title: Remission of Severe Opioid Use Disorder with Ibogaine: A Case Report.
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.
authors.affiliation: a Department of Medicine , University of British Columbia , Vancouver , BC , Canada.
authors.forename: Laurie
authors.initials: L
authors.lastname: Cloutier-Gill
authors.affiliation: a Department of Medicine , University of British Columbia , Vancouver , BC , Canada.|b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , BC , Canada.
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.affiliation: c Liberty Root , Vancouver , BC , Canada.
authors.forename: Trevor
authors.initials: T
authors.lastname: Millar
authors.affiliation: d Primary Care and Addiction Medicine , Surrey , BC , Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Ferris
authors.affiliation: a Department of Medicine , University of British Columbia , Vancouver , BC , Canada.|b British Columbia Centre for Excellence in HIV/AIDS , St. Paul's Hospital , Vancouver , BC , Canada.
authors.forename: M
authors.initials: M
authors.lastname: Eugenia Socias
mesh_terms: D000328:Adult; D005260:Female; D006213:Hallucinogens / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007050:Ibogaine / Q000009:adverse effects / Q000627:therapeutic use*; D008691:Methadone / Q000008:administration & dosage; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D030014:Tabernaemontana / Q000737:chemistry*; D016896:Treatment Outcome
chemical_list: D006213:Hallucinogens; D007050:Ibogaine; D008691:Methadone
keywords: Ibogaine; methadone; methadone maintance therapy; opioid agonist treatment; opioid use disorders