Copyright 1992 Globe Newspaper Company
The Boston Globe
November 9, 1992, Monday, City Edition
SECTION: SCIENCE & TECHNOLOGY; Pg. 29
LENGTH: 1371 words
HEADLINE: HALLUCINOGEN BEING STUDIED AS TREATMENT FOR ADDICTION; PHARMACOLOGY
BYLINE: By Dolores Kong, Globe Staff
In the urgent search for new treatments for cocaine and heroin addiction, scientists are studying an unusual substance: a hallucinogenic West African plant derivative used in religious and hunting rituals.
The National Institute on Drug Abuse is conducting animal tests on ibogaine, which comes from the rain forest shrub Tabernanthe iboga, found primarily in the African nations of Congo and Gabon. In addition, researchers at the University of Miami will begin trials in about a dozen cocaine addicts early next year to assess the compound’s safety and effectiveness.
In privately sponsored human experiments in the Netherlands, a single dose of ibogaine in capsule form is reported to have stopped addicts’ craving for heroin, cocaine and other drugs for up to six months with few or no withdrawal symptoms. Those results could not be verified.
Researchers caution that the substance is a long way from being proven safe, effective and nonaddictive itself, and they are especially concerned about its potential toxicity.
At this point, ibogaine is “a scientific curiosity” and “more of a longshot,” says Charles Grudzinskas, director of the National Institute on Drug Abuse medications development division.
But if it is proven safe and effective, the substance, which comes from the root of the iboga plant, could be an important treatment weapon in the nation’s war on drugs.
Few treatment options exist now, and those that do – such as daily doses of methadone for heroin addicts – can be as addictive as the drugs themselves. Some AIDS activists have been lobbying since the late 1980s for federal approval of ibogaine as a heroin treatment, to help stop the spread of the deadly AIDS virus among intravenous drug users.
“If ibogaine turns out to be the real McCoy,” it would not be the first time someone has come forth with claims about the medicinal properties of a natural substance and been proven right, says Frank Vocci, director of the National Institute on Drug Abuse’s ibogaine research project and deputy director of the institute’s medications development division.
The person who first brought ibogaine to the institute’s attention is Howard Lotsof, a self-described former heroin addict who says he discovered ibogaine’s anti-addictive properties in 1962, when he tried the compound for a new “high” soon after he left college in New Jersey. He found instead that he no longer craved heroin. Lotsof, the chief proponent of ibogaine, is now president of NDA International and holds patents on using the substance for treating addiction. Ibogaine itself cannot be patented, because it is a natural substance.
Lotsof says his company successfully treated drug addicts in the Netherlands, where laws allow experimental therapy without approval from the government or a research institution. Officials at the National Institute on Drug Abuse could not verify the claims but said they have heard anecdotal reports.
Ibogaine is illegal in the United States, in the same category as heroin and marijuana, but it can be obtained for research purposes. According to the book “Plants of the Gods,” by Richard Evans Schultes, a Harvard professor emeritus, and Albert Hofmann, discoverer of LSD, ibogaine has been used by some West Africans to seek information from spirits and ancestors and to create a trance-like state during night hunting watches.
Recent studies in laboratory animals, some of them funded by the National Institute on Drug Abuse, show the substance does appear to be unique in its long-lasting effect and its ability to act on addiction to and withdrawal from a host of drugs.
“It’s a very unusual compound, and it definitely is exciting,” says chairman Stanley D. Glick of the pharmacology and toxicology department at Albany Medical College, who has received National Institute on Drug Abuse funding to study ibogaine in rats addicted to morphine, cocaine and amphetamines. “It does things we never would have expected it to do.”
Others agree. Patricia Broderick, associate medical professor at the City University of New York Medical School, has found that ibogaine reduced the effects of cocaine in rats. “It definitely merits attention,” she says.
But researchers also caution that more studies must be done.
“What’s really critical is looking at the toxicity of the drug,” says Vocci, the director of the National Institute on Drug Abuse’s ibogaine research project.
Grudzinskas, the director of the medications development division of the National Institute on Drug Abuse, acknowledges that ibogaine is one of perhaps three dozen substances that the institute is reviewing seriously. Some, such as LAAM and buprenorphine for heroin addiction, have already been clinically tested in hundreds of people.
Within six months, enough animal data should be available for NIDA officials to decide whether they should proceed with human clinical trials of ibogaine, Grudzinskas says.
After looking at the limited data available, researchers say the substance’s potential advantages may lie in its curious nature. While most treatments work only on one drug, such as cocaine or heroin, by blocking or substituting for the drug’s specific effects on dopamine, the pleasure-causing brain chemical, ibogaine appears to work on a variety of addictions.
Compounds that substitute for a drug’s effects also can be addictive themselves, but Vocci says he doubts ibogaine is addictive because hallucinogens, with the exception of PCP, are not habit-forming.
“People are still skeptical . . . but something is happening there,” says Henry Sershen, a neuroscientist at the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, N.Y., who has studied ibogaine in mice. “An understanding of its mechanism may be important to understanding how drugs of abuse work.”
Glick of Albany Medical College agrees: “There are quite a number of mysterious findings with the drug we’ve never really ever seen with others before.”
The mystery should be no barrier, says Lotsof, who holds the patents on ibogaine’s use. He says that out of about 50 addicts in the Netherlands experiments, some of whom flew there from the United States for the treatment, about 10 needed only a single dose to go drug-free for six months or longer. About 25 needed multiple doses backed up by counseling and behavioral therapy to achieve the same results, he says.
One 40-year-old real estate office manager in New York, addicted off and on for 25 years to heroin and then to methadone, underwent a single dose of ibogaine treatment in the Netherlands in April. She reports she experienced few withdrawal symptoms and now has no uncontrollable craving for heroin or methadone. She says the treatment kept her awake for about 24 hours and at times caused her to see visions.
Lotsof cautions that the compound is effective only in people who are ready to tackle their addiction. NDA International, based in Staten Island, N.Y., charges between $ 10,000 and $ 20,000 for a treatment in the Netherlands, depending on the individual’s cost for travel and lodging, and the medical personnel. Lotsof says the cost of the compound itself is between $ 50 and $ 150 a gram, with one to two grams being the usual dosage.
Over the last few years, Lotsof has joined forces with the AIDS Coalition to Unleash Power, known as ACT-UP, the Boston-based National AIDS Brigade and some groups in minority communities to support ibogaine as one way to help stop the spread of the AIDS virus among intravenous drug users.
“Everybody agrees there is a deficit in treatment,” says Dana Beal, a member of ACT-UP/New York. “Others say you can’t use a drug to treat a drug addiction. We have an AIDS crisis. We just don’t have the luxury of letting them do it their way. We have to have as many things as possible.”
But before ibogaine can be touted as an effective weapon against AIDS or the drug epidemic, researchers say, its safety and effectiveness must be carefully evaluated.
“As a scientist, you have to have an open mind and be skeptical at the same time,” says Vocci of the National Institute on Drug Abuse. “You have to listen to people and yet say, ‘We have to do something to evaluate this ourselves.’ ”
GRAPHIC: PHOTO, Dr. Stanley D. Glick of Albany Medical College says of ibogaine, “It does things we never would have expected it to do.” / GLOBE PHOTO / ALAN SOLOMON
LOAD-DATE-MDC: November 10, 1992