Ibogaine is a powerful South American hallucinogen that is being used as a radical treatment for meth and cocaine addiction. Some therapists say it resets the brain in a sense, and affects memories and cues involved in cravings and relapse. Other new research is showing that salt, an essential element for almost all life on our planet, and something that all humans seem to crave, may help us understand the reasons that addictions are so powerful. And the drug propranolol, a beta blocker used to treat hypertension, is showing promise in the treatment of meth and cocaine.
Transcript (edited):
HOWARD: Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions, I am Howard La Mere. We’ll be looking at news of note in addiction, drug education, neurochemistry, psychopharmacology. Dr. Drew, weve talked about him before, it’s a good thing when TV brings attention to the issues of addiction but – a reality TV show? Charlie Sheens ex-wife is talking about going into treatment in Mexico for her addiction her meth addiction issues and is using the psychedelic drug Ibogaine. Lets talk a little bit about that before we go on to other things.
DARRYL: Ibogaine continues to generate interest, continues to have an advocate in Dr. Deborah Marsh and a number of other people who claim it resets the brain or somehow affects the frontal cortex. Ive never been able to get a real detailed answer on how it affects the brain, but it eliminates lifelong cravings for the abusive drugs. Originally Ive seen it used mainly for opiate addiction and now more and more people, as you mentioned with Dr. Drews thing, it is being talked about to treat methamphetamine and cocaine addiction. What people have to know though is that Ibogaine is, as far as I know, still a schedule 1 illegal substance.
HOWARD: Schedule 1 or schedule 2, yeah.
DARRYL: Its absolutely schedule 1, so its prohibited except for federal research and as far as I know, the federal government is not sponsoring any studies on it because of deaths that occurred during the original research.
HOWARD: Right, which is the reason that Brooke Mueller is going to Mexico.
DARRYL: Right. Dr. Deborah Marsh practices in Florida, has a clinic in the Canary Islands where she treats patients with Ibogaine. What surprises me is and of course it’s because of the costs involved in traveling to these exotic places, the people who partake of the cure, so to speak, are people of means, celebrities and people who can afford to do it. Its interesting that we continue to hear about people willing to take it or have it injected into them. Its a psychedelic basically, it causes major distortions of perception, like any hallucinogenic or psychedelic drug, but the claim is that it kills your interests or your hunger for your drug of addiction forever, which makes it of interest to me.
HOWARD: The story reported personality changes that seem to be permanent, or semi-permanent.
Something else turned up here and I only have a smattering of information, but it showed up in National Geographic magazine, which was quoting Science magazine, I think, about the connection between cocaine and salts, using the same brain pathways. And I think this is brand new research, Darryl. Do you have any information on that or any thoughts on that?
DARRYL: Well, definitely we all know that, not just cocaine, but heroin and all addictions have an overwhelming survival mechanism or need that is very deep within the unconscious part of the mind the primal brain and maybe even before that maybe even in the reptilian brain. And the basis for that, you know, is not clear. I must confess, when I first saw the title of that article, I thought it was about the bath salt connection.
HOWARD: Well, actually, so did I!
DARRYL: “Bath salts” contain different chemical derivatives that are being used pretty much just like methamphetamine and cocaine in terms of how they work in the brain. But what research shows is that all multi-cellular species (like ourselves and reptiles and everything else) came out of the ocean. We started evolving in saltwater in the ocean and as we evolved, there remained a connection to requiring salt. Salt is abundantly available in the ocean, but on land it is a trace element, so it is not available except as rock salt deposits or ocean beds and things like that. Weve seen in a variety of animals, even avians parrots and things like that, who crave salt. They have to find their salt lick, they crave it – basically pulling them back to their survival instincts which are accessed in the most primitive part of their brain, the drive to satisfy that salt need. This article says that all addictive drugs mainly I think the article was talking about cocaine and heroin, but to me it would be the same process in the brain hijack that process hijack that area of the brain and cause the brain to crave the drug in much the same way the primitive need to crave salt exists in order to maintain life. And I think thats just another way of looking at what weve been saying about addiction all along, looking at what we call the addiction pathways and the go switch or the reward/reinforcement switch or the survival reinforcement switch as the center of that activity. It’s a compulsive drive to seek out the drug, it’s not about feeling that youre getting loaded not about dealing with your problems because that occurs on a conscious cortical level. Its all in the subcortical survival automatic instinctive level – like all things having an ancient drive to get back to their salt roots.
HOWARD: And then theres another interesting cocaine-related story about a high blood pressure medication propranolol to treat cocaine – which is particularly difficult to treat with medication. This drug has some potential in the treatment of posttraumatic stress disorder, apparently it affects the memory or it affects the way we access our memories, which of course is a significant part of posttraumatic stress, but is also another one of those key aspects of addiction behavior, because the cues keep bringing you back. So, I thought this was fascinating, Darryl, and again, its new research, so I dont know if you know much about it, but the potential is obviously very interesting.
DARRYL: You know, that was fascinating just hearing from you about that research. I havent seen the article, but propranolol also known under the trade name, Inderal is one of the oldest medications used to treat high blood pressure and cardiac arrhythmias and different problems with the heart. It is what we call in medicine, or pharmacology, a beta adrenergic blocker where it blocks the beta system, your sort of nervous system that operates and has effects on slowing the heart. By blocking beta, you can slow down the heart rate and slow down the extra rhythms. And it was interesting because way back in the early 70s with Dr. Skip Gay, when we were shooting by our hip and not having a lot of medical resources to rely on, were just treating overdoses and cocaine addiction and things like that where a lot of people thought it was all mental and not physical, but we actually published a paper that was a very short paper. It was published in the New England Journal of Medicine about the use of propranolol in the treatment of cocaine overdoses. So, its kind of fun to see this thing come all the way around. But we never thought about it being used to treat addiction itself. And propranolol has a central calming effect or sort of sedating effect and so in that way, it could be used to treat or have that as a side effect, treating the hyperactivity of cocaine, but it also blocks the beta system which cocaine activates and in doing so, maybe allaying another view of addiction that we are looking at closer and closer now and thats addiction is an aberration of your stress reaction. You have a natural stress reaction and addictive drugs sort of hijack that system and replace that system and propranolol will block out some of that system. And then related to it, as you said, we know that all addiction and relapses and especially triggers are activation of your emotional memories. Your memories that are stored through your emotion system and activated or processed through the amygdala and a beta blocker drug, like propranolol, could have a profound effect on blocking out that action. There is some research done with mice and rats in which they learn to associate different kind of rooms. They have their choice going through a maze of entering room A or B and its called state dependent learning where they addict the animal to a drug like cocaine in one room with special colors or special floors or special furnishings, if you will, and the animal learns or associates their addiction with that room and therefore, after theyve been detoxified and taken off the drugs for a long time, when they give them a choice again of whether they can have the room that they got clean in or the room they used drugs in, they immediately go back into the drug room to get more drugs. And thats state dependency. But, the research thats interesting with propranolol is when they inject the mice or rats with propranolol, it disrupts that memory system or that trigger system and the mice dont enter the room that they used to use cocaine in. So maybe it has more of an effect on memory and especially emotional memory and able to block it out than I figured. So that it is fabulous research and I think we are going to see more and more of that as scientists continue to unravel the layers of the onion to really find out what is addiction. What is the molecular system of addiction and the cellular mechanism of addiction? And therefore, what are ways that we can intervene or interrupt or disrupt that system so that people are no longer compulsive about their drug use and can finally remain clean and sober from drugs of addiction. Because again, it is on such a primitive level and addicts have to learn that too. Its not about getting high. Its on a very primitive level – its unconscious, instinctive, automatic – the same that drives the salt requirement – emotional memory drive or whatever. In some cases perhaps it’s a stress mechanism that drives a person to continue to access that drug. Not for its high or not for its pleasing effects or because it helps a person forget bad things but just because of how it impacts the way the brain is set up.
HOWARD: Fascinating. It is fascinating research. We continue to find out more as we dig deeper, which of course is what science does. One closing note – the passing of Betty Ford, she was so important in bringing to the forefront – addiction in the modern world. Addiction was pretty much a taboo topic, not really discussed or acknowledged as a problem, the massive use of alcohol by a lot of people or massive abuses of tobacco, Betty Ford really kind of opened our eyes to it. So I wanted to honor her.
DARRYL: Absolutely Howard. And you know, she did a lot. I dont know if she was aware of it or not, but as our first lady, she showed courage and made a difference with her straight forwardness. She was a very direct lady. And even though the research at that time showed addiction was very different than how it was portrayed in the media or what the public’s perception was, she was the one to bring it forward and show that addiction was not just in the ghetto, not in the underprivileged and the degenerates, but addiction impacted people of all walks of life. In fact, our most intelligent and our most valued people, like Betty Ford herself, was not immune to addiction. So she brought that forward and was courageous enough to break her anonymity, something that some in this field are saying we need to encourage – so that they can help take that mask off addiction and show how prevalent it is amongst people of value in our society. She did that and it began to change and erode our thinking about addiction. It took until 2008 to finally pass legislation that accepted addiction as a true illness or a true disease. The other thing Betty Ford did that was way ahead of her time was to show that prescription drugs things we think are safe because we get them from doctors, can lead to a profound addiction. The benzodiazepines and sedative hypnotic drugs she was taking, a lot of people in society say, “well, its safe, my doctor prescribed it. Its a FDA drug, so its not going to be like heroin, its not going to be like meth and its not going to be like barbiturates. Its going to be a safe, effective medication and not a drug.” She was the first one to bring awareness, so my hats off to Betty Ford. I thank her so much for how much she meant to this field and how much she brought forward and we are going to miss her advocacy and her wisdom.
HOWARD: Yes indeed. Well, thats about the time we have for today. Thanks for listening. We would love to hear your comments, questions or suggestions. email us: info@cnsproductions.com. Please check back soon for the next in the series and visit our website, www.cnsproductions.com