Ibogaine: Can it Cure Addiction Without the Hallucinogenic Trip?
Photo Illustration by Levi van Veluw
Ron Price needs his milkshake. It's 10 o'clock on a Monday morning and the bald-headed, barrel-chested former bodybuilder is shuffling around the kitchen of a posh rehab clinic in Tijuana, wearing slippers and a blue Gold's Gym T-shirt. Price had been employed as a stockbroker in New Mexico, until his training regimen left him with debilitating injuries that forced him to undergo 33 surgeries in less than a decade. His doctor prescribed Oxycontin, and Price quickly became dependent on the potent painkiller. More recently, he started snorting cocaine and chugging booze to numb the pain. Now, 53 years old and three weeks into rehab, all he wants is a milkshake and to crawl back into bed.
Clare Wilkins, the vivacious 40-year-old director of Pangea Biomedics, pops the lid of the blender to check the consistency of the concoction Price craves: peanut butter, soy milk, agave syrup, hemp protein powder, and a few scoops of chocolate-flavored Green SuperFood.
Oh, and a half-teaspoon of root bark from the tabernanthe iboga plant.
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Since having graduated from the Artez Art School in Arnhem the Netherlands, Levi van Veluw has enjoyed a remarkable amount of success in a short period of time, with his work being showcased in many different locations across Europe and the States and Asia, earning him a number of prestigious awards that include the Photographer of the Year Award at the IPA International Photo Awards in the USA. His work will be featured at the Armory Show 2011, New York.
Taken in sufficient quantity, the substance triggers a psychedelic experience that users say is more intense than LSD or psilocybin mushrooms. Practitioners of the Bwiti religion in the West African nation of Gabon use iboga root bark as a sacrament to induce visions in tribal ceremonies, similar to the way natives of South and Central America use ayahuasca and peyote. Wilkins is one of a few dozen therapists worldwide who specialize in the use of iboga (more specifically, a potent extract called ibogaine) to treat drug addiction.
Now she pours the thick, chocolatey liquid into a mason jar but agrees to hand it over to Price only on the condition that he'll stay awake and out of bed and interact with his fellow residents and the staff. Price grudgingly agrees and takes a seat at the dining-room table. Sunlight pours in through a sliding-glass door that opens to a terrace with a sweeping view of the Pacific Ocean and the San Diego skyline in the distance.
"Ron, I remember when you called me [three weeks ago], you were crying on the phone. You were so devastated, you couldn't leave the house," Wilkins says gently. "When you use, you end up alone in a bathroom or something. You need a community. As weird and misfits as we are, we need this sense of community. You need to learn to deal with being in your body each day instead of relying on the fucking ibogaine.
Ibogaine and iboga root bark are illegal in the United States but unregulated in many countries, including Canada and Mexico. Wilkins, though, is hardly alone in her belief that iboga-based substances can be used as a legitimate treatment for drug addiction. Researchers at respected institutions have conducted experiments and ended up with hard evidence that the compound works—as long as you don't mind the mindfuck.
"All drugs have side effects, but ibogaine is unique for the severity of its side effects," says Dorit Ron, a neurology professor at the University of California–San Francisco. "I think ibogaine is a nasty drug. But if you can disassociate the side effects from the good effects, there is a mechanism of action in ibogaine that reduces relapse in humans."
Now, using chemical variations, scientists have devised ways to make ibogaine non-hallucinogenic. The trouble, say Wilkins and others who have used ibogaine, is that the psychedelic journey carries the secret to the drug's success.
It was Hunter S. Thompson who introduced ibogaine to a wide audience, in the pages of Rolling Stone. Thompson was covering the 1972 presidential election, reporting what would eventually become Fear and Loathing on the Campaign Trail '72. When Democratic contender Edmund Muskie acted strangely during a campaign stop in Florida, Thompson suggested that the candidate was taking ibogaine, "an exotic brand of speed" that "nobody in the press corps had ever heard of."
"It is entirely conceivable—given the known effects of ibogaine—that Muskie's brain was almost paralyzed by hallucinations," Thompson wrote. "He looked out at that crowd and saw gila monsters instead of people . . . his mind snapped completely when he felt something large and apparently vicious clawing at his legs."
The notion of Ed Muskie on an ibogaine bender was absurd, and Thompson knew it. Most experienced users say the drug is extremely unpleasant when ingested in large doses, causing severe nausea, vertigo, sleeplessness, and visions that can be nightmarish. The effects last up to 36 hours, and the strain can be so great that some users are bedridden for days after.
"I only took one capsule of extract. It was very weak, but it was still strong enough to make me puke for six hours," says Dana Beal, a New York–based activist and longtime lobbyist for ibogaine legalization. "I had my head in a wastebasket or sink or toilet the entire time. It's aversive. I can tell you from personal experience that I don't ever want to take it again."
While Hunter Thompson brought ibogaine into popular parlance, credit for discovering the drug's medicinal potential is widely attributed to a man named Howard Lotsof. Ten years before the events that gave rise to Fear and Loathing, Lotsof was a junkie living in New York. Having bought some ibogaine for recreational use, Lotsof was astounded to find that when the hallucinogen wore off, he no longer craved heroin. Days passed, and he didn't experience any of the excruciating symptoms associated with kicking a dope habit.
Lotsof, who died earlier this year of liver cancer at age 66, devoted his life to making ibogaine available as an addiction treatment. He experienced a significant setback in 1967, when the U.S. government banned the drug, along with several other psychedelics. In 1970 officials categorized ibogaine as a Schedule I substance—on par with heroin, marijuana, and other drugs that by definition have "a high potential for abuse" and "no currently accepted medical use."
Eventually, Lotsof shifted his focus and began using ibogaine to treat heroin addicts at a rehab clinic in the Netherlands. In 1985, he obtained a U.S. patent for the use of ibogaine to treat substance abuse.
By the late '80s, doctors and scientists were confirming what Lotsof knew: Ibogaine blocks cravings and withdrawal symptoms for many types of drugs, and opiates in particular.
"Its effects are pretty dramatic," says Dr. Kenneth Alper, an associate professor of psychiatry at New York University who specializes in addiction research. "I've observed this firsthand, and it's difficult to account for."
Dr. Stanley Glick, a pharmacologist and neuroscientist at Albany Medical College, was among the first researchers to test ibogaine on rats. Glick hooked up the rodents to IVs in cages with levers that allowed them to inject themselves with morphine.
If the rats do it, you can be pretty sure that humans will abuse it if given the opportunity, Glick explains. It's really the time-tested model of any human behavior.
Strung-out rats dosed with ibogaine stopped pressing the lever that gave them morphine. Glick and other researchers have subsequently replicated the morphine results with other addictive drugs, including alcohol, nicotine, cocaine, and methamphetamine.In the early 1990s, Lotsof teamed with Dr. Deborah Mash, a neurologist and pharmacologist at the University of Miami, to study the effect of ibogaine on people. Mash was granted FDA approval to administer ibogaine in 1993 and was able to test the drug on eight people before the experiment came to an abrupt halt.
"I was unable to get it funded," Mash says. "We had the rocket ship on the launch pad, with no fuel."
A few months after the FDA gave Mash the green light, a committee of academics and pharmaceutical-industry professionals assembled by the National Institute on Drug Abuse (NIDA) concluded that the U.S. government should not fund ibogaine research. Earlier that year, a researcher from Johns Hopkins University had found that rats injected with massive doses of ibogaine suffered irreparable damage to the cerebellum, the part of the brain that controls balance and motor skills. According to Dr. Frank Vocci, former director of treatment research and development at NIDA, the fact that ibogaine increases the risk of seizures for people addicted to alcohol or benzodiazepines such as Valium raised eyebrows as well.
"The question that was posed to them was, 'Do you think that this could be a project that could result in, essentially, a marketable product?' " Vocci recalls. "There was concern about brain damage, seizures, and heart rate. But it wasn't so much that the ultimate safety of the drug was being damned, it was just felt that there were an awful lot of warts on this thing."
Mash and Lotsof soon parted ways, on unfriendly terms. Lotsof sued his former colleague and the University of Miami in federal court in 1996, claiming that her research had infringed on his patent. A judge eventually ruled in favor of Mash and her employer, absolving them of wrongdoing.
Lotsof went his own way, mentoring fellow former addicts who opened ibogaine rehab centers abroad. Mash opened a private clinic on the Caribbean island of St. Kitts and administered ibogaine to nearly 300 addicts. "It really works," Mash says now. "If it didn't work, I would have told the world it doesn't work. I would have debunked it, and I would have been the most outspoken leader of the pack. That's my scientific and professional credibility on the line."
Clare Wilkins is one of Howard Lotsof's protégés. Born in South Africa and raised in Los Angeles, she got hooked on heroin at the age of 20 while majoring in Latin American studies and psychology at Cornell University. Drug use led to depression and she dropped out her senior year. She'd been trying to get clean using methadone for eight and a half years when her younger sister learned about ibogaine via the Internet. Wilkins, then 30 years old and employed as bookkeeper, read up on the subject, started saving up, and in 2005 shelled out $3,200 for a session at the Ibogaine Association, a clinic in Tijuana.
The trip—in both senses of the word—changed her life.
"I received a direct message that I was washed in love," Wilkins says of her first encounter with the hallucinogen. "That the universe in its entirety is full of love and that courses through us and was there for me. There was this soul body, this light body that had no beginning and no end. My fingers had no end, there were atoms coming in and going out.
"It got me off methadone completely," she says. "My sense of shame about my addiction was washed away without having to practice with a therapist and talk, talk, talk."
The experience was so profound that she elected to stay on at the clinic as a volunteer. Confident and chatty, with long brown curls and a disarming smile, Wilkins feels she has a knack for guiding patients through their ibogaine-induced spiritual awakenings.
"On ibogaine, all your walls come down," she says. "You can't lie. You get an opportunity to look at yourself honestly and see how you respond. My role is to be there as a comfort. People compliment me by saying, You knew exactly when to hold my hand.'
In 2006 Ibogaine Association director Martin Polanco offered Wilkins a full-time job. She'd heard rumors that he was considering selling the clinic in the coming year, and on a whim she offered to buy the operation from him outright.
"It was one of those 'Can I put that back in my mouth?' moments," Wilkins recounts with a laugh. "I didn't have the money, I didn't even have a car."
Wilkins borrowed $3,000 from her mother for a down payment, changed the clinic's name to Pangea Biomedics, and made monthly payments to Polanco for the next year and a half.
Having paid off the $65,000 debt, Wilkins's first order of business was to relocate. Tijuana residents—and rehab clinics in particular—have been terrorized during Mexico's ongoing drug war. Late last month, gunmen stormed a clinic and murdered 13 people, execution-style. (The mayhem wasn't random; drug gangs operate such facilities as safe havens for their foot soldiers.) Wilkins's primary concern, however, was noisy neighbors in the duplex, not narco-violence.
"We'd hear cell phones ring through the wall, and ranchero music—you'd hear everything," she recalls. "You'd try to go into a guided meditation and hear someone hammering a nail."
Wilkins now rents a lavish four-bedroom home on a hill overlooking Tijuana's upscale Playas neighborhood. Amenities include a hot tub, weight room, fireplace, and veranda with panoramic views. Safety was not overlooked: The subdivision is gated, and security guards inspect every vehicle that enters.
Stays at Pangea aren't cheap. For the standard 10-day detox, Wilkins charges $7,500, travel not included. She employs a staff of 10, including two Mexican physicians, a paramedic, a masseuse/acupuncturist, and a chef. The chef, Wilkins's sister, Sarah, is a recovering addict who credits ibogaine for kicking her drug dependence.
Aaron Aurand, a live-in volunteer, feels the same way.
"I did eight months of court-ordered inpatient treatment before I came here," says Aurand, a native of Spokane, Washington. "I got more therapy here in five days than I did in that entire time. Lots of junkies don't want to look inside themselves. With this, you'll get shown."
In addition to ibogaine, Clare Wilkins emphasizes nutrition. The clinic's pantry is mostly organic and gluten-free and boasts a cache of vitamins and supplements that patients gobble by the handful.
The body has its own framework and can heal itself if you remove harmful substances and balance the systems. We do colon cleanses and liver cleanses even before they get the ibogaine, Wilkins explains, pointing out that there are practical reasons for the former: You get people who come in hereespecially opiate addictswho are clogged up.
To date, Wilkins says, she has treated more than 300 patients. "Sixty-two percent of our clients are chronic-pain patients," she says. "You're not talking IV [heroin] addicts or crack addicts. You're talking grandmas on Oxycontin."
Some people come for "psycho-spiritual" purposes. Ken Wells, an environmental consultant from Santa Rosa, California, with a neatly trimmed gray mustache and wire-frame glasses, says he underwent conventional counseling for depression for 15 years before trying ibogaine as a last-ditch effort to save his crumbling marriage.
Three days after taking ibogaine for the first time, Wells compares the experience to "defragging a computer hard drive." He experimented with psychedelics decades ago in college but says ibogaine is like nothing else.
"It was outrageously powerful," Wells says. "It was like the inside of my eyeballs was an IMAX screen. It was all-encompassing, just a multitude of images, like 80,000 different TVs, all with a different channel on—just jillions of images, shapes, and colors."
Did the experience help him find what he was looking for?
"I think I'm different," he says. "But I don't know."
It's easier to track ibogaine's effect on hardcore addicts. Wilkins, who keeps tabs on former clients, estimates that one out of every five stays off his or her "primary substance" for six months or more.
Tom Kingsley Brown, an anthropologist at the University of California–San Diego who describes his area of study as "religious conversion and altered states of consciousness," recently began recruiting Pangea patients for an independent assessment of ibogaine's long-term efficacy. Brown follows up monthly with opiate addicts during the year regarding their ibogaine treatment, to gauge whether their quality of life has improved.
"People I've interviewed at the clinic have had really good results, especially in the first month or so," reports Brown, who has enrolled four study subjects to date and hopes for a group of 30. "We know ibogaine interrupts the addiction in the short term, but what we're really curious about is: Does that translate into long-term relief from drug dependence?"
Participants in Brown's study fill out questionnaires that ask them to rate the intensity of different aspects of their trips, on a scale of one to five.
"People have been circling a lot of fours and fives," Brown says. "One of the things we're trying to look at is if the intensity of the ibogaine experience correlates with treatment success. I strongly suspect there's some sort of psychological component. I doubt it's just a biological phenomenon."
Some scientists beg to differ. Foremost among them are Deborah Mash and Stanley Glick.
"The hallucinations are just an unfortunate side effect," Glick asserts, explaining that ibogaine works on the brain like a "hybrid" of PCP and LSD. "Part of the problem is that when you go through this thing, it's so profound you've got to believe it's doing something. In part, it's an attempt by the person who's undergoing it to make sense of the whole thing."
Generally speaking, Glick's research on rats has shown that ibogaine "dampens" the brain's so-called reward pathway, reducing the release of neurotransmitters like dopamine, which cause the highs associated with everything from heroin to sugary foods. The compound has also been proven to increase production of GDNF, a type of protein that quells cravings, and to block the brain's nicotinic receptors, the same spots that are stimulated by tobacco and other addictive substances. In other words, ibogaine doesn't work in any one particular way or even on one specific part of the brain, and it's these multiple "mechanisms of action," researchers say, that make it so effective for so many different types of addiction.
People who have taken ibogaine say it can have the unintended consequence of temporarily turning them off a substance other than their drug of choice. Lauren Wertheim traveled from her hometown of Omaha, Nebraska, to a rehab center called Awakening in the Dream House near Puerto Vallarta, Mexico, and used ibogaine to kick her meth habit.
"Ibogaine resets all your [tolerance] levels to zero, like you've never done drugs," she says. "Even coffee—the first cup set me off like a rocket launcher. That's when I was like, 'This stuff is for real.' "
Mash, the researcher from Miami, is convinced that ibogaine works long-term because it is stored in fat cells and processed by the liver into a metabolite called noribogaine that possesses powerful detoxifying and antidepressant properties.
"If you gave somebody LSD or psilocybin and they were coming off opiates or meth, they'd go right back out and shoot up," Mash says. "There's evidence that it's not the visions that get you drug-free; it is the ability of the metabolite to block the craving and block the signs and symptoms of opiate withdrawal and improve mood."
Though they don't question its effectiveness, both Mash and Glick believe it's unlikely that ibogaine will ever be widely accepted in the United States. It's not just that ibogaine makes people hallucinate. It can be fatal.
Since 1991, at least 19 people have died during or shortly after undergoing ibogaine therapy. Alper, the NYU professor, examined the causes of death in the fatalities, which occurred between 1991 and 2008. His findings suggest that ibogaine itself was not the culprit; the patients died because they had heart problems or combined the hallucinogen with their drug of choice. (By way of comparison, a study published last year by the Centers for Disease Control and Prevention found that between 1999 and 2006 more than 4,600 people in the United States died from overdoses involving methadone.)
"It's knowing who to treat and who not to treat," Alper contends. "None of [the 19 fatalities] appear to have involved a healthy individual without pre-existing disease who didn't use other drugs during treatment. Two deaths occurred when they took ibogaine in crude alkaloid or root-bark form—they didn't know what they were taking or how much."
Three of the deaths occurred at Clare Wilkins's Tijuana clinic. She says two involved patients who had cocaine in their systems and the third victim had a pre-existing heart condition. Wilkins says she's now more selective about her clients and requires that they undergo a drug test.
"The learning curve has been difficult at times, but people need to know this can be safe," Wilkins says. "We have to show people how far we've come."
Some of the scientists, however, think they've found alternatives that will make the risks—and the tripping—associated with ibogaine unnecessary.
Mash has devised two ways to isolate the metabolite noribogaine and administer it: a pill, and a patch similar to the nicotine variety. She hopes to begin testing the products on humans by the end of this year.
"It has all the benefits without the adverse side effects—including no hallucinations," Mash says. "I spent a lot of years really pushing ibogaine as far as I could, both in preclinical and clinical studies. But everything that I've learned in the course of 18 years of working on ibogaine has convinced me that the active metabolite is the drug to be developed."
Glick, meanwhile, teamed up with a chemist named Martin Kuehne from the University of Vermont to create and research a chemical called 18-MC (short for 18-methoxycoronaridine) that mimics ibogaine's effect on a specific nicotinic receptor. Just like ibogaine, 18-MC appears to work wonders on drug-addicted rats.
"Cocaine, meth, nicotine, morphine—we did the same studies with 18-MC, and it worked as well or better than ibogaine," Glick says. "We also have data that it will be useful in treating obesity. In animals, it blocks their intake of sweet and fatty foods without affecting their nutrient intake."
Glick and his cohorts have yet to determine whether their synthetic ibogaine has psychedelic properties. The rats, after all, aren't talking.
"You look at an animal given ibogaine, and you can't tell if they're hallucinating. But they look positively strange," Glick says. "You give them 18-MC and you can't really tell. But we hope when it gets to people, it won't produce hallucinatory effects."
The first human testing of 18-MC is scheduled to begin later this month in Brazil. But scientists there won't be studying its effect on addiction. They'll be investigating the drug's potential as a cure for the parasitic infection leishmaniasis, an affliction similar to malaria that is common in tropical climates. Through pure coincidence, 18-MC is chemically similar to other drugs that are used to treat the disease.
The Americans jumped at the chance to test their product in South America. Although 18-MC has shown promise and no observable side effects in animals, not a single pharmaceutical company has shown interest in developing it as an anti-addiction product.
"We're fortunate we have this other disease apart from addiction where we know it can be tested," says Kuehne, a veteran of big pharma who worked for Ciba (a predecessor of Novartis). "Pharmaceutical companies don't like cures. Really, they don't—that's the sad thing. They like treatment. Something for cholesterol or high blood pressure that you [take] for years and years, every day. That's where the profit is."
Further complicating matters is the fact that 18-MC has proven difficult to manufacture. Obiter Research, a company based in Champaign, Illinois, that specializes in synthesizing experimental chemicals, spent nearly two years refining the process before successfully creating about 200 grams of the substance—just enough to send to Brazil to be administered to human subjects.
"Imagine a Tinkertoy Ferris wheel," says Bill Boulanger, Obiter's CEO and a former chemistry professor at the University of Illinois. "It's like taking that apart, then trying to use half of the parts to build a fire engine. Ibogaine is a natural product, and sometimes Mother Nature does a better job than the lab."
Boulanger is convinced there's money to be made from 18-MC. With Obiter, he plans to patent the manufacturing process and secure intellectual-property rights. He and two partners also created a separate company, Savant HWP, in hopes of eventually opening addiction clinics across the United States that administer 18-MC in conjunction with conventional rehab techniques such as 12-step programs.
One part is resetting the trigger that's saying, 'Oh, I've got to have it, Boulanger says. That's helping the people fight withdrawal, and that would be part of the whole operation. But it's just one facet. It's got to be holistic. Just handing out a pill and sending them on their way is a bad idea.
The notion of hallucination-free ibogaine, however, rubs the drug's die-hard supporters the wrong way.
"With methadone, they just removed euphoria from opiates," says Dimitri "Mobengo" Mugianis. "This is the same process they're doing now—removing psychedelic and visionary experience. Ibogaine works. What are they trying to improve or fix? It's not broken, and they're spending a great amount of time and money to fix it."
A former heroin addict, Mugianis is an underground ibogaine-treatment provider. He kicked his habit with the help of ibogaine administered at Lotsof's clinic in the Netherlands. The experience was so extraordinary that Mugianis was inspired to travel to Gabon to be initiated into the native Bwiti religion and was trained by local shamans. He says he has performed more than 400 ritualistic ceremonies on addicts, most of them in New York City hotel rooms, using ibogaine and iboga root bark.
Despite his strong belief in the power of ibogaine, Mugianis does not see it as a miracle cure for addiction.
"The 12-step approach really helped in combination with ibogaine," he says. "I say it interrupts the physical dependency, because that's what it does. There's no cure. It's not a cure. It allows you a window of opportunity, particularly with opiate users."
Efforts are afoot to legalize—or at least legitimize—ibogaine in the United States. Convincing doctors and elected officials to support a potent, occasionally lethal hallucinogen can be a tough sell. That pitch becomes doubly difficult when some of the ibogaine enthusiasts themselves inspire skepticism.
One of ibogaine's most outspoken advocates is Dana Beal. An eccentric character who helped found the Youth International Party (more commonly known as the Yippies) in the 1960s, Beal sports a bushy white mustache that inspired a New York Times reporter to liken him to "a Civil War-era cavalry colonel." Beal travels the country giving PowerPoint presentations touting the benefits of ibogaine and medical marijuana.
In June 2008, he was arrested by police in Mattoon, Illinois, and charged with money laundering. He was carrying $150,000 in cash in two duffel bags, money he claims was going to finance an ibogaine clinic and research center in Mexico. Beal maintains his innocence and is free on bail as the case heads to trial.
It's folks like Beal, says pharmacologist Stanley Glick, who keep ibogaine and 18-MC from being embraced by the medical mainstream.
"Some of my colleagues, as well as funding agencies, lump us together without really considering the data," Glick says. "There's a lot of baggage that comes with ibogaine, some of it warranted, some of it unwarranted. It's really a stigma. Drug abuse itself has a stigma, and unfortunately so does ibogaine. It has really hurt the science."
Beal shrugs off the criticism, arguing that grassroots activism is the only way to ensure that politicians will endorse ibogaine. Besides, he adds, the government stopped funding ibogaine research long before he was arrested.
"[The scientists] think if they stay away from us activists, NIDA will bless them," says the self-styled rabble-rouser. "NIDA is not blessing them. They're washed up and on a strange beach. How will they get FDA-approved clinical trials without activists? Explain to me a way that works, and I will do it."
Beal jokes that the best advertisement for ibogaine might be an episode from the 11th season of Law & Order: Special Victims Unit in which a heroin addict who needs to testify in court is administered ibogaine to make his withdrawal symptoms disappear overnight. Maybe Congress will watch SVU and say, 'Maybe we should check this outwow!it works for methamphetamine, too?' he says sarcastically.
In truth, ibogaine's effectiveness against meth has already helped it gain acceptance abroad. Lawmakers in New Zealand, where methamphetamine use has skyrocketed in recent years, recently tweaked the nation's laws to allow physicians to prescribe ibogaine. Dr. Gavin Cape, an addiction specialist at New Zealand's Dunedin School of Medicine, says the nation's doctors are so far reluctant to wield their new anti-meth weapon.
"[There are] no true controlled studies to give evidence as to its safety and effectiveness," Cape says. "There is a strong advocacy group [in New Zealand] for ibogaine, and it may turn out to have a place alongside conventional therapies for the addictions, but I'm afraid we are a few years away from that goal."
Last month, dozens of ibogaine researchers, activists, and treatment providers gathered for a conference in Barcelona, where topics included safety and sustainable sourcing of ibogaine from Africa. Dr. Kenneth Alper was among the attendees who gave a presentation on the benefits of ibogaine to the Catalan Ministry of Health. The NYU prof believes ibogaine's most likely path to prominence in the United States will be as a medication for meth addiction, for the simple reason that doctors and treatment providers have found that small daily—and thus drug-company-friendly—doses seem to work better for meth addiction than the mind-blowing "flood doses" used on opiate addicts.
Alper says no one thought to try non-hallucinogenic quantities of ibogaine until recently. Ibogaine treatment providers tend to have been former ibogaine users, and most assumed that the introspection brought on by tripping was key to overcoming their addictions. "That's just how it evolved," he says, noting that the large doses do seem to work best for opiate detox. "You're talking about a drug that has been used in less than 10,000 people in the world in terms of treatment. It's not surprising that's how it evolved."
"The visions have some psychological content that is salient and meaningful," Alper adds. "On the other hand, there is no successful treatment for addiction that's not interpreted as a spiritual transformation by the people who use it. It's the G-word. It's God. We as physicians don't venture into that territory, but most people do."
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