Abstract
Introduction
Opioid dependence is a significant health concern in New Zealand. It has been estimated that there are 10,000 people who are daily or almost daily intravenous users of opioid drugs, half of whom are receiving opioid substitution treatment (OST) Similar to overseas countries. It is also estimated that there is a growing number of people in New Zealand who are dependent on prescribed opioids. However how many is currently unknown (Adamson et al., 2012). One alternative intervention for opioid dependence is ibogaine treatment. Ibogaine is a hallucinogenic drug that alleviates opioid withdrawal symptoms for up to three months. (Alper, Lotsof, Frenken, Luciano, & Bastiaans, 1999). However, ibogaine's metabolites interfere with cardiac centres in the brain, in some cases causing heart arrhythmia and death (Maas & Strubelt, 2006). Ibogaine providers promote pre-treatment tests (bloods and electrocardiogram (ECG)) reducing this risk (Alper, Lotsof, & Kaplan, 2008). Anecdotal reports suggest ibogaine treatments can occur with support from ibogaine treatment providers, ranging to; ‘peer to peer’ use with unknown medical advice. The aim of this study was to explore the experiences of people who had used ibogaine in New Zealand; and to discover what, or if, any medical tests had been sought and/or accessed.
Method
A qualitative, collective case-study research design was used. Ten people who used ibogaine for their opioid detoxification were recruited. Face-to-face interviews were conducted with each of the participants, in participants' homes or public cafes. The interviews were recorded and transcribed. Common experiences were coded then grouped into themes and analysed.
Findings
Seven identified themes and their described interactions collectively related an ibogaine user’s experience. It began with 'not sitting comfortably on opioids', due to associated low moods, physical side effects, stigma and despair. Hope of a successful and quick opioid detoxification treatment, with no opioid withdrawal experience was the main motivator for people choosing ibogaine. All participants sought medical testing before ibogaine treatment but those who had the support of an ibogaine treatment provider (ITP) received the most appropriate medical screening and recommended test. People had more positive treatment experiences when medical supports such as nausea control, sleep management, use of ibogaine booster doses and psychological support after treatment were available. Ibogaine treatment had major positive effects on mood and anxiety reduction for the participants, and was the main contributing factor for seven respondents who remained opioid-abstinent. Respondents described seeking and obtaining a spiritual or deep psychological change regarding their drug use and attributed this to ibogaine treatment.
Conclusions
The collective experience of the ten participants provided implications for possible future practise of ibogaine treatment. Use of an ibogaine treatment provider (ITP) afforded safer, more positive treatment outcomes. The continued legality of ibogaine is supported by this study, where respondents, supported by an ITP, had better access and greater medical support when ibogaine was legal. The use of additional doses of ibogaine and medical management of nausea and sleep appeared to affect better treatment results. This case study participants sought the hallucinogenic effect of ibogaine as part of the treatment and had better treatment results when psychedelic experiences were achieved. Best treatment results were described as, no opioid withdrawals, positive effects on mood and anxiety and ultimately, opioid abstinence.