Remission of Severe Opioid Use Disorder with Ibogaine: A Case Report.

A 37-year-old woman with a 19-year history of severe opioid use disorder, who had never achieved more than two months of continuous abstinence while on methadone, maintained an ongoing 18-month period of abstinence after a four-day ibogaine treatment. No safety issues were observed. The authors suggest that ibogaine may produce transformative experiences that lead to long-term remission in some treatment-refractory patients, but rigorous trials are needed to establish safety and efficacy.

Study at a glance

Abstract

Opioid use disorders (OUD) translate into major health, social, and economic consequences. Opioid agonist medications, which generally require long-term administration, are the mainstay pharmacological treatment of OUD. However, a large proportion of individuals with OUD either refuse or fail to respond to these therapies. Ibogaine, a naturally occurring substance found in the Tabernanthe iboga plant, has shown potential to bring about transformative or spiritual experiences that have reportedly been associated with long-term abstinece. Although research on ibogaine is limited, an ibogaine subculture persists, offering unregulated ibogaine preparations for the treatment of addiction. We describe the case of a 37-year-old female with a 19-year history of severe OUD achieving an ongoing 18-month period of abstinence following a four-day ibogaine treatment. Her previous longest period of continuous abstinence from opioids was two months while on methadone. No safety issues associated with ibogaine were observed. A four-day treatment with ibogaine was succesful in achieving long-term remission of a previously treatment-refractory patient with severe OUD. While rigorous trials are required to establish safety and efficacy, future studies should seek to delineate the potential role of ibogaine or other molecules that may produce transformative experiences for individuals with substance use disorder.