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Fhe effects of Ibogaine treatment are e iewed in three cuteeones: acute, intermediate and long-term. the acute and intermediate effects have s'ometintes been referred to as the et7erts and aftereffects. I-he two major effects of Ibogaine are A I the ability to interrupt narcotic and stimulant withdrawal and Bf the attenuation or eLimina[ion of the craving to continue to seal. and usr opiates. stimulants ,utd alcohol I Lotsof 198. 1986. 19891. Knowledge concerning the use of Ibogaine in treating alcohol dependence is limited tu: I I a single alcohol-onh~ dependent patient and_ I [he attenuation and, in some cases. cessation of alcohol we in persons treated for poh-drug dependence disorders. Ibogaine'. ability [o treat nicotine dependence Q.otsot: 1991 I has been seen in pok-drug dependent subjecn [reefed primarih for opiate and/or cocaine use . First, [here are some general considerations. The priman obligations of the treatment team are tintr-fold: I l to cam the trust of the patient. to main[ain the cumfon otthr patient-? ~ to assist the patients in interrupting then chemical dependence and ~i to supph [he pse chosocml support networ6 needed be the majority of patients to enable them to develop a sense of personal accomplishment and the abilih to function us produc[ive members of socien. Ihis is a process the Dutch treatment comrtmnin refers [o us normalitation_ In the Lotsof Proceduresm. for which a martual is now beme prepared. [he sense nt conflict ;een in mos[ treatment modalities hetween the doctor and patiem over the itmnedia[e eeasme of drug use does not exist. fhe patients haer been allowed, if narcotic-dependrn[. [o continue [hen use of narcotics until a cenam time prwr to [reatment with Ibogaine- I here is no cunfLci oe er opiate uiC before treaunent us our position ties been that Ibogaine will either wort. to interrupt chemical dependence ur it will not Patients dependent on stimulanti ore not maintained on ;timulants and this has not created a problem for [he patients or the medical staff. Prior [u our conducting Ibogaine treatments m hospitals, addicted patients were allowed to usr their personal supply oC narcotics until [he ce ening before treatment. However, during hospital-udtninistered Ibogaine sessions. the narcotic-dependent patient is maintained tin medications prescribed he the principal tin estigator during the three [o the day inta6r process preceding their ueamtrnt with Ibogaine. Le en under these circuntstancen. patient disnatst o[ the medical establishmen[ and their e~[reme tear of going into withdrawal has resulted in the smuggling of narcotics into hospiml environments. In order to protect the patien[ fium possible overdose due to narcotics. stimulants ur other <Lvgs. a thorough phe sisal c~ammation a perfornted tin all patients upon their utLnission to hosptml environments- Che c~anunu[ion wtd a scorch ul the patienf~ possessnaa prior to treatment with Ibogaine xne two iropurtunt functions. fhe ties[. is to limn the possibilin of accidental oeerdose from ,ecrtted drugs- I he ,ccond. is [e. prue Cdr a complete underswndmg of the puoent ~ physical health, since main of the people seeAmg treannen[ for chemical dependence haee ntasl.ed carious ;md often numerous medical problems for eeurn or teen decades he :elf-medieatim~ with illici[ drugs ~aCL fF EFFE;C~fti RECiIMkih 1-he acute ettec[s of lbogainr ;ire dramatic. fhe initial reaction a usualh no[ed wuhin tom-tiee minu[es after the oral dose rind lull effrcts are _eneratle ce idem within [wu to mu and a half hours. fhe eudiest subjec[iee indicunon be patients of lbogaines effects is the report of a pore asne oscillaring sound. Che pa[ien[ [ends io lie down and, ifasAed to stand or wal6- shows stns of uta~ia_ Che protocol for the Lotsof Proceduresm stipulates [hat the patiem remain in bed wuh as little movement us possible Itom [he time of Ibogaine administration, as nausea associated with Ibogaine use has pnn en [o he motion-related or. in later stages I those longer than four hour, after