Ibogaine Treatment

What is Ibogaine?

Ibogaine is a psychoactive compound that has been used since the early 1980s as a way of managing withdrawal from opioid addiction. It also helps to reduce cravings for many other drugs and addictive behaviors. 

This use originally grew out of communities and organizations of people who used drugs. Since then it has been promoted by the stories of the tens of thousands of people who have experienced it. 

Today, it is attracting more interest from researchers all over the world. And even though it is prohibited in the United States as well as many other countries, ibogaine treatment is becoming more accepted among care providers and clinics.

Where Does Ibogaine Come From?

Ibogaine is found in a few different plant sources, but it is known because it is the primary active alkaloid in Tabernanthe iboga. Iboga is a shrub native to the rainforests of Central Africa where it has been used since well before written historical records.

Left to mature, iboga can grow to tree-like stature well over 2 meters tall. Ibogaine is concentrated in the inner layer of iboga’s root bark. Fresh or dried bark is often used in traditional rituals of healing and initiation. 

It is also sought out locally for everything from grief or psychological distress, to major health issues. But sometimes it is used to mark a major turning point in a person’s spiritual growth.

In the region of present-day Gabon, Bwiti and other traditional practices that use iboga are widespread, deeply shaping Gabonese worldview and cultural identity. 

In the year 2000, the late President Omar Bongo declared iboga to be a “strategic heritage cultural reserve,” moving to have iboga and its conservation protected. Today there are a number of not-for-profit groups that are working to prevent overharvesting from the wild and to encourage the development of sustainable plantations.

Howard Lotsof

The traditional use of iboga would have included treatments for experiences like addiction, but ibogaine’s ability to relieve opioid withdrawals and drug cravings specifically wasn’t discovered until more recently.

In 1962 Howard Lotsof was 19 years old and living in Staten Island when he first tried ibogaine. At the time he was physically dependent on heroin, and had an interest in experimenting with other drugs.

At the end of a long and difficult trip he discovered that he was not experiencing heroin withdrawal. He said “I realized I no longer had any fear of death.” 

Lotsof went on to give ibogaine to a small group of friends who all had a similar experience.

Lotsof went on to generate interest from a number of researchers and helped to get funding for early clinical research from the National Institute on Drug Abuse (NIDA). 

Although the NIDA trials were discontinued, he went on to collaborate with other researchers, authoring and co-authoring many peer reviewed papers. 

Lotsof passed away in 2010 but new generations of care providers continue the work he started.

Ibogaine treatment

What is a Treatment Like?

Ibogaine treatments vary from center to center, but most places offer stays anywhere from 5 to 10 days, sometimes longer. Usually you will arrive, settle in, and go through a medical intake that should involve medical exams and a drug test. If you are detoxing from opiates you will be stabilized on morphine during that time, enough to stay well until just before the treatment starts.

For people who are using stimulants it is important that these are out of your system prior to treatment. Some people need to wait for drug tests to clear before taking ibogaine. Stimulants and other substances like alcohol and psychiatric prescriptions should be discussed and stopped prior to arrival to avoid complications.

Once you are cleared for treatment most detoxes are done with a single flood dose of ibogaine. Prior to dosing, providers will wait to see that you are going into the first phase of withdrawal to make sure that opioids are leaving your system. 

A flood dose is usually separated into a series of capsules that are taken over the course of a few hours, so that the effects come on more gradually. Generally, people start to feel relief from withdrawal even after the first dose. However, in order to build up and extend the long-term effects that help with cravings sometimes treatment is followed by booster doses in the days or weeks that follow.

How Ibogaine works

There are some mechanisms of how ibogaine works that are not well understood, but enough is known about the withdrawal process to at least partly describe the effect.

When the body becomes habituated to opioids it stops producing its own endorphins, the body’s natural painkillers. It also desensitizes the receptors so that when the body does produce endorphins it doesn’t have the same effect as it normally would. This is what produces a tolerance to opioids and the extreme discomfort associated with withdrawal. While the acute withdrawal period can be a week or more, afterwards many people experience post-acute withdrawals and depression that can last for months or even years.

In the short term, ibogaine’s effects include re-sensitizing the body’s dopamine receptors to such an extent that even long-time opioid users have a dramatic reduction in tolerance. This same effect reduces both the withdrawal symptoms and the continuing discomfort, allowing the body to more easily self-regulate.

Along with this reduced tolerance, ibogaine stimulates a repair of some types of dopaminergic neurons. This is dramatic enough that it is visible in people with Parkinson’s disease, a condition that involves degeneration of dopamine neurons. 

There are also reports that people have seen a slowed onset of Parkinson’s symptoms after just a few weeks of microdosing ibogaine, something that isn’t possible with any other known medication.

For most people this desensitization and the repair that follows helps make overcoming opioid withdrawal feel like something manageable.

Psychological Effects

Along with these physiological effects and the relief from withdrawal ibogaine also has psychoactive effects that a lot of people describe as deeply meaningful. Sometimes people have intense visual experiences. It is common to hear about people who feel like the content of this experience is very personal or familiar, like dreams. These can be images, either faint or clear, sometimes of memories or stories.

Not everyone has these kinds of visual experiences and sometimes they can be difficult to recall later, very much like a dream. Everyone will experience ibogaine differently, and even the same personal will have different experiences from one time to the next. 

In place of visions, or alongside them, some people will have an introspective flow of thoughts or insights, sometimes like a conversation or like a personal inventory. Other people talk about powerful physical shifts and new ways of connecting with and relating to their body.

Whatever does come up, it’s not necessary to have an intense psychedelic experience to find relief or to learn. And the experience continues. Sometimes these insights and shifts of perspective can be felt not only in those first intense hours, but also in the days, weeks and months that follow.

Other Uses of Ibogaine

Ibogaine is also used by people struggling with other kinds of addictive behaviors, eating disorders. and other types of mental distress like depression and anxiety for similar insights and reductions in cravings.

In Gabon, for example, iboga is used for a variety of treatments because disease is seen to have a spiritual origin. Given the effectiveness of placebo responses in many treatments, this is perfectly rational. 

However, ibogaine has also shown very real neuronal repair and neuroprotective effects. It is sometimes sought out by people who are looking for alternative treatments for Parkinson’s and other neurodegenerative disorders such as Multiple Sclerosis and Fibromyalgia, with some reports of success.

Very few places offer treatments that are specifically tailored towards people with other kinds of problems, mostly because they lack the experience and people are not seeking out treatment as often. However, a lot of providers offer ‘psychospiritual’ treatments for people with other personal intentions who are not ending a chemical dependency.

Planning for Aftercare

After the Detox

Fairly soon after the onset of the effects, ibogaine starts to be converted into its primarily metabolite noribogaine. Noribogaine has a lot of the same qualities as ibogaine, including helping to reduce withdrawal and cravings, and changes in visual and sensual perceptions. Some people believe that noribogaine, which can stay in the body for days, weeks, or months after ibogaine, is at least partly responsible for the long-term reduction in cravings.

It’s also important to realize that even though ibogaine makes things much easier and relieves a significant part of the discomfort, it can be a challenging experience in other ways. When taking a flood dose, the most common dose range used by providers, the effects can last anywhere from 12 to 24 hours or longer. These effects usually peak a few hours after they begin, and taper off gradually. 

These extended effects mean that many people end up missing a night of sleep. The day after treatment is often called a “gray day.” Physical and mental exhaustion is common during that period, but people start to recover with rest.

Some people continue to say they get less sleep than normal after the experience. This is the discomfort for a break from habit, because ibogaine actually makes the body require less sleep for a while. Another factor is that people sometimes manage their sleep schedule with substances, and so taking this away just means sleep isn’t as readily and immediately accessible as before. The discomfort caused by and around sleeplessness tend to pass gradually.

Although there is a huge reduction, people often do experience some amount of discomfort and post-acute withdrawals after the treatment. It is almost always significantly less than it would have been, but it helps to be prepared for this.

Booster Doses

Booster doses of ibogaine usually refer to smaller doses that are taken after treatment to extend and prolong the post-treatment effects. Sometimes boosters are given in the days right after treatment to deal with any lingering or post-acute withdrawal symptoms. Other times people like to take a booster as the effects of noribogaine start to wear off.

It’s inevitable that at some point the effects of ibogaine are going to wear off. Life is going to feel less comfortable without the same ways of coping with pain or stress. Booster doses aren’t an alternative way to solve those problems, but they can help support other efforts to strengthen your recovery.

Ongoing Recovery

Ending an addiction is more than just ending a chemical dependency. For many it means learning how to cope with things that have been unfelt and un-acknowledged. Learning new ways of facing problems and moving through discomforts rather than avoiding them is an ongoing process. 

In a lot of ways, doing ibogaine is just the beginning of the journey. If you look at addiction as part of your spiritual learning, then it can be part of a process that will continue for the rest of your life.

It’s helpful to think about ibogaine as just part of the process. It’s important to think about what steps to take after treatment. Your path will be different than anyone else’s, but there are resources available to draw support and guidance. There are a number of different aftercare treatments, including residential centers that focus on continuing to work with medicine and other recovery tools. 

Group therapy and meetings can be even more useful for recovery after ibogaine than they are before it. There are even some group meetings that are starting to focus on working with people who are using psychedelics.

  • Disintegration Group, NYC
  • Psychedelics in Recovery –  Online 12-step fellowship (https://www.psychedelicsinrecovery.org)
  • Life After Ibogaine – Online SMART Recovery meeting (https://www.ceibaibogaine.com/life-after-ibogaine)

Working with a coach or a counselor is helpful for a lot of people. It helps to find someone you connect well with, and someone who understands the changes and process you’re going through. All of these things can be sound investments in the process. Taking Ibogaine is just the beginning. 

Choosing An Ibogaine Treatment Center

Types of Treatments

Ibogaine treatment carries certain medical risks. Having an experienced and equipped provider is an important part of managing those risks and making sure that the treatment is as safe and as smooth as possible.

When planning for treatment, it can be helpful to ask about the medical support, psychological support, and what the treatment environment will be like. Some ibogaine centers are more or less medical clinics that are focused on medical safety, providing treatments in hospitals or similar settings. For some people this might provide a sense of security especially if there are specific risk factors, but most of the time it helps to be comfortable.

Outside of these focused medical clinics other providers focus on creating a comfortable environment, providing therapeutic and even a ceremonial context around the treatment. These providers are almost always medically supported to some extent, but it is important to understand what people are prepared for.

Why you shouldn’t do Ibogaine without an experienced guide

Proper screening, informed management of medications during detox, and proper dosing are major reasons why there are increased risks associated with doing a treatment without an experienced guide. 

But some vendors will provide online dosing protocols for people to self administer Ibogaine at home. This is dangerous. 

Without prior screening and checking how you respond to a test dose, there is no way their recommendations can be well informed or trusted. Self administering Ibogaine is not a good idea and can be fatal.

Risks of Ibogaine Treatment

Serious side effects with ibogaine are rare. A knowledgeable treatment provider or clinic will do what they can to inform you about those risks, and, more importantly, how they are able to manage them. 

The most significant risks are associated with the following:

  • Pre-existing cardiac issues
  • Dehydration and low electrolyte levels
  • Seizures from alcohol or benzodiazepine withdrawals
  • Using opioids or other substances too close to the treatment.

Cardiac Side Effects

Cardiac side effects are usually managed through screening. Any reasonably informed provider will request for an electrocardiogram and for a full blood panel. 

It is also important to ask what kind of cardiac monitoring people do during the treatment. Questions you need to ask include:

  • Will you be hooked up to a heart monitor? 
  • What kinds of interventions are they prepared for if there is a cardiac emergency? 
  • Can they defibrillate you? 
  • Do they have a crash cart for medications? 
  • What medical personnel will be present to respond? 
  • Is the hospital within 10 or 15 minutes away?

Electrolytes

One of the reasons for obtaining a blood panel is to look at levels of magnesium and potassium, two electrolytes that play an important role in heart conduction. Some of the reported adverse events were a result of people doing heavy cleanses or purges prior to ibogaine and lowering levels of electrolytes. Many providers will do electrolyte replacements or IV vitamins prior to treatment.

Benzodiazepines

It’s important to also understand that ibogaine interacts with many drugs and medications, but not with others. Although it works on multiple types of receptors, ibogaine does not affect the gabanergic system which mediates the effects of benzos. That means ibogaine does not help with Benzodiazepine withdrawal. 

Ibogaine can make people slightly more susceptible to seizures in general, and so it increases the risk of these emerging as a side effect of Benzodiazepine withdrawal. For anyone who is habituated to Benzodiazepine use it is important to make sure that their use remains stable during the entire course of ibogaine treatment. It is very important to discuss the details of any Benzodiazepine use with your provider.

Detoxing from benzos is something that is best done with a long-term taper, usually after an ibogaine treatment. A helpful resource for this is the Ashton Manual (https://benzo.org.uk/manual/).

Psychiatric Medications

Psychiatric medications generally act on the central nervous system and many have interactions with ibogaine. Generally, providers will ask that you stop taking any psychiatric medications prior to treatment, usually at least 5-7 days before arriving.

The Icarus project has a useful harm reduction guide for withdrawing from psychiatric medications: https://theicarusproject.net/resources/publications/harm-reduction-guide-to-coming-off-psychiatric-drugs-and-withdrawal/

Overdose

Because ibogaine sensitizes the body’s response to opioids it can be dangerous to have opioids in your system during treatment. Generally, clinics will want to see you starting to show signs of withdrawal to be sure the opioids are leaving your system before administering ibogaine. 

Some of the tragic adverse events with ibogaine have been with people who used just before or during treatment, or who overdosed afterwards because they didn’t account for the reduction of tolerance.

Reducing Treatment Risks

It’s important to remember that all of these risks are manageable. With the right preparation and experienced support, Ibogaine treatment can be a safe way to detox. Making sure that the clinic that you’re attending is experienced and medically supervised is the best way to manage those risks.

You can expect a clinic to ask you for medical tests in advance or to conduct them immediately after arriving. Those tests include a 12-lead electrocardiogram and a full blood panel including potassium, magnesium, and liver enzymes. 

Sometimes it is necessary to do an echocardiogram or cardiac stress test if more information is needed. An important question to ask is how clinics do this kind of screening, and under what conditions have they refused treatment in the past?

How much does ibogaine treatment cost?

A reasonable, medically supervised ibogaine treatment can cost $5,000 and $7,000 dollars over the course of a week. This takes into account all medical staff, resort-style accommodations, private room and board, and all medication costs (including the cost of ibogaine).

When you are planning your treatment it is helpful to understand that ibogaine is just a part of the process. Thinking about how to continue recovery after treatment will make a big difference. 

It is recommended to look at paying for a long-term treatment if you are able. Many people also benefit from attending a residential aftercare center while they recuperate physically and to take the time to plan for the many changes you will experience. 

Whether or not that is an option, it can be helpful to work with a coach or a counselor and to reach out to other resources for support. Taking all of these things into consideration as part of the cost is important if it is an option for you.

Ibogaine and the law

Currently, ibogaine is listed as a Schedule 1 substance in the United States. That means that according to the federal government it has no redeeming medical value whatsoever. 

In some parts of the US there are state-level initiatives to try to make ibogaine available, but none of them have made significant progress. The City of Oakland, California has decriminalized plant and fungus-derived psychedelics including ibogaine, but it doesn’t mean that treatments will be openly available there in the near future.

Most ibogaine treatment centers are located in other countries. Ibogaine, unlike ayahuasca and other psychedelics, is not listed on the United Nations Green list, which means that unless it is specifically mentioned in a country’s drug policy it is unregulated. 

Mexico, Costa Rica, Brazil, and parts of Europe, have become destinations for people looking for treatment where medical providers don’t face legal threats for their involvement.

For a more complete list of ibogaine policies in different countries click on the following link: 

Conclusion

Ibogaine may not be the right choice for everyone. In order to know for sure it is important you take the time to talk with an experienced counselor to guide you in your decision.

If you still have a question that was not addressed in this post you can book a 15 minute consultation with me for free. Just follow this link to pick a time that is convenient for you: 

https://bookme.name/dimitrimugianis/lite/15-minute-free-phone-consultation

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