for http://www.assembly.state.ny.us/comm/Alcohol/20041215/

Dana Beal 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.

Dana/cnw


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 
no-bid arrangement.

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 
addictions.

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: 
http://www.oasas.state.ny.us/AdMed/meds/fyiibogaine.htm

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.





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