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PSYCHOSOCIAL SUPPORT All aspects of treatment for chemical dependence disorders common to other treatment modalities are common to ibogaine tran ant psychiatrist, social worker, therapist, paraclinician and the patient often bond into a cohesive working group to accomplish a state of long-term non-dependence to the drug(s) of abuse for which the patient is under treatment. treatment. The patient's characteristics in terms of REDUCTION IN THE NEED FOR SLEEP psychopathology, behaviour, societal In all cases, ibogaine reduces the patient's Pp . accomplishments, as well as the skills of the need for sleep to as little as three or four . treatment team are significant to treatment hours a night. This effect may last a month - | outcomes. or more, gradually returning to normal. ! ' ‘ In cases when the patient already has the Two theories have been put forth concern- 7 , Y -- occupational and educational skills needed ing this effect. The first theory suggests the | Filed al 7 * to succeed in society, the task may be some- long-lasting bioavailability of ibogaine or i “ t ’ what easier. one of its metabolites. This is in keeping ‘s is In cases where the patient does not have with pharmacokinetic studies conducted at lll ‘ ~ those societal skills, or lacks medical care the University of Miami (Mash, 1995). The “ for disorders other than chemical depen- second theory suggests that the cause is the io — dence, care and training must be provided decrease in the psychological requirements Tr. i i through psychosocial support structures. for sleep associated with the need to dream. 3 Trauma suffered by the patient during Evidence supporting this theory is that ibo- childhood appears to play an important part gaine promotes an intense emulation of \ in the drive for love and the fear of aban- dreaming that lasts for many hours during donment that is common to many of the its acute stage of activity. patients treated (Bastiaans, 1991). The reduction in the need for sleep is Many of the accepted parameters of dis- viewed by the majority of patients as a dis- 5 tance between the therapist and the patient comfort, since they have been used to using a | r are not effective in ibogaine treatment. drugs and sleep as escape mechanisms. Patients will require closer and more inten- v These patients may require some mild form ta sive guidance, and generally be more open of sedation during the first days after ibo- - to it. They will require faster intervention gaine treatment. . to learn societal skills and to overcome and Normal precautions should be taken in Flower of the Tabernanthe iboga plant. understand objectively the various traumas providing sedatives to persons with a history experienced during their lives. of chemical dependence. In a minority of cases, patients have Ibogaine is therefore not a treatment modality for clinicians used this newly available time to advantage in their busy work whose preference is simply to administer a pill and then distance schedules. themselves from their patients. References Bornmann, W.G., Kuehne, MLE. and Glick, 12. Gollnhofer, O. and Sillans, R., "L'Tboga 1. Aceto, M.D., "Biological Evaluation of S.D., "Mechanisms of Action of Ibogaine and Psychotrope Africain" ("Iboga, An African Compounds for Their Physical Dependence Harmaline Congeners Based on Radioligand Psychotropic Agent"), Psychotropes 1(1):11-27, Potential and Abuse Liability", US National Binding Studies", Brain Research 571:242-247, 1983. Institute for Drug Abuse (NIDA) Research 1992. 13. Gollnhofer, O. and Sillans, R, "Usages Monograph 119(506):520-523, 1991. 7. Depoortere, H., "Neocortical Rhythmic Slow _Rituels de I'Iboga au Gabon" ("Ritual Uses of 2. Bastiaans J., "The Psychiatric and Activity During Wakefulness and Paradoxical Tboga in Gabon"), Psychotropes 2(3):95-108, Psychosomatic Dimensions of Trauma", person- Sleep in Rats", Neuropsychobiology 18:160- 1985. al communication with Howard Lotsof, 1991. 168, 1987. 14a. Goutarel, R., Gollnhofer, O. and Sillans, 3. Broderick, P.S., Phelan, F.T. and Berger S.P., 8. Dzoljic, E.D., Kaplan, C.D. and Dzoljic, R., "Pharmacodynamics and Therapeutic "Ibogaine Alters Cocaine-Induced Biogenic and M.R., "Effects of Ibogaine on Naloxone- Applications of Iboga and Ibogaine", Psychostimulant Dysfunction, but Not Precipitated Withdrawal Syndrome in Chronic Psychedelic Monographs & Essays 6:71-111, [3H]GBR-12935 Binding to the Dopamine Morphine-Dependent Rats", Archive of 1993. Transporter Protein", Problems of Drug International Pharmacodynamics 294:64-70, 14b, Goutarel, R., Gollnhofer, O. and Sillans, Dependence 1991, Proceedings of the 53rd IRE we . R., "L'Tboga et I'ibogaine contre la dépendance a ee oe ant Ar Eimoerphy ef xp: Pharmacodyn capi esearch Monograj :285, 5 ous 0 b 5 Z : (I yep 4. Broderick, PS. Phelan, E.T., Eng, F. and University Press, USA, 1982. io (payee seapsnieEs aoe EO) Wechsler, T., "Tbogaine Modulates Cocaine 10. Glick, S.D., Rossman, K., Rao, NC., - straddaeWeronallcommuntcatontit Responses which are Altered Due to Maisonneuve, I. M. and Carlson, J.N., "Effects H d Lotsof, 1993 Environmental Habituation: In Vivo of Ibogaine on Acute Signs of Morphine OHI : oo. . "i . . ee) . * . 16. Kaplan, C.D., personal communication with Microvoltammetric and Behavioural Studies", Withdrawal in Rats: Independence From . Pharmacology, Biochemistry and Behaviour Tremor", Neuropharmacology 31(5):497-500, Howard Lotsof, 1990. 49(3):711-728, 1994. 1992. 17. Kaplan, C.D., Ketzer, E, de Jong, J. and de 5. Cappendijk, S.L.T. and Dzoljic, M.R., 11. Glick, $.D., Rossman, K., Steindorf, S., Vries, M., "Reaching a State of Wellness: "Inhibitory Effects of Ibogaine on Cocaine Self- | Maisonneuve, I.M. and Carlson, J.N., "Effects Multistage Explorations in Social ; Administration in Rats", European Journal of and Aftereffects of Ibogaine on Morphine Self- _ Neuroscience", Social Neuroscience Bulletin Pharmacology 241:261-265, 1993. Administration in Rats", European Journal of 6(1), Winter 1993. 6. Deecher, D.C., Teitler, M., Soderlund, D.M., Pharmacology 195:341-345, 1992. Continued overleaf ... NEXUS - 33 AUGUST - SEPTEMBER 1997