Permalink to Why Is This Option Beyond the Pale for Heroin Addicts?

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?

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  1. Profile photo of katievs Inactive

    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
    • February 9, 2014 at 5:07 am
  2. Profile photo of Fred Cole Member

    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
    • February 9, 2014 at 5:35 am
  3. Profile photo of Fricosis Guy Coolidge

    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)?

    • #3
    • February 9, 2014 at 5:59 am
  4. Profile photo of HVTs Member

    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.

    • #4
    • February 9, 2014 at 6:01 am
  5. Profile photo of Franco Member

    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…..

    • #5
    • February 9, 2014 at 6:08 am
  6. Profile photo of Goldgeller Member

    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.

    • #6
    • February 9, 2014 at 6:24 am
  7. Profile photo of Crow's Nest Member
    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.

    • #7
    • February 9, 2014 at 6:27 am
  8. Profile photo of Tommy De Seno Contributor

    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.

    • #8
    • February 9, 2014 at 6:28 am
  9. Profile photo of Leslie Watkins Member

    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. 

    • #9
    • February 9, 2014 at 6:29 am
  10. Profile photo of Black Prince Member

    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.

    • #10
    • February 9, 2014 at 6:58 am
  11. Profile photo of Foxman Inactive
    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.

    • #11
    • February 9, 2014 at 7:16 am
  12. Profile photo of outstripp Inactive

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

    • #12
    • February 9, 2014 at 7:17 am
  13. Profile photo of Podkayne of Israel Member

    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.

    • #13
    • February 9, 2014 at 7:21 am
  14. Profile photo of katievs Inactive
    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.

    • #14
    • February 9, 2014 at 7:28 am
  15. Profile photo of HVTs Member
    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?
    • #15
    • February 9, 2014 at 7:28 am
  16. Profile photo of Crow's Nest Member
    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.

    • #16
    • February 9, 2014 at 7:42 am
  17. Profile photo of Manfred Arcane Inactive
    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?

    • #17
    • February 9, 2014 at 7:48 am
  18. Profile photo of BrentB67 Inactive
    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.

    • #18
    • February 9, 2014 at 7:53 am
  19. Profile photo of Manfred Arcane Inactive

    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…..

    • #19
    • February 9, 2014 at 7:54 am
  20. Profile photo of HVTs Member
    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.

    • #20
    • February 9, 2014 at 7:55 am
  21. Profile photo of Zafar Member

    Sadly there’s less profit in curing addictions than catering to them. 

    Manfred Arcane

    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? 

     It’s always going to be a public sector sort of thing, imho – because capital will not freely flow towards it in preference to (for eg) bars, nightclubs, cigarette companies, wine cooler manufacturers, etc. The opportunity cost is too high.

    • #21
    • February 9, 2014 at 7:59 am
  22. Profile photo of BrentB67 Inactive
    Zafar: Sadly there’s less profit in curing addictions than catering to them. 
    Manfred Arcane

    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? 

     It’s always going to be a public sector sort of thing, imho – because capital will not freely flow towards it in preference to (for eg) bars, nightclubs, cigarette companies, wine cooler manufacturers, etc. The opportunity cost is too high. · 0 minutes ago

    Fascinating. I think you are on to something here.

    • #22
    • February 9, 2014 at 8:05 am
  23. Profile photo of Crow's Nest Member
    HVTs

    Alcoholics Anonymous and its related Narcotics group works effectively. It requires the addict to go to meetings and to 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. 

    I’m quite familiar with AA’s program from seeing extended family members go through it and find success with it. I’m not sure if I’ve posted this before, but there was a great article a few months ago at the New Atlantis dealing with character formation and AA.

    Ultimately, we agree that an individual must make the conscious choice to stay clean. A network of friends and family and fellow recovering addicts is most conducive to that end.

    I don’t think there is any treatment that can “save everyone”. There will always be those whose will fails, or who choose death. I’m simply open to the possibility that if there is something that can make it easier to begin, we oughtn’t rule it out of hand.

    • #23
    • February 9, 2014 at 8:12 am
  24. Profile photo of Franco Member
    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: 

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

     No one is saying there are no risks. Certainly some people are not suited psychologically/ or took a over-large dose/ or ingested ‘bad’ acid and any combiniation of these things – which are as much the effect of illegality and lack of regulation. This is no reason to condemn the whole family of substances called psychedelics, or a reason to assert special knowledge. By that logic, guns, automobiles and fire should all be outlawed because there are significant risks to their use. 

    • #24
    • February 9, 2014 at 8:22 am
  25. Profile photo of HVTs Member
    Crow’s Nest

     I’m simply open to the possibility that if there is something that can make it easier to begin, we oughtn’t rule it out of hand. 

    This sounds reasonable but avoids the question, which is how much money should we spend chasing after a “possibility”? Those that are committed to their own recovery don’t need it. Those that are not, it seems, are impervious to whatever benefit a long series of such alternative treatments have to offer.

    • #25
    • February 9, 2014 at 8:25 am
  26. Profile photo of Leslie Watkins Member

    Not sure if you mean my post, Franco, but just so you know, I “dropped” LSD dozens of times in the early 1970s, and it did absolutely nothing for my ongoing agony with depression (which, because of its ubiquity in my family, I think has more to do with my people coming from the dark, depressing climes of northern Wales than with a particular problem adjusting to life, though it comes from that too). These experiences were fascinating beyond belief and had an impact on my view of reality, but they also were the most frightening internal experiences I’ve ever had. (I would drop LSD and dare myself to go to (high!)school, to see how much of the experience I could take without freaking out.) I’m not at all sorry (nor in the least bit proud) that I had these experiences but would encourage others not to go in that direction, and I would never ever eat a mushroom or drop a psychedelic pill ever again.

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

    ….. · 2 hours ago

    • #26
    • February 9, 2014 at 8:30 am
  27. Profile photo of Manfred Arcane Inactive
    Judith Levy, Ed.

    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? · 

    So I think it’s time maybe we “have that conversation”. Are we really trying hard to diminish illicit drug use in_America? Really. Take the poppy fields in Afghanistan. Have we done much about them? Don’t think so.

    While I appreciate the Libertarian sentiments of Mr. Cole (really I do), I submit that we don’t exert ourselves nearly as much as we could to rid the world of the scourge of the ‘hard’ drugs at least. Countries that permit pockets of cultivation and manufacturing in their midst should be put under interdict and treated as harboring terrorists of the worst stripe, IMO. 

    4,251 heroin-drug_overdose_deaths_a_year_in_the_USA. 2.1 million habitual users – whose lives are ruined, or headed_to_ruin. How many Americans die of terrorist acts a year in comparison? (“…The explosions killed 3 spectators_and_injured 264” -Boston bombing.)

    • #27
    • February 9, 2014 at 8:31 am
  28. Profile photo of DocJay Member

    I feel highly qualified to discuss this. I’ve had a patient use ibogaine and I researched it extensively a couple years ago. I’ve seen a few hundred or more people wirthdaw ( which never kills you ). I have done a number of controlled narcotic withdrawals successfully. I think the FDA and the war on drugs is a joke. As far as psychedelics pros and cons, I’ve been to 25 Grateful Dead show 😉 and there isn’t much I don’t know about occasional use and long term use of them( no this is not part of my adult life and I lost a friend to these drugs). With that all said, it appears most of the commenters brought their own bias here instead of looking at the medical and economic reality. It’s just another drug with potential pros and cons. It theoretically works a lot better than an expensive clinic. Potentially the odd effects might decrease the desire long term but I’m skeptical as narcs for some ease quite a bit of emotional pain. I’ve seen the needle and the damage done, a little part of it in everyone, but every junkie’s like a setting sun.

    • #28
    • February 9, 2014 at 8:32 am
  29. Profile photo of Franco Member

    What is significant about ibogaine is that it has long-term effects which keep desire for heroin at bay. There is a fundamental transformation which serves as a basis for a life without the need for narcotics.

     Of course any caring person would suggest continued talk-therapy as well, but this shouldn’t be construed as evidence that ibogain has only temporary residual effects – the studies at the site are all focused on long-term effects and recidivism.

    This is not another temporary crutch as many here are implying. If that were the case, this would be entirely unworthy of discussion. 

    • #29
    • February 9, 2014 at 8:37 am
  30. Profile photo of Crow's Nest Member
    HVTs
    Crow’s Nest

     I’m simply open to the possibility that if there is something that can make it easier to begin, we oughtn’t rule it out of hand. 

    This sounds reasonable but avoids the question, which is how much money should we spend chasing after a “possibility”? Those that are committed to their own recovery don’t need it. Those that are not, it seems, are impervious to whatever benefit a long series of such alternative treatments have to offer. · 2 minutes ago

    I’m not avoiding it at all. My position isn’t that we should sink the 51b we spend on the war on drugs into this research (though we might argue over whether public funding should be available at all), my position is rather that the government shouldn’t prohibit the research into the usage of ibogaine, and if that research bears fruit it should not prohibit an MD from prescribing it as part of a treatment program.

    • #30
    • February 9, 2014 at 8:37 am
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