5.Treatment+Outcomes+and+Role+of+Therapist



//Treatment Outcomes: Advantages and Disadvantages// Like every psychotherapeutic treatment approach, there are positive and negative outcomes that clients may be subjected to. In a study focusing on the effectiveness of Ibogaine as a psychoanalytic psychotherapeutic approach, Brackenridge (2010) found that out of the 45 patients he was treating for opiate addiction, 15 of them were able to completely cease their substance abusing habits long term. The remainder of participants either relapsed within a period of two weeks, or dropped out of the contract. Considering the chances of relapsing when first attempting to cease a substance abuse addiction are quite high, especially with a treatment model that is fairly recent, the fact that 15 members were able to sustain their sobriety using Ibogaine can be looked at as favorable when comparing it to other treatment models and their outcomes. There have also been studies completed on Ibogaine as a psychotherapeutic approach focusing on the neurological benefits it can have on previous drug users. Individuals who abuse substances usually show higher levels of dopamine than those who do not abuse substances. Blackburn and Szumlinksi (1997) found that Ibogaine can act as positive factor in stimulating dopamine levels, which in turn can reduce the cravings for drug rewarding behaviors, resulting in decreased urgings to use. It is important to note that in regards to Ibogaine stimulating induced levels of dopamine, it was only able to do so effectively in individuals who had a history of drug experience. Therefore, perhaps the effectiveness Ibogaine has on helping individuals reduce their opiate consumption is dependent upon an individual’s history with opiates, and the influence opiates have had on them neurologically. Studies have also shown the benefits Ibogaine can have on helping to relieve withdrawal symptoms. According to Brackenridge (2010) Ibogaine is a very effective tool in helping to relieve withdrawal symptoms associated with opiates and opiate users. He found that when individuals who were freshly coming off opiates, and had taken Ibogaine within 48 hours, none of the individuals attempted to obtain opiates for a period of 72 hours. Although the individuals did experience a very small fracture of the withdrawal symptoms such as chills and sweating, there was no present urge to use. It is important to note that the above findings do not necessarily identify Ibogaine as a cure for individuals who suffer from opiate addiction, but rather suggests that it is more effective as a short-term fix, and should be used along other therapies, such as CBT to provide the most effective results. Ibogaine creates the opportunity for users to maintain sobriety and continue on a healthy path with additional therapies teaching them how to. Although many scientific studies have noted Ibogaine as a psychotherapeutic method in treating opiate addiction to be rather safe, other studies focusing on using Ibogaine to treat other substance addictions, such as alcoholism, have found Ibogaine to be life-threatening. For example, in a case study focusing on a man entering treatment for alcohol detoxification, the man was reported dead 12 – 24 hours after receiving Ibogaine (Papadodima, Dona, Evaggelakos, Goutas & Athanselis, 2013). This holds important clinical implications, and suggests that perhaps Ibogaine and the side effects that are involved with Ibogaine are only safe to use with individuals who have a drug history with opiates, or are best suited with the withdrawal symptoms associated with opiates. Brackenridge (2010) reports that in over 3,500 treatments involving Ibogaine only 11 deaths were reported, with all of them being a result of pre-existing medical conditions such as heart or liver disease, Schizophrenia or psychosis, all in which were triggered by the side effects involved with Ibogaine.

//Role of the Psychotherapist// The psychotherapist does not seem to have a strong influence on Ibogaine treatment up until the final stages of the therapy process. Considering the most important component of Ibogaine therapy consists of the patient being in a lucid dream-like state where they are able to regain awareness into a new and re-fulfilled way of seeing life, the psychotherapist plays more of a passive role during the early stages of treatment. In a sense, the Ibogaine substance itself acts as the psychotherapist in helping the patient to acknowledge a deeper appreciation of the unconscious experiences that make up their life every day, including those that have lead to their drug abuse. It has also been referred to as a “death experience” in the sense that the patient’s substance abuse has died, and they are being reborn into a new life. In stage three of Ibogaine treatment, the psychotherapist follows up with assessments, and begins to structure a plan to help the client re-enter into the life process successfully. Considering Ibogaine therapy seems to be deeply rooted within a psychoanalytic psychotherapeutic framework, following up Ibogaine treatment with psychoanalytic therapy may help the client to gain an even deeper understanding of themselves through discovering repressed feelings and emotions.

__Discussion Questions:__ The treatment of Ibogaine involves individuals being in a deep lucid dream-like state, and hallucinogenic properties may take place. How can you see this as potentially harmful for treating substance abusers? Consider this especially may be harmful once they have moved into stage three of their Ibogaine treatment. What are the potential risk factors involved with Ibogaine treatment in regards to helping individuals achieve sobriety. How may these factors interfere with gaining insight into a life without addiction?

**References** Blackburn, J. & Szumlinkski, K. (1997). Ibogaine effects on sweet preference and amphetamine induced locomotion: implications for drug addiction. //Behavioral Brain Research//, 89, 99-106. Brackenridge, P. (2010). Ibogaine therapy in the treatment of opiate dependency. //Drugs and Alcohol Today//, 10, 1-25. Papadodima, S., Dona, A., Evaggelakos, C., Goutas, N. & Athanselis, S. (2013). Ibogaine related sudden death: A case report. //Journal of Forensic and Legal Medicine//, 20, 809-811.