Tag Archive: treatment


Kidnappings, incarceration and the world’s worst heroin habit

In a country with more than two million heroin addicts, Irina Teplinskaya was one of the first. It was back in 1981, as a 14-year-old girl in the Baltic port of Kaliningrad, that she first tried the drug. She came from a prestigious family of senior Communists and was one of just a few who could afford the exciting new drug. She became addicted and suddenly, instead of a move to Moscow to study, her life began to take a very different path. She spent over a decade in prison and contracted hepatitis C, tuberculosis and HIV. right align image
During her last stay in jail, which ended in 2007, her HIV transitioned into full-blown Aids. Her life could have been very different, she says, if people had treated her drug addiction as an illness rather than a crime.
„The answer for me and for millions of others is simple,“ says Ms Teplinskaya, 44, who now works for an organisation advocating a more humane drug policy in Russia – substitution therapy. Almost every country in Europe allows treatment using methadone. Like heroin, it is an opiate, but is administered orally, meaning no risk of HIV transmission through needles.

Russia is the world’s largest heroin consumer and, to add to that, risky injecting practices have fuelled one of the world’s fastest-growing HIV epidemics. With tens of thousands of people dying every year, in a country where the population is shrinking, the twin epidemics are a catastrophe.
Campaigners say methadone would help tame both the heroin and HIV epidemics. As well as preventing HIV transmission, giving addicts methadone also brings them into the medical system, help steer them away from committing crimes to fund their habit and takes trade away from illegal dealers. Even China uses the technique to treat drug addicts. But Russian officials will have none of it. Government figures say it is perverse to treat drug addiction with other drugs and favour methods based on full withdrawal, sometimes against an addict’s will. It’s risky even to discuss methadone – advocates can be accused of „pro-drugs propaganda“ and taken to court.

„There is no logical reason behind Russia’s opposition to substitution therapy,“ says Anya Sarang, a campaigner who advocates the introduction of methadone. „I’ve been fighting this battle for 12 years and I don’t understand the mentality at all. The scientific evidence is all there to prove that it works.“

Ms Sarang and a group of Western academics published a study in the British Medical Journal last year which found that the widespread introduction of substitution therapy could cut rates of HIV transmission in Russia by up to 55 per cent. Estimates vary, but it’s thought that more than two million Russians inject heroin and the drug causes 30,000 deaths per years, as well as tens of thousands of new HIV cases. Russia is located on the transit route for drugs from Afghanistan to Europe and cheap heroin is readily available – a dose of heroin on the streets costs about 600 roubles (£12). If methadone therapy is not available, activists say programmes that offer addicts clean needles and syringes to avoid HIV transmission are essential.

The government, however, is adamant that only aggressive punitive measures can work to tackle drug use. Needle-exchange programmes funded by foreign donors have been discontinued in recent years, leading many addicts to share injecting equipment.
While there is some discussion about whether needle exchanges should be reintroduced, methadone is completely taboo. Leading Russian drugs specialists denounce substitution therapy as a failed Western imposition and see it as a „legalisation“ of drug use.

„We have no evidence from the international community that methadone is effective,“ said the Health minister, Tatyana Golikova, this week, reiterating a long-held government policy.
Others go further. Evgeny Roizman is a former Russian MP from the city of Yekaterinburg in the Ural mountains. He runs a series of clinics there where drug addicts go cold turkey, without methadone or any other drugs to ease the withdrawal symptoms.

He insists that methadone advocates are simply being disingenuous. „These people will say anything to get Western funding,“ says Mr Roizman. „I have worked with drug addicts for years, and I can tell you: methadone doesn’t work.“

He wants to bring in a range of policies, including harsher penalties for drug dealers and compulsory drugs testing in all Russian schools and colleges. „We need forced treatment for drug addicts,“ he says. „We need to force them into special institutions where there are no drugs and where they can be treated. This is the answer, not methadone.“

Last year, a disciple of Mr Roizman was sentenced to three-and-a-half years in prison for kidnapping drug addicts. Yegor Bychkov said addicts‘ parents had given him permission to „cure“ their children. „Patients were tortured, chained up to steel beds, starved,“ says Ms Sarang. „It was absolutely outrageous and when the court case against him started, we thought there would be a scandal.“

But a huge wave of support for Mr Bychkov swept through the country. Even many from Russia’s beleaguered human rights community joined with church figures and government officials to condemn his trial and in the end the court suspended his sentence and he was released. Mr Bychkov was „overenthusiastic“, said Mr Roizman, but his heart was in the right place.
Ms Teplinskaya, who is still a heroin user, travelled to Moscow last week to meet Navi Pillay, the UN High Commissioner for Human Rights, and ask her to press the Russian government on substation therapy. „I think I could have done a lot of good things for my country,“ she said. „But instead, I’ve lost my home, my health and my family. Methadone could have helped me lead a normal life.“

But her opponents are confident their views will prevail. Mr Roizman says: „They can shout as much as they want with their Western money. Methadone will never be legal in Russia.“

source:http://www.independent.co.uk/news/wo…t-2220673.html

Advertisements

Ron Price needs his milkshake. It’s 10 o’clock on a Monday morning and the bald-headed, barrel-chested former bodybuilder is shuffling around the kitchen of a posh rehab clinic in Tijuana, wearing slippers and a blue Gold’s Gym T-shirt. Price had been employed as a stockbroker in New Mexico, until his training regimen left him with debilitating injuries that forced him to undergo 33 surgeries in less than a decade. His doctor prescribed Oxycontin, and Price quickly became dependent on the potent painkiller. More recently, he started snorting cocaine and chugging booze to numb the pain. Now, 53 years old and three weeks into rehab, all he wants is a milkshake and to crawl back into bed.

Clare Wilkins, the vivacious 40-year-old director of Pangea Biomedics, pops the lid of the blender to check the consistency of the concoction Price craves: peanut butter, soy milk, agave syrup, hemp protein powder, and a few scoops of chocolate-flavored Green SuperFood.

Oh, and a half-teaspoon of root bark from the tabernanthe iboga plant.

Taken in sufficient quantity, the substance triggers a psychedelic experience that users say is more intense than LSD or psilocybin mushrooms. Practitioners of the Bwiti religion in the West African nation of Gabon use iboga root bark as a sacrament to induce visions in tribal ceremonies, similar to the way natives of South and Central America use ayahuasca and peyote. Wilkins is one of a few dozen therapists worldwide who specialize in the use of iboga (more specifically, a potent extract called ibogaine) to treat drug addiction.

Now she pours the thick, chocolatey liquid into a mason jar but agrees to hand it over to Price only on the condition that he’ll stay awake and out of bed and interact with his fellow residents and the staff. Price grudgingly agrees and takes a seat at the dining-room table. Sunlight pours in through a sliding-glass door that opens to a terrace with a sweeping view of the Pacific Ocean and the San Diego skyline in the distance.

„Ron, I remember when you called me [three weeks ago], you were crying on the phone. You were so devastated, you couldn’t leave the house,“ Wilkins says gently. „When you use, you end up alone in a bathroom or something. You need a community. As weird and misfits as we are, we need this sense of community. You need to learn to deal with being in your body each day instead of relying on the fucking ibogaine.”

Ibogaine and iboga root bark are illegal in the United States but unregulated in many countries, including Canada and Mexico. Wilkins, though, is hardly alone in her belief that iboga-based substances can be used as a legitimate treatment for drug addiction. Researchers at respected institutions have conducted experiments and ended up with hard evidence that the compound works—as long as you don’t mind the mindfuck.

„All drugs have side effects, but ibogaine is unique for the severity of its side effects,“ says Dorit Ron, a neurology professor at the University of California–San Francisco. „I think ibogaine is a nasty drug. But if you can disassociate the side effects from the good effects, there is a mechanism of action in ibogaine that reduces relapse in humans.“

Now, using chemical variations, scientists have devised ways to make ibogaine non-hallucinogenic. The trouble, say Wilkins and others who have used ibogaine, is that the psychedelic journey carries the secret to the drug’s success.

It was Hunter S. Thompson who introduced ibogaine to a wide audience, in the pages of Rolling Stone. Thompson was covering the 1972 presidential election, reporting what would eventually become Fear and Loathing on the Campaign Trail ’72. When Democratic contender Edmund Muskie acted strangely during a campaign stop in Florida, Thompson suggested that the candidate was taking ibogaine, „an exotic brand of speed“ that „nobody in the press corps had ever heard of.“

„It is entirely conceivable—given the known effects of ibogaine—that Muskie’s brain was almost paralyzed by hallucinations,“ Thompson wrote. „He looked out at that crowd and saw gila monsters instead of people . . . his mind snapped completely when he felt something large and apparently vicious clawing at his legs.“

The notion of Ed Muskie on an ibogaine bender was absurd, and Thompson knew it. Most experienced users say the drug is extremely unpleasant when ingested in large doses, causing severe nausea, vertigo, sleeplessness, and visions that can be nightmarish. The effects last up to 36 hours, and the strain can be so great that some users are bedridden for days after.

„I only took one capsule of extract. It was very weak, but it was still strong enough to make me puke for six hours,“ says Dana Beal, a New York–based activist and longtime lobbyist for ibogaine legalization. „I had my head in a wastebasket or sink or toilet the entire time. It’s aversive. I can tell you from personal experience that I don’t ever want to take it again.“

While Hunter Thompson brought ibogaine into popular parlance, credit for discovering the drug’s medicinal potential is widely attributed to a man named Howard Lotsof. Ten years before the events that gave rise to Fear and Loathing, Lotsof was a junkie living in New York. Having bought some ibogaine for recreational use, Lotsof was astounded to find that when the hallucinogen wore off, he no longer craved heroin. Days passed, and he didn’t experience any of the excruciating symptoms associated with kicking a dope habit.

Lotsof, who died earlier this year of liver cancer at age 66, devoted his life to making ibogaine available as an addiction treatment. He experienced a significant setback in 1967, when the U.S. government banned the drug, along with several other psychedelics. In 1970 officials categorized ibogaine as a Schedule I substance—on par with heroin, marijuana, and other drugs that by definition have „a high potential for abuse“ and „no currently accepted medical use.“

Eventually, Lotsof shifted his focus and began using ibogaine to treat heroin addicts at a rehab clinic in the Netherlands. In 1985, he obtained a U.S. patent for the use of ibogaine to treat substance abuse.

Longtime Yippie activist Dana Beal was charged with money laundering after police caught him carrying $150,000 in cash. He says the money was going to finance a Mexican ibogaine clinic.
Tom Kingsley Brown, a researcher from the University of California–San Diego, is studying whether ibogaine works long-term to quell addiction.

By the late ’80s, doctors and scientists were confirming what Lotsof knew: Ibogaine blocks cravings and withdrawal symptoms for many types of drugs, and opiates in particular.

„Its effects are pretty dramatic,“ says Dr. Kenneth Alper, an associate professor of psychiatry at New York University who specializes in addiction research. „I’ve observed this firsthand, and it’s difficult to account for.“

Dr. Stanley Glick, a pharmacologist and neuroscientist at Albany Medical College, was among the first researchers to test ibogaine on rats. Glick hooked up the rodents to IVs in cages with levers that allowed them to inject themselves with morphine.

“If the rats do it, you can be pretty sure that humans will abuse it if given the opportunity,” Glick explains. “It’s really the time-tested model of any human behavior.”

Strung-out rats dosed with ibogaine stopped pressing the lever that gave them morphine. Glick and other researchers have subsequently replicated the morphine results with other addictive drugs, including alcohol, nicotine, cocaine, and methamphetamine.In the early 1990s, Lotsof teamed with Dr. Deborah Mash, a neurologist and pharmacologist at the University of Miami, to study the effect of ibogaine on people. Mash was granted FDA approval to administer ibogaine in 1993 and was able to test the drug on eight people before the experiment came to an abrupt halt.

„I was unable to get it funded,“ Mash says. „We had the rocket ship on the launch pad, with no fuel.“

A few months after the FDA gave Mash the green light, a committee of academics and pharmaceutical-industry professionals assembled by the National Institute on Drug Abuse (NIDA) concluded that the U.S. government should not fund ibogaine research. Earlier that year, a researcher from Johns Hopkins University had found that rats injected with massive doses of ibogaine suffered irreparable damage to the cerebellum, the part of the brain that controls balance and motor skills. According to Dr. Frank Vocci, former director of treatment research and development at NIDA, the fact that ibogaine increases the risk of seizures for people addicted to alcohol or benzodiazepines such as Valium raised eyebrows as well.

„The question that was posed to them was, ‚Do you think that this could be a project that could result in, essentially, a marketable product?‘ “ Vocci recalls. „There was concern about brain damage, seizures, and heart rate. But it wasn’t so much that the ultimate safety of the drug was being damned, it was just felt that there were an awful lot of warts on this thing.“

Mash and Lotsof soon parted ways, on unfriendly terms. Lotsof sued his former colleague and the University of Miami in federal court in 1996, claiming that her research had infringed on his patent. A judge eventually ruled in favor of Mash and her employer, absolving them of wrongdoing.

Lotsof went his own way, mentoring fellow former addicts who opened ibogaine rehab centers abroad. Mash opened a private clinic on the Caribbean island of St. Kitts and administered ibogaine to nearly 300 addicts. „It really works,“ Mash says now. „If it didn’t work, I would have told the world it doesn’t work. I would have debunked it, and I would have been the most outspoken leader of the pack. That’s my scientific and professional credibility on the line.“

Clare Wilkins is one of Howard Lotsof’s protégés. Born in South Africa and raised in Los Angeles, she got hooked on heroin at the age of 20 while majoring in Latin American studies and psychology at Cornell University. Drug use led to depression and she dropped out her senior year. She’d been trying to get clean using methadone for eight and a half years when her younger sister learned about ibogaine via the Internet. Wilkins, then 30 years old and employed as bookkeeper, read up on the subject, started saving up, and in 2005 shelled out $3,200 for a session at the Ibogaine Association, a clinic in Tijuana.

The trip—in both senses of the word—changed her life.

„I received a direct message that I was washed in love,“ Wilkins says of her first encounter with the hallucinogen. „That the universe in its entirety is full of love and that courses through us and was there for me. There was this soul body, this light body that had no beginning and no end. My fingers had no end, there were atoms coming in and going out.

„It got me off methadone completely,“ she says. „My sense of shame about my addiction was washed away without having to practice with a therapist and talk, talk, talk.“

The experience was so profound that she elected to stay on at the clinic as a volunteer. Confident and chatty, with long brown curls and a disarming smile, Wilkins feels she has a knack for guiding patients through their ibogaine-induced spiritual awakenings.

„On ibogaine, all your walls come down,“ she says. „You can’t lie. You get an opportunity to look at yourself honestly and see how you respond. My role is to be there as a comfort. People compliment me by saying, “You knew exactly when to hold my hand.‘ ”

Clare Wilkins is director of Pangea Biomedics, a rehab clinic in Tijuana's Playas neighborhood that administers ibogaine to drug addicts. 

Keegan Hamilton
Clare Wilkins is director of Pangea Biomedics, a rehab clinic in Tijuana’s Playas neighborhood that administers ibogaine to drug addict

Bill Boulanger, CEO of Obiter Research, holds a few grams of 18-MC (18-methoxycoronaridine), a synthetic ibogaine derivative that he believes can cure drug addiction.

In 2006 Ibogaine Association director Martin Polanco offered Wilkins a full-time job. She’d heard rumors that he was considering selling the clinic in the coming year, and on a whim she offered to buy the operation from him outright.

„It was one of those ‚Can I put that back in my mouth?‘ moments,“ Wilkins recounts with a laugh. „I didn’t have the money, I didn’t even have a car.“

Wilkins borrowed $3,000 from her mother for a down payment, changed the clinic’s name to Pangea Biomedics, and made monthly payments to Polanco for the next year and a half.

Having paid off the $65,000 debt, Wilkins’s first order of business was to relocate. Tijuana residents—and rehab clinics in particular—have been terrorized during Mexico’s ongoing drug war. Late last month, gunmen stormed a clinic and murdered 13 people, execution-style. (The mayhem wasn’t random; drug gangs operate such facilities as safe havens for their foot soldiers.) Wilkins’s primary concern, however, was noisy neighbors in the duplex, not narco-violence.

„We’d hear cell phones ring through the wall, and ranchero music—you’d hear everything,“ she recalls. „You’d try to go into a guided meditation and hear someone hammering a nail.“

Wilkins now rents a lavish four-bedroom home on a hill overlooking Tijuana’s upscale Playas neighborhood. Amenities include a hot tub, weight room, fireplace, and veranda with panoramic views. Safety was not overlooked: The subdivision is gated, and security guards inspect every vehicle that enters.

Stays at Pangea aren’t cheap. For the standard 10-day detox, Wilkins charges $7,500, travel not included. She employs a staff of 10, including two Mexican physicians, a paramedic, a masseuse/acupuncturist, and a chef. The chef, Wilkins’s sister, Sarah, is a recovering addict who credits ibogaine for kicking her drug dependence.

Aaron Aurand, a live-in volunteer, feels the same way.

„I did eight months of court-ordered inpatient treatment before I came here,“ says Aurand, a native of Spokane, Washington. „I got more therapy here in five days than I did in that entire time. Lots of junkies don’t want to look inside themselves. With this, you’ll get shown.“

In addition to ibogaine, Clare Wilkins emphasizes nutrition. The clinic’s pantry is mostly organic and gluten-free and boasts a cache of vitamins and supplements that patients gobble by the handful.

“The body has its own framework and can heal itself if you remove harmful substances and balance the systems. We do colon cleanses and liver cleanses even before they get the ibogaine,” Wilkins explains, pointing out that there are practical reasons for the former: “You get people who come in here—especially opiate addicts—who are clogged up.”

To date, Wilkins says, she has treated more than 300 patients. „Sixty-two percent of our clients are chronic-pain patients,“ she says. „You’re not talking IV [heroin] addicts or crack addicts. You’re talking grandmas on Oxycontin.“

Some people come for „psycho-spiritual“ purposes. Ken Wells, an environmental consultant from Santa Rosa, California, with a neatly trimmed gray mustache and wire-frame glasses, says he underwent conventional counseling for depression for 15 years before trying ibogaine as a last-ditch effort to save his crumbling marriage.

Three days after taking ibogaine for the first time, Wells compares the experience to „defragging a computer hard drive.“ He experimented with psychedelics decades ago in college but says ibogaine is like nothing else.

„It was outrageously powerful,“ Wells says. „It was like the inside of my eyeballs was an IMAX screen. It was all-encompassing, just a multitude of images, like 80,000 different TVs, all with a different channel on—just jillions of images, shapes, and colors.“

Did the experience help him find what he was looking for?

„I think I’m different,“ he says. „But I don’t know.“

It’s easier to track ibogaine’s effect on hardcore addicts. Wilkins, who keeps tabs on former clients, estimates that one out of every five stays off his or her „primary substance“ for six months or more.

Tom Kingsley Brown, an anthropologist at the University of California–San Diego who describes his area of study as „religious conversion and altered states of consciousness,“ recently began recruiting Pangea patients for an independent assessment of ibogaine’s long-term efficacy. Brown follows up monthly with opiate addicts during the year regarding their ibogaine treatment, to gauge whether their quality of life has improved.

„People I’ve interviewed at the clinic have had really good results, especially in the first month or so,“ reports Brown, who has enrolled four study subjects to date and hopes for a group of 30. „We know ibogaine interrupts the addiction in the short term, but what we’re really curious about is: Does that translate into long-term relief from drug dependence?“

Participants in Brown’s study fill out questionnaires that ask them to rate the intensity of different aspects of their trips, on a scale of one to five.

„People have been circling a lot of fours and fives,“ Brown says. „One of the things we’re trying to look at is if the intensity of the ibogaine experience correlates with treatment success. I strongly suspect there’s some sort of psychological component. I doubt it’s just a biological phenomenon.“

.

„The hallucinations are just an unfortunate side effect,“ Glick asserts, explaining that ibogaine works on the brain like a „hybrid“ of PCP and LSD. „Part of the problem is that when you go through this thing, it’s so profound you’ve got to believe it’s doing something. In part, it’s an attempt by the person who’s undergoing it to make sense of the whole thing.“

Generally speaking, Glick’s research on rats has shown that ibogaine „dampens“ the brain’s so-called reward pathway, reducing the release of neurotransmitters like dopamine, which cause the highs associated with everything from heroin to sugary foods. The compound has also been proven to increase production of GDNF, a type of protein that quells cravings, and to block the brain’s nicotinic receptors, the same spots that are stimulated by tobacco and other addictive substances. In other words, ibogaine doesn’t work in any one particular way or even on one specific part of the brain, and it’s these multiple „mechanisms of action,“ researchers say, that make it so effective for so many different types of addiction.

People who have taken ibogaine say it can have the unintended consequence of temporarily turning them off a substance other than their drug of choice. Lauren Wertheim traveled from her hometown of Omaha, Nebraska, to a rehab center called Awakening in the Dream House near Puerto Vallarta, Mexico, and used ibogaine to kick her meth habit.

„Ibogaine resets all your [tolerance] levels to zero, like you’ve never done drugs,“ she says. „Even coffee—the first cup set me off like a rocket launcher. That’s when I was like, ‚This stuff is for real.‘ “

Mash, the researcher from Miami, is convinced that ibogaine works long-term because it is stored in fat cells and processed by the liver into a metabolite called noribogaine that possesses powerful detoxifying and antidepressant properties.

„If you gave somebody LSD or psilocybin and they were coming off opiates or meth, they’d go right back out and shoot up,“ Mash says. „There’s evidence that it’s not the visions that get you drug-free; it is the ability of the metabolite to block the craving and block the signs and symptoms of opiate withdrawal and improve mood.“

Though they don’t question its effectiveness, both Mash and Glick believe it’s unlikely that ibogaine will ever be widely accepted in the United States. It’s not just that ibogaine makes people hallucinate. It can be fatal.

Since 1991, at least 19 people have died during or shortly after undergoing ibogaine therapy. Alper, the NYU professor, examined the causes of death in the fatalities, which occurred between 1991 and 2008. His findings suggest that ibogaine itself was not the culprit; the patients died because they had heart problems or combined the hallucinogen with their drug of choice. (By way of comparison, a study published last year by the Centers for Disease Control and Prevention found that between 1999 and 2006 more than 4,600 people in the United States died from overdoses involving methadone.)

„It’s knowing who to treat and who not to treat,“ Alper contends. „None of [the 19 fatalities] appear to have involved a healthy individual without pre-existing disease who didn’t use other drugs during treatment. Two deaths occurred when they took ibogaine in crude alkaloid or root-bark form—they didn’t know what they were taking or how much.“

Three of the deaths occurred at Clare Wilkins’s Tijuana clinic. She says two involved patients who had cocaine in their systems and the third victim had a pre-existing heart condition. Wilkins says she’s now more selective about her clients and requires that they undergo a drug test.

„The learning curve has been difficult at times, but people need to know this can be safe,“ Wilkins says. „We have to show people how far we’ve come.“

Some of the scientists, however, think they’ve found alternatives that will make the risks—and the tripping—associated with ibogaine unnecessary.

Mash has devised two ways to isolate the metabolite noribogaine and administer it: a pill, and a patch similar to the nicotine variety. She hopes to begin testing the products on humans by the end of this year.

„It has all the benefits without the adverse side effects—including no hallucinations,“ Mash says. „I spent a lot of years really pushing ibogaine as far as I could, both in preclinical and clinical studies. But everything that I’ve learned in the course of 18 years of working on ibogaine has convinced me that the active metabolite is the drug to be developed.“

Glick, meanwhile, teamed up with a chemist named Martin Kuehne from the University of Vermont to create and research a chemical called 18-MC (short for 18-methoxycoronaridine) that mimics ibogaine’s effect on a specific nicotinic receptor. Just like ibogaine, 18-MC appears to work wonders on drug-addicted rats.

„Cocaine, meth, nicotine, morphine—we did the same studies with 18-MC, and it worked as well or better than ibogaine,“ Glick says. „We also have data that it will be useful in treating obesity. In animals, it blocks their intake of sweet and fatty foods without affecting their nutrient intake.“

Glick and his cohorts have yet to determine whether their synthetic ibogaine has psychedelic properties. The rats, after all, aren’t talking.

„You look at an animal given ibogaine, and you can’t tell if they’re hallucinating. But they look positively strange,“ Glick says. „You give them 18-MC and you can’t really tell. But we hope when it gets to people, it won’t produce hallucinatory effects.“

The first human testing of 18-MC is scheduled to begin later this month in Brazil. But scientists there won’t be studying its effect on addiction. They’ll be investigating the drug’s potential as a cure for the parasitic infection leishmaniasis, an affliction similar to malaria that is common in tropical climates. Through pure coincidence, 18-MC is chemically similar to other drugs that are used to treat the disease.

The Americans jumped at the chance to test their product in South America. Although 18-MC has shown promise and no observable side effects in animals, not a single pharmaceutical company has shown interest in developing it as an anti-addiction product.

„We’re fortunate we have this other disease apart from addiction where we know it can be tested,“ says Kuehne, a veteran of big pharma who worked for Ciba (a predecessor of Novartis). „Pharmaceutical companies don’t like cures. Really, they don’t—that’s the sad thing. They like treatment. Something for cholesterol or high blood pressure that you [take] for years and years, every day. That’s where the profit is.“

Further complicating matters is the fact that 18-MC has proven difficult to manufacture. Obiter Research, a company based in Champaign, Illinois, that specializes in synthesizing experimental chemicals, spent nearly two years refining the process before successfully creating about 200 grams of the substance—just enough to send to Brazil to be administered to human subjects.

„Imagine a Tinkertoy Ferris wheel,“ says Bill Boulanger, Obiter’s CEO and a former chemistry professor at the University of Illinois. „It’s like taking that apart, then trying to use half of the parts to build a fire engine. Ibogaine is a natural product, and sometimes Mother Nature does a better job than the lab.“

Boulanger is convinced there’s money to be made from 18-MC. With Obiter, he plans to patent the manufacturing process and secure intellectual-property rights. He and two partners also created a separate company, Savant HWP, in hopes of eventually opening addiction clinics across the United States that administer 18-MC in conjunction with conventional rehab techniques such as 12-step programs.

“One part is resetting the trigger that’s saying, ‚Oh, I’ve got to have it,” Boulanger says. “That’s helping the people fight withdrawal, and that would be part of the whole operation. But it’s just one facet. It’s got to be holistic. Just handing out a pill and sending them on their way is a bad idea.”

The notion of hallucination-free ibogaine, however, rubs the drug’s die-hard supporters the wrong way.

„With methadone, they just removed euphoria from opiates,“ says Dimitri „Mobengo“ Mugianis. „This is the same process they’re doing now—removing psychedelic and visionary experience. Ibogaine works. What are they trying to improve or fix? It’s not broken, and they’re spending a great amount of time and money to fix it.“

A former heroin addict, Mugianis is an underground ibogaine-treatment provider. He kicked his habit with the help of ibogaine administered at Lotsof’s clinic in the Netherlands. The experience was so extraordinary that Mugianis was inspired to travel to Gabon to be initiated into the native Bwiti religion and was trained by local shamans. He says he has performed more than 400 ritualistic ceremonies on addicts, most of them in New York City hotel rooms, using ibogaine and iboga root bark.

Despite his strong belief in the power of ibogaine, Mugianis does not see it as a miracle cure for addiction.

„The 12-step approach really helped in combination with ibogaine,“ he says. „I say it interrupts the physical dependency, because that’s what it does. There’s no cure. It’s not a cure. It allows you a window of opportunity, particularly with opiate users.“

Efforts are afoot to legalize—or at least legitimize—ibogaine in the United States. Convincing doctors and elected officials to support a potent, occasionally lethal hallucinogen can be a tough sell. That pitch becomes doubly difficult when some of the ibogaine enthusiasts themselves inspire skepticism.

One of ibogaine’s most outspoken advocates is Dana Beal. An eccentric character who helped found the Youth International Party (more commonly known as the Yippies) in the 1960s, Beal sports a bushy white mustache that inspired a New York Times reporter to liken him to „a Civil War-era cavalry colonel.“ Beal travels the country giving PowerPoint presentations touting the benefits of ibogaine and medical marijuana.

In June 2008, he was arrested by police in Mattoon, Illinois, and charged with money laundering. He was carrying $150,000 in cash in two duffel bags, money he claims was going to finance an ibogaine clinic and research center in Mexico. Beal maintains his innocence and is free on bail as the case heads to trial.

It’s folks like Beal, says pharmacologist Stanley Glick, who keep ibogaine and 18-MC from being embraced by the medical mainstream.

„Some of my colleagues, as well as funding agencies, lump us together without really considering the data,“ Glick says. „There’s a lot of baggage that comes with ibogaine, some of it warranted, some of it unwarranted. It’s really a stigma. Drug abuse itself has a stigma, and unfortunately so does ibogaine. It has really hurt the science

Beal shrugs off the criticism, arguing that grassroots activism is the only way to ensure that politicians will endorse ibogaine. Besides, he adds, the government stopped funding ibogaine research long before he was arrested.

„[The scientists] think if they stay away from us activists, NIDA will bless them,“ says the self-styled rabble-rouser. „NIDA is not blessing them. They’re washed up and on a strange beach. How will they get FDA-approved clinical trials without activists? Explain to me a way that works, and I will do it.“

Beal jokes that the best advertisement for ibogaine might be an episode from the 11th season of Law & Order: Special Victims Unit in which a heroin addict who needs to testify in court is administered ibogaine to make his withdrawal symptoms disappear overnight. “Maybe Congress will watch SVU and say, ‚Maybe we should check this out—wow!—it works for methamphetamine, too?’” he says sarcastically.

In truth, ibogaine’s effectiveness against meth has already helped it gain acceptance abroad. Lawmakers in New Zealand, where methamphetamine use has skyrocketed in recent years, recently tweaked the nation’s laws to allow physicians to prescribe ibogaine. Dr. Gavin Cape, an addiction specialist at New Zealand’s Dunedin School of Medicine, says the nation’s doctors are so far reluctant to wield their new anti-meth weapon.

„[There are] no true controlled studies to give evidence as to its safety and effectiveness,“ Cape says. „There is a strong advocacy group [in New Zealand] for ibogaine, and it may turn out to have a place alongside conventional therapies for the addictions, but I’m afraid we are a few years away from that goal.“

Last month, dozens of ibogaine researchers, activists, and treatment providers gathered for a conference in Barcelona, where topics included safety and sustainable sourcing of ibogaine from Africa. Dr. Kenneth Alper was among the attendees who gave a presentation on the benefits of ibogaine to the Catalan Ministry of Health. The NYU prof believes ibogaine’s most likely path to prominence in the United States will be as a medication for meth addiction, for the simple reason that doctors and treatment providers have found that small daily—and thus drug-company-friendly—doses seem to work better for meth addiction than the mind-blowing „flood doses“ used on opiate addicts.

Alper says no one thought to try non-hallucinogenic quantities of ibogaine until recently. Ibogaine treatment providers tend to have been former ibogaine users, and most assumed that the introspection brought on by tripping was key to overcoming their addictions. „That’s just how it evolved,“ he says, noting that the large doses do seem to work best for opiate detox. „You’re talking about a drug that has been used in less than 10,000 people in the world in terms of treatment. It’s not surprising that’s how it evolved.“

„The visions have some psychological content that is salient and meaningful,“ Alper adds. „On the other hand, there is no successful treatment for addiction that’s not interpreted as a spiritual transformation by the people who use it. It’s the G-word. It’s God. We as physicians don’t venture into that territory, but most people do.“

source: http://www.villagevoice.com/2010-11-17/news/ibogaine-hallucingen-heroin/6/

Researchers say ayahuasca, found in the Peruvian rainforest, could be used for a variety of ailments

New research suggests ayahuasca, a jungle vine found in the Peruvian rainforest, can have a powerful effect on the human central nervous system when brewed with other plants. Researchers say one of ayahuasca’s most promising uses could be in treating drug and alcohol addiction.

According to the World Health Organization, medicines derived from plants play a major role in the health care of 80 percent of the world’s population. Western medicine has synthesized many of these natural drugs, from the painkillers in willow bark to the anti-cancer compounds in the neem tree, and is constantly searching for more pharmaceuticals in the biodiversity of the world’s forests.

Ayahuasca is one traditional plant-based medicine that has drawn the attention of investigators. In the South American jungles, it is used in religious ceremonies to induce visions and also as a remedy to cure ills.

Vine of the dead could help improve life

At the Onanyan Shobo spiritual retreat center in the rainforest near Iquitos, Peru, shaman Alfredo Kayruna Canayo shows off a section of the twisting, leafy vine. „What ayahuasca means is vine of the dead,“ he explains through an interpreter. „Some people call it soul vine.“

Ayahuasca is known as a master plant, a very powerful remedy that treats the whole person: body, mind, and soul. „The ayahuasca [can] cure anything you have,“ the shaman says. „Start with simple things. For example, it’s very simple to cure or repel the bad energies from your insides. What is the bad energy? One of them could be the fears, then some wound or injury you have.“

VOA – E. Celeste

Shaman Alfredo heads for a treatment at Onanyan Shobo.

Whether the plant is being used for religious or medicinal purposes, ayahuasca is taken only in a ceremonial setting under the direction of an experienced shaman. To turn it into a drink, also called ayahuasca, pieces of the vine are pounded into a pulp and combined with several other plants, then brewed down for eight or more hours into a thick orange liquid.

That combination, shaman Alfredo says, is critical. „Only by itself, this plant doesn’t work good, you have to add this with the other plant – the chacruna – which is the help to the ayahuasca. In Shipibo culture, they believe the chacruna is the wife of ayahuasca because they help and work together.“

A sophisticated chemical concoction

An international research team is investigating the pharmaceutical potential of ayahuasca, known scientifically as Banisteriopsis caapi. Principal investigator, Dr. Charles Grob, is a professor of psychiatry and pediatrics at the UCLA School of Medicine. His team has done a chemical analysis of the medicinal drink.

VOA – E. Celeste

Pieces of the vine are pounded into a pulp and combined with several other plants, then brewed down for eight or more hours into a thick orange liquid.

While the shaman’s characterization of the herbal interaction may be whimsical, Grob says science confirms that the ayahuasca brew is a potent medication. „It’s a very sophisticated form of pharmacology, which somehow the native peoples of the Amazon region have figured out. Ayahuasca is generally a decoction of two plants. Each plant if taken separately has no effects on the human central nervous system, but when taken together there’s a very powerful synergy.“

The active ingredients in the brew are DMT, a naturally occurring brain chemical similar to serotonin, and a natural antidepressant. DMT is inactivated in the human gut, but when combined with the antidepressant, it can be absorbed by the body.

Grob says one of ayahuasca’s most promising uses is in treating drug and alcohol addiction. „Number one, it does not appear to be addictive and the individuals do not develop a tolerance, they do not go through withdrawals, and generally speaking, it is very unusual for people to take it on consecutive days over an extended period of time.“

The potion also has anti-parasitic properties, which can help prevent malaria. There is also some evidence that it diminishes the symptoms of Parkinson’s disease.

An illegal brew, for now

The U.S. Food and Drug Administration classifies the principal active ingredient in ayahuasca as a Schedule 1 controlled substance, which is not considered to have any legitimate medical use. As a result, the ayahuasca brew is illegal in the United States, and most of the pharmaceutical studies are being conducted in South America.

Grob says the studies are important. „There’s great potential to learn about the range of ayahuasca and to explore its therapeutic value, but first steps first, and I think first we need to fully understand how it’s utilized in South America and then do trials in the U.S. and Europe.“

VOA – E. Celeste

Retreats like Onanynan Shobo in the Peruvian jungle, have become popular destinations for the medical tourism industry.

Because many Shamans claim ayahuasca cures a variety of cancers, tumors, and other diseases, the Peruvian jungle has become a popular destination for the medical tourism industry.

Most of the visitors at Onanynan Shobo, where Shaman Alfredo practices, are European, with the remainder coming from the United States, Australia and Asia.

As long as its use in western medicine is illegal, anyone wishing to explore ayahuasca’s medical benefits will have to come to the source in South America.

Addictive drugs can profoundly affect social behaviour both acutely and in the long-term. Effects range from the artificial
sociability imbued by various intoxicating agents to the depressed and socially withdrawn state frequently observed in chronic
drug users. Understanding such effects is of great potential significance in addiction neurobiology. In this review we focus on
the ‘social neuropeptide’ oxytocin and its possible role in acute and long-term effects of commonly used drugs.

Oxytocin regulates social affiliation and social recognition in many species and modulates anxiety, mood and aggression. Recent
evidence suggests that popular party drugs such as MDMA and gamma-hydroxybutyrate (GHB) may preferentially activate
brain oxytocin systems to produce their characteristic prosocial and prosexual effects. Oxytocin interacts with the mesolimbic
dopamine system to facilitate sexual and social behaviour, and this oxytocin-dopamine interaction may also influence the
acquisition and expression of drug-seeking behaviour. An increasing body of evidence from animal models suggests that even
brief exposure to drugs such as MDMA, cannabinoids, methamphetamine and phencyclidine can cause long lasting deficits in
social behaviour. We discuss preliminary evidence that these adverse effects may reflect long-term neuroadaptations in brain
oxytocin systems. Laboratory studies and preliminary clinical studies also indicate that raising brain oxytocin levels may
ameliorate acute drug withdrawal symptoms. It is concluded that oxytocin may play an important, yet largely unexplored, role
in drug addiction. Greater understanding of this role may ultimately lead to novel therapeutics for addiction that can improve
mood and facilitate the recovery of persons with drug use disorders.
British Journal of Pharmacology (2008) 154, 358–368; doi:10.1038/bjp.2008.132

Continue reading here: From_ultrasocial_to_antisocial_a_role_for_oxytocin_in_the_acute_reinforcing_effects_and_long-term_adverse_consequences_of_drug_use

PORTO, Portugal—This country’s move to decriminalize illicit substances—Europe’s most liberal drug legislation—turns 10 years old this month amid new scrutiny and plaudits.

Portugal’s decriminalization regime has caught the eye of regulators in Europe and beyond since it was implemented in 2001. Proponents credit the program for stanching one of Europe’s worst drug epidemics. Critics associate it with higher crime and murder rates. Approaching a decade in force, it is providing a real-world model of one way to address an issue that is a social and economic drag on countries world-wide.

Norway’s government formed a committee to look at better strategies for dealing with drug abuse and sent two delegates to Portugal in early May. Danish politicians have also talked of moving toward full decriminalization. In March, Danish parliamentarian Mette Frederiksen of the opposition Social Democrats praised the Portuguese model.

„For us, this is about the addicts leading a more dignified life,“ she told Danish daily Berlingske. „We want to lower the death rates, the secondary symptoms and the criminality, so we look keenly to Portugal.“

Markel Redondo for The Wall Street JournalA patient takes her methadone dose at a Porto rebab center that is part of Portugal’s decadelong experiment with drug decriminalization.

PORTDRUG

PORTDRUG

Decriminalization has been criticized by United Nations bodies. In its 2009 annual report, the International Narcotics Control Board expressed „concern“ over approaches that decriminalize drugs or introduce alternative treatments. „The movement poses a threat to the coherence and effectiveness of the international drug-control system and sends the wrong message to the general public,“ the board wrote.

In July 2000, Portugal moved beyond previous liberalization regimes in places like the Netherlands by passing a law that transformed drug possession from a matter for the courts to one of public and community health. Trafficking remained a criminal offense but the government did away with arrests, courts and jail time for people carrying a personal supply of anything from marijuana to cocaine to heroin. It established a commission to encourage casual users to quit and backed 78 treatment centers where addicts could seek help.

Portugal’s Fight Against Drugs

About 500 patients from Porto’s Cedofeita rehab center take methodone daily.

In 2008, the last year for which figures are available, more than 40,000 people used the rehab centers and other treatment programs, according to the Institute for Drugs and Drug Addiction, a branch of Portugal’s Ministry of Health. The ministry says it spends about €50 million ($64.5 million) a year on the treatment programs, with €20 million more provided through a charity funded by Portugal’s national lotteries.

Before decriminalization, Portugal was home to an estimated 100,000 problem heroin users, or 1% of the country’s population, says João Goulão, director of the Institute for Drugs and Drug Addiction. By 2008, chronic users for all substances had dropped to about 55,000, he says. The rate of HIV and hepatitis infection among drug users—common health issues associated with needle-sharing—has also fallen since the law’s 2001 rollout.

Portuguese and European Union officials are loath to give publicly funded treatment centers sole credit. They say the drop in problematic drug users could also be attributed to heroin’s declining popularity in Portugal and the rising popularity of cocaine and synthetic drugs among young people.

At the same time, Portugal’s drug-mortality rate, among Europe’s lowest, has risen. Mr. Goulão says this is due in part to improved methods of collecting statistics, but the number of drug-related fatalities can also be traced to mortality among those who became addicted to heroin during the country’s 1980s and 1990s epidemic.

Violent crime, too, has risen since the law’s passage. According to a 2009 report by the U.N. Office on Drugs and Crime, Portugal’s drug-use and murder rates rose in the years after decriminalization. The general rise in drug use was in keeping with European trends, but the U.N. noted with some alarm that cocaine use doubled and cocaine seizures jumped sevenfold from 2001 to 2006.

Murders rose 40% in the period. The report tentatively links that with drug trafficking, but points out overall murder rates in Portugal remain low.

Pedro do Carmo, deputy national director of Portugal’s judiciary police, says he doesn’t see link the rise in violent crime with decriminalization. Instead, he praises the program for reducing the fear and stigma attached with drug use. „Now, when we pick up an addict, we’re not picking up a criminal,“ he says. „They are more like victims.“

The Portuguese began considering drug decriminalization following a leap in heroin addiction decades ago in the country, a major entry point for drug trafficking from Latin America and North Africa.

The then-ruling Socialist Party government of Prime Minister António Guterres launched a political debate to discuss how to resolve the problem. Members of the right-wing People’s Party decried any tolerance for drug use, saying it would invite drug tourism.

Mr. Guterres’s government pushed through a full decriminalization law. A subsequent center-right coalition led by José Manuel Barroso, now president of the European Commission, didn’t repeal it.

The legislation was the first in a series of liberal policy shifts in this predominantly Roman Catholic country. In May, President Aníbal Cavaco Silva ratified a law allowing same-sex marriage, making it the sixth European country to do so. In 2007, Portugal went from having among the toughest restrictions on abortion to among the most liberal.

Portugal’s focus on close-knit community and protecting the family may be at the heart of many of these reforms, say some observers. In a 1999 report that paved the way for new drug legislation, current Portuguese Prime Minister José Sócrates implored that „drugs are not a problem for other people, for other families, for other people’s children.“

Portugal’s rehab clinics, called Centros de Atendimento de Toxicodependentes, are central to the strategy. In the lively northern port city of Porto, dozens of patients pop in daily to the Cedofeita rehab center to pick up free doses of methadone. Others have scheduled therapy or family counseling sessions, also free.

„The more they can be integrated in their families and their jobs, the better their chances of success,“ says José González, a psychiatrist at Cedofeita. Mr. González says that about half of his 1,500 patients are in substitution treatment, 500 of which take methadone daily. He says there is no defined model or timeline for treatment.

The European Monitoring Centre for Drugs and Drug Addiction, a Lisbon-based European Union agency, says methadone or other substance-substitution programs are generally viewed as successful but has observed that some Portuguese are beginning to question long-term methadone therapy.

„Now that the epidemic is under control for the most part, people start asking questions,“ says Dagmar Hedrich, a senior scientific analyst with the EMCDDA. „The question now is what is going to happen next? There is a part of the population who do not have the possibility of leaving the treatment.“

Prescribing heroin to addicts who can’t kick their habit helps them stay off street drugs, British researchers said Friday.

So far, doctors have had little hope of treating the 10 percent or more of heroin users who don’t respond to methadone, the standard anti-addiction medication. Fueled by drug cravings, those users often spiral downward into crime and diseases spread by dirty needles and unhealthy living.

Short of actually getting addicts off the drug, „heroin clinics“ can at least get them off the streets.

„What we are dealing with here is a very severe group of heroin addicts, where all of the treatments have been tried and have failed,“ said Dr. John Strang, an addiction expert at King’s College London, who led the new study.

„They are like oil tankers heading for disaster,“ he added. „The question we were asking was, ‚Can we change the trajectory of these tankers?‘ And the answer was, ‚Yes we can.'“

To test how prescription heroin would work for this group, Strang and his colleagues invited 127 addicts into supervised injecting clinics. The researchers then randomly chose who would get heroin, injected methadone or typical swallowed methadone.

After six months, 101 addicts had stuck with their treatment. More than two-thirds of those on heroin had no sign of street heroin in their urine at least half the time they were tested; before the study, they had been using the street drug almost every day.

In comparison, less than a third of the addicts on either type of methadone had a similar number of „clean“ tests.

At this point, said Strang, several users have continued in the program for more than two years. He did not have exact numbers, but told Reuters Health that some had been able to get jobs and reconnect with their families.

„These sorts of changes are typical of what we are seeing,“ he said. „People are not only physically getting better, but they’re getting back into society.“

The researchers had to treat about two addicts for each one who get off of street drugs at least half of the time.

An estimated 3.7 million people in the US have used heroin at some point in their lives, according to the National Institute on Drug Abuse. Of current users, studies suggest that some 200,000 spend time in jails each year.

The most common drug treatment for heroin users is methadone, a synthetic drug related to heroin. Although methadone decreases the cravings for its chemical cousin, it doesn’t produce the same high, according to experts. This could help explain why a substantial proportion of addicts in treatment backslide.

Before the new study, a handful of other reports had indicated that prescription heroin could help these people. But the scientific community wasn’t completely convinced, in part because earlier urine tests weren’t very sophisticated.

„What this study did is that it used a very novel urine test that can differentiate between street heroin and prescription heroin,“ said Thomas Kerr, director of the Urban Health Research Initiative at the University of British Columbia in Vancouver, Canada. Street heroin contains papaverine, a remnant of the opium poppy that can be detected in the urine.

Now, he said, „the evidence is quite clear that there is a place for prescription heroin for the treatment of individuals who do not respond to methadone.“

Only a few European countries prescribe heroin to addicts, and in the US this practice has been illegal since before World War I.

Many argue that giving addicts more of the substance they abuse makes little sense, and would be like treating an alcoholic with whiskey. But Kerr said that analogy wasn’t apt. „I would argue it’s completely immoral and unethical to fail to treat those individuals and to allow them to suffer and allow the community around them to suffer,“ Kerr said. Strang said he supported the UK Government’s 2008 Drug Strategy, which proposes rolling out prescription heroin. „Now that we know that it works, we have to debate whether or not we should use it,“ he said. SOURCE: The Lancet, May 28, 2010. http://www.thelancet.com/

Very few studies have considered heroin users’ views on substitute prescribing, in
particular with regards to subutex. The aim of this study was to conduct detailed
qualitative analysis, using the Grounded theory approach, on heroin users’ views on
substitute prescribing, paying specific attention to methadone and subutex. Semistructured
interviews were conducted with nine subjects recruited from an
abstinence-based, structured day care treatment program. All of the subjects were
either currently on a subutex prescribing program, or had remained abstinent from
illicit substances following the completion of a subutex treatment program. Five major
themes emerged from the analysis. These were reasons for obtaining a methadone
prescription, experiences with methadone programs, views on methadone, views on
subutex and views on an ideal opioid treatment program. Most of the findings were
supported by previous qualitative studies such as that of Neale (1999a) and Fischer
and colleagues (2002). However, there does appear to be some discrepancies
between qualitative and quantitative research with regards to consumer satisfaction
of methadone, in comparison to subutex, as a substitute drug. This study clearly
highlights the need for further research into users’ views on substitute prescribing,
with emphasis being placed on qualitative research considering users’ experiences
with subutex.

Read the full File: methadoneversussubutex kopie

MORE THAN TWO THIRDS OF
people with addiction see a
primary care or urgent care
physician every 6 months, and many
others are regularly seen by other medical
specialists.1,2

These physicians are
therefore in a prime position to help patients
who may have drug abuse problems
by recognizing and diagnosing the
addiction, helping to direct patients to
a program that can meet their treatment
needs, and helping to monitor
progress after specialty treatment and
during recovery.3-6

Many physicians,
however, find the domain of drug abuse
particularly daunting and often avoid
the issue with their patients. This is understandable
given the relatively short
shrift drug abuse is given in formal
medical education. There is a widespread
misperception that drug abuse
treatment is not effective, which may
account for the reluctance of physicians
to even broach the subject of drug
abuse or treatment with their patients.
On the other hand, over the past 15
to 20 years, advances in science have
revolutionized our fundamental understanding
of the nature of drug abuse
and addiction and what to do about it.
In addition, there are now extensive
data showing that addiction is eminently
treatable if the treatment is welldelivered
and tailored to the needs of
the particular patient.

There is an array
of both behavioral and pharmacological
treatments that can effectively
reduce drug use, help manage drug
cravings and prevent relapses, and restore
people to productive functioning
in society.7-9
Of course, not all drug abuse treatments
are equally effective, and there
is no single treatment appropriate for
all patients. Fortunately, recent scientific
advances have provided insights
both into the nature of drug abuse and
addiction and into the principles that
characterize the most effective treatment
approaches and programs.10 These
treatment principles should make the
primary care or nonaddiction specialty
care physician’s tasks of screening
and referral much easier.

Read more: 20.03.10

Key findings   11
Operation of the world drugs market   11
Production   11
Consumption   11
Revenues   12
Drug-related problems   13
Policies   13
Policy assessment   15
Conclusions   16
Main report: Assessing changes in global drug problems, 1998-2007 19
Peter Reuter
1. Introduction and methodology   21
2. Markets and quantities   23
2.1 Operation of the markets   23
2.2 Production   25
2.3 Consumption   28
2.4 Revenues 31
3. Drug-related problems 35
3.1 Introduction 35
3.2 Drug-related deaths   35
3.3 HIV   36
3.4 Crime   36
3.5 Economic cost estimates 3  6
4. Policies   39
4.1 Introduction   39
4.2 Prevention   40
4.3 Treatment   40
4.4 Harm reduction   41
4.5 Enforcement   41
5. Policy assessment   45
5.1 Introduction   45
5.2 Unintended consequences   46
5.3 Drug epidemics   47
5.4 Production and trafficking controls   49
5.5 Domestic enforcement  51
5.6 Methodological issues  51
6. Conclusions  53
References   55

Abstracts 59
Report 1 59
The operation of the global drug market
Peter Reuter
Report 2 61
Estimating the size of the global drug market: A demand-side approach
Beau Kilmer
Rosalie Pacula
Report 3 63
Issues in estimating the economic cost of drug abuse in consuming nations
Rosalie Liccardo Pacula
Stijn Hoorens
Beau Kilmer
Peter Reuter
Jim Burgdorf
Priscilia Hunt
Report 4 65
Drugs problem and drug policy, developments between 1998 – 2007
Franz Trautmann
Peter Reuter
André van Gageldonk
Daan van der Gouwe
Report 5 67
The unintended consequences of drug policies
Peter Reuter
Report 6 69
Methodological challenges in the country studies
André van Gageldonk
Peter Reuter
Franz Trautmann

Read more :report_short_10_03_09_en

The National Institute on Drug Abuse (NIDA) supports most of the world’s research on drug abuse and addiction.
NIDA-funded research enables scientists to apply the most advanced techniques available to the study of every aspect of
drug abuse, including:
• genetic and social determinants of vulnerability and response to drugs;
• short- and long-term effects of drugs on the brain, including addiction;
• other health and social impacts of drug abuse, including infectious diseases and economic costs;
• development and testing of medication and behavioral treatments for abuse and addiction; and
• development and evaluation of effective messages to deter young people, in particular, from abusing drugs.
Included in this document are selections of topic-specific articles reprinted from NIDA’s research newsletter,
NIDA Notes. Six times per year, NIDA Notes reports on important highlights from NIDA-sponsored research,
in a format that specialists and lay readers alike can read and put to use. Selections like the current one are intended to remind regular NIDA Notes readers and inform other readers of important research discoveries during the periods they cover.

.A_Collection_of_Articles_That_Address_Heroin_Prevention,_Treatment_and_Research

For those interested in
Iboga/Ibogaine:

Here you can find a collection of Iboga/Ibogaine documentaries. Quite interesting. You need BitTorrent to download it, which is easily found and not hard to install/configure.
The Download Link:Iboga and Ibogaine Collection
(http://thepiratebay.org/torrent/5277688)
that’s whats in it:
A collection of Videos, Literature and Pictures of Iboga, Ibogaine and the Bwiti with a focus on the anti-addictive and healing properties of Ibogaine.

Ibogaine/Iboga has been shown to possibly help treating Addiction (Nicotine, Opioids, Opiates, Crack, Cocaine, Alcohol, Kratom, Methamphetamine, Amphetamine, etc.), Depression, Anxiety and other psychological or psychosomatic diseases as well as to help spiritual seekers.

==================== |||—–Table of Contents—-|||====================

—-|≥___Movies & Videos___≤|—-
+ Movies (7 files):
-Facing the Habit
-Iboga Therapy House
-Ibogaine – Rite of Passage
-Ibogaine Therapy
-One Life – Detox or Die
-The Prince of Pot and Ibogaine Therapy
-Ibogaine – The ENDABUSE Report

+ News Clips (7 files)
+ Scientific/Ethnopharmacologic Videos & Reports (22 files)
+ Testimonies & Experience Reports (31 files)
+ Videos on Bwiti Culture & Iboga Usage (10 files)

—-|≥___Literature___≤|—-
+ eBooks (12 files):
-Ibogaine – Proceedings from the First International Conference
-Alkaloids – Chemistry and Biology of Ibogaine (Chps.11-16)
-Pharmacodynamics and Therapeutic Applications of Iboga and Ibogaine
-Ibogaine Therapy: A Uncontrolled Experiment?
-Breaking Open the Head – Daniel Pinchbeck
-Drug-Abuse Handbook
-Drug Metabolism in Pharmaceuticals
-Fear and Loathing – On The Campaign Trail ’72
-Psychedelics Encyclopedia (3rd Edition) – Stafford, Peter
-Cognitive Behavioural Therapy for Dummies
-Hallucinogenic Plants – A Golden Guide
-Timothy_Leary_-_The_Psychedelic_Experience NOT DIRECTLY IBOGA RELATED

+ Manuals & FAQs Usage and Treatment with Iboga (13 files)
e.g.: -forms and dose regimen
-the big iboga FAQ
-How to make an Extract
-Iboga Therapy Guiding Principles
-Manual for Ibogaine Therapy
-Treatment of Acute Opioid Withdrawal with Ibogaine
-Treatment with for opioids, alcohol, stimulants and benzodiazepines

+ Bwiti Culture & Iboga Usage (8 files)
+ Newspapers and Magazine Articles (33 files)
+ more than 350 Scientific Articles on Iboga, Ibogaine and related
e.g.: -Assessment of neurotoxicity of ibogaine testing and brain imaging
-Derivatves of the ibogaine alkaloids
-Facilitation of Memory Retrieval by the ‚Anti-addictive‘ Alkaloid Ibogaine
-Fatalities after taking ibogaine
-18-Methoxy-Coronaridin-studies (25)
-Patents relating to Ibogaine
-Ibogaine neurotoxicity- a re-evaluation
-Ibogaine therapy – Addictions – New approaches to Treatment
-Life after Ibogaine – An exploratory study of the long-term effects of ibogaine
-Mechanisms of Anntiaddictive Actions of Ibogaine
-The ibogaine medical subculture
-TiHKAL on Ibogaine

The .PDF files have to be opened with Adobe Acrobat (Reader).
You can download it for free here: http://get.adobe.com/reader/

—-|≥___Pictures___≤|—-
+ Ibogaine Related Pictures
+ Ibogaine inspired Art
+ Bwiti/Tribal photographs
+ Iboga (plant & preparation) pictures

Also see the provided .txt files for further Links, Videos, Information etc.
================================================== ================

Enjoy. And please help against the drug slavery that can destroy our society.

Ibogaine treatment can be done safely in an clinical setting, Dr Deborah Mash have safely treated more than 400 persons in her clinic. It is very important to realise that the ibogaine treatment is not for everyone and that the exclusions criteria has to be followed rigorously, like with other very potent medicines in general.

In case you consider doing a treatment, please consult the provided Videos and Literature and do extensive research and spend time thinking about this. THERE ARE DANGERS AND RISKS TO IBOGAINE TREATMENT, but they can be minimized if certain things are paid attention to. Do not treat yourself. Do your research. Do know what you are doing!

This torrent is the 3rd update of the previous torrent „Death drugs and a possible solution“ as well as „IBOGA ebook and video collection about ibogaine“. Please do not continue seeding these, instead seed this new torrent. It features a lot more and up to date articles (till early 2010), more ebooks, more Movies and Videos (especially testimonials) as well as pictures and an update link structure. Also, several files have been reduced in size while keeping the same quality, and the formats have been changed to .avi for better compatibility (no real-player files). Also the filenames and folder-structure has been overhauled for easier use.

PLEASE SEED THIS TORRENT AS LONG AS POSSIBLE.
This torrent may potentially and actually save peoples lifes or change them for the better. No one looses money through this torrent, no Music CDs and Cinema Movies are provided, there is no risk for you. However, seeding this will help keep this torrent alive and provide information to the people who need it.
Thank you.

THE POSSIBLE DANGER OF IBOGAINE TREATMENT IS OBVIOUSLY TO A LARGE DEGREE THE ILLEGALIZER’S RESPONSIBILITY’S, THE TREATMENTS WOULD BE A LOT SAFER IN A HOSPITAL SETTING AND MORE PEOPLE WOULD BE FREE FROM THE SLAVERY OF ADDICTIVE DRUGS.

SEED AS LEAST AS MUCH AS YOU HAVE DOWNLOADED…PLEASE! ‚If we all seed just 1:1, give at least what we take, this torrent will NEVER DIE‘
Please seed as much as possible.

DiamorphineinUK 12

Beschreibt die notwendigen Indikation fuer eine Diamorphin-Verschreibung

im Vereinigten Koenigreich (England, Wales, Scotland and the nothern of  Eire!

Ebenso natuerlich die Praxis!

BMJHeroine

Introduction
An estimated 25 000 heroin addicts live in the Netherlands
(population 16 000 000 inhabitants).1 Most users
(75-90%) inhale heroin (“chasing the dragon”).2 About
three quarters of these addicts are served by a comprehensive
treatment system, including various kinds of
abstinence oriented treatment facilities and a wide
range of facilities focusing on stabilisation or
minimisation of harm.1 However, 5000-8000 people
on methadone maintenance treatment regularly use
illegal heroin, have serious physical and mental health
problems, and live in socially marginalised conditions,
characterised by illegal activities and a lack of social
contacts outside the drug scene.3–5
A large cohort study in Switzerland ascertained the
feasibility, safety, and efficacy ofmedical prescription of
injectable heroin to 1969 addicts. There were considerable
improvements in physical and mental health, various
aspects of social integration, and illegal drug use in
237 patients who completed 18 months of heroin
treatment.6 Although this study indicated that heroin
assisted substitution treatment is feasible, the effectiveness
of treatment was difficult to judge because no
(random) controls were available, before and after
comparisons were restricted to those who completed
treatment, and participants were obliged to take part in
mandatory psychosocial counselling and care.7–9 In a
small randomised controlled trial (n = 51) in which
intravenous heroin was compared with some standard
treatment, functioning of the participants in the heroin
group was significantly better after six months.10 However,
these positive effects could have been the result of
the additional, and mandatory, psychosocial interventions
in the group allocated to heroin.
We examined the effectiveness of medically coprescribed
heroine in two open label randomised controlled
trials among heroin addicts who had responded
insufficiently to methadone maintenance treatment.

HeroinAdd5-2

  1. Introduction ………………………………………………………………………………………………….8
    The Clinical and Therapeutic Aspects of Personality Disorders
    in Addicted Patients …………………………………………………………………………………….14
    Addiction and symptoms of psychopathology ………………………………………………….14
    Addiction and psychopathological dimensions ………………………………………………..14
    Addiction and Personality Disorders ………………………………………………………………16
    Antisocial Personality Disorder (APD) …………………………………………………………………………18
    Personality and the etiopathogenesis of addiction …………………………………………..19
    The self-medication hypothesis for addictive disorders …………………………………………………..19
    The role of subjective effects: the self-selection hypothesis …………………………………………….20
    Sensation-seeking behaviour and impairment of gratification: what is too little
    or too much? ……………………………………………………………………………………………………………..21
    The psychology of addiction: evolution of theoretical models. ………………………….22
    Psychodynamic theories ………………………………………………………………………………………………22
    Beyond psychodynamics …………………………………………………………………………………………….24
    Addiction and Bipolar Spectrum ……………………………………………………………………25
    Treatment of Personality Disorders during Methadone Maintenance ……………….30
    Conclusions …………………………………………………………………………………………………31
    The Clinical and Therapeutic Aspects of Mood Disorders
    in Addicted Patients …………………………………………………………………………………….32
    Epidemiology ……………………………………………………………………………………………….32
    Assessment and evaluation of depression in addicted patients ………………………….34
    Family History of Mood Disorders …………………………………………………………………35
    Primary or secondary nature of comorbid mood disorder in relation
    to addiction ………………………………………………………………………………………………….36
    Impact of comorbid mood disorders on the natural course
    of heroin addiction ……………………………………………………………………………………….37
    Substance use among Bipolar Patients …………………………………………………………..38
    Addiction and Suicide …………………………………………………………………………………..38
    Heroin addiction and its consequences on mood …………………………………………….41