Herbal medicines for the management of opioid addiction: Safe and effective alternatives to conventional pharmacotherapy?

CNS Drugs

Volumn 25, Issue 12, 2011, Pages 999-1007

  Ward, Jeanine ^a   Rosenbaum, Christopher ^a   Hernon, Christina ^a   McCurdy, Christopher R ^b   Boyer, Edward W ^a  

^a UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL   (United States)

^b UNIVERSITY OF MISSISSIPPI   (United States)

Author keywords

Drug abuse; Ginseng; Herbal medicines; Ibogaine; Mitragyna speciosa; Opioid abuse; Traditional Chinese medicine.

Indexed keywords

7 HYDROXYMITRAGYNINE; AMINOTRANSFERASE; BUPRENORPHINE; GINSENG EXTRACT; HEANTOS; HERBACEOUS AGENT; IBOGAINE; KRATOM EXTRACT; LEVOTETRAHYDROPALMATINE; LOFEXIDINE; MITRAGYNINE; NALOXONE; OPIATE; PLANT EXTRACT; PSEUDOGINSENOSIDE; TAI KANG NING; TETRAHYDROPALMATINE; UNCLASSIFIED DRUG; WEINICOM;

ABSTINENCE; ALTERNATIVE MEDICINE; AMINOTRANSFERASE BLOOD LEVEL; ANOREXIA; ARTHRALGIA; ARTICLE; ATAXIA; BRADYCARDIA; CHINESE HERB; CHINESE MEDICINE; CLINICAL TRIAL (TOPIC); COCAINE DEPENDENCE; CONSTIPATION; DRUG EFFICACY; DRUG FATALITY; DRUG SAFETY; EVIDENCE BASED MEDICINE; HALLUCINATION; HEART VENTRICLE ARRHYTHMIA; HEROIN DEPENDENCE; HUMAN; HYPERPIGMENTATION; HYPOTENSION; INSOMNIA; KRATOM; LACRIMATION; LETHARGY; MYALGIA; MYOCLONUS; NONHUMAN; NYSTAGMUS; OPIATE ADDICTION; PRIORITY JOURNAL; QT PROLONGATION; RESPIRATION DEPRESSION; RHINORRHEA; SIDE EFFECT; SUDDEN DEATH; TORSADE DES POINTES; TREMOR; VOMITING; WEIGHT REDUCTION; WITHDRAWAL SYNDROME; XEROSTOMIA;

ANALGESICS, OPIOID; ANIMALS; BEHAVIOR, ADDICTIVE; DRUGS, CHINESE HERBAL; HUMANS; PLANT PREPARATIONS; SUBSTANCE-RELATED DISORDERS;

EID: 82555177323     PISSN: 11727047     EISSN: 11791934     Source Type: Journal    
DOI: 10.2165/11596830-000000000-00000     Document Type: Article

References (73)

1. Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med 2010; 363: 1981-5
2. Mokri A. Brief overview of the status of drug abuse in Iran. Arch Iran Med 2002; 5: 184-90 (Pubitemid 35314992)
3. Liu L, Fang Y, Wang X. Drug abuse in China: past, present and future. Cell Mol Neurobiol 2008; 28: 479-90
4. Rawson R. Drug abuse problems in the Middle East: 2005 online. Available from URL: www.uclaisap.org/slides/rawson/ Drug%20Abuse%20Problems%20in%20the%20Mid dle%20East.ppt Accessed 2011 Apr 1
5. Boyer E, Wines J. Impact of Internet pharmacy regulation on opioid analgesic availability. J Stud Alcohol Drugs 2008; 69: 703-8
6. Boyer EW, Babu KM, Adkins JE, et al. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction 2008 Jun; 103 (6): 1048-50 (Pubitemid 351715216)
7. Babu KM, McCurdy CR, Boyer EW. Opioid receptors and legal highs: Salvia divinorum and kratom. Clin Toxicol (Phila) 2008 Feb; 46 (2): 146-52 (Pubitemid 351225539)
8. Adkins JE, Boyer EW, McCurdy CR. Mitragyna speciosa, a psychoactive tree from southeast Asia with opioid activity. Curr Topics Medicinal Chem 2011; 11: 1-11
9. Sunwalert S. A study of kratom eaters in Thailand. Bull Narc 1975; 27: 21-7
10. Grewal KS. Observations on the pharmacology of mitragynine. J Pharmacol Exp Ther 1932 Nov; 46: 251-71
11. Takayama H. Chemistry and pharmacology of analgesic indole alkaloids from the rubiaceous plant, Mitragyna speciosa. Chem Pharm Bull 2004; 52 (8): 916-28 (Pubitemid 41701864)
12. Matsumoto K, Mizowaki M, Suchitra T, et al. Antinociceptive action of mitragynine in mice: evidence for the involvement of supraspinal opioid receptors. Life Sci 1996; 59 (14): 1149-55 (Pubitemid 26300401)
13. Matsumoto K, Horie S, Takayama H, et al. Antinociception, tolerance and withdrawal symptoms induced by 7-hydroxymitragynine, an alkaloid from the Thai medicinal herb Mitragyna speciosa. Life Sci 2005 Nov 19; 78 (1): 2-7 (Pubitemid 41527225)
14. Takayama H, Ishikawa H, Kurihara M, et al. Studies on the synthesis and opioid agonistic activities of mitragyninerelated indole alkaloids: discovery of opioid agonists structurally different from other opioid ligands. J Med Chem 2002 Apr 25; 45 (9): 1949-56 (Pubitemid 34415389)
15. Beckett AH, Casy A. Synthetic analgesics: stereochemical considerations. J Pharm Pharmacol 1954; 6: 986-1001
16. McCurdy CR, Prisinzano T. Narcotic analgesics. In: Abraham D, editor. Burger's medicinal chemistry, drug discovery and development. Vol. 7. 6th ed. Hoboken (NJ): John Wiley & Sons, 2010: 569-73
17. Jansen K, Prast C. Ethnopharmacology of kratom and the Mitragyna alkaloids. J Ethnopharmacol 1988; 23: 115-9
18. Jansen K, Prast C. Psychoactive properties of mitragynine (kratom). J Psychoactive Drugs 1988; 20: 455-7 (Pubitemid 19047404)
19. Boyer E, Babu K, McCurdy S, et al. Self-treatment of opioid withdrawal with kratom. Addiction 2008; 103: 1048-50
20. Macko E, Weisbach J, Douglas B. Some observations on the pharmacology of mitragynine. Arch Int Pharmcodynamics 1972; 198: 145-61
21. Nelson J, Lapoint J, Hodgman M, et al. Seizure and coma following kratom (Mitragynina speciosa Korth) exposure. J Med Toxicol 2010; 6: 424-6
22. Boyer E, Babu K, Macalino G. Self-treatment of opioid withdrawal with a dietary supplement, Kratom. Am J Addictions 2007; 16: 352-6 (Pubitemid 47450751)
23. Osterhaus H. Natural herb flavors student's day: the University Daily Kansan 2008 Jan 23 online. Available from URL: http://www.kansan.com/news/2008/ jan/23/os terhaus-natural-herb-flavors-students-day/Accessed 2011 Oct 16
24. Krauth D. Substance called 'kratom' becoming a growing problem. Palm Beach Post 2011 Jul 1 online. Available from URL: http://www.palmbeachpost.com/ health/sub stance-called-kratom-becoming-a-growing-problem-1575630. html Accessed 2011 Oct 16
25. Mash D. Ibogaine therapy for substance abuse disorders: clinical addiction psychiatry. Cambridge: Cambridge University Press, 2010: 50-60
26. Lotsof H. Ibogaine in the treatment of chemical dependence disorders: clinical perspectives. Newsletter of the Multi-disciplinary Association for Psychedelic Studies 1995; 5:16-27
27. A chronology of selected abstracts for ibogaine: rapid method for the interruption of the narcotic addiction syndrome, presented as a courtesy to the American Association for the Treatment of Opioid Dependence. Bear (DE): Addiction Research Institute, 2004
28. Vastag B. Addiction treatment strives for legitimacy. JAMA 2002; 288: 3096-101 (Pubitemid 36014125)
29. Controlled substance schedules online. Available from URL: http://www.justice.gov/dea/pubs/scheduling.html Accessed 2011 Oct 16
30. Kontrimaviciute V, Olivier M, Mathieu-Daude J. Distribution of ibogaine and noribogaine in a man following poisoning involving root bark of the Tabernanthe iboga shrub. J Analyt Toxicol 2006; 30: 434-40 (Pubitemid 44371484)
31. Hough L, Bagal A, Glick S. Pharmacokinetic characterization of the indole alkaloid ibogaine in rats. Methods Findings Exp Clin Pharmacol 2000; 22: 77-81 (Pubitemid 30304433)
32. Helsley S, Rabin R, Winter J. Further investigations of the serotonergic properties of the ibogaine-induced discriminative stimulus. Prog Neuropsychophamacol Biol Psychiatry 1999; 23: 317-26 (Pubitemid 29156848)
33. Deecher D, Teitler M, Soderland D, et al. Mechanisms of action of ibogaine and harmaline congeners based on radioligand binding studies. Brain Res 1992; 571: 242-7
34. Sweetnam P, Lancaster J, Snowman A, et al. Receptor binding profile suggests multiple mechanisms of action are responsible for ibogaine's putative anti-addictive activity. Psychopharmacology 1995; 118: 369-76
35. Codd E. High affinity ibogaine binding to a mu opioid agonist site. Addiction Biol 1995; 57: 315-20
36. Itzak Y, Ali S. Effects of ibogaine on the various sites of the NMDA receptor comles and sigma binding sites in the brain. Ann NY Acad Sci 1998; 844: 245-51 (Pubitemid 28367813)
37. Leal M, Michelin K, Sousa D, et al. Ibogaine attenuation of morphine withdrawal in mice: role of glutamate N-methy-D-aspartate receptors. Prog Neuropsychophamacol Biol Psychiatry 2003; 27: 781-5 (Pubitemid 36969805)
38. Arias H, Rosenberg A, Targowska-Duda K, et al. Interaction of ibogaine with human a3b4-nicotinic acetylcholine receptors in different conformational states. Int J Biochem Cell Biol 2010; 42: 1525-35
39. Glick S, Maisonneuve I, Kitchen B, et al. Antagonism of a3b4 nicotinic receptors as a strategy to reduce opioid and stimulant self-administration. Eur J Pharmacol 2002; 438: 99-105 (Pubitemid 34242925)
40. Onaivi E, Ali S, Chirwa S, et al. Ibogaine signals addiction genes and methamphetamine alteration of long-term po-tentiation. Ann NY Acad Sci 2002; 965: 28-46 (Pubitemid 34721955)
41. He D, Ron D. Autoregulation of glial cell line-derived neurotrophic factor expression: implications for the long-lasting actions for the anti-addiction drug ibogaine. FASEB J 2002; 20: E1820-7
42. Sheppard S. A preliminary investigation of ibogaine: case reports and recommendations for further study. J Subst Abuse Treat 1994; 11: 379-85 (Pubitemid 24265694)
43. Alper K, Lotsof H, Frenken G, et al. Treatment of acute opioid withdrawal with ibogaine. Am J Addictions 1999; 8: 234-42 (Pubitemid 29409791)
44. Alper K, Lotsof H, Kaplan C. The ibogaine medical subculture. J Ethnopharmacol 2008; 115: 9-24 (Pubitemid 350166796)
45. Mash D, Kovera C, Pablo J, et al. Ibogaine: complex pharmacokinetics, concerns for safety, and preliminary efficacy measures. Ann NY Acad Sci 2000; 914: 394-401
46. Witter S. Ibogaine. The Times (London) magazine. London: TIME, 1998 Jun
47. Alper K, Glick S. Ibogaine: proceedings of the First International Conference. San Diego (CA): Academic Press, 2001
48. Shulgin A, Shulgin A. Tihkal: the continuation. Berkeley (CA): Transform PR, 1997 online. Available from URL: http://www.erowid.org/library/books-online/ tihkal/tihkal. shtml Accessed 2011 Oct 16
49. Luciano D. Observations on treatment with ibogaine. Am J Addictions 1998; 7: 89-90
50. Hoelen D, Spiering W, Valk G. Long-QT syndrome induced by the antiaddiction drug ibogaine. N Engl J Med 2009; 360: 308-9
51. Lotsof H, Wachtel E. Manual for ibogaine therapy: screening, safety, monitoring, and aftercare. The ibogaine dossier 2003 online. Available from URL: http://www.ibogai ne.org/manual.html Accessed 2011 Apr 4
52. Maas U, Strubelt S. Fatalities after taking ibogaine in addiction treatment could be related to sudden cardiac death caused by autonomic dysfunction. Medical Hypoth 2006; 67: 960-4 (Pubitemid 44062110)
53. Miller L. Herbal medicinals. Arch Intern Med 1998; 158: 2200-11
54. Espinoza EO, Mann M-J, Bleasdell B. Arsenic and mercury in traditional Chinese herbal balls. N Engl J Med 1995; 333: 803-4
55. Chen M, Jin G. Role of d-tetrahydropamatine in the inhibition of dopamine and serotonin or synaptosomes in the rat brain. Chin J Physiol Sci 1996; 12: 25-30 (Pubitemid 26225858)
56. Liu Y, Liang J, Yan L, et al. Effects of l-tetrahydropalmatine on locomotor sensitization to oxycodone in mice. Acta Pharmacol Sinica 2005; 26: 533-8 (Pubitemid 40676161)
57. Ge X, Zhang H, Xu Z, et al. Experimental study of tetrahydroprotoberberines inhibiting morphine withdrawal syndromes. Chin J Drug Depend 1999; 8: 178-84
58. Yang Z, Shao Y, Li S, et al. Medication of l-tetrahydropalmatine significantly ameliorates opiate craving and increases the abstinence rate in heroin users: a pilot study. Acta Pharmacol Sinica 2008; 29: 781-8
59. Gillis C. Panax ginseng pharmacology: a nitric oxide link. Biochem Pharmcol 1997; 54: 1-8 (Pubitemid 27353216)
60. Attele A, Wu J, Yuan C. Ginseng pharmacology: multiple constituents and multiple actions. Biochem Pharmcol 1999; 58: 1685-93 (Pubitemid 29505408)
61. Takahashi M, Tokuyama S. Pharmacological and physiological effects of ginseng on actions induced by opioids and psychostimulants. Methods Find Exp Clin Pharmacol 1998; 20: 77-84 (Pubitemid 28162657)
62. Shi J, Xu G, Liu T, et al. A comparative clinical study of the effects of the traditional Chinese medicine Jinnui capsules and lofexidine on acute heroin withdrawal symptoms. Am J Drug Alcohol Abuse 2008; 34: 792-800
63. Harris I. Regulatory and ethical issues with dietary supplements. Pharmacotherapy 2000; 20 (11): 1295-302
64. Li Z, Wu C, Pei G, et al. Antagonistic effect of psuedoginsenoside-F11 on the behavioral actions of morphine in mice. Pharmacol Biochem Behav 2000; 66: 595-601 (Pubitemid 30440856)
65. Li Z, Xu N, Wu C, et al. Pseudoginsenoside-F11 attenuates morphine-induced signalling in Chinese hamster ovary-mu cells. Neuroreport 2001; 12: 1453-6 (Pubitemid 32476146)
66. Seo J, Lee J, Lee W, et al. Inhibitory effects of ginseng total saponin on up-regulation of cAMP pathway induced by repeated administration of morphine. Arch Pharm Res 2008; 31: 167-70
67. KTBotanicals.com online. Available from URL: www. ktbotanicals.com/xuan- xia-qudu-jiaonang-100-capsules-p-7994.html Accessed 2009 Apr
68. Hao W, Zhao M. A comparative clinical study of the effect of WeiniCom, a Chinese herbal compound, on alleviation of withdrawal symptoms and craving for heroin in detoxification treatment. J Psychoactive Drugs 2000; 32: 277-84
69. Kang L, Li B, Gao L, et al. Tai-Kang-Ning, a Chinese herbal medicine formula, alleviates acute heroin withdrawal. Am J Drug Alcohol Abuse 2009; 34: 269-76 (Pubitemid 351572455)
70. Wang X, Li J, Huang M, et al. A study of Fu-Yuan Pellet, a traditional Chinese medicine formula for detoxification of heroin addicts. Am J Drug Alcohol Abuse 2009; 35: 408-11
71. Aldhous P. Drug rehabilitation: cold turkey, Vietnamese style. Nature 2005; 433: 568-9 (Pubitemid 40282969)
72. Cohen H, Law-Yone B, Lu S. Poppy to fugu: a historical perspective of the treatment of opiate addiction in China. J Chinese Med 2002; 68: 15-20 (Pubitemid 34173426)
73. Boggan S. Heroin cure may have killed six. The Independent 1998 Feb 25 online. Available from URL: http://www. independent.co.uk/news/heroin-cure-may- have-killed-six-1146810.html Accessed 2011 Oct 16