Though methadone, an opioid agonist therapy and ibogaine, a substance having diverse complex mechanisms of actions appear quite different in their effects both medications have strong patient advocacy support. With the two medications being so distinct in their dose regimen and treatment profile it is interesting to note the advantages of early generation patients of each modality and the power they held compared to later generations of patients.

Within the methadone context this special status of early patients, many of whom became Research Assistants (RAs) was directly attributable to the two doctors responsible for the development of methadone maintenance, Drs. Vincent Dole and Marie Nyswander. Ibogaine provides a somewhat different scenario wherein the medication's discovery as an antiaddictive agent came from the drug using counter culture. As ibogaine was lead into formal regulatory development by its discoverer, Howard S. Lotsof, he maintained a strong working relationship with patients and patient advocates who were immediately incorporated into early research through the International Coalition for Addict Self-help (ICASH) founded by Robert Sisko and Dutch Addict Self-help (DASH), established by N.F.P. Adriaans, G. Frenken and their associates.

As methadone moved further and further from its Dole/Nyswander beginning, providers became repressive and controlling towards their patients with strong antipatient and antiadvocacy positions taken within clinics to which methadone distribution was restricted. It should be noted that there are exceptions and that agencies within the federal government as well as, private groups and some methadone clinics themselves have recognized the detrimental effects associated with stigma and prejudice towards patients and are now beginning to attempt to reverse these conditions that are not conducive to recovery or the benefit of patients.

Ibogaine has not moved that far from its roots and we do not yet see the biased treatment of patients nor the ability to control them in a manner associated with methadone clinics. However, the patients themselves appear to have little direct access to ibogaine and to no longer participate in its administration to other patients in therapeutic self-help environments. While Lotsof believes that the ibogaine community can return to a situation closely identified with the patient/provider relationship similar to the golden age of methadone, Dr. Dole, the father of methadone maintenance therapy believes that the return to such practices for methadone itself will not be possible.

This project of the Dora Weiner Foundation (DWF) is to document in reports and photographs the early generation of patients and advocates within both the ibogaine and methadone community for historical comparison in the hope that we may improve the lives of current patients through an understanding of the past. These reports and photographs will be presented at the American Association for the Treatment of Opioid Dependence (AATOD) Conference to be held in Washington, DC in April 2003.

The first of a series of documents being made available in furtherance of this project is Methadone and Ibogaine: A Historical Comparison of Patient Status and Advocacy Issues. The presentation is a PowerPoint slide show that will download when you click on the above link. The file is 2mb and will take from 1 to 10 minutes in transmission time depending on how you access the Internet.

A Manual of supporting documents to the presentation is available.

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