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April 2022

Iboga, Ayahuasca, Kratom & Opioid Use Disorder

Opioid use disorder continues to be a major health crisis in the US. Treatment centers have opened nationwide in an attempt to get those who suffer back on a healthy path. But many people are also seeking alternative treatments. Be prepared to discuss these with patients.

There are many anecdotal claims that some psychedelics, such as iboga, can help people to kick addictions after just one dose. Currently, those claims are not supported by research. Some small, low-quality studies do suggest that ibogaine, the active chemical in iboga, might help reduce opioid withdrawal symptoms and the risk of relapse. But researchers are starting to take a harder look. A pharmaceutical company recently partnered with the National Institute on Drug Abuse (NIDA) to test the effects of ibogaine on various substance use disorders, including opioid use disorder. Safety concerns remain, but this pending research should help answer many questions about the role that ibogaine might play in treatment.

Research on ayahuasca is also picking up, primarily for its use in depression. It’s an herbal psychotropic drink made from several plants that contain the hallucinogen dimethyltryptamine (DMT). While it’s used in religious rituals throughout the Amazon, there are reports of serious side effects after use. There’s also no standardized dosing because the contents of the drink vary. For now, it’s not clear if it helps with opioid withdrawal and safety is too uncertain.

You might also hear about kratom. Unlike psychedelics, some chemicals in kratom have opioid-like effects, and safety concerns are well established. Any claims that it can be used to help with opioid withdrawal are not supported by evidence. Kratom has many of the same serious safety concerns as other opioids, including the risks of abuse, overdose, and death. The FDA recently stepped up its efforts to keep this ingredient out of supplement products, but it’s still available online and in some states. Tell patients to steer clear.

We’ll keep you updated as we learn more. For now, refer to our Pharmacist’s Letter resource on the Treatment of Opioid Withdrawal.

The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2022 Natural Medicines Inc. Commercial distribution or reproduction prohibited. Natural Medicines is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.