Psychedelics may be game changer for opioids. But KY proposal seems sketchy at best. | Opinion

Bryan Hubbard is obviously a sincere and passionate advocate for the multitudes of Kentuckians suffering from opioid use disorder.

As chairman and director of the Kentucky Opioid Advisory Abatement Commission — tasked with dispersing $842 million in settlements from the drug companies who spread opioids and their subsequent hell across our state — Hubbard has embarked on a one-man search for a cure. He calls it another “Manhattan Project” to change the world, and has found his uranium, an African plant called ibogaine, which, according to compelling anecdotal accounts, can change the brain’s chemistry to release it from opioids’ deathly grip. It can also cause heart attacks, which it has done with enough frequency to quash clinical trials in the United States.

At a press conference in May, Hubbard and Attorney General Daniel Cameron announced they wanted to spend $42 million of the settlement money to fund clinical trials of ibogaine.

Now, I think it’s wonderful that in a state that took many years to legalize medical marijuana, law and order candidates like Cameron are willing to consider the untapped potential of psychedelic drugs. Good for Hubbard for pushing a creative, possibly game-changing solution.

But the rollout of this plan left many — including commission members — bemused and bewildered. Hubbard and Cameron held the press conference without bothering to tell the commissioner members who will have to approve it about this plan. Hubbard, a long-time state government attorney, certainly knows that the first rule in Frankfort, or anywhere, really, is don’t get out in front of your bosses no matter how exciting the news.

Also curious is Hubbard’s insistence on focusing solely on ibogaine, despite promising research being conducted on other psychedelics such as psilocybin, LSD, and ayahuasca, a similar plant-based hallucinogen. “It restores the brain to a pre-opioid state,” Hubbard told me. “Ibogaine heals the neurochemical system by restarting organic dopamine and serotonin production.”

In the 1990s, the National Institute on Drug Abuse shut down clinical trials because ibogaine’s adverse effects on the heart were too dangerous. Deborah Mash, the leading ibogaine researcher at the time, took her work to the Saint Kitts, where she reported promising results on 300 people who took the drug. According to Scientific American Magazine, “Mash reported that ibogaine detox blocked at least 90 percent of the opiate withdrawal symptoms in chronic heroin users. More than half of the patients stayed clean a year after the treatment, according to self-reports and family interviews.”

Mash has now formed a company, DemeRex, that would be a perfect receptacle for $42 million in clinical trials; she is scheduled to discuss a public forum on the idea. Commission member Sharon Walsh, a University of Kentucky researcher who oversees traditional opioid withdrawal programs across the state, pointed out the obvious conflict of interest. She also said the settlement money is required to be used only for evidence-based treatment, which means treatment approved by the Food and Drug Administration.

Hubbard, however, is convinced by his own research that ibogaine is the only substance that can actually fix the brain’s pathways from opioid use disorder. He says that any entity that received the RFP for ibogaine research would be required to match the $42 million; the state of Kentucky would be a partner in any research breakthroughs that occur.

He is correct that our current solutions, like medications for opioid use disorder (MOUD) are imperfect; buprenorphine and methadone are expensive and basically trade one drug for another, and force the state to pay millions of dollars to some of the same pharmaceutical companies that got us here in the first place. He’s also probably right that pharmaceutical companies haven’t jumped on ibogaine because it works so quickly, requiring far fewer doses as opposed to the constant maintenance of medication assisted treatment.

But right now, the evidence-based solutions of buprenorphine, methadone and naltrexone are all we have to actually save lives.

If the commission wanted to have an immediate effect, it could fund an expansion of the current pilot project that provides medication and therapy to people in jail. Under that program 11 counties offer treatment to those suffering from opioid withdrawal; we know that the forced abstinence of incarceration leads to deadly overdoses when those folks are released. At the same time, commission members could also give funds to ibogaine and other psychedelic research.

But to make such a splash over one civil servant’s research into one drug looks strange, especially when that civil servant’s boss is running for governor. According to KREF and Open Secrets, Mash is not a financial supporter of Cameron’s campaign (if you have better information, let me know). Even if ibogaine were proven beyond a doubt to work, it’s quite a step for a gubernatorial candidate to push so hard on one psychedelic drug, but maybe psychedelics are now considered OK in the GOP playbook. If so, bravo. We’re decades behind in finding out their exciting possibilities.

Nonetheless, when something sounds too good to be true, it probably is. It’s irresponsible to act as though one drug holds all the answers to one of the most complicated societal problems we’ve ever faced. The commission owes it to the state of Kentucky to come up with solutions that are as far-encompassing as this scourge itself.

Public hearings on the proposed ibogaine project will be held July 17 and Aug. 16, from 9 a.m. to 3:30 p.m. in Room A125 of the Administrative Office of the Courts Building, 1001 Vandalay Dr,, Frankfort.