The ibogaine medical subculture.
OBJECTIVE
Ibogaine is a naturally occurring psychoactive indole alkaloid that is used to treat substance-related disorders in a global medical subculture, and is of interest as an ethnopharmacological prototype for experimental investigation and possible rational pharmaceutical development. The subculture is also significant for risks due to the lack of clinical and pharmaceutical standards. This study describes the ibogaine medical subculture and presents quantitative data regarding treatment and the purpose for which individuals have taken ibogaine.


METHODS
All identified ibogaine "scenes" (defined as a provider in an associated setting) apart from the Bwiti religion in Africa were studied with intensive interviewing, review of the grey literature including the Internet, and the systematic collection of quantitative data.


RESULTS
Analysis of ethnographic data yielded a typology of ibogaine scenes, "medical model", "lay provider/treatment guide", "activist/self-help", and "religious/spiritual". An estimated 3414 individuals had taken ibogaine as of February 2006, a fourfold increase relative to 5 years earlier, with 68% of the total having taken it for the treatment of a substance-related disorder, and 53% specifically for opioid withdrawal.


CONCLUSIONS
Opioid withdrawal is the most common reason for which individuals took ibogaine. The focus on opioid withdrawal in the ibogaine subculture distinguishes ibogaine from other agents commonly termed "psychedelics", and is consistent with experimental research and case series evidence indicating a significant pharmacologically mediated effect of ibogaine in opioid withdrawal.
Alper
Kenneth R
KR
Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA. kra1@nyu.edu
Lotsof
Howard S
HS
Kaplan
Charles D
CD
D003625:Data Collection; D006213:Hallucinogens / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007050:Ibogaine / Q000494:pharmacology / Q000627:therapeutic use*; D020407:Internet; D016488:Medicine, African Traditional; D009293:Opioid-Related Disorders / Q000188:drug therapy; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy; D019966:Substance-Related Disorders / Q000188:drug therapy*
D006213:Hallucinogens; D007050:Ibogaine