SCOTT DETROW, HOST:
Fifty billion dollars is on its way to state and local governments over the coming years. The pool of funding comes from multiple legal settlements with pharmaceutical companies that profited from manufacturing or selling opioid painkillers. As that money continues to be dispersed, officials are trying to figure out how to spend it best to help communities devastated by the deadly opioid epidemic.
We're going to take a close look at one of the ways that Kentucky is considering using some of that money. Kentucky has had some of the nation's highest opioid overdose death rates, and it's expecting over $800 million over the coming years. A state commission there is considering supporting research on an illegal psychedelic drug called ibogaine as a treatment for addiction. With us now is reporter Morgan Watkins of Louisville Public Media, who's been following the ibogaine debate. Welcome to ALL THINGS CONSIDERED.
MORGAN WATKINS, BYLINE: Thanks for having me.
DETROW: So what exactly is ibogaine?
WATKINS: It's a substance found in the iboga plant that grows in West Central Africa. People who take it can experience a state of waking dreams. There's some evidence that it might reduce or eliminate addiction withdrawal symptoms and cravings. Dakota Meyer is a decorated military veteran from Kentucky, and in September, he spoke to the state commission that decides how to spend a lot of Kentucky's opioid settlement money. Meyer said ibogaine helped him process the traumas that haunted him.
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DAKOTA MEYER: The experience was intense and transformative, helping me break free from the suffocating grip of PTSD and depression.
WATKINS: Now, using ibogaine isn't without risk. Some research shows it can cause heart problems. Dr. Mark Haigney is a cardiologist. Here's what he told the Kentucky commission in October.
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MARK HAIGNEY: My opinion is that ibogaine is not safe. The efficacy is unproven. It's unlikely to be approved by FDA in a reasonable time period, and the cost to Kentucky would be unsupportable.
WATKINS: However, ibogaine advocates say the risks can be managed with medical supervision, and the drug is still worth researching.
DETROW: I mean, of all the different ways to tackle the opioid epidemic, why are Kentucky officials considering this research in the first place?
WATKINS: Well, the idea came from Bryan Hubbard when he was leading the state commission. Back in May, he proposed spending $42 million from the opioid settlements to support ibogaine research. He said he's heard from a lot of people that ibogaine could work as an addiction treatment.
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BRYAN HUBBARD: If this anecdotal evidence can be clinically validated, ibogaine would represent a transformative therapeutic for treatment of opioid use disorder.
DETROW: I mean, but since he made that proposal, it seems like there's been a change in leadership. Does that affect the way that Kentucky is thinking about doing this research?
WATKINS: Hubbard's idea had support from Kentucky's last attorney general, but now there's a new AG, Russell Coleman, and he replaced Hubbard with a former DEA agent who will lead the state opioid commission from now on. It's not clear if the new leadership will support the ibogaine proposal. Amber Capone is CEO of a group called Veterans Exploring Treatment Solutions. She says it's disheartening to see that Kentucky may shift away from ibogaine and hopes the new AG will seriously consider it. Capone says her organization helps veterans access ibogaine at reputable clinics in Mexico, where the drug is unregulated, and they've seen the difference it can make.
AMBER CAPONE: We have had veterans in our program that have had opioid dependency issues from injuries sustained on the battlefield, etc., and they have reported a complete reversal of those challenges following ibogaine.
DETROW: I mean, so this question is up in the air at the moment. What else is the state going to be doing with this money, which, again, is about $800 million - more than that - over the coming years?
WATKINS: The ibogaine proposal is just one of many ideas that the state commission has been considering. The Attorney General's office reports Kentucky already has invested over $32 million of the funds in addiction prevention, treatment and recovery efforts. Local governments, similarly, are evaluating how to spend their portion of the settlements. And Kentucky will receive the opioid settlement funds in stages over the course of more than a decade. So the task of deciding how to spend that money is just beginning.
DETROW: That's Morgan Watkins with Louisville Public Media. Thank you so much.
WATKINS: Thanks.
(SOUNDBITE OF RICHARD HOUGHTEN'S "FADING INTO PURPLE") Transcript provided by NPR, Copyright NPR.
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