Ibogaine and Subjective Experience: Transformative States and Psychopharmacotherapy in the Treatment of Opioid Use Disorder.

Ibogaine, a powerful oneiric alkaloid derived from Tabernanthe iboga, produces subjective experiences that may contribute to its therapeutic capacity for opioid use disorder. In 44 participants from two observational treatment studies, 43% achieved a "complete mystical experience" in more than five of seven domains on the States of Consciousness Questionnaire. Qualitative analysis revealed themes of auditory and visual phenomena, cyclic visions, confronting realizations of remorse and regret, and release from guilt and worthlessness. Many reported spiritual transformation. The oneiric effects appear to be a discrete element in ibogaine's healing capacity, distinct from its pharmacological actions that reduce withdrawal and craving.

Study at a glance

Abstract

This article examines the therapeutic potential of ibogaine, a powerful oneiric alkaloid derived from Tabernanthe iboga, through exploring the subjective experiences of 44 participants from two observational treatment studies for opioid use disorder. Following treatment with ibogaine HCl, the participants (Mexico, n = 30; New Zealand, n = 14) completed the States of Consciousness Questionnaire (SCQ) to quantify the magnitude of their psychotropic experience. Participants were asked to provide written transcripts of their experiences, with those supplied being analyzed thematically through an iterative process, to produce a set of coded themes. Mean SCQ scores in many domains exceeded 0.6, the cutoff score for a "complete mystical experience," with 43% of participants achieving this in more than five of seven domains. Qualitative data described multiple phenomenological themes, including auditory and visual phenomena. Ibogaine's strong oneiric action promoted cyclic visions leading to confronting realizations involving remorse and regret for participants' actions towards others, but also release from feelings of guilt and worthlessness. Many participants reported feeling a sense of spiritual transformation. We propose that the reported experiences support the meaningfulness of ibogaine's oneiric effects as a discrete element in its capacity for healing, which is distinct from pharmacological actions associated with reduced withdrawal and craving.