Kentucky considers $42 million ibogaine study to tackle opioid crisis
Published 8:00 am Saturday, July 22, 2023
FRANKFORT—Jessica Blackburn grew up in Betsy Lane, an Eastern Kentucky town home to 650 people. She had a great childhood, she said, filled with love, friendship and community.
She’s not the typical person you’d expect to become addicted to opioids, she said Monday at a Kentucky Opioid Abatement Advisory Commission public hearing.
The KOAAC is considering allocating $42 million from its $842 million share of federal opioid settlement funds towards research into ibogaine, which is currently illegal in the U.S. as a classified Schedule 1 drug.
Ibogaine researchers and proponents think that it has the potential to completely alter the landscape of the opioid crisis.
Ibogaine is a naturally occurring substance from central African country Gabon. It is known for its hallucinogenic properties that put people through an immersive, dream-like, often spiritual experience.
Observational studies have also demonstrated its ability to reset an opioid user’s brain.
When a person abuses opioids, the drugs begin to hijack their brain. They rewire it, triggering unnatural surges of dopamine that can overload circuits in multiple regions of the brain, including those involved in decision-making, self control and emotion.
So even when a person detoxes from opioids, the brain is still in its rewired state. It can take weeks to months to transition to a normal, withdrawal and craving free state, an amount of time that treatment centers and other recovery methods often do not afford.
Ibogaine eliminates that transition period. It’s a single dose that takes about 45 minutes to act. It opens the brain’s plasticity, allowing it to be remolded.
Blackburn told the commission about her experience with addiction, that eventually led to her taking ibogaine.
By the time Blackburn was in middle school, pills were omnipresent. Kids would pass them around to their peers after stealing them from their parents’ medicine cabinets. It was around the time that just about everyone in Eastern Kentucky had an opioid prescription, Blackburn said.
The economic decline caused by coal mine closures made people desperate. Blackburn said people like her friends’ grandparents became drug dealers.
While she wasn’t interested in taking the drugs in middle school, they piqued her curiosity. And they only proliferated more.
In high school, parties weren’t just places to drink and smoke. There was also OxyContin everywhere.
By 17, Blackburn had developed intense depression and anxiety, and pills seemed like a solution. Her first time on opioids was the first time in a while she felt calm and in control.
But what began as an escape turned quickly into a nightmare.
“I didn’t understand fully what I was doing to my body until I became very sick,” Blackburn said. “ I thought I had the flu. But it was opiate withdrawal.”
Opioid withdrawal is a clinically robust syndrome, said Dr. Kenneth Alper, associate professor of psychiatry and neurology at NYU School of Medicine.
It’s marked by nausea, vomiting, muscle aches and tension, sweating, insomnia and anxiety, often for weeks to months, he said. During the withdrawal period, people often become desperate for the only thing sure to provide relief—more opioids.
Such was the case for Blackburn. She said that when she realized she was experiencing withdrawal, the only thing on her mind was how to get more drugs.
Blackburn continued to fall deeper down the rabbit hole. She failed all her classes her first semester of college, but she didn’t care, because all her problems disappeared when she got her next high.
Her parents took her out of school and entered her into an inpatient treatment facility. Blackburn remembers seeing the bill—$28,000 a month, half of which her parents had to pay out of pocket.
It would not be the last treatment Blackburn’s family had to pay for.
“I tried every traditional treatment that is out there—like all of them,” she said. “ Inpatient, detox, outpatient, residential, 12 Step, support groups, smart recovery—you name it, I tried it. I was very blessed. My family had quality resources, so I received a lot more opportunities than a lot of people would receive.”
Eventually, Blackburn had all but given up. She said she was “an empty shell.” That’s when her parents happened to come across ibogaine. It was a risky move. Blackburn flew to Mexico to get treatment in a non-clinical environment, since the drug is not FDA-approved or legal in the U.S.
She didn’t expect it to be successful.
“Truly, I wanted my life to end,” she said. “I didn’t believe in myself. I didn’t believe in God. I didn’t believe in anything, and that’s how I showed up in Mexico.”
But 45 minutes after Blackburn took her first dose, all her withdrawal symptoms disappeared. She no longer had cravings for any drug. All she wanted was a banana, she said.
In August, she will be eight years clean.
The KYOAAC listened intently as Blackburn told her story at Monday’s public hearing. They also heard from a panel of medical experts on ibogaine and neurology.
Alper said that there is a need for better treatments for Opioid Use Disorder because current ones are not cutting it.
He said that while users are in treatment, 20% to 60% of them still use illicit opioids. He added that attempts at “detoxification” fail a third to half of the time, and even when they succeed, they are followed by a relapse within four to six weeks about 75% of the time.
Dr. Deborah Mash, professor of neurology and molecular and cellular pharmacology, conducted government-approved research on ibogaine offshore in Saint Kitts in 2018.
Of 277 patients, most of whom were long-term, hardcore opioid users, 91.7% said the ibogaine treatment helped them, according to her research.
Dr. Nolan Williams, associate professor at Stanford University, also conducted a 2018 study whose results are expected to come out in the next month or so.
While he couldn’t break the peer review process by revealing too much, Williams did say that his scientist colleagues have found the results “shocking.”
There are several common concerns about ibogaine. First, it’s a Schedule 1 drug, and thus illegal in the United States.
Mash said that this doesn’t have to be the case. Unlike other hallucinogens like LSD, there is little worry that people will become addicted to ibogaine, she said. The immersive experience people go through on it is not pleasant, according to patients.
For example, Blackburn said that the hallucination showed her how her actions were impacting others in her life, particularly her mother. She said that at one point, she was seeing her own funeral from the perspective of her mother.
Second, there have been instances of cardiac toxicity. But, Mash said, these are largely due to a lack of proper bloodwork to rule out patients who have a medical history of heart issues, or improper doses.
The panelists argued that this could all be solved if ibogaine were allowed to be administered in a controlled, clinical setting.
But in order to get there, they need to get through Phase 2 and 3 of the FDA’s drug development process.
In order to answer key questions about ibogaine, like how beneficial it really is and what risks there are, they need a large-scale clinical trial, said Dr. Srinivas Rao, chief scientific officer at biopharma company atai Life Sciences.
If they can show a positive pattern, and understand the drug more, there is a greater change that ibogaine can hit the market in the coming years and begin to treat people with Opioid Use Disorder who have been resistant to all other treatments.
Time is of the essence to get momentum going with this one-time federal flow of cash dedicated to solving this crisis, Mash said.
The opioid crisis has cost Kentucky taxpayers trillions in societal costs, she said. Specifically, $1.04 trillion in 2018, $98 billion in 2019 and nearly $1.5 trillion in 2020, according to a University of Kentucky report.
According to the CDC, Kentucky ranks fourth of 38 reporting states in per-resident cost—$5,491.
Ibogaine is not magic or a “miracle drug,” the panelists emphasized. But, it does have potential to help those who are resistant to everything else.
““More of the same is not what we need to move past this problem,” Blackburn said.
“The state has some of the best and brightest in the country here today ready to help and as well equipped to move this forward for the betterment of our state, our loved ones, those living in addiction who still suffer and for families who have lost hope, with your support. No Kentuckians should have to leave the country to receive this lifestyle saving treatment.”
The commission will decide whether to allocate the funds at its November 13 meeting.