Is this the valediction to addiction?

Heroin is one of the scourges of our times, and it is a growing scourge - horrifying in its effects and horribly painful to escape. Now, out of Africa, comes a cure that offers new hope for addicts. By Jerome Burne

"After about an hour, I start visualising pink-green diamond shapes ... sounds are especially irritating ... there is a constant zooming sound in the room as if there is a gigantic fly ... There is the sound of an African drum in the back of my head ... I have visions of walking through the jungle of dark Africa ... I am making vibration sounds with my mouth but I don't understand why ... Now I am walking through my brain as if through a giant computer-like file cabinet..."

These are, indeed, the stoned ramblings of someone on a drug, but it is a drug with revolutionary potential. The speaker is Geerte, a 26-year- old Dutch woman who is addicted to heroin, yet it is not heroin that is prompting these visions. It is a drug called ibogaine, and a growing band of researchers believe that the experiences Geerte and other addicts have had after taking ibogaine just once can cure them of their heroin addiction.

If all this is to be believed, ibogaine could be the ultimate answer to a drug problem that appears to be increasing. Last week, police made one of their largest seizures of heroin, a haul said to have been worth some pounds 20m, in a raid on a central London car park; two days later in east London, police seized 25kg of the drug, worth around pounds 2m. Heroin is now the most commonly seized Class A drug, and assuming that the volume of drugs seized is a fraction of those being used, warnings by police and Customs of an impending epidemic seem all too plausible.

In this context, the claims made for ibogaine, a drug scarcely known in Britain, deserve to be taken seriously. The drug has an extraordinary ability to give people a kind of high-speed overview of their life. At the end of the 36 hours that an ibogaine session lasts, addicts claim a depth of insight into their behaviour that professionals estimate is the equivalent of a year in conventional therapy.

Geerte's experience is typical. "I see myself as a foetus in my mother's womb," she says. "I am actually going through a rebirthing process very rapidly. I feel incredible devotional love coming from my parents. This memory enables me to accept the mistakes I thought my parents had made in the process of my growing up. For the first time I can feel respect for my parents, which shapes our whole relationship into a harmonious reality."

The next morning she awakes feeling ravenously hungry and gives away her heroin supply. "It is as if all the information in my brain has been shaken out into one big pile, looked at objectively and put back, untwisted from emotional trauma." Six months later she was still free of her addiction.

Although ibogaine, which comes from a West African shrub, has been known in the West for well over 100 years, its use as an addiction cure is largely due to the efforts of an American, Howard Lotsof. Back in the 1960s, then a heroin addict, he took a drug that someone promised would get him really high. He had a remarkable time, seeing visions and being taken back through his personal history, but what really amazed him was that afterwards his desire for heroin had vanished.

There had been no withdrawal pains, no effort of will. He just didn't want it any more. Not only that, but the craving didn't come back. He was clean. Wondering if it was a fluke, he persuaded six of his addict friends to take the new drug. Five of them also came off heroin - and stayed off. There then followed a period of "informal" testing to discover the optimum dosage and conditions, and in the mid-80s Lotsof patented ibogaine as a cure for heroin, cocaine and alcohol addiction.

Although largely unknown to the public, ibogaine has long been of interest to drug researchers because of its remarkable properties. But because governments are uneasy about sanctioning studies on mind-altering drugs, all the experiments have been carried out on animals. Nevertheless, last year, after a lengthy period of indecision, the Federal Drug Administration gave the green light to the University of Miami to begin a series of trials on human volunteers to test the drug's safety.

Since the use of ibogaine is restricted in America, the system devised by Lotsof has been used in both Amsterdam and Panama. Robert Sisko and his colleagues at the International Coalition for Addict Self-Help (ICASH) in New York have documented more than 20 cases of addicts using ibogaine to end their addiction to drugs. Working with Lotsof outside the conventional medical establishment, ICASH members, along with DASH (Dutch Addict Self- Help), have been administering ibogaine to volunteer addicts in the Netherlands over the past seven years.

Not only does ibogaine give instant insight, they say, it also removes the other major hurdle to giving up drugs. "Heroin addicts are terrified of withdrawal," Barbara Judd, an expert in drug rehabilitation, told a conference in Washington last year. "But the three patients I treated with the Lotsof method all appeared calm and showed no signs of it. Using ibogaine is a much more humane and dignified approach to detox."

So far Lotsof claims to have formally treated 35 patients, most of whom had had numerous unsuccessful experiences with other programmes. "The majority stayed off drugs for between three and six months after a single dose of ibogaine, and 10 per cent were free for two or more years," he says. "It seems that for most, what's needed is several ibogaine treatments over a two-year period before they are completely free."

Patients come into the hospital and can keep using their drugs up to the night before; they then take about a gram of ibogaine hydrochloride and lie down. The only mildly unpleasant physical effects they are likely to encounter are nausea and a lack of co-ordination. After a couple of hours they go into the waking dream state. They can talk, but they don't want to because they are concentrating on the parade of images. "It's like a movie run at high speed," says Lotsof. "It's so compressed that distracting the patient even for a moment may interfere with the process of abreaction." This lasts for three to five hours.

Then comes a period of "intellectual evaluation", when there's a review of the parade of images. "Mostly when we make a decision it seems like the only option," says Lotsof "But under ibogaine, patients can see that there are alternatives. This helps them to make changes." Any withdrawal symptoms are psychosomatic, says Lotsof. "A few claim withdrawals but they never have any of the physical signs - dilated pupils, running nose, goose bumps." If they sleep, they usually wake up completely alert, ravenously hungry. It is a miracle in itself for a heroin addict of 10 years, who has been shooting a gram and a quarter of heroin a day, to wake up wanting a breakfast of steak and eggs.

So what is going on at the level of body chemistry to produce this remarkable range of effects? Unfortunately, the most straightforward answer at the moment is that we don't know, not least because most of the research has been done on laboratory animals, who are not very informative about the brain mechanisms involved in changing the way people feel about their parents. Another problem is that, despite years of research, we don't even really know why people become addicted in the first place.

There are a number of pointers to some of the areas of the brain involved, however. Most addictive drugs such as cocaine, morphine, and amphetamine, have their effect by increasing the amount of a brain chemical known as dopamine in one of the pleasure centres called the nucleus accumbens; one of the effects of ibogaine is to reduce the amount of dopamine available. This could be why people report getting the shakes, because another area affected by dopamine is in the basal ganglia, which controls movement. Patients with Parkinson's disease shake all the time and have low levels of dopamine.

Another, highly speculative, part of the dopamine connection involves an area called the amygdala, a part of the brain that deals with the emotions, especially fear. People with Post Traumatic Shock Syndrome suffer vivid flashbacks, during which the amygdala is highly active. Dramatic replays of the past are a key feature of the ibogaine experience, but without the nightmare quality of PTSS.

Even the mystical reports - seeing wise beings and having something similar to a Near Death Experience - fit the picture. Yet another area of the brain involved with dopamine is the temporal lobes, which are also very much connected with mystical experiences, either during epileptic seizures or when they are electrically stimulated.

Besides cutting down on dopamine, ibogaine also has the effect of increasing the amount of another key brain chemical, serotonin. But here matters start getting complicated. Not only is serotonin involved in very broad areas of brain chemistry - the best-selling anti-depressant Prozac works by keeping serotonin levels high, while low levels are linked with violence and suicide - it also interacts with dopamine receptors. It could be, however, that raising serotonin levels is what permits painless withdrawal.

Whatever the final brain mechanisms turn out to be, if ibogaine is widely used it will mark a dramatic change in the approach to addiction. All previous attempts to fight drugs with drugs have either involved trying to block the effect of the drug in question or to find a substitute, but none of them have been at all effective. "Ibogaine presents a potential new strategy for treating addiction to diverse drug classes," Professor Piotr Popik of the National Institute of Health, Bethesda concluded in a recent major review of the scientific literature.

However, not everyone is happy with that prospect. The possibility of a genuinely effective cure has set alarm bells ringing among powerful groups who benefit from drug addiction. "In Mexico, several doctors were introduced to the idea of ibogaine and were exceedingly intrigued, until they were told of the 75 per cent success rate," says Lotsof. "They retreated immediately because of the number of patients they would potentially lose and the threat this would present for their families and themselves."

Enquiries about ibogaine treatment should be addressed to Intake Department, NDA International Inc, PO Box 100506, Staten Island, NY 10310-0506, USA. For more details see web site http://www.ibogaine.Desk.nl

BOX HEAD BOX HEAD BOX HEAD

Ibogaine is one of several alkaloids found in the West African shrub, Tabemanthe iboga. The first reports came from French and Belgium explorers in the last century. "In small quantities it is an aphrodisiac and a stimulant of the nervous system," wrote one traveller in 1864. "Warriors and hunters use it constantly to keep themselves awake during the night watches." There were claims that people on ibogaine could keep on having sex for up to 17 hours.

Ibogaine was initially used by the Mitsogho, a tribe from an area which now forms part of Gabon. For 300 years it was an integral part of a once- in-a-lifetime rite of passage that transformed them from boys into men - girls couldn't take it, and males who didn't complete the initiation were forever branded as girls.

It was certainly demanding. The candidate had to chew shavings of the iboga root for days, despite the fact that within half an hour of taking it he was violently sick and that getting the dose wrong could mean paralysis, coma and death. (What is taken today is a purified form of just one of the alkaloids in iboga. Candidates used to ingest the whole plant). The surrounding rituals were daunting, too - the skull was struck three times with a hammer, the tongue pricked with a needle and the head shaved and sprinkled with a red wood dye.

But these trials were gladly suffered for the sake of the visions, which started after about 10 hours. At first they were hazy and disjointed, then menacing animals appeared, followed by feelings of peace and tranquillity - all of which was a build up to a meeting with higher spiritual entities.

Like coffee or coca leaves, ibogaine was first used in the West as a tonic. French chemists crystallised it at the beginning of the century (about the time cocaine was crystallised from coca) and it was used as a treatment for sleeping sickness and for convalescents. Pills, under the trademark Lambarene, were sold in France in the 30s, containing 8mg of ibogaine. They were supposed to banish fatigue and improve appetite but made no mention of sex. In the 60s ibogaine fell victim to the LSD- inspired scare about hallucinogens and was banned in America, although it is not illegal in this country.