I didn’t know Phillip Seymour Hoffman, the gifted and apparently bedeviled actor who died of a heroin overdose this week. I have, however, known more than one friend who died from the same drug. They were middle class, suburban guys, honors students, active in their churches and communities. They would now be in their mid- and late-thirties, had they lived. But they didn’t live.
Even as a growing number of states begin the process of piecemeal decriminalization of marijuana, hard drugs like heroin remain another matter. Many people from both sides of the political spectrum agree that our marijuana laws ought to be radically reformed. I’ve written before about the economics of legalization. Civil libertarians, both right- and left-leaning, argue that prohibition offends principles of personal autonomy. Pot, though, is relatively safe — no more dangerous by most metrics than alcohol or tobacco, for however much that means. The fact that, as a general rule, people don’t die from smoking weed makes decriminalization an easier sell for legal reformers.
Heroin, on the other hand? The Drug Enforcement Administration reports that 3,038 people died of heroin overdoses in 2010, the last year for which the DEA has published statistics. A federal survey suggests that 335,000 people used heroin in the U.S. in the past month. (Compare this to an estimated 19.1 million pot users in the same time span, with nary an overdose among them.) Even when an overdose doesn’t kill, the addiction often leaves the user with an abysmal quality of life. Heroin addiction is also a perniciously treatment-resistant dependency. Abstinence rates for recovering opiate addicts are about 10 percent after one year.
Opioid replacement therapies like methadone offer one possible avenue for recovery from heroin addiction, but they are fraught with a lot of their own problems. Under federal law, methadone must be administered primarily at heavily regulated clinics often located in seedy neighborhoods. Also, methadone is a maintenance drug — instead of using heroin daily, an addict uses methadone daily for the long term. Furthermore, methadone carries its own alarming rate of overdose.
Ibogaine, a Schedule I drug in the United States, is available in many other countries, including Canada, South Africa, the Netherlands, Mexico, Norway, and the U.K. among others, where it is used to treat addiction. Unlike methadone, ibogaine is not a maintenance therapy: addicts typically experience relief after one or two doses. Its efficacy rate is reportedly extremely high. So, why isn’t this potentially life-saving anti-addiction drug available in the United States?
Who’s to blame for the legal unavailability of ibogaine?