We recently received an interview with one of our iCAAD London speakers, Jeffery Kamlet - the world's leading authority on ibogaine, conducted by The Tabula Rasa Retreat. We hope you enjoy reading it.

Tabula Rasa Retreat: The International Conference on Addiction and Associated Disorders (iCAAD) is quite possibly the largest and most fascinating forum for discussing addiction in the world. The 2018 London Conference attracted over 1000 delegates representing 27 countries around the world. Their virtual and physical gathering space offered a large audience of health care professionals (66% of all attendees) to dozens of fascinating speakers, including addictions and mental health experts, philosophers, and influencers.

In anticipation of this year’s London iCAAD conference (which kicks off in May) Tabula Rasa Retreat’s Founder Alvaro De Ferranti and Jeremy Weate (who helped Alvaro develop the TRR programmeme) lobbied iCAAD Director Samantha Quinlan to add Jeffrey D. Kamlet, MD, a fearless ibogaine advocate, to the stable of noteworthy speakers already participating in the event. With very little convincing, Quinlan agreed that iboga’s addiction-healing qualities were well worth discussing at this year’s conference, and Dr, Kamlet was invited to address the conference on the life-saving benefits of ibogaine treatment.

Note: Dr Kamlet can be found at the iCAAD conference at booth 47 along with Alvaro de Ferranti, Jeremy Weate and others from the Tabula Rasa Retreat team all conference long.

Dr. Kamlet has worked as a neurologist and cardiologist, and he served as the Chief Medical Director for the South Florida Emergency Medical Service, in addition to having taught as an Adjunct and Associate Professor of Medicine at various universities. Dr. Kamlet was also the first physician to administer ibogaine in a clinical trial setting, and he has since supervised over 1000 treatment sessions. He currently “serves as the Chief Medical Advisor as well as Editor in Chief of the Global Ibogaine Therapeutic Alliance (GITA’s) Clinical Guidelines for Ibogaine-Assisted Detoxification.”

Dr. Kamlet currently practices Internal Medicine, Addiction Medicine and Pain Management in Miami Beach, Florida and he has served as the principal investigator for 20 FDA clinical trials for major pharmaceutical companies. He is a uniquely persuasive advocate for ibogaine treatment because of his impressively varied medical resume, and his passionate commitment to battling addiction.

We at Tabula Rasa Retreat couldn’t be more excited for his presentation, and Dr. Kamlet was kind enough to answer a few of our questions in advance of what will be a historic speech at ICAAD 2019

  • How close do you think we are currently to extensive clinical trials of ibogaine as an addiction/mental health treatment?

I do not believe we are close to getting any real phase 1 clinical trials for Ibogaine done in the United States in the near future. What we know for sure is that flood dosing with Ibogaine greatly ameliorates the symptoms of opiate withdrawal and alleviates Post-Acute Withdrawal Syndrome (PAWS). Many other benefits for Ibogaine have also been reported. My lecture at ICAAD 2019 will comment on those other disease processes, but will focus on Ibogaine flood dosing for opiate dependency.

There are many theories as to whether small doses of Ibogaine, nor-ibogaine, or 18MC will help a slow opiate detox taper adjunct, or possibly work as a relapse prevention drug. Small clinical trials have been done in other countries looking at the myriad of possible disease Ibogaine may help with, (Ie; micro dosing for Parkinsonism). However, until we have FDA-approved research studies in the United States I do not see ibogaine or its metabolites being available as a pharmaceutical treatment anytime in the near future. Once approved in the rigorous US clinical trials system, the drug will be approved world wide.

Compounding this problem is the fact that Ibogaine is a scheduled I drug in the United States, which means it has high risk for abuse and no medical benefits. This is clearly not correct. Medical cannabis is still a schedule I drug on a federal level making even research into medical cannabis difficult to do.

In the United States pharmaceutical model, no medication is a good medication unless it can bring profits to the manufacturer. Thus, those doing research into Ibogaine for financial benefit are focusing their efforts on small doses of nor ibogaine or 18 MC , so that they produce a drug that patients must take long term and which they can make more profit from. In the USA the pharmaceutical companies live by the maxim: “we exist to turn profits for our shareholders”. The problem here is that single treatment cures are not profitable. How absurd is this when we know that flood dosing of ibogaine can be done safely and effectively and that it works much better than any other form of opiate detox available anywhere? In spite of an opiate epidemic in United States with 80,000 plus deaths per year, clinical trials for flood dosing are not currently in the pipeline.

  • Do you feel that it is beneficial for proponents of ibogaine treatment to group the substance with psychedelic-based alternative treatments (such as ayahuasca for addiction or psilocybin to treat depression)?

Other entheogenic drugs are being studied with great promise, i.e: Ayahuasca for bipolar disorder, psilocybin for depression and nicotine cessation, MDMA for PTSD and even IV and nasal ketamine for depression and chronic pain. This brings legitimacy to the use of entheogenic drugs. I believe this to be a dawn of a new medical paradigm. This also helps bring attention to Ibogaine and its metabolites for multiple disease processes.

However, there is a huge difference between studying these substances and ibogaine. Psychiatric diagnoses like depression and bipolar disorder are very hard to subjectively and objectively measure for improvement outcome in conditions. Acute opiate withdrawal is not subtle and has a fixed set of very measurable objective findings. Seeing a person addicted to opiates feel perfectly well after an ibogaine flood dose is quite obvious to the observer when compared to typical prolonged agony of pharmaceutical substitution detox followed by 90 days of PAWS which is the only other alternative available today. Staying on methadone or suboxone (buprenorphine products), may accomplish the goal of harm reduction but they keep the patient dependent to the substance.

I believe that Ibogaine flood dosing, done according to safe, ethical medical protocols, will someday be the standard of care of for opiate dependence. This is easily measurable and raises the question; why in the face of a worldwide opiate epidemic is ibogaine flood dosing not being studied?

  • How big of an impact do you think ibogaine treatment could realistically have on the opioid epidemic?

Over 20 years ago, after seeing and treating my first few patients with ibogaine, I stated “In my opinion, Ibogaine is the most important discovery in the history of addiction medicine” and I still stick to that statement.

I believe flood dosing with Ibogaine in a safe ethical medical model can be done with zero morbidity and mortality and that this option should be made available to the hundreds of thousands of opiate addicts who still suffer and die from this disease.

  • What precautions do you feel must be taken for the safe use of ibogaine? What regulations do you think would be necessary to ensure that the treatment is safely used?

Ibogaine flood dosing carries significant risk for morbidity and mortality if not done properly.

Aside from the pre and post-treatment therapeutic component - which is critical for sustained recovery from opiate dependence -, a complete medical history and physical as well as complex lab tests and electrocardiograms must be done prior to treatment. Certain medications and even foods must be stopped prior to ibogaine ingestion. Comprehensive and repeated drug testing must also be done.

During Flood Dose treatment for opiate dependency, all patients must have intravenous access, constant 3-lead EKG and vital sign monitoring, and a physician with the minimum of Advanced Cardiac Life Support (ACLS) certification - as well as training in the usage of Ibogaine - present from start to end of treatment. Flood dosing of ibogaine has been associated with marked hypotension, bradycardia, complex cardiac arrhythmias and QT prolongation yielding potentially lethal arrhythmia. Yet, physicians such as myself have done hundreds of treatments without any adverse events or deaths. This is because strict pre, during and post-ibogaine flood dosing protocols were followed.

I will address many of these risks in greater detail at iCAAD 2019

Also, of critical importance is the “standardization of product” ingested. The purity and chemical form of the product ingested must be considered in this “vast uncontrolled experiment”. If Ibogaine is to me a “medicine” used in a safe ethical protocol, then all providers must be using the same medicine ie: 98.5% pure Ibogaine Hcl. The medicine must be given orally as first pass metabolism via the liver CYP450 2D6 pathway produces the active metabolites. Ibogaine has also been shown to be very effective in preventing alcoholics from relapsing but they must be alcohol detoxed and sober with normal liver functions before treatment. So the only drug Ibogaine produces cessation from withdrawal symptoms is opiates.

To summarize, I not only believe but am sure we have the best-known cure for opiate dependency. Yet issues with Big pharma and researchers/providers who are profit-motivated and lack strict adherence to safety protocols put addicts, desperate for help, at the hands of those who are less than ethical at best.

A word from Tabula Rasa Retreat

The team at Tabula Rasa Retreat would like to thank Dr Jeffrey Kamlet for his time, and iCAAD and its Founder and Director Samantha Quinlan for agreeing to invite ibogaine advocates and experts to participate in this year’s event for the first time ever. Having witnessed the life-changing benefits of ibogaine treatment in the dozens of people who’ve accessed our residential ibogaine treatment programmeme since we opened our doors, we strongly believe, just as Dr Kamlet does, that ibogaine has a lot to offer to the addiction treatment community.