1. Ibogaine in the treatment of chronic hepatitis C Howard S. Lotsof. President Dora Weiner Foundation Staten Island, NY http://www.doraweiner.org 2007 International Drug Policy Reform Conference New Orleans, LA Friday, December 7 Astor Crown Plaza

2. Tabernanthe iboga source of ibogaine Found in West African rain forests

3. Purified Ibogaine HCl Courtesy Jason Callan President and Founder Ethnogarden Botanical www.ethnogarden.com

4. Ibogaine HCl pharmaceutical grade 99.4% purity

5. 1973: Non A, Non B hepatitis is described 1989: HCV RNA virus identified 1990: Anti HCV effects of ibogaine reported 2005: Patent application for ibogaine to treat chronic HCV filed Hepatitis C (HCV) timeline

6. Most common chronic blood borne viral Infection in the United States New infections per year 1990 - 242,000 New infections per year 2001 - 25,000 New infections per year 2004 - 25,000 Greater than 75% of IVDUs test positive HCV infection

7. 1.The discovery of ibogaine’s use in treating both chemical dependence and HCV was by ibogaine activist advocates who were themselves treated or self-treated with ibogaine. 2.Scientific research followed patent development in the treatment of chemical dependence and it is hoped the same will be true for ibogaine related HCV research. Science follows patent development

8. 1.Rapid method for interrupting the narcotic addiction syndrome, US 4,499,096 (1985) 2.Rapid method for interrupting the cocaine and amphetamine abuse syndrome US 4,587,243 (1986) 3.Rapid method for attenuating the alcohol dependency syndrome, US 4,957,523 (1989) 4.Rapid method for interrupting or attenuating the nicotine/tobacco dependency syndrome, US 5,026,697 (1991) 5.Rapid method for interrupting or attenuating poly- drug dependency syndromes, US 5, 124,994 (1992) Ibogaine Patents

9. 1.Broad ranging claims of ibogaine to treat multiple forms of chemical doubted 2.Over time, all claims for chemical dependence effect have been confirmed by research a)Opioids, b)stimulants, c)Alcohol d) nicotine Research follows skepticism

10. Opioids

11. Cocaine

12. Alcohol

13. Nicotine

14. International Coalition for Addict Self- Help (ICASH) 1989 Dutch Addict Self-Help (DASH) 1990 Ibogaine Underground 2004 Individual contacts via the Internet Ibogaine activists and organizations play role in ibogaine HCV research

15. HCV patent application

16. Example 1 Report A thirty-three year old male diagnosed with HCV and using 1/4 gram of heroin a day was administered 25 mg/kg ibogaine HCl. Following administration of ibogaine heroin use ceased along with swelling of the liver and pain in the area of the liver.

17. Example 2 Liver enzyme values reduced by 14 mg/kg ibogaine EnzymePrePost ALT41050 AST20125 GGT15533

18. Example 3 A sixty year old male testing positive for HCV RNA genotype I, administered the following dose regimens of ibogaine HCl. Subject weighed 79 kg. Doses ibogaine administered were as total doses and not mg/kg. Day 1: 10 mg, Day 2: 20 mg, Day 3: 20 mg, Day 4: 30 mg, Day 5: 50 mg, Day 6: 75 mg, Day 8: 100 mg.Day 10: 150 mg, Day 14: 300 mg.. An additional 250 mg ibogaine

19. Review Example 3 StatusV.loadALPASTALTDate Baseline 2,330,000797513311/02 Data point780,0008452772/03 Ibogaine644,00079751701/04 Ibogaine154,00058691702/06 Data point78,200715210910/06 A.E.1,240,000761002069/07 Data pointN/A78418911/07 Data point?????

20. Example. 4 A forty-two year old female testing positive for HCV RNA type 3. RNA IU/ml was 12,600,000. Subject was administered a total of 27 mg/kg ibogaine HCl in the following regimen: 6 x 2 mg/kg 1 x 12 mg/kg 1 x 3 mg/kg HCV RNA IU/ml was reduced to 50,100. Prior to ibogaine treatment patient’s urine was dark and stool light. Post treatment color of urine and stool returned to normal.

21. Encouraging results 1.Repetitive low dosing with ibogaine provided continuous depression of viral load. 2.Genotype 3 appears highly responsive in keeping with results of interferon riboviron therapy. 3.Continued reduction in viral load after stopping of ibogaine therapy observed until adverse event with celebrex. 4.Less toxic than current HCV therapies.

22. Problems 1.Failure of ibogaine providers to track HCV viral load and liver enzyme levels in patients 2.Costs of testing that are prohibitive to patients 3.Failure of patients and providers to understand the importance of HCV and liver enzyme data collection

23. Future development 1.Ibogaine providers and patients to take greater interest in data collection. 2.Interest of pharmaceutical companies with experience in development of HCV drugs. 3.Preclinical confirmation of efficacy if possible. 4.Phase I/II clinical studies to confirm findings and establish preferred dose regimen. Studies most likely to be included in research of ibogaine’s effects on opioid withdrawal in studies now discussed for Israel and India.

24. Thanks to Patients and Ibogaine Activists that have given us an early look into these promising data