Howard Lotsof 1943–2010

Howard Lotsof, a persevering advocate for the use of ibogaine in addiction treatment, died January 31, 2010, from liver cancer.¹

Lotsof was addicted to heroin during the early years of his adulthood, but his life changed in 1962 when he ingested ibogaine, an extract from the West African shrub iboga (Tabernanthe Iboga, Apocynaceae).^2,3 While iboga has been used by indigenous African tribes during ceremonies and to treat fatigue and hunger for many years, Lotsof was the first known person to attest to its effects on drug addiction. About 36 hours after taking ibogaine, the psychoactive state it had induced began to wear off, and the heroin withdrawal symptoms Lotsof usually experienced were absent. While he once thought of heroin’s high as euphoric, he now saw it as an emulation of death.

“I followed the tree up into the sky and I saw these clouds in the sky, and I realized for the first time in my life, I wasn’t afraid,” said Lotsof at a 2008 lecture.² “And that brought me to the understanding that at least certain drug addiction is fear and anxiety driven, and that fear and anxiety were gone for the first time in my life.”

Lotsof then administered dosages of ibogaine to about 20 people, seven of whom were heroin addicts, and five of the 7 addicts reported that they did not use heroin for 6 months or longer.³ These studies, however, were carried out in unconventional settings. Further research was prohibited, as the US Food and Drug Administration (FDA) labeled ibogaine as a Schedule I substance in the late 1960s, a time when many psychedelic and hallucinogenic drugs were banned by the government. Lotsof’s passion for ibogaine continued, however, and he would eventually become its foremost advocate.

“He had a great medical and personal intuition, and his knowledge in addiction science was amazing,” said Boaz Wachtel, a former Israeli Army medic who worked with Lotsof on several ibogaine research projects (e-mail, May 9, 2010). “He was a true activist who dedicated his life for the promotion of a drug addiction interrupter.”

Lotsof began encouraging researchers, public officials, and pharmaceutical companies to study ibogaine’s potential as an addiction interrupter, and in 1982 he created the Dora Weiner Foundation, named for his grandmother, in order to work for the development of an ibogaine medicine.¹ But the foundation had difficulty obtaining funding for research, largely because the pharmaceutical industry was uninterested in developing the plant substance into a drug.

In 1986, Lotsof obtained patents on ibogaine for heroin, cocaine, amphetamine, alcohol, nicotine, and polysubstance abuse, after which he formed the private company NDA International.³ He began working with international partners on laboratory studies, which showed efficacy in animals. From 1991 to mid-1993, NDA co-sponsored several non-medicalized human studies in the Netherlands and one in Panama, with 2 other addict treatment organizations.

Many addicts in these studies reported improvements in withdrawal, drug-seeking behaviors, and the length of time before relapse,³ and it has been reported that about two-thirds of them stopped using drugs for 4 months to 4 years.¹ This was an improvement compared with conventional addiction treatment, after which addicts usually relapse within 6 months. In 1993, however, a female subject in one of NDA’s Dutch studies died, and though ibogaine was not suspected to be the cause of death, NDA stopped its treatment programs in the Netherlands. According to Rick Doblin, PhD, founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS), who knew Lotsof for about 20 years, Lotsof sympathized with the family of the deceased woman and had great compassion for those who have died in treatment clinics. He thought these deaths could have been avoided if studies were conducted in more medicalized settings (oral communication, April 27, 2010).

The US National Institute on Drug Abuse (NIDA) had been developing Phase I and II clinical trial protocols for ibogaine but decided to end this project in 1995.³ Exact causes for the cancellation remain unknown, but rumored reasons range from contract disagreements, fear of unproven neurotoxicity, the pharmaceutical industry’s alleged lobby against it, and NIDA’s supposed bias against the psychedelic aspects of ibogaine.

“That was the closest that ibogaine ever came to ever being studied [in the United States],” said Dr. Doblin. “Howard was heartbroken when that happened.”

Because Lotsof still believed in ibogaine’s positive results, he continued to push for research, said Wachtel. He produced research protocols, created safety guidelines, searched for funding, and joined with partners interested in ibogaine research and treatment facilities. One partner, Deborah Mash, PhD, received FDA approval for a Phase I study on ibogaine in 1993, but the research was never completed. While conducting controlled research on ibogaine remained difficult, Lotsof focused his attention on the independent ibogaine clinics in Europe, Mexico, and the Caribbean, which have been treating addicts for years.

“He dreamed that [ibogaine] would eventually pass the FDA and be used under clinical environment,” said Wachtel. “It did not happen the way he expected, but [ibogaine] is used today mostly outside the USA with complete disregard to the FDA status. As an ex-addict, Howard knew that the addicts had very few choices or medications to treat their addiction, and here there was a substance with such profound positive results that he probably said to himself, ‘If I would not pursue [ibogaine] development, I would be sorry and feel guilty the rest of my life.’”

While scientists in the United States appear to be tentatively re-opening the doors into the study of certain psychedelics and hallucinogens, clinical research on ibogaine remains at a standstill.⁴ Despite a lack of evidence of recreational use or abuse, ibogaine continues to be classified as a Schedule I substance in the United States.

“I don’t think [ibogaine] has too great of a risk profile,” said Dr. Doblin. “And the treatment of addiction is a significant problem. The question is who will pay for the research? The addict is still, in our culture, the other. The way for us to respond to Howard’s life and death is to continue to explore ibogaine and get new data.”

According to Wachtel, attendees at an ibogaine conference held in 2009 formed a federation for ibogaine treatment providers, and they plan to elect a board and implement worldwide ibogaine safety standards.

“We are all following his footsteps,” said Wachtel. “He leaves a legacy of compassion, of going after social/ medical improvements with major personal cost, as a beam of light for people who seek hope in the face of lifelong struggle with addiction. Many people owe their recovery and freedom from the slavery to drug addiction to Howard’s discovery.”

“I think Howard died somewhat disappointed,” said Dr. Doblin. “But at the same time, he knew that he had started something that isn’t going to disappear and will eventually become accepted.”