Trials on veterans suggest ibogaine could provide a new treatment for PTSD

J. was a traveling Ibogaine ... healer? He went from city to city, summoned by the loved ones of advanced heroin addicts, to attempt one last Hail Mary shot at recovery.

These were situations of absolute desperation, and I can’t overstate the seriousness with which he took his adopted occupation. He described to us in detail his process.

First, he interviewed the person requesting help, seeing what else they had tried and trying to suss out if Ibogaine would be worth the risk. He turned away most callers.

Those who he accepted would be dropped off at his van, inside which was a mobile, DIY ICU of sorts: a bed, food, water and emergency medical supplies. He would administer the ibogaine (I don’t know what form this took), and then, in his words, the patient would undergo a 2 to 3-day continuous hallucination.

During this time, in J.’s observations, the patient was almost always ‘visited’ by dead relatives, who typically admonished the patient for what had become of them, laying into them with real talk about the state of their life.

J. said half of the patients came out of this experience fundamentally changed, and effectively cured of their addiction to heroin. I don’t know if he had any data (anecdotal or otherwise) on recidivism, but the implication was that this was likely to be permanent.

But, he said, the other half went insane, which is why he spent a great deal of effort screening families and informing them of the risks.

I don’t know how much, if any, of this is true. I don’t know what ‘insane’ means, or meant. But I remember vividly how seriously this guy took it, without ever coming off as some kind of self-satisfied guru or medicine man, believing himself to be a god, or anything like that. He never accepted money. He lived somewhat roughly. I wonder whatever happened to that guy.

The US also spends a large amount of money on each veteran. If they can find a cure for trauma they would benefit hugely from it. The side effect of this is that others would benefit as well.

Presumably isn't how science is done. They did an experiment with veterans who had ptsd and ibogaine so the results are relevant to veterans with ptsd using ibogaine.

One could, presumably, extrapolate that result to an even wider audience and say "hallucinogens could help people who experience trauma" but that'd be unscientific and irresponsible to imply this study showed that.

Well, anybody who wishes to can get their hands on this medication and treat themselves. People have been doing it for decades.

We’re one step below “think of the children”

Any study like this is nearly useless without a control group, unfortunately. There is no way to tell if the treatment caused the changes or if they naturally occurred over the study period.

You’d be surprised to read the statistics about how poorly ECT works, and how little they understand about how to use it a treatment.

Totally different ballparks. Well-established results vs. very little formal research.

Have you had ECT, or do you know anyone who has? It's a last resort for horrible depression and not much else. It has huge risks, and while it does often make these people's lives manageable, it shouldn't be in the same discussion as a medication that's been out of discussion for political reasons.

shivers at the thought of ECT

They ended their life a few years afterwards.

So no, ”very often works on depression” is not a characterization I would use.

PTSD is a trauma response.

Are you thinking of TBI? TBI is a cumulative impact of small and large head trauma.

for starters, she had to go through cardiac tests before they would even administer the stuff because it can cause serious cardiac symptoms, up to and including death. Somebody in her group was kicked out because they had been using meth the week of the trip (no pun intended). They were telling them that even too much caffeine could increase their risk of cardiac symptoms.

Then the trip itself was like 48 hours and it wasn't a fun trip like acid or mushrooms. The few things she would tell me about were awful, and she still won't talk about most of it almost a decade after the fact.

Some drugs don't need to be caught up in federal approval but ibogaine is absolutely a drug that needs the red tape and all the pomp and circumstance of FDA approval.

Not really true. There have been clinical trials for Ibogaine over the years in the US and abroad. The United States isn’t the only country capable of running trials.

A big blocker for ibogaine is that it’s cardiotoxic. Multiple deaths have occurred within clinical trials for ibogaine. It’s really hard to justify and get approval for additional clinical trials for a drug that has caused deaths even in small trials.

There are analogs of ibogaine being studied, too. These are designed to lack the cardiac properties of ibogaine and would hold much more promise. There’s a real problem of mistrust with “artificial chemicals” that causes this to be ignored while ibogaine gets the attention. I suppose that’s to be expected with politicians driving research.

Just frame it as "this drug lets you send scarred soldiers right back into the fray for pennies" and see that red tape dissolve

If dissociation is better than regular PTSD, then go for it. We don’t expect people with hip replacements to have 100% mobility. We don’t expect cochlear implants to hear better than healthy ears. Mental health interventions have similar tradeoffs.

Your comment also seems to imply that this treatment involves consuming ibogaine habitually or regularly

The protocol for ibogaine treatment, according to the article and the experiments being done, do not have this requirement.

Like other treatments involving psychedelics and hallucinogens, the protocol here is that a one-off treatment, a single dose, results in meaningful improvements in both addictive behaviors and PTSD symptoms a month later and potentially longer

This is not the same as something like methadone or naltrexone, which _are_ what you describe: replacing a more harmful opiate with a less harmful one.