dana at phantom.com
Tue Jan 4 16:50:54 EST 2005
Please feel free to suggest changes, corrections. Any one else who
wants to testify should.
My name is Dana Beal, and I represent the AIDS activist group Cures not
Wars. First I would like to thank Chairmans Dinowitz and Gottfried for
the opportunity to testify fully and frankly on this public health
crisis. Let me by blunt:
When all other illicit substances are eliminated by interdiction,
methamphetamine is what's left. Crystal meth is easily manufactured in
thousands of small guerrilla labs using products available over the
counter. Therefore to ask what more law enforcement can do to dry up
the supply or disrupt the traffic is an exercise in political
misdirection. Law enforcement turns polydrug users into crystal
addicts. Law enforcement caused the problem.
Likewise there are severe limits on what can be done with education.
Crystal already has a TERRIBLE reputation among drug users--but the
ones who do abuse it do so in defiance of all social norms--all sanity.
The only answer is to cut demand, and to do that you need effective
treatment that will stop people from doing crystal meth as effectively
as naltrexan or methadone block heroin use.
You need a treatment breakthrough, since conventional wisdom as
represented by the recent GMHC report on Crystal Meth and AIDS in the
Gay community is that "there is no known treatment for crystal meth."
You need to bite the bullet and turn to nostrums in the medication
development pipeline that have been rejected until now as too
innovative, too big of a paradigm shift.
It's time to take a look at the first true addiction interrupters, the
iboga alkaloids, effective across the broad spectrum of abused
substances--cocaine, methamphetamine, nicotine, opiates and
alcohol--which work by upping the level of dopamine in the part of the
brain that initiates drug seeking behavior. It is noteworthy that mice
or rats, once started, will inject cocaine or amphetamines, ignoring
food and water, until they die. But mice bio-engineered not to have
something called the Messenger Glutamate Receptor 5 soon stopped
pushing the lever that injected them with stimulants. Catheters showed
that their dopamine was spiking, serotonin was spiking...but
nonetheless they lost interest in the lever after a few injections and
went back to their food and water.
We believe this is the mechanism for ibogaine and the iboga alkaloids,
which are a kind of glutamate antagonist.
These compounds have been too controversial for the National Institute
of Drug Abuse, which abandoned ibogaine development in 1995 in favor of
buprenorphin, which has no utility whatsoever in combatting stimulant
abuse. Worldwide, 85% of all drug development money for addiction
treatments comes from NIDA. Big pharma is not interested in either the
stigma or the excessive regulatory requirements involved in new
treatments for addictions. And private philanthropical resources
(together with whatever government monies they can leverage) are almost
exclusively channeled into feel-good public relations efforts like the
current "Crystal Free and Sexy" campaign in the Gay Community designed
by AmFAR and partially funded by the City of New York under a special
Assemblyman Lentol once asked if he should worry that Ibogaine, if
legalized, would make it to the street and become a new drug of abuse.
Let me say, for the record, that not only is ibogaine physically hard
to take, requiring constant personal attendants, especially during the
early hours when the subject is in a form of sleep paralysis, but also
that only the FDA case officer who ever really looked it, Dr. Curtis
Wrght, characterized its abuse potential as "very low to nonexistent."
It is also the only semi-licit drug where providers require 3 medical
tests--EKG, EEG and liver assay--before they'll give it. I say
semi-licit because ibogaine is already legally available in Canada and
Mexico, making the 4 month after-effect impossible to prohibit, and
denying effective treatment only to those impoverished by addiction who
need it most.
Rich addicts can already fly to St. Kitts, and pay $12,000. The middle
class pays $3,000 in Mexico.
Chairman Lentol's question is emblematic of the special problem with
medications development for treatment of drug dependency. Unlike the
victims of every other disease, society does not trust patients who
have exhibited a pattern of drug abuse to tell them what treatments
work for them.
Even though Ibogaine is currently the only compound available for the
interruption of compulsive stimulant abuse, the kneejerk reaction seems
to be to keep it illegal because it was discovered by a heroin addict,
and is principally used to detoxify addicts from methadone, the gold
standard of opiate maintenance. Many's the time Ibogaine exponents have
encountered methadone practitioners incensed at the very notion that an
ibogaine-like substance might be a better answer for addicts with
compromised immune systems or impaired liver function.
Yet the fact is both methamphetamine and methadone up-regulate the
replication of HIV. And methadone competes with protease inhibitors,
for instance, in the liver, so that even higher doses are required to
achieve opiate satiation.
One of the concerns in assessing potential treatments for crystal meth
addiction is not just how conventional treatment for hepatitis and HIV
can be better targeted for hidden addict populations, but how to treat
these people's addictions with pharmacotherapies that help--instead of
messing up--the patients liver function and immune status. We have
enough anecdotal data in this respect to be confident in the anti-viral
effects of iboga alkaloids. Significant improvement in T-cell count,
impressive drying-up of herpes, dramatic improvement in hepatitis C
status are not unusual in folks who take ibogaine to interrupt their
Recently the New York State Office of Alcohol and Substance Abuse
Services updated their ibogaine webpage to address the issue of
efficacy of ibogaine in treating addiction to crystal. Unfortunately
they only inserted the word methamphetamine in the list of things the
Glick drug, 18 MC is good for. I need to dispell any impression that
ibogaine is not also every bit as useful, since careful reading of
results of animal studies at Glick's lab at Albany Medical College
reveals that ibogaine is actually more effective for amphetamine than
18 MC. (Conversely, 18 MC is twice as effective for cigarettes).
Presently, the only treatments in humans of crystal meth addiction have
been with the natural compound, Ibogaine HCl or the "Indra" extract.
The OASAS Website is:
Dr Stanley Glick at the Albany Medical Center was not looking for a
more effective treatment for cigarettes when he designed 18 MC. He was
trying to come up with an iboga alkaloid without the potential for
bradycardia (dangerous slowing of heartbeat and breathing), or the NMDA
and Sigma-2 toxicity. Yet the implication is plain: somewhere among the
iboga alkaloids is one that is particularly effective for crystal meth.
If the voters of California can earmark $3 Billion for stem-cell
research, the least it seems the New York State Assembly can do is
provide a much more modest amount for Dr. Glick to finish his research
and bring some medications to market, as well loosening restrictions on
research by re-scheduling Ibogaine to reflect the fact that it has NO
potential for abuse, and abundant medical uses besides treatment of
addictions, including anti-stroke, anti-viral, anti-tumor,
anti-obsessive/compulsive disorder indications, as well as potential in
the treatment of drug resistant tuberculosis.
[I should note that ibogaine also addresses, as an obsessive/compulsive
disorder, binge sex on crystal .]
If the Assembly is not willing to recognize the work of New York State
researchers and the State's own substance abuse office, OASAS, and take
official notice that a whole new family of compounds exists to treat
stimulant abuse, then we'll never avail ourselves of the most obvious
place to look for new answers — the new treatments that are already in
the medications development pipeline.
More information about the Ibogaine