The American journal on addictions
January 1, 1999
K R Alper, H S Lotsof, G M Frenken et al.
201 citations
In a review of 33 cases of ibogaine treatment for opioid detoxification in non-medical settings, 25 patients showed complete resolution of opioid withdrawal signs and cessation of drug-seeking behavior within 24 hours, sustained over 72 hours. Other outcomes included drug-seeking without withdrawal (4 patients), abstinence with attenuated withdrawal (2 patients), drug-seeking with continued withdrawal (1 patient), and one fatality possibly from surreptitious heroin use. The average daily heroin use was 0.64 grams, primarily intravenously. The findings suggest the need for systematic clinical research to confirm ibogaine's potential for rapidly alleviating severe opioid withdrawal.
The American journal on addictions
August 1, 2016
Joseph J Palamar, Monica J Barratt, Jason A Ferris et al.
49 citations
Nearly half (46.4%) of a self-selected sample of US nightclub attendees reported lifetime use of at least one new psychoactive substance (NPS). Synthetic cannabinoids were the most common (24.8%), followed by tryptamines (23.0%), psychedelic phenethylamines (21.7%), euphoric stimulants (16.2%), and synthetic cathinones (10.5%). Females and older respondents (ages 22-60) had lower odds of any NPS use. Frequent nightclub attendance, especially weekly versus less than once a month, was linked to higher odds of NPS use overall. The authors suggest harm reduction initiatives are needed for this population, where environmental factors may amplify risks from lesser-known substances.
The American journal on addictions
April 1, 2015
Cole J Marta, Wesley C Ryan, Alex Kopelowicz et al.
17 citations
Ibogaine, a naturally occurring hallucinogen used illegally for addiction treatment, can trigger manic episodes even in people with no prior bipolar diagnosis. This case series reports three patients who developed mania after using unregulated ibogaine—two for self-treating addictions and one for psycho-spiritual purposes. No previous reports of ibogaine-induced mania exist in the literature. Clinicians encountering new-onset mania should inquire about substance use, especially ibogaine, given its growing popularity among vulnerable populations seeking addiction treatment. The authors advise discussing the lack of safety and efficacy data with patients considering ibogaine.
The American journal on addictions
January 1, 2014
Bob Prue
16 citations
Peyote use among American Indians rose sharply to nearly 10% in the four years after the 1994 amendment to the American Indian Religious Freedom Act (AIRFA) legally protected its religious use, before leveling off just below that rate. For the rest of the US population, peyote use remained stable between 1% and 2% from 1985 to 2010. Analysis of 886,088 nationally representative surveys (12,749 from American Indians) and peyote harvest data suggests that pre-AIRFA rates were suppressed by social desirability bias due to peyote's illegal status. The rapid post-AIRFA increase exceeded what could be explained by growth in the Native American Church or available peyote supplies, indicating that under-reporting of illicit drug use can be substantial.
The American journal on addictions
November 1, 2023
Amanda Kim, Joji Suzuki
15 citations
Addiction specialists mostly view psychedelics positively for treating mental health and substance use disorders, though a notable minority worry about their addictive potential. An anonymous online survey of 145 addiction specialists assessed their opinions on therapeutic promise, risks, and legalization of psychedelics, including both classic serotonergic drugs and nonserotonergic ones like ketamine and MDMA. Familiarity with psychedelic research was the strongest predictor of positive views, while concern about addiction was the strongest negative predictor. Overall attitudes were more favorable than the authors hypothesized, possibly due to recent research acceleration. The findings highlight the need for better physician education on psychedelics' risks and benefits.
The American journal on addictions
April 1, 2018
Joseph El-Khoury, Evelyne Baroud
3 citations
Recreational use of salvia divinorum, a potent naturally occurring hallucinogen, is increasing internationally despite limited information about its long-term health effects. The substance is readily available and often portrayed as safe and non-addictive. Two patients presented with an enduring and pervasive pattern of salvia use. The authors strongly encourage evaluating patients for salvia use during clinical assessment, especially among young polysubstance users. Clinicians should be mindful of the multifaceted psychiatric effects of salvia, including the potential for a use disorder.
The American journal on addictions
May 1, 2024
Michael Rogan, Julio C Nunes, Catherine Z Xie et al.
2 citations
Greater childhood trauma is linked to lower aversive effects from higher doses of THC in people being treated with methadone for opioid use disorder. In a placebo-controlled crossover trial with 25 participants, those with more childhood trauma reported fewer negative subjective effects after taking 20 mg of oral THC. This reduced sensitivity to THC's aversive effects may contribute to increased cannabis use among individuals with opioid use disorder. The findings highlight the importance of assessing childhood trauma in opioid use disorder treatment and research.
The American journal on addictions
January 28, 2026
Mariana C De Oliveira, Cláudia C De Araujo Palmeira, André B Negrão et al.
1 citation
A 25-year-old woman with opioid use disorder, chronic pain, and major depressive disorder received eight weekly intravenous ketamine infusions (0.5 mg/kg) alongside a gradual reduction of her methadone dose. After the protocol, her methadone dosage was cut by 50%, and she experienced better control of pain and cravings, fewer withdrawal symptoms, and increased participation in psychotherapy. The report suggests that ketamine-assisted bridge therapy may help support opioid tapering in patients with multiple co-occurring conditions.
The American journal on addictions
May 10, 2025
Jessica Van Denend, Jeremy Weleff, Kelly Park et al.
Religion and spirituality (r/s) are often overlooked in harm reduction research, which focuses on reducing the negative consequences of substance use rather than requiring abstinence. This literature review examined 169 papers from 457 identified, finding that 100 discussed alignment between r/s values and harm reduction, 39 described strategic use of r/s resources, 22 addressed substances with religious or spiritual significance (e.g., psychedelics), and 8 discussed r/s support for harm reduction workers. Only 18 papers were coproduced with people with lived/living experience, while 75 were informed by such relationships, and 76 had no noted engagement. The review demonstrates that r/s is relevant beyond abstinence models and suggests opportunities to understand r/s as both a barrier and resource for harm reduction, with proximity to lived experience influencing alignment with harm reduction values.