FOR HEROIN ADDICTS, A BIZARRE REMEDY

Howard Lotsof wasn't trying to end his addiction. A college dropout with a
heroin habit and a taste for pharmacological adventure, he was simply
curious about ibogaine, an alkaloid derived from a West African shrub.

But a single dose of the drug sent him on a 36-hour psychedelic journey,
filled with dreamlike visions and painful self-discovery that miraculously
killed his craving for dope. "It wasn't until the next day when I walked
out of my house, I realized, 'Gee, I'm clean, I'm not going through
withdrawal,' " the Staten Island, N.Y., resident says, remembering his
first ibogaine experience in 1962. "I used to think of [heroin] as my
comfort, but 36 hours later I thought, 'Boy, that drug emulates death.' "

Since then, Lotsof, the treatment's most zealous promoter, has administered
the hallucinogen to dozens of addicts in the Netherlands and Panama.
Clinics have popped up from Slovenia to St. Kitts -- though not in the
United States, where ibogaine is as illegal as any street narcotic.

The drug has been linked to long-term brain damage and death. But serious
medical interest persists, in part because the current pharmacological
therapies are far from ideal. Methadone, the primary remedy for heroin
addiction, must be taken every day for months, even years. And about 30
percent of methadone users relapse within 12 months of beginning therapy.

Waking Dream

Ibogaine is concocted from the bark of Tabernanthe iboga, a plant from the
forests of Gabon. Initiates into the Bwiti religion are fed the drug to
facilitate communication with the dead.

In the United States, gonzo journalist Hunter S. Thompson suggested
absurdly in Fear and Loathing: On the Campaign Trail '72 that presidential
candidate Edmund Muskie's odd behavior was caused by ibogaine abuse.

An ibogaine trip is compared with a waking dream, in which childhood
memories flicker through the mind like movies. This hallucinatory phase,
which lasts several hours, is followed by a period of introspection during
which addicts say they confront the damage they have caused themselves and
loved ones. After crashing from exhaustion, patients typically awaken
famished, and without a yen to get high (although some later relapse).

Tales of ibogaine's effectiveness are legion among addicts, but data are in
short supply. "The whole trouble is that all these stories are just
stories," says Stanley Glick, chairman of the department of pharmacology
and neuroscience at Albany Medical College, who last month co-directed the
First International Conference on Ibogaine at the New York University
School of Medicine. "We need systematic clinical trials." An FDA-approved
trial at the University of Miami commenced in 1993 but has been suspended
due to a patent fight.

However, recent work with rats and mice has shed light on ibogaine's
neuronal mechanisms. Researchers believe the drug binds to the brain's NMDA
receptor, blocking out the neurotransmitter glutamate. Glutamate
transmission plays a key role in sensitizing addicts to drugs, and
preventing that transmission may combat the hunger for cocaine, heroin,
even alcohol.

Though intrigued by ibogaine, the National Institute on Drug Abuse is
currently funding only one researcher, Glick. In 1995, a panel of NIDA
consultants, troubled by evidence that ibogaine causes seizures in monkeys
and dogs, as well as by reports of deaths among native practitioners,
recommended against developing the drug.

"We then said we would fund pre-clinical and clinical trials that got
meritorious scores through the peer-review process," says Frank Vocci,
director of NIDA's Medications Development Division. "And that is still our
position."

But Glick says the drug's neurotoxicity can be avoided. He has a patent
pending on an ibogaine derivative called 18-methoxycoronaridine that,
unlike its sister compound, does not kill cells in the cerebellum, a part
of the brain associated with repetitive behavior. Glick hopes this safety
improvement will interest pharmaceutical manufacturers.

"There is a stigma, an enormous stigma, attached to addiction," says
Lotsof, adding that drug companies view the nation's estimated 600,000
heroin addicts as problematic subjects. But he says such stereotypes should
not be allowed to stall new cures, no matter how offbeat.