Kentucky has made psychedelic history, but will it continue to do so? At the beginning of June, the state announced that it may allocate $42 million of its opioid settlement money to research and develop ibogaine as a pharmaceutical addiction treatment to help fight the opioid epidemic. This week, the commission overseeing this decision held a hearing to further explore the idea.
Companies that made, distributed, or sold painkillers have been forced to make amends for the havoc that these drugs wreaked on society. Companies, including Johnson & Johnson and Walmart, have made amends to the tune of over 50 billion dollars— given to local governments to help them deal with the ongoing opioid crisis that these companies instigated several decades ago. No state is in need of new solutions to this problem more than Kentucky.
Back in the 90s, opioid addiction spread across Kentucky like wildfire spreads across California in October. According to Jessica Blackburn, a lifelong Kentucky resident and recovered opioid addict, she was first exposed to painkillers in middle school. At this time, many kids’ parents had prescriptions for opioids, and they were often left out on the bathroom counter for little hands to grab. This is not an uncommon story for Eastern Kentucky residents.
Jessica was able to overcome her addiction with the help of the psychedelic medicine Ibogaine. However, not everyone has been so fortunate. Every day, 150 people in the US die from opioid overdoses, and 6 of those people hail from Kentucky. Dr. Deborah Mash described this issue as “a plane crash a day of people dying. Fentanyl is a chemical attack on this country.”
With the introduction of fentanyl into the illicit drug market, more people are dying from overdoses than ever before. Even first-time users are at risk of dying due to the prevalence of tainted drugs. Once safe neighborhoods have become riddled with theft and violence due to this particularly nasty class of drugs.
Current treatment options for opioid addiction are not solving the problem, and Ibogaine is the most promising new treatment on the horizon. Roughly 75-85% of people who attempt to break free of opioid use disorder (OUD) will relapse within two months of treatment, which is why experts suggested to the Opiate Abatement Advisory Commission that Ibogaine could be used as a way to help addicts detox and prevent relapse.
The commission— made up of law enforcement, scientists, politicians, and even a mother grieving the loss of her son to the opioid epidemic— spent hours questioning the panel, which consisted of five experts on the subject. There was a mix of optimism and skepticism coming from the commission members, and rightfully so. It is their job to help Kentucky heal from the harm done to its communities by opioids.
The main concern voiced by the committee is the cardiac toxicity of ibogaine. There have been several reported cases of death due to heart arrhythmias which are sometimes caused by ibogaine. However, the panel of experts was confident that this issue is entirely preventable when the right precautions are taken.
Since Ibogaine is illegal, people are forced to leave the US to seek treatment, often going to Central or South America. The ibogaine clinics there are not regulated. As a result, some use dangerous practices, such as dosing patients multiple times. All five panelists were confident that this side effect is completely avoidable with the use of medical screenings, supervision, and proper dosing.
The commission’s chairman, Bryan Hubbard, is the one leading the effort, and everyone was in agreement that there is a need for new pharmaceutical solutions for the opioid epidemic. However, some were skeptical as to whether that solution is Ibogaine. Nevertheless, the panelists responded to every question with encouraging data and anecdotes.
Dr. Nolan Williams of Stanford University said of a recent study tracking the effects of ibogaine on traumatic brain injuries in US military special operators: “Findings were shocking. We’ve never seen a drug do this before.” Unfortunately, the results of the study will not be available until the paper has completed the peer review process in 6-8 weeks, but Williams said he is looking forward to sharing his team’s findings.
Panelists Dr. Mash and Dr. Rao also spoke about the unique nature of what opioids do to the brain and how ibogaine could help overcome it. Dr. Mash of DemeRx, said, “Hard drugs hijack the brain. They rewire the brain.” Though there isn’t extensive data on how ibogaine affects the brain yet, psychedelics such as psilocybin and LSD have been proven to increase neuroplasticity and help rewire the brain. It is believed that Ibogaine has a similar effect, which is what has helped numerous people overcome their addictions— something that current pharmaceuticals often fail to do.
Initially, some people objected to using this funding for ibogaine research and development because they believe there are already effective medicines available to treat OUD. The two young women who testified on their own struggle with opioid addiction strongly disagreed. Juliana Mulligan describes her experience of going through opioid withdrawal as “feeling like my body was in a hot frying pan.” Jessica Blackburn shared a similar experience, but within 45 minutes of taking ibogaine, her withdrawals were completely gone.
Both women tried several times to break their addictions using the traditional route. This generally consists of an in-patient rehab program followed by long-term use of opioid antagonists or agonists such as suboxone or methadone. These commonly used pharmaceuticals and treatment protocols failed to break their cycle of addiction; in fact, methadone is what initially got Juliana hooked on opioids.
While there was some skepticism in hearing as to whether ibogaine is the solution to the opioid epidemic, there was also a great deal of hope. Many people in the room had been personally affected by the opioid epidemic. One of the commissioners pondered why they wouldn’t pursue the development of this drug if it is so promising in preventing tragic deaths— many agreed.
Every single concern was met with a scientific response that quelled uncertainty. One former police officer voiced his own skepticism: “I’m a little cynical cause I spent 19 years with lots of people who said they have got the cure for the opioid epidemic… I don’t think there is a silver bullet to a very complex disease.” The panelists explained that this isn’t some miracle drug that will cure everyone struggling with addiction, however, it has the potential to work far better than the current treatment options, which are failing to help people.
Another former law enforcement officer on the commission expressed concern about the potential abuse of Ibogaine. Dr. Rao assured everyone listening that there is a very low risk for abuse. Ibogaine is not a particularly pleasant experience. In fact, Jessica Blackburn described her experience as “painful but important.” During the psychedelic experience, she saw her life like a movie and witnessed how her addiction had devastated her family. While it was far from a pleasant experience, she credits ibogaine for her years of sobriety.
The commission seemed open to the idea of allocating $42 million of the $421 million that it has been tasked with distributing for Ibogaine research. They spent the better part of a day striving to understand how exactly this novel drug would be researched and potentially commercialized.
$42 million may sound like a lot, but it is only 5% of the entire budget allocated to fighting the opioid epidemic. 90% of the money will go to supporting existing treatments. The ultimate goal would be to obtain additional funding through a public-private partnership to push ibogaine through FDA approval swiftly but safely. If Kentucky were to get ibogaine through the approval process, and the drug is as much of a breakthrough as many people believe it to be, it could positively affect the entire country.
All in all, the hearing was informative, heart-wrenching, and certainly historic. Several other states and federal agencies have begun to fund psychedelic research, but none have proposed anything of this magnitude. The hearing in Kentucky painted the picture of civil servants desperate to help the people they have been put in charge of protecting. It is not yet known if they will approve the budget for this project, but based on the hearing, the odds are in Ibogaine’s favor.