4.2 Article

Death due to consumption of ibogaine: case report

Journal

FORENSIC SCIENCE MEDICINE AND PATHOLOGY
Volume 17, Issue 1, Pages 126-129

Publisher

HUMANA PRESS INC
DOI: 10.1007/s12024-020-00342-0

Keywords

Forensic science; Toxicology; Ibogaine; Substance abuse; Opioid detoxification

Funding

  1. Ministry of Education and Science of the Republic of Serbia [III 41022, OI 175093]

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Ibogaine is a psychotropic substance extracted from the roots of a plant, known for its euphoric and hallucinogenic effects. Widely used in addiction treatment, it can have serious side effects and even result in death when taken in large doses.
Ibogaine is a psychotropic indole alkaloid extracted from the roots of the Tabernanthe iboga shrub from the Apocynaceae family. Depending on the taken dose, it can lead to stimulant effects, euphoria, visual and auditory hallucinations, along with auditory, olfactory, and gustatory synesthesia. In addition to its historical usage in spiritual rituals of African tribes, these days iboga extract presents a prohibited, alternative drug widely used as a part of addiction treatment. Ibogaine used in opioid withdrawal is associated with serious side effects and sudden deaths. Besides its main use as an anti-addiction medication in alternative medicine, in moderate doses (from 100mg to 1g) ibogaine most commonly causes a trance-like state. In this paper, we report the case of a heroin addict who died suddenly 5-12 hours after oral ingestion of powder labeled Tabernanthe iboga which had been bought online and used in the process of detoxification during an addiction treatment. The man was found dead in a rented apartment, where he was undergoing the addiction treatment. External examination revealed no lesions other than nonspecific injuries on the legs. The autopsy showed congestion of internal organs and pulmonary edema. Histopathological analysis of the heart showed neither macroscopic nor microscopic abnormalities. The concentration of ibogaine was 3.26mg/L. Moreover, systematic toxicological analyses of biological samples showed the presence of morphine and codeine. These data suggest that death, which occurred unnaturally after initiation of the treatment, was probably the result of the cardiovascular effects caused by the ibogaine powder. The presented case highlights the worldwide problem of various products being widely available over the internet and the danger associated with consumption thereof.

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