Ibogaine for Cocaine and Crack Addiction: What the Research Shows

Ibogaine has been explored for cocaine and crack dependence for decades, with encouraging but limited evidence. In rats, a single dose reduced cocaine self-administration for more than 48 hours. In people, open-label studies from St. Kitts and Brazil reported reduced cravings and periods of abstinence after treatment. There are no controlled trials yet, and because cocaine itself strains the heart, a careful cardiac evaluation and a cocaine-free period before treatment are essential.

Key takeaways

• There is no approved medication for cocaine use disorder, which is one reason ibogaine has attracted interest.
• In a 1993 animal study, one dose of ibogaine reduced cocaine intake in rats for more than 48 hours.
• An open-label series of 191 patients detoxing from opioids or cocaine in St. Kitts reported reduced cravings and no significant adverse events.
• In a Brazilian study of 75 people, many using cocaine or crack, 61% were abstinent at follow-up.
• Cocaine damages the heart and blood vessels, so screening is stricter and the last use must be well before treatment.

Why cocaine is hard to treat

Unlike opioid or alcohol dependence, cocaine use disorder has no FDA-approved medication. The best-supported treatments are behavioral, such as contingency management and cognitive behavioral therapy. Cocaine withdrawal is not usually physically dangerous, but the "crash" of exhaustion, low mood and intense craving drives many relapses.

Ibogaine's possible role is different from opioids: rather than stopping a physical withdrawal syndrome, it may reduce craving and give a window of clarity to start recovery.

What the research shows

Animal studies

In a 1993 study in the European Journal of Pharmacology, a single injection of ibogaine significantly reduced cocaine self-administration in rats, an effect that lasted more than 48 hours. Repeated weekly doses produced a stronger effect. Because ibogaine leaves the body quickly, the authors suggested a long-acting metabolite was responsible; that metabolite is now known as noribogaine.

Human studies

• St. Kitts, 191 patients (Mash et al., 2018): an open-label case series of people detoxing from opioids or cocaine with medical monitoring. Researchers measured craving with standardized questionnaires and reported that ibogaine reduced cravings, with no significant adverse events at the doses used.
• Brazil, 75 patients (Schenberg et al., 2014): a retrospective study of people dependent on cocaine, crack, alcohol or cannabis, most using several drugs, treated with ibogaine plus psychotherapy. At follow-up, 61% were abstinent, with a median of 5.5 months of abstinence after one treatment and 8.4 months after several.

These studies have no control groups and mix different substances, so they cannot prove ibogaine works for cocaine. They do justify controlled trials.

Cocaine and the heart: why screening is stricter

Cocaine raises blood pressure and heart rate, narrows blood vessels and can damage the heart muscle over time. It can also prolong the QT interval. Ibogaine prolongs the QT interval too. That is why people who use cocaine need:

• A thorough cardiac evaluation, including an EKG and, when indicated, further heart tests.
• A cocaine-free period before treatment, defined by the medical team, so cocaine is out of the system.
• Disclosure of all substances. Alcohol combined with cocaine forms cocaethylene, which is more toxic to the heart. Street cocaine may also contain other drugs, including fentanyl.

Read more in ibogaine side effects and heart safety.

What treatment looks like

1. Medical and cardiac screening and a full review of substances and medications.
2. A supervised cocaine-free period before arrival, with a plan for the crash and cravings.
3. Ibogaine treatment with an on-site cardiologist, continuous EKG telemetry and one-to-one ACLS nursing.
4. Recovery and integration during the rest of the 7-day program.
5. 90-day aftercare, ideally linked to behavioral therapy at home, which has the strongest evidence for cocaine.

See how treatment works, what is included and who can apply in our ibogaine program for cocaine and stimulants.

Frequently asked questions

Can ibogaine cure cocaine addiction?

No. Ibogaine is not a cure and is not approved for cocaine use disorder. Animal research and open-label human studies suggest it may reduce craving, but controlled trials are still needed.

How long before ibogaine do I need to stop cocaine?

It varies with your pattern of use and heart health. Our medical team defines the exact period after your evaluation.

Does ibogaine work for crack as well as powder cocaine?

Both are the same drug in different forms. The Brazilian study included people using crack. The same cardiac precautions apply.

I use cocaine and opioids. Can I be treated?

Yes, many patients in the studies used both. Opioids require their own transition plan; see ibogaine for opioid addiction and ibogaine for fentanyl.

Will the cravings come back?

They can, especially under stress or around old triggers. Aftercare and therapy are what turn a reduction in craving into lasting recovery.

References

• Cappendijk, S. L., Dzoljic, M. R. "Inhibitory effects of ibogaine on cocaine self-administration in rats." European Journal of Pharmacology, 1993;241:261–265. PubMed
• Mash, D. C. et al. "Ibogaine detoxification transitions opioid and cocaine abusers between dependence and abstinence: clinical observations and treatment outcomes." Frontiers in Pharmacology, 2018.
• Schenberg, E. E. et al. "Treating drug dependence with the aid of ibogaine: a retrospective study." Journal of Psychopharmacology, 2014;28(11):993–1000. PubMed

Ready to talk about cocaine? Our medical team will review your health and history confidentially and tell you honestly whether ibogaine is a safe option. Request your evaluation.