SHRUB EXTRACT A CURE FOR ADDICTION?

Maybe, but drug is stuck in limbo

What if addiction, whether to cocaine, heroin or alcohol, could be broken by
taking a single pill?

That's the audacious claim behind ibogaine, an extract of an African shrub.
But don't look for it at your local treatment center anytime soon.

Ibogaine is stuck in limbo.

Anecdotal reports of addiction-breaking power go back about 30 years. There
have been animal studies and initial research on humans. And the federal
government has spent more than $2 million on preliminary ibogaine research.

More than 150 papers about ibogaine have appeared in scientific journals,
said Dr. Kenneth Alper, who directed a conference at the New York University
School of Medicine.

However, no one had conducted elaborate studies that could convince
addiction specialists about the drug's effectiveness. In addition, neither
the government nor pharmaceutical industry will debate the issue.

Ibogaine is illegal in the United States but is available through an
international black market. It is also used in clinics in Panama City and
the Caribbean. For $1,500 and up, you can get it from a nurse or
psychiatrist on a boat cruising international waters off South America.

"It's not a matter of debate whether ibogaine should be made available. It
is already available," said Geerte Frenken, who helped organize
International Addict Self-Help in the Netherlands to offer treatments.

Advocates have said that ibogaine painful withdrawal symptoms that make it
difficult to quit drugs.

Also, ibogaine halts or reduces drug cravings for weeks to months they have
said. That can be long enough for a person to get psychological help.

What makes the ibogaine story more curious is of taking it.

First come visions: four to eight hours of fantasies like floating in space
or fast-forward reviews of one's life. For another eight hours or so,
addicts mull the meaning of those visions, a step that can provide insights
that promote staying clean.

Ibogaine comes from the roots of the 4-foot-tall, flowering African shrub
Tabernanthe iboga. Its root bark is chewed in rituals in Gabon.

Ibogaine was purified from root bark around the turn of the century and low
doses were sold for fatigue and depression in France from 1939 to 1970.

In 1962, Howard Lotsof, a 19-year-old New Jersey history major, had used
heroin for a few months. One day, he tried ibogaine after a chemist friend
mentioned it.

"Thirty-three hours later, I was no longer a heroin addict," Lotsof said.
"The first time Mr. Lotsof called me up and told me about this, I thought he
was a lunatic," said Dr. Stanley Glick, chairman of the pharmacology and
neuroscience department at Albany Medical College.

Yet as Glick and others looked at ibogaine's performance in lab animals,
they found evidence that it did act against addiction to cocaine, alcohol
and opioids, the class that includes heroin. Their results showed up in
journals about 10 years ago.

Around that same time, two self-help groups of addicts offered ibogaine
treatments to a heroin addicts in the Netherlands.

Frenken's group found that seven of the eight addicts stayed clean for an
average of six months.

The latest on ibogaine comes from a clinic on the Caribbean island of St.
Kitts, where the drug has been used with addicts who were not helped by
conventional treatment.

They were "self-destructing, at the end of the road. This thing really spins
them around," said Deborah C. Mash of the University of Miami School of
Medicine. She has studied more than 80 addicts treated at the clinic.

While her work is preliminary, she's finding it "extremely effective" in
blocking withdrawal from opiates such as heroin and morphine, as well as the
"crash" from stimulants like cocaine and amphetamine.

The studies suggest that a single dose of ibogaine can block craving for
opiates and cocaine for at least 30 days. It also lifts depression and
anxiety, she said.

However, Mash said she has studied too few patients to make definite
statements.