Addicted to Addiction

University of Miami's Deborah Mash believes ibogaine could be the wonder drug to end all drugs. And she's ready to risk everything to prove it.

But Molliver's research dominated the session. Mash spent precious time discussing his conclusions, not those of her own team, and defending her own studies against Molliver's, which had the backing of one of the most renowned scientific institutions in America. Glancing at the panelists, Mash could see she was losing the debate. Reporters had begun to leave to file their stories. Frantic, she followed, pressing them to ask Molliver about the extent of the cell damage, just as she'd been doing. "I'm running out trying to speak to the media, trying to get them on track -- then running back in and asking Dr. Molliver very tough questions," she says. "And I had had it. I had had it. I had had it!"

Under FDA rules, researchers may request confidential forums for discussing their applications for drug trials because they may have pending patents to protect. In frustration Mash invoked that prerogative. "I said, 'Okay, meeting closed!'" she recalls, defiance still clear in her tone. "I was the investigator, and I had the right to say, 'Meeting closed.' It looked like we were going down in flames. It was over."

In fact, Mash's colleagues -- certain the panel would refuse their application to study ibogaine -- had already given up and left for the airport. Mash braved the closed session alone. And it wasn't until late into the night -- twelve hours after she'd first gazed around the meeting room -- that the FDA advisory committee reached a decision, a compromise really. Mash had hoped she would be free to define her own parameters for human safety trials of ibogaine, but that was not to be. The University of Miami team could administer the drug safety trials on humans at dosages established by the FDA, but only on those who had already used ibogaine and who would participate in the experiments at their own risk.

After the vote, Mash made her way to a hotel elevator and began to cry. A reporter who followed her inside patted her arm and said, "You've won." But Mash remembers that she felt no joy: "I had never, never felt so beaten up in my entire life."

Mash says she first heard about ibogaine in 1991, when a man approached her after a speech she'd given at the University of Miami on the chemistry of cocaine abuse. He wanted to know if she'd heard of an African plant that could wean people off cocaine and alcohol. "I believe I looked [at him] in total disinterest," she recalls. "I said, 'Thank you, but I need to talk to these other people.'"

But later that year, at a NIDA conference in Palm Beach County, she listened in as a group of researchers discussed the chemical structure of ibogaine and whether it could reduce drug cravings. Returning to her UM office, she found an intriguing message on her answering machine. The caller was Howard Lotsof, who gave her his background and briefly explained the work he'd done with ibogaine.

"I said, 'What's this about ibogaine? What is ibogaine?'" Mash recalls. "It was like curiosity gets the cat. Lotsof described his studies in the Netherlands, his treatment, and what his results were. I got so curious as a pharmacologist. I just wanted to know what it was. What did the molecule look like? Was it a new class of compounds? Was there something unique about it? What did it teach us about addiction in the brain?"

In December 1992 Lotsof flew Mash and Dr. Juan Sanchez-Ramos, the neurophysician on her research team, to Liden, the Netherlands, to observe him treat three male ibogaine volunteers, each of whom was addicted to either heroin or cocaine. Lotsof had settled the men into hotel rooms for the duration of the 36-hour treatment. Mash sat at one man's bedside as he experienced the drug, and she interviewed all three after its effects had subsided.

Under the supervision of a Dutch psychiatrist, the addicts were given capsules of ibogaine. One reported no unusual perceptions. The other two told Mash they experienced the sensation of viewing significant events in their lives -- as if they were watching a video. The patients hardly moved. They consumed only fluids but were provided food once ibogaine's effects had lessened. A day later one patient declared he had no cravings for cocaine or heroin and that he suffered no withdrawal symptoms. The visions, while traumatic, helped him understand the causes of his addiction. (Mash has maintained contact with him; he is now attending art school in New York.)

Before witnessing the treatments, Mash had been fascinated, curious, and eager to explore the drug. Afterward her interest escalated to a firm resolve to secure permission to conduct human trials. Her reports on the three ibogaine patients had in fact helped persuade the FDA advisory committee to allow limited human trials. But even so, she was without sufficient funding to continue much longer. "We did everything with a loaf and a fish," she says. "We never had significant dollars -- we were piecing together small amounts of money and asking investigators [from the University of Miami and other institutions] to donate their time and expertise."

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