iodo-1H-indol-3-yl)ethyl)-2-azabicyclo[2.2.2]oct-5-ene is obtained. Using palladium acetate in DMF the ibogaine is obtained. If the exo ethyl group on the 2-azabicyclo[2.2.2]octane system in ibogaine is replaced with an endo ethyl then epiibogaine is formed.

Crystalline ibogaine hydrochloride is typically produced by semi-synthesis from voacangine in commercial laboratories.[15][36]

Derivatives[edit]

A synthetic derivative of ibogaine, 18-methoxycoronaridine (18-MC), is a selective α3β4 antagonist that was developed collaboratively by the neurologist Stanley D. Glick (Albany) and the chemist Martin E. Kuehne (Vermont).[37] This discovery was stimulated by earlier studies on other naturally occurring analogues of ibogaine such as coronaridine and voacangine that showed these compounds also have anti-addictive properties.[38][39]

Natural occurrence[edit]

Ibogaine occurs naturally in iboga root bark. Ibogaine is also available in a total alkaloid extract of the Tabernanthe iboga plant, which also contains all the other iboga alkaloids and thus has only about half the potency by weight as standardized ibogaine hydrochloride.[15]

History[edit]

The use of iboga in African spiritual ceremonies was first reported by French and Belgian explorers in the 19th century. The first botanical description of the Tabernanthe iboga plant was made in 1889. Ibogaine was first isolated from T. iboga in 1901 by Dybowski and Landrin[40] and independently by Haller and Heckel in the same year using T. iboga samples from Gabon. Complete synthesis of ibogaine was accomplished by G. Büchi in 1966.[41] Since then, several other synthesis methods have been developed.[42]

From the 1930s to 1960s, ibogaine was sold in France in the form of Lambarène, an extract of the Tabernanthe manii plant, and promoted as a mental and physical stimulant. The drug enjoyed some popularity among post World War II athletes. Lambarène was withdrawn from the market in 1966 when the sale of ibogaine-containing products became illegal in France.[43]

In the late 1960s the World Health Assembly classified ibogaine as a “substance likely to cause dependency or endanger human health,” the U.S. Food and Drug Administration (FDA) assigned it Schedule I classification, and the International Olympic Committee banned it as a potential doping agent.[44]

Anecdotal reports concerning ibogaine's effects appeared in the early 1960s.[45] Its anti-addictive properties were discovered accidentally by Howard Lotsof in 1962, at the age of 19, when he and five friends—all heroin addicts—noted subjective reduction of their craving and withdrawal symptoms while taking it.[46] Further anecdotal observation convinced Lotsof of its potential usefulness in treating substance addictions. He contracted with a Belgian company to produce ibogaine in tablet form for clinical trials in the Netherlands, and was awarded a United States patent for the product in 1985. The first objective, placebo-controlled evidence of Ibogaine's ability to attenuate opioid withdrawal in rats was published by Dzoljic et al. in 1988.[47] Diminution of morphine self-administration was reported in preclinical studies by Glick et al. in 1991.[48] Cappendijk et al. demonstrated reduction in cocaine self-administration in rats in 1993,[49] and Rezvani reported reduced alcohol dependence in three strains of "alcohol preferring" rats in 1995.[50]

As the use of ibogaine spread, its administration varied widely; some groups administered it systematically using well developed methods and medical personnel, while others employed haphazard and possibly dangerous methodology. Lotsof and his colleagues, committed to the traditional administration of ibogaine, developed treatment regimens themselves. In 1992, Eric Taub brought ibogaine to an offshore location close to the United States, where he began providing treatments and popularizing its use.[51] In Costa Rica Lex Kogan, another leading proponent, joined Taub in systematizing its administration. The two men established medically monitored treatment clinics in several countries.[52]

In 1981 an unnamed European manufacturer produced 44 kg of iboga extract. The entire stock was purchased by Carl Waltenburg, who distributed it under the name "Indra extract" and used it in 1982 to treat heroin addicts in Christiania, Denmark, a squatter village where heroin addiction was widespread.[53] Indra extract was available for sale over the Internet until 2006, when the Indra web presence disappeared. Various products are currently sold in a number of countries as "Indra extract", but it is unclear if any of them are derived from Waltenburg's original stock. Ibogaine and related indole compounds are susceptible to oxidation over time.[54][55]

The National Institute on Drug Abuse (NIDA) began funding clinical studies of ibogaine in the United States in the early 1990s, but terminated the project in 1995.[56] Data demonstrating ibogaine's efficacy in attenuating opioid withdrawal in drug-dependent human subjects was published by Alper et al. in 1999.[57] A cohort of 33 patients were treated with 6 to 29 mg/kg of ibogaine; 25 displayed resolution of the signs of opioid withdrawal from 24 hours to 72 hours post-treatment, but one 24-year-old female, who received the highest dosage, died. Mash et al., (2000) using lower oral doses (10–12 mg/kg) in 27 patients, demonstrated significantly lower objective opiate withdrawal scores in heroin addicts 36 hours after treatment, with self-reports of decreased cocaine and opiate craving and alleviated depression symptoms. Many of these effects appeared sustainable over a one-month post-discharge follow-up.[58]

Society and culture[edit]

Legal status[edit]

The Global Ibogaine Therapy Alliance publish a map of ibogaine legal status in various countries around the world.[59]

Brazil[edit]

On 14 January 2016, Ibogaine was legalized for prescription use in São Paulo, Brazil, with this legalization to extend to the rest of the country in a few months.[60]

Canada[edit]

Ibogaine was unregulated in Canada in 2009.[61][62] Then Health Canada added ibogaine to the Prescription Drug List (PDL) in 2017.[63]

Germany[edit]

Ibogaine is unregulated in Germany, but for medical use it can be regulated by the pharmacy rules (AMG).

New Zealand[edit]

Ibogaine was gazetted in New Zealand in 2009 as a non-approved prescription medicine.[64]

Norway[edit]

Ibogaine is illegal in Norway (as are all tryptamine derivatives).[65]

Sweden[edit]

Ibogaine is schedule I in Sweden.[66]

United Kingdom[edit]

As of January 2017 in the United Kingdom, ibogaine was an unlicensed medical product.[67]

United States[edit]

Ibogaine is classified as a Schedule I-controlled substance in the United States,[68] and is not approved there for addiction treatment (or any other therapeutic use) because of its hallucinogenic, neurotoxic, and cardiovascular side effects, as well as the scarcity of safety and efficacy data in human subjects.[69]

Treatment clinics[edit]

Ibogaine treatment clinics have emerged in Mexico, Canada, the Netherlands, South Africa, and New Zealand, all operating in what has been described as a "legal gray area".[70][71]Costa Rica also has treatment centers, most notably one run by Lex Kogan, a leading proponent of ibogaine.[72] Covert, illegal neighborhood clinics are known to exist in the United States, despite active DEA surveillance.[73] While clinical guidelines for ibogaine-assisted detoxification were released by the Global Ibogaine Therapy Alliance in 2015,[74][75] addiction specialists warn that the treatment of drug dependence with ibogaine in non-medical settings, without expert supervision and unaccompanied by appropriate psychosocial care, can be dangerous — and, in approximately one case in 300, potentially fatal.[71]

Media[edit]

Documentary films[edit]

Detox or Die (2004)

Directed by David Graham Scott.[76] David Graham Scott begins videotaping his heroin-addicted friends. Before long, he himself is addicted to the drug. He eventually turns the camera to himself and his family. After 12 years of debilitating, painful dependence on methadone, Scott turns to ibogaine. Filmed in Scotland and England, and broadcast on BBC One as the third instalment in the documentary series One Life.[77]

Ibogaine: Rite of Passage (2004)

Directed by Ben Deloenen.[78] Cy a 34-year-old heroin addict undergoes ibogaine treatment with Dr Martin Polanco at the Ibogaine Association, a clinic in Rosarito Mexico. Deloenen interviews people formerly addicted to heroin, cocaine, and methamphetamine, who share their perspectives about ibogaine treatment. In Gabon, a Babongo woman receives iboga root for her depressive malaise. Deloenen visually contrasts this Western, clinical use of ibogaine with the Bwiti use of iboga root, but emphasizes the Western context.

Facing the Habit (2007)

Directed by Magnolia Martin.[79] Martin's subject is a former millionaire and stockbroker who travels to Mexico for ibogaine treatment for heroin addiction.

Tripping in Amsterdam (2008)

In this short film directed by Jan Bednarz, Simon "Swany" Wan visits Sara Glatt's iboga treatment center in Amsterdam.[80]Current TV broadcast the documentary in 2008, as part of their "Quarter-life Crisis" programming roster.

I'm Dangerous with Love (2009)

Directed by Michel Negroponte.[81] Negroponte examines Dimitri Mugianis's long, clandestine career of treating heroin addicts with ibogaine.

"Hallucinogens" (2012)

In one of five segments from this episode of Drugs, Inc. on National Geographic Channel, a former heroin user treats addicts with ibogaine in Canada. He himself used ibogaine to stop his abuse of narcotics.:[82]

"Addiction" (2013)

This episode of the HBO documentary series Vice[83] devotes a segment to the use of ibogaine to interrupt heroin addiction.

"The Ibogaine Safari" (2014)

A documentary by film maker Pierre le Roux, investigating the claims of painless withdrawal from Opiates such as Njope/Heroin in South Africa by taking several addicts on an adventure 'safari' while taking Ibogaine. The documentary won the award of excellence for 'Best documentary short' at the 2014 Canada International film festival.[84]

Print media[edit]

While in Wisconsin covering the primary campaign for the United States presidential election of 1972, gonzo journalistHunter S. Thompson submitted a satirical article to Rolling Stone accusing Democratic Party candidate Edmund Muskie of being addicted to ibogaine. Many readers, and even other journalists, did not realize that the Rolling Stone piece was facetious. The ibogaine assertion, which was completely unfounded, did a significant amount of damage to Muskie's reputation, and was cited as a factor in his loss of the nomination to George McGovern.[85] Thompson later said he was surprised that anyone believed it.[86] The article is included in Thompson's post-election anthology, Fear and Loathing on the Campaign Trail '72 (1973).[87]

Author and YippieDana Beal co-wrote the 1997 book The Ibogaine Story.[88]

American author Daniel Pinchbeck wrote about his own experience of ibogaine in his book Breaking Open the Head (2002),[89] and in a 2003 article for The Guardian titled "Ten years of therapy in one night".[90]

Television drama[edit]

Ibogaine factors into the stories of these episodes from television drama series:

Radio[edit]

  • "Sink or Swim. Act Two. I'm Not A Doctor But I Play One At The Holiday Inn.". This American Life. Episode 321. 1 December 2006.  — A former heroin addict realizes that he wants to help other addicts kick their habits. The problem is, he wants to do this using a hallucinogenic drug - ibogaine - that is completely illegal, and which requires medical expertise he doesn't have.[97]

Research[edit]

Addiction treatment[edit]

The most-studied therapeutic effect of ibogaine is the reduction or elimination of addiction to opioids. An integral effect is the alleviation of symptoms of opioid withdrawal. Research also suggests that ibogaine may be useful in treating dependence on other substances such as alcohol, methamphetamine, and nicotine and may affect compulsive behavioral patterns not involving substance abuse or chemical dependence. Researchers note that there remains a "need for systematic investigation in a conventional clinical research setting."[45]

Many users of ibogaine report experiencing visual phenomena during a waking dream state, such as instructive replays of life events that led to their addiction, while others report therapeutic shamanic visions that help them conquer the fears and negative emotions that might drive their addiction. It is proposed that intensive counseling, therapy and aftercare during the interruption period following treatment is of significant value. Some individuals require a second or third treatment session with ibogaine over the course of the next 12 to 18 months. A minority of individuals relapse completely into opiate addiction within days or weeks. A comprehensive article (Lotsof 1995) on the subject of ibogaine therapy detailing the procedure, effects and aftereffects is found in "Ibogaine in the Treatment of Chemical Dependence Disorders: Clinical Perspectives".[98] Ibogaine has also been reported in multiple small-study cohorts to reduce cravings for methamphetamine.[99]

There is also evidence that this type of treatment works with LSD, which has been shown to have a therapeutic effect on alcoholism. Both ibogaine and LSD appear to be effective for encouraging introspection and giving the user occasion to reflect on the sources of their addiction, while also producing an intense, transformative experience that can put established patterns of behaviour into perspective;[100] ibogaine has the added benefit of preventing withdrawal effects.[45]

Chronic pain management[edit]

In 1957, Jurg Schneider, a pharmacologist at CIBA (now a division of Novartis), found that ibogaine potentiated morphineanalgesia.[101] No additional data was ever published by CIBA researchers on ibogaine–opioid interactions. Almost 50 years later, Patrick Kroupa and Hattie Wells released the first treatment protocol for concomitant administration of ibogaine with opioids in human subjects, indicating that ibogaine reduced tolerance to opioid drugs. Their paper in the Multidisciplinary Association for Psychedelic Studies Journal demonstrated that administration of low "maintenance" doses of ibogaine HCl with opioids decreases tolerance, but noted that ibogaine's potentiating action could make this a risky procedure.[102]

Psychotherapy[edit]

Ibogaine has been used as an adjunct to psychotherapy by Claudio Naranjo, documented in his book The Healing Journey.[103] He was awarded patent CA 939266  in 1974.

See also[edit]

References[edit]

  1. ^Galea, Susanna; Lorusso, Mino; Newcombe, David; Walters, Carina; Williman, Jonathon; Wheeler, Amanda (March 2011). Goodyear-Smith, Felicity, ed. "Ibogaine—be informed before you promote or prescribe"(PDF). Journal of Primary Health Care. Royal New Zealand College of General Practitioners. 3 (1): 86. ISSN 1172-6156. Retrieved 4 December 2015. 
  2. ^ abcdefgKoenig, X; Hilber, K (29 January 2015). "The anti-addiction drug ibogaine and the heart: a delicate relation". Molecules (Basel, Switzerland). 20 (2): 2208–28. doi:10.3390/molecules20022208. PMC 4382526. PMID 25642835. 
  3. ^ abBrown, Thomas (March 2013). "Ibogaine in the treatment of substance dependence". Current Drug Abuse Reviews. 6 (1): 3–16. doi:10.2174/15672050113109990001. PMID 23627782. 
  4. ^Alper, K.R.; Lotsof, H.S.; Kaplan, C.D. (2008). "The Ibogaine Medical Subculture". J. Ethnopharmacol. 115 (1): 9–24. doi:10.1016/j.jep.2007.08.034. PMID 18029124. Archived from the original on 6 February 2008. Retrieved 22 February 2008. 
  5. ^Hamilton, Keegan (17 November 2010). "Ibogaine: Can it Cure Addiction Without the Hallucinogenic Trip?". The Village Voice. 
  6. ^Alper, Kenneth R. (2001). "Chapter 1: Ibogaine: A Review". In Alper, Kenneth R.; Glick, Stanley D. Ibogaine : proceedings from the first international conference. The Alkaloids. 56. Academic. pp. 2–33. ISBN 9780120532063. 
  7. ^Chris Jenks: Extracting Ibogaine Chris Jenks tells about the findings of his Extraction Studies.
  8. ^Iboga Extraction Manual Compiled 2009 by Dr. Chris Jenks.
  9. ^US patent 2813873, Morrice-Marie Janot & Robert Goutarel, "Derivatives of the ibogaine alkaloids", issued 19 November 1957, assigned to Les Laboratoires Gobey 
  10. ^Soriano-García, M.; Walls, F.; Rodríguez, A.; López Celis, I. (1988). "Crystal and molecular structure of ibogamine: An alkaloid from Stemmadenia galeottiana". Journal of Crystallographic and Spectroscopic Research. 18 (2): 197–206. doi:10.1007/BF01181911. 
  11. ^Arai, G.; Coppola, J.; Jeffrey, G. A. (1960). "The structure of ibogaine". Acta Crystallographica. 13 (7): 553–564. doi:10.1107/S0365110X60001369. 
  12. ^Alper, Kenneth R.; Beal, Dana; Kaplan, Charles D. (2001). A CONTEMPORARY HISTORY OF IBOGAINE IN THE UNITED STATES AND EUROPE(PDF). Academic Press. p. 256. 
  13. ^Obembe, Samuel (2012). Practical Skills and Clinical Management of Alcoholism & Drug Addiction. Elsevier. p. 88. ISBN 9780123985187. Retrieved 6 September 2012. 
  14. ^Vastag, B (15 April 2005). "Addiction research. Ibogaine therapy: a 'vast, uncontrolled experiment'". Science. 308 (5720): 345–346. doi:10.1126/science.308.5720.345. PMID 15831735. 
  15. ^ abcJenks, C. (2002). "Extraction Studies of Tabernanthe Iboga and Voacanga Africana". Natural Product Letters. 16 (1): 71–76. doi:10.1080/1057563029001/4881. PMID 11942686. 
  16. ^ abAlper, Kenneth; Bai, Rong; Liu, Nian; Fowler, Steven J.; Huang, Xi-Ping; Priori, Silvia G.; Ruan, Yanfei (1 January 2016). "hERG Blockade by Iboga Alkaloids". Cardiovascular Toxicology. 16 (1): 14–22. doi:10.1007/s12012-015-9311-5. ISSN 1530-7905. 
  17. ^O'Hearn, E.; Molliver, M. E. (1 July 1993). "Degeneration of Purkinje cells in parasagittal zones of the cerebellar vermis after treatment with ibogaine or harmaline". Neuroscience. 55 (2): 303–310. doi:10.1016/0306-4522(93)90500-f. ISSN 0306-4522. PMID 8377927. 
  18. ^ abMash, D. C.; Kovera, C. A.; Buck, B. E.; Norenberg, M. D.; Shapshak, P.; Hearn, W. L.; Sanchez-Ramos, J. (30 May 1998). "Medication development of ibogaine as a pharmacotherapy for drug dependence". Annals of the New York Academy of Sciences. 844: 274–292. doi:
Shredded bark of tabernanthe iboga for consumption. Contains ibogaine.
The general structure of tryptamines.

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