Methadone, Suboxone and Ibogaine

For many addicts, opiate agonist drugs like Methadone and Suboxone are life saving options that allow them to transition out of addiction.

Opioid agonist therapy (OAT) is an effective treatment for addiction to drugs such as heroin, oxycodone, hydromorphone (Dilaudid), fentanyl and Percocet. However,  Methadone and Suboxone create a chemical dependency; essentially swapping one addiction for another. Many patients remain on these drugs for months, years, or even for life, subject to an array of side effects.

In the case of methadone, there’s a high risk of abuse with serious side effects that range from drowsiness and gastrointestinal upset to irregular heartbeat, depressed respiratory function and seizures.

Many patients that have relied on Methadone or Suboxone eventually reach a point where they want to be free of the medication, but are daunted by the withdrawal process.

Enter: Ibogaine, a naturally occurring psychoactive substance found in the Tabernanthe iboga plant. Traditionally used for spiritual and ritual purposes in West Africa, Ibogaine has shown to be effective in treating addiction to opiates by easing withdrawal symptoms and cravings. But how does it compare to Methadone or Suboxone?

To answer this question, it’s important to understand the differences between the three substances and how they affect brain receptors. 

Methadone.

Methadone is a full opioid agonist.  This means that the drug binds to opioid receptors in the brain and activates them. As a result, users don’t feel cravings for other opioids, like heroin or prescription painkillers and uncomfortable withdrawal symptoms like nausea and vomiting are kept at bay. However, by occupying brain receptors, Methadone creates a chemical reaction that leaves an individual vulnerable to dependence.

Suboxone.

Suboxone is a synthetic opioid that was developed with the intention to help treat opioid addiction. Suboxone is  made with 80 percent buprenorphine, a partial opioid agonist, and 20 percent naloxone, a medication used to block the effects of opioids.

When Suboxone is consumed, buprenorphine binds to receptors in the brain and activates them in a way that provides relief from withdrawal symptoms, while  the naloxone blocks the opioid’s effect, preventing the body from experiencing any kind of high.

Ibogaine.

Like Methadone and Suboxone, Ibogaine binds to opioid receptors helping eliminate withdrawal symptoms and cravings. However, that’s where the similarities end.

Unlike Methadone and Suboxone, Ibogaine is not a synthetic opioid. It’s a naturally occurring psychoactive substance. When Ibogaine is administered, it metabolizes in the body as Noribogaine, a serotonin reuptake inhibitor that binds to opioid receptors. In lieu of acting like a stand-in for other opioids, Noribogaine resets the brain back to its pre-addictive state. Essentially, it turns off the withdrawal process and the neurological receptors that crave more drugs or alcohol.

How Ibogaine is administered is also very different. Methadone and Suboxone are taken on an ongoing, regular basis in order to treat opioid addiction. On the other hand, Ibogaine is typically administered only once during the detox process.

Ibogaine elicits a psychedelic state which can last from 8 to 12 hours. During this process, past traumas rise to the surface allowing addicts to gain insight into their addictions and confront old demons head-on. This added psychological benefit simply doesn’t exist with more traditional treatments like opioid agonist therapy.

In addition, the impact Ibogaine has on cravings and withdrawal symptoms is notable.

According to observational studies, a single dose of Ibogaine can decrease signs of opioid withdrawal and achieve either cessation or reduced use of opioids for up to 12 months following treatment.

Detoxing from Methadone with Ibogaine

Whether a patient is detoxing from Methadone, Suboxone or another opioid, Ibogaine offers a potential solution for addicts who want to break the chain of addiction and dependence. With that being said, Ibogaine treatment for methadone requires careful planning with an experienced medical professional.

Since methadone is a long acting opiate, a patient can’t immediately begin Ibogaine treatment after taking their last dose of methadone. Instead, a doctor will switch the patient to short acting opiates (such as morphine sulphate) prior to ibogaine treatment.

Detoxing from Suboxone with Ibogaine

Specific considerations also need to be given to patients who are detoxing from Suboxone.

As mentioned above, Ibogaine metabolizes in the body as Noribogaine, a serotonin reuptake inhibitor that binds to opioid receptors and helps restore them to their pre-addicted form. However, Suboxone contains the opioid blocker, naloxone, which makes it impossible for Ibogaine to do its job.

If a patient takes Ibogaine while they still have Suboxone in their system, they may still enter into a psychedelic state and experience a reduction in withdrawal symptoms. However, because brain receptors can’t be restored to a pre-addicted state, withdrawal symptoms and cravings return when the effects of Ibogaine wear off.

If a patient is using a drug like Suboxone that contains opiate blockers, it’s recommended that they wait at least 30-45 days after their last dose before taking Ibogaine. Waiting to take Ibogaine helps ensure the body is completely clear of opioid blockers and that the treatment works effectively.

For many addicts, Ibogaine is a viable alternative to opioid replacement therapy and can help individuals who’ve found other methods ineffective. However, Ibogaine isn’t for everyone.

If you’re considering Ibogaine, it’s important to only seek treatment in a facility with a high level of medical supervision. A thorough screening process that adheres to the guidelines set forth by The Global Ibogaine Therapy Alliance will help determine whether Ibogaine is the right choice for your future.