On the steps of the state capitol building in Frankfort on May 31, the Kentucky Opioid Abatement Advisory Commission (KYOAAC) announced the launch of a new state-funded program that would aim to help stem the damage and destruction wrought by the ongoing opioid crisis that has devastated the lives of millions and led to the deaths of hundreds of thousands. But the new initiative wasn’t simply to throw more money and resources into tried-and-true public health programs.
Instead, the commission announced it was going to explore allocating tens of millions of dollars toward studying and promoting the use of the controversial, plant-based hallucinogen ibogaine in psychedelic-assisted therapy to combat the opioid crisis, as well as treat a host of other mental health issues. The goal is to make Kentucky the first state in the nation to pursue a clinical program around ibogaine—currently legal or unrestricted in only a a few countries like Mexico and New Zealand.
“This administration recognizes that the opioid epidemic is one of the most tragic and visible symptoms of spiritual affliction which pervades our society,” Bryan Hubbard, chairman and executive director of KYOCC, told The Daily Beast. “We must do better. We must explore every possible avenue which holds the potential for improvement.”
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The news was lauded by advocates of psychedelic-assisted therapy, an increasingly popular form of mental health treatment.
“With yesterday’s announcement, Kentucky is taking a bold leadership role to addressing the opioid epidemic,” Jesse MacLachalan, state policy and advocacy coordinator for Reason For Hope, a psychedelic therapy advocacy nonprofit, told The Daily Beast. “This is a prudent and measured approach to explore innovative solutions to the greatest addiction crisis our country has experienced in its history. We applaud the Bluegrass State for the example they are setting for states across the country.”
Kentucky’s new plan is unusual, however, in its use of ibogaine, instead of more commonly known and better-studied psychoactive drugs like psilocybin, MDMA, or ketamine. The drug is derived from the roots of an evergreen shrub native to Central Africa. When used, ibogaine can produce strong hallucinations, which some clinicians try to use to induce feelings of profound introspection. Anecdotal evidence, according to Hubbard, suggests the drug has the potential to reset the brain’s opioid receptors and restore neurochemical activity to pre-opioid exposure levels. According to the Multidisciplinary Association for Psychedelic Studies (MAPS), ingesting ibogaine usually results in about 18–36 hours of psychoactive effects, substantially longer than any other type of psychedelic used as a part of psychiatric therapy.
However, it can also cause spikes in cardiac activity and heavy states of ataxia. Very little is understood about how to effectively administer ibogaine as a therapeutic in clinical environments. Despite optimism from some members of the clinical psychiatric community, ibogaine has led to the deaths of at least 19 people between 1990 and 2008, mostly due to cardiac arrhythmia, and mixing ibogaine with other powerful pharmaceuticals like methadone and diazepam.
“There’s a lot of news about psychedelics that have come out, but this one requires by far several orders of magnitude, more supervision, medical observation,” Joseph Barsuglia, a clinical psychologist and the former director of research and CEO at the now-closed addictions treatment center Crossroads Treatment in Mexico, told The Daily Beast. “It needs to be done where you can house people for several days. You need live cardiac monitoring. There's metabolic risks with people that have organ dysfunction or metabolic conditions. People that have had psychotic disorders or bipolar disorder sometimes are too mentally unstable to go through an ibogaine experience. There’s some case reports of people that had mania that was induced by ibogaine.”
Hubbard and other members of KYOAAC believe the severity of the opioid crisis is cause for pursuing more unconventional solutions even in a conservative state like Kentucky, where opioid overdose-related fatalities are the second highest in the nation behind West Virginia. “We lost 2,127 Kentuckians to overdoses last year. And those are just the preliminary numbers,” state attorney general Daniel Cameron said at Wednesday’s announcement. “Overdose deaths in our state are up 60 percent since 2019, in just three years. That same report indicates that since 2019, we've lost 7,665 Kentuckians to overdose. That’s more than one-fourth the population of Frankfort. We know that opioids account for 90 percent of these deaths.”
Cameron’s enthusiasm for the program is notable, given that he has expressed a bit of reticence over the legalization of medical marijuana in Kentucky that Gov. Andy Beshear (D) signed into law in March. Cameron is running against Beshear in the 2024 gubernatorial election.
When asked by The Daily Beast why the commission wanted to allocate millions toward studying a psychedelic compound rather than expanding resources to more tried-and-true public health initiatives, Hubbard argued that while medications like methadone, buprenorphine, and naltrexone are part of the solution, “it comes with consequences. Diversion independently fuels the epidemic,” and that the money gone into expanding access to these drugs has not yet had enough of an impact.
KYOACC is proposing to fund the program to the tune of $42 million over the next six years, derived from a larger pool of $842 million collected from settlements received from federal lawsuits against pharmaceutical providers and manufacturers for the role they played in the opioid crisis affecting people across the nation—including Wal-Mart, CVS, and Walgreens. Over $8 million has already been assigned to two dozen organizations specializing in prevention, treatment, and recovery services.
If funding is approved, the program’s first steps are to form an advisory council to initiate and oversee clinical research into the use of ibogaine for the treatment of mental health disorders like PTSD, addiction to substances like opioids, and severe depression. Through this council, the state government hopes to establish public-private partnerships with local clinical psychologists, nurse practitioners, and other licensed physicians to develop research studies. Public hearings will be scheduled in the coming months to collect more testimony from experts and iron out new details such as how to pursue the new pilot program and recruit participants for new trials.
Psychedelic-assisted therapy’s star has risen rapidly in recent years, with advocates touting its ability to treat depression, PTSD, and alcoholism. Though ibogaine has not been studied as well as other hallucinogens, there are a few investigations that show its potential—including a new clinical trial launched in 2020 by Stanford University psychiatrist Nolan Williams, to treat combat veterans experiencing PTSD. The trial is still ongoing, but Williams has said the results so far have been positive.
Experts like Barsuglia point out that ibogaine’s big potential lies in how much more powerful its effects are versus other psychedelics. Rather than having to undergo several sessions before patients start to feel significant relief from mental health disorders, ibogaine would only require as few as one or two sessions. Those struggling with opioid use disorder would not have to enroll in a lengthy treatment program before experiencing some help.
Some veterans have been especially vocal advocates for expanding the study of ibogaine as part of mental health treatment. At Wednesday’s announcement, Retired Navy SEAL medic Tommy Aceto told the story of how trauma he experienced in the field led him to abuse opioids and alcohol. Aceto said it was ibogaine that helped him to recover.
“I knew that if I didn't try something new, I wouldn't be around much longer,” he told the audience. “Ibogaine showed me how to feel the separation between my body and my soul, my mind. I felt safe letting go of my addictions and my past traumas. I felt safe to feel again.”
The eventual goal of the new program is to make it possible for ibogaine to receive FDA approval as a breakthrough therapy, like the one given to psilocybin in 2019, which would accelerate the regulatory pathway for legal status nationwide.
“We must overcome the opioid epidemic by any and all humanitarian means necessary,” Hubbard said in closing remarks at Wednesday’s announcement. “Our history demands it.”
