Philip-Seymour-Hoffman.jpg

Why Is This Option Beyond the Pale for Heroin Addicts?

Ted Scheinman has a piece up at Pacific Standard arguing that there already exists an effective means of helping heroin addicts conquer their enslavement to the drug:

There is only one short-term chemical therapy that actually obviates the wrenching withdrawal symptoms of any opiate. This therapy involves the administration of a therapeutic dose of ibogaine, an alkaloid derivative of a family of plants in Central West Africa that Bwiti worshipers have long used as a visionary sacrament. A dissociative and powerful psychedelic compound, ibogaine induces a dream-state described variously as beatific, clarifying, and terrifying; the after-effects, usually a hazy state of dull relaxation, can last a number of days. In the majority of reported cases in Europe and Africa, cravings disappear once the psychoactive iboga wears off…

This treatment is scarcely even spoken of, let alone officially researched, because ibogaine is itself a psychedelic drug:

Most scientists at R1 schools (especially those with a research budget to lose) are uncomfortable speaking publicly about the treatment because to do so is to league oneself with the black sheep of the American scientific community—psychedelic researchers, a culture still stained by the legacy of Timothy Leary’s decades-long LSD boosterism. Even tenured researchers express a certain skittishness when the subject arises. 

There is one organization, the Multidisciplinary Association for Psychedelic Studies (MAPS), that is pursuing research on the use of ibogaine for heroin addiction. MAPS is conducting studies of the long-term effects of ibogaine on patients undergoing therapy at independent treatment centers in Mexico and New Zealand. Rick Doblin, a public policy Ph.D. from Harvard’s Kennedy School who co-founded MAPS, advocates a multilateral treatment program that combines ibogaine with “collaborative rehab and the talking cure.” 

The war on drugs is costing taxpayers an annual $51 billion and accomplishing very little. Surely it’s reasonable to suggest that a portion of that whopping tally be expended for research into a practical solution to the nightmare of addiction? Where is the logic in the continued refusal to countenance research into the beneficial effects of psychedelic drugs?

  1. katievs

    Do you think maybe the resistance has partly to do with a certain moral intuition? I mean that when it comes to addiction, there’s really no way out but through.  Sooner or later the addict who wants to be free will have to suffer the pain of withdrawal and do the hard work of recovery.

    It may also have to do with what we learned through the experiments with psychedelic drugs in the 70′s.  I mean that they mess with the mind in ways that are hard to predict and control.

    I wouldn’t say I’m absolutely opposed to the therapeutic use of psychedelic drugs in extreme cases of addiction.  But I do have doubts about it.  They are similar to my doubts that drugs are a good solution to ADHD.

    All treatments that address a human subject as if he’s nothing more than a biological organism are in danger of doing more harm than good.

  2. Fred Cole

    LSD was shown to be amazing in helping alcoholics to recover. Here’s the thing about drugs like this, Judith: What if people take them? Then they’ll end up on welfare and we’ll have to carry them. Better to spend that $51,000,000,000 fighting and losing a pointless War on Drugs than to let people be free and have them possibly go on welfare. So heroin addicts, and alcoholics, and people who benefit from medicinal uses of other drugs will just have too stuffer, because thats better than having people be free.

  3. Fricosis Guy

    Still doesn’t address the question of why alcoholics and addicts get the insane idea that they can use again. We know how to detox reasonably well. For example, Hoffman’s physical cravings would have been long gone after his 20+ years clean. Why did the mental obsession to use return (or persist)?

  4. HVTs

    I think it’s time for realism.  Eliminating drug abuse is as likely as eliminating poverty.  Jesus’ comment that “the poor will always be among you” was not a reflection of his thoughts on public policy, but about our common humanity.   He might have said the same for addicts.  No matter what ‘cure’ we come up with, some people will self-medicate.  The fact that prominent people like PSH succumb excites our empathy . . . we will soon go back to sleep.  This doesn’t mean we should give up on warning people about the dangers of drug addiction.  There’s a larger number of people than the population of addicts for whom social opprobrium is an effective prophylactic.  They are the target audience for the impossible-to-win War on Drugs.  (Impossible because we are not ever going to be as ruthless as the drug kingpins.). But there is a committed few for whom pumping toxins into their bloodstream is simply the exercise of free will.  Offering them psychedelics instead is just pushing the food around their plate . . . they will simply wait for the next meal.

  5. Franco

    There is so much ignorance of drugs and especially psychedelic drugs and we see it on display here and everywhere. Unless one has actually taken a psychedelic ‘drug’ -which is a very poor description, because it is absolutely unlike any other ‘drug’ – one is operating in the world of superstition. 

    Trumping every conversation is someone wagging a finger, and 99% of the time they haven’t a clue about what they are talking about.

    Timothy Leary didn’t stain the culture with LSD boosterism, it was the culture of abject fear of these drugs from know-nothings, afraid their own frail psychological underpinnings were at risk and projected these fears onto a ‘drug’ and a drug culture. Timothy Leary was merely a convienient lightning rod for the debate.

    My own experience tells me that psychedelics are like an antidote to addiction, and are non-addictive themselves. The last substances people want to ingest with psychedelics are alcohol or narcotics, and subjects report a complete loss of desire for these ‘fixes’ well after the psychedelics wear off. 

    Incomprehensively to most people, subjects have no craving or desire for more psychedelics either. This is one reason classifying them as ‘drugs’ is misleading…..

  6. Goldgeller

    Thank you for the post. I had no idea that this type of “treatment” was out there. I’ll remove the quote marks once more research is done. I’m all for that type of research if it really does help people break these addiction, and presuming it doesn’t replace it with another equally unhealthy addiction.

  7. Crow
    Judith Levy, Ed.There is one organization, the Multidisciplinary Association for Psychadelic Studies (MAPS), that is pursuing research on the use of ibogaine for heroin addiction. MAPS is conducting studies of the long-term effects of ibogaine on patients undergoing therapy at independent treatment centers in Mexico and New Zealand. Rick Doblin, a public policy Ph.D. from Harvard’s Kennedy School who co-founded MAPS, advocates a multilateral treatment program that combines ibogaine with “collaborative rehab and the talking cure.” 

    Bravo, I say. Whatever the exact mix between physiological need and psychological dependency that fuels addiction (and to what degree it is a choice and to what degree one simply becomes a slave to the drug), it would appear that in some way both play a role.

    If this cycle can be broken and the dependency dispensed with via another drug with some hope of success, we ought to consider it an option.

    To remove the need is hardly to solve all problems or put someone’s life back together–once they’re free of the drug, there are still many wounds to heal.

    Further study appears warranted to suss out what the effects of this treatment are.

  8. Tommy De Seno
    C

    We are lunatics.  All of us.

    We make moral judgments about plants.   You are a good plant.  You are a socially unacceptable plant.

    In the entire measure of human history, we have used plants to alter our consciousness. 

    Yet we make moral judgments about altering consciousness.  Your altered state is good.  Your altered state is socially unacceptable.   Good grief.

    This bizarre exercise leaks into medicine.   Even if a plant will cure or give palliative relief, we pass laws against it seemingly to admonish the plant itself.  It’s as if we expect our  disapproval of it to cause the plant to find Jesus and reform itself.

    We are lunatics.

  9. Leslie Watkins

    Narcotics don’t kill people. People kill people. Obviously I have no idea what formally plagued PSH, but I’ll go with the Greek view of the furies (what we today call demons). I suspect that many actors and other artists who achieve fame feel completely unworthy of the attention and money they receive. They dive into art to escape the negativity that shapes their sense of self (non-self), only to return to the surface to face the adulation and fame that bring back all those horrible feelings. And what quicker, non-conscious way to get rid of lots of undeserved money than to throw it into the wind?  Guilt is a terrible thing. (Shame is completely different: we could use a lot more of it, IMO.) Unworthiness. Phoniness. Feelings of being a total fraud. They’re killers. But also the mother of much talent. No other drug is going to stop that agony without having effects that the person dislikes just as much–losing the energy of their creative selves. This treatment, like that for bipolar disorder, will hinge on peoples’ willingness to take the drug, and that, ironically, might be very hard to do. 

  10. Black Prince

    Well said, Franco (#5) and Tommy (#8).  I’ll readily admit my complete ignorance regarding psychedelics, but if the reports are true, then it sounds like they can “reboot” the brain—I wonder if psychedelics can help with mental illnesses such as depression.

  11. Foxman
    katievs: Do you think maybe the resistance has partly to do with a certain moral intuition? I mean that when it comes to addiction, there’s really no way out but through.  Sooner or later the addict who wants to be free will have to suffer the pain of withdrawal and do the hard work of recovery.

    It may also have to do with what we learned through the experiments with psychedelic drugs in the 70′s.  I mean that they mess with the mind in ways that are hard to predict and control.

    I wouldn’t say I’m absolutely opposed to the therapeutic use of psychedelic drugs in extreme cases of addiction.  But I do have doubts about it.  They are similar to my doubts that drugs are a good solution to ADHD.

    All treatments that address a human subject as if he’s nothing more than a biological organism are in danger of doing more harm than good. · 1 hour ago

    Edited 1 hour ago

    To summarize:  You have sinned and must be punished.

     I think I will leave judgment to God.

  12. outstripp

    I read somewhere that kicking heroin addiction is not nearly as hard as the movies/media would have us believe.

  13. Podkayne of Israel

    As I understand it, the problem with getting off opiates and staying off is much more than just symptoms of withdrawal. In nursing school, we visited an addictions center, where former and current addicts explained to us that heroin withdrawal is not as bad as they claim in the movies. They described it as 2 weeks of a really horrible bout of flu, with all that entails. Vomiting, pain, aches, diarrhea, etc, but after that, *it’s over*.The real problem is staying clean–whatever drove you to use in the first place, “the worm”, remains. Worst of all, the addict is left with the subjective feeling of knowing that relief from the psychic pain that led him to addiction can still be relieved by using the drug.If such, Ibogaine is only useful in the first stage, the easy one to overcome.

  14. katievs
    Foxman

    katievs: 

    To summarize:  You have sinned and must be punished.

     I think I will leave judgment to God. 

    That’s how you read my comment?

    Sheesh.

  15. HVTs
    Tommy De Seno: We are lunatics.  All of us.

    We make moral judgments about plants.   You are a good plant.  You are a socially unacceptable plant.

    Yet we make moral judgments about altering consciousness.  Your altered state is good.  Your altered state is socially unacceptable.   Good grief.

    The distinction being judged morally is sobriety versus non-sobriety. Yes, there are degrees of intoxication and less is generally deemed better than more.  There are degrees of mind-altering effects, with attendant loss of the ability to recognize reality, and generally less is considered better than more.  You are not arguing we can’t make distinctions, are you?
  16. Crow
    Podkayne of Israel: The real problem is staying clean–whatever drove you to use in the first place, “the worm”, remains. Worst of all, the addict is left with the subjective feeling of knowing that relief from the psychic pain that led him to addiction can still be relieved by using the drug.If such, Ibogaine is only useful in the first stage, the easy one to overcome.

    But this is pretty close to what the MAPS participants are saying about ibogaine. Thus this:

    Rick Doblin, a public policy Ph.D. from Harvard’s Kennedy School who co-founded MAPS, advocates a multilateral treatment program that combines ibogaine with “collaborative rehab and the talking cure.” 

    The point being, the underlying causes that drove this addictive behavior are not going to be washed away ibogaine–they are still going to have be confronted and overcome. 

    If usage of ibogaine (as part of a wider program–i.e. non-recreational but rather medicinal) might help bring about that confrontation by removing some of the obstacles to it in the opening stages of the process of recovery, I’d say its a worthy candidate to pursue further study on.

  17. Manfred Arcane
    Judith Levy, Ed.

    This treatment is scarcely even spoken of, let alone officially researched, because ibogaine is itself a psychedelic drug:

    Most scientists at R1 schools (especially those with a research budget to lose) are uncomfortable speaking publicly about the treatment because to do so is to league oneself with the black sheep of the American scientific community—psychedelic researchers, a culture still stained by the legacy of Timothy Leary’s decades-long LSD boosterism. Even tenured researchers express a certain skittishness when the subject arises. 

    The war on drugs is costing taxpayers an annual $51 billion and accomplishing very little. Surely it’s reasonable to suggest that a portion of that whopping tally be expended for research into a practical solution to the nightmare of addiction? Where is the logic in the continued refusal to countenance research into the beneficial effects of psychedelic drugs? · · 4 hours ago

    Richly provocative post, Ms. Levy.  

    Is there a lesson here about the deficiencies of Federal funded research?  Would there be more “creativity” if private foundations (probably funded by Rich Folks) provided the bulk of funding?

  18. BrentB67
    Fred Cole: LSD was shown to be amazing in helping alcoholics to recover. Here’s the thing about drugs like this, Judith: What if people take them? Then they’ll end up on welfare and we’ll have to carry them. Better to spend that $51,000,000,000 fighting and losing a pointless War on Drugs than to let people be free and have them possibly go on welfare. So heroin addicts, and alcoholics, and people who benefit from medicinal uses of other drugs will just have too stuffer, because thats better than having people be free. · 2 hours ago

    Interesting calculus Fred. How about if we repeal the Federal welfare state. That should save us more than $51B.

  19. Manfred Arcane

    Boy, I don’t like the tone of this post at all.  I “lost” a brother to these ‘drugs’ many years ago.  It warped his mind badly.  And he was a good, good soul.  Some people know more about these ‘drugs’ than you presume, Mr..

    Franco: There is so much ignorance_of_drugs and especially psychedelic drugs and we see it on display here and everywhere. Unless one has actually taken a psychedelic ‘drug’ -which is a very poor description, because it is absolutely unlike any other ‘drug’ – one is operating in the world of superstition. 

    Trumping every conversation is someone wagging a finger, and 99% of the time they haven’t a clue about what they are talking about.

    Timothy Leary didn’t stain the culture with_LSD_boosterism, it was the culture of abject fear of these drugs from know-nothings, afraid their own frail psychological underpinnings were at risk and projected these fears onto a ‘drug’ and a drug culture. …

    My own experience tells me that psychedelics are like an antidote to addiction, and are non_addictive themselves. …

    Incomprehensively to most people, subjects have no craving or desire for more psychedelics either. This is one reason classifying them as ‘drugs’ is misleading…..

  20. HVTs
    Crow’s Nest

    Podkayne of Israel: The real problem is staying clean–whatever drove you to use in the first place, “the worm”, remains. … Ibogaine is only useful in the first stage, the easy one to overcome.

    The point being, the underlying causes that drove this addictive behavior are not going to be washed away ibogaine–they are still going to have be confronted and overcome.

    Alcoholics Anonymous and its related Narcotics group works effectively. It requires that addicts go to meetings and seek help from their sponsor when they are feeling vulnerable to relapse.  It requires no drugs and relies upon no government program.  It’s the only thing that works for the vast majority of addicts over time.  Some, like PSH, relapse despite the availability of 12-step programs and more exotic treatments.  It’s up to the individual to decide whether to pick up that bottle or that needle.  The rest is simply what bureaucracies do to rationalize budgets and what scientists do to rationalize research funding.

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