Dying to get clean: is ibogaine the answer to heroin addiction?

Ibogaine for alcoholism

Dying to get clean: is ibogaine the answer to heroin addiction?

This article is more than 6 years old

Ibogaine is a drug harvested from the roots of a plant found in Gabon. When all else fails, some heroin addicts have used it to conquer their cravings. But is it effective and are the serious risks it carries worth it?

Ibogaine for alcoholism

At the age of 12, Jay was smoking cigarettes and weed; by 16, he was snorting coke; two years later he was taking heroin and crack – but he says by the time he left university he was a “functional drug addict”, able to get up in the morning, put a suit on, travel from his parents’ home in north London to his job as a banker in the City.

Then his marriage broke down; his health deteriorated; he got hooked on the powerful painkiller Tramadol following an unrelated operation on his stomach; and when doctors stopped that dose, he replaced it with heroin.

Ibogaine for alcoholism

Jay checked into a £10,000-a-week rehab centre in Thailand in 2016 which kept him clean for a while, but then he started using again. A friend had told him about ibogaine, a drug from an obscure African plant that he said would enable him to come off heroin without the lengthy, painful withdrawal – and stay off. It would help him understand why he was an addict, his friend insisted, that he’d “Talk to God.”

Curious, Jay began to research ibogaine on the internet, but as he dived down a rabbit hole, he found horror stories: he read that it slowed the heart to dangerously low levels; that it was unregulated, dished out by unscrupulous providers, most of them former addicts; there were tales of people who had heart attacks. Then there were the deaths.

Ibogaine for alcoholism

Last summer, ibogaine’s use was restricted in the UK when the Psychoactive Substances Act came into effect – sweeping legislation designed to address the public panic surrounding synthetic marijuana, or so-called “legal highs”. But for Jay, rehab hadn’t worked and he refused to try methadone (“a horrendous drug. I’ve seen what it does to people and I didn’t want to replace one addiction for another”) so he booked a flight to Durban, South Africa, to seek treatment at an ibogaine clinic that he thought seemed genuine.

Bitter medicine: Dr Anwar Jeewa with Howard Lotsof at an ibogaine conference in Washington DC

A day before he flew, he stopped taking drugs as per instructions from the clinic and at the airport began to suffer the symptoms of withdrawal. “It’s like the worst flu you’ve ever had,” he said. “Your bones inside are hurting. You shiver and you’re cold, then you’re hot, you’re sweating, you can’t eat, you’re throwing up – out of both ends.”

Ibogaine, Jay believed, was his only hope.

The Tabernanthe iboga plant grows in the rainforests of Gabon. It’s a leafy green shrub with fruits that look not unlike fat, orange jalapeño peppers, but it’s the bark of the root from which you extract ibogaine. For centuries it has been used to induce visions in participants in the bwiti ceremony, a traditional, days-long tribal coming-of-age ritual where hallucinogenic visions are understood as a death and rebirth. They believe that iboga enables them to commune with their ancestors (bwiti is roughly translated as ancestor).

According to the Global Ibogaine Therapy Alliance, which publishes research and information on ibogaine, this ancestor worship by Gabonese tribes holds that by learning the language of the spirits of things it is possible to communicate with God.

In the mid-1800s researchers brought a specimen back to France and, 60 years on, ibogaine was being marketed there under the name Lambarène for use as a stimulant. In 1985 a man called Howard Lotsof was awarded the first US patent for its use in treating opioid addiction – two decades earlier Lotsof had himself been an addict when he’d first tried ibogaine. “The next thing I knew,” he told the New York Times in 1994, “I was straight.” But it remained banned in the US even as, by the late 1990s, it was being touted on the nascent internet as a miracle drug for opioid addicts.

This September, an ibogaine conference in Vienna saw 20 experts – some with medical backgrounds, others providers or activists – gather to increase awareness of the drug and to encourage more research in Europe. But is it the magic bullet that some claim? Or is ibogaine restricted in the UK and banned outright in America for a reason – a dangerous drug, administered by charlatans with little or no medical knowledge?

I met Jay one afternoon at a café near his home in north London. He’d initially found a clinic in Mexico online and Skyped with the owner, but was quickly discouraged. He showed me email correspondence he’d had with the facility. The cost of the seven-day addiction programme was “normally $8,000 [£5,900], however I would be able to credit $1k of that towards your airfare,” one email read. “I would need a $500 refundable deposit on a credit card. The remaining $6,500 can be paid via wire transfer, or a cashier’s check.” The man added that his nurse could do the health screening over Skype or email.

“I just didn’t feel comfortable,” Jay said. “There are lots of retreats in Costa Rica and places, but it feels like they’re trying to make a quick buck, whether it’s from a hippy that’s trying to have a life experience, or an addict.”

Root of the problem: a Gabonese man with an iboga shrub from which ibogaine is harvested. Photograph: Laurent Sazy

Eventually, Jay found someone he thought he could trust – a man by the name of Dr Anwar Jeewa who ran a clinic in South Africa. Jeewa, “a chap in his mid-50s, with a white beard”, was waiting for Jay at Durban airport when he arrived, and he immediately gave him a dose of morphine for his withdrawals. “He was very relaxed. He’d clearly done this a few times,” Jay said.

On the Monday morning Jeewa gave Jay a test dose of ibogaine – a brown plastic capsule to swallow, with a glass of water. An hour later Jay felt like his withdrawals had disappeared. The next 12 to 18 hours were a blur, but he recalled a nurse administering more pills – eight in total. “I lay there not being able to move, almost paralysed. And every time I closed my eyes I started thinking and dreaming.” He remembers one vivid dream in particular: “I could see a lady, almost like Mother Mary, shaking a finger at me. She was offering to take me to wherever she was going, and I was saying, ‘No, no, no.’”

Jay now thinks it was a sign: “I have a co-dependent relationship with my mum. We love each other to bits, but I need her validation and I’m not getting it, so I take it out on other people or I get upset.” That, he told me, was one of the reasons he kept turning back to drugs.

In the 24 hours following treatment, those who have taken ibogaine talk about experiencing what they term a “grey day”. “You feel sluggish and shitty and your legs aren’t really working,” Jay said. But a day after that, “you experience pure elation. You discover you’re no longer addicted to anything. Even a cup of tea with sugar tastes horrible.”

Jay flew back home and in the 10 months since he hasn’t had a single relapse. “I went to a stag do recently and all my friends were taking cocaine and I didn’t. Back in the day I wouldn’t have been able to say no. I’ve developed a new sense of confidence. I’ve got a new job, got a new girlfriend. I feel like I’m an actual functioning member of society.”

Jay has become an ibogaine evangelist, but there’s a caveat. Just ahead of his flight home he began having palpitations, and once he was back in England was rushed into hospital and diagnosed with a congenital heart problem – something he said could have been exacerbated by taking ibogaine.

review of medical reports of heart issues associated with ibogaine published in 2015 notes that “alarming reports of life-threatening complications and sudden death cases” associated with ibogaine had been accumulating. The review found that in addition to lowering the heart rate, it interacts with the heart’s electrical signals – which probably explains “ibogaine’s potentially life-threatening cardiotoxicity [damage to the heart muscle].”

It’s estimated that one in 400 people die from taking ibogaine, because they have pre-existing heart conditions, from seizures due to acute withdrawal from alcohol or other drugs not recommended for treatment with ibogaine, or else from taking opioids while under the influence of ibogaine.

Jay told me he wasn’t given an ECG to check for any heart problems before his treatment and that Jeewa had “kind of skipped something he shouldn’t have”. An ECG could have revealed his heart defect, and if it had, there’s a chance he wouldn’t have gone through with it.

‘I saw faces from the past’: Jeremy Weate, who took part in an eight-day bwiti ritual in Gabon. Photograph: Courtesty of Jeremy Weate

From his clinic in South Africa, Jeewa told me that what happened with Jay “only happens in 1% of our cases. That’s why I don’t let it stress me out. I always believe if you have a heart or liver problem, you’ll know about it before you get to me.”

Jeewa, who insisted his protocol is safe, said he usually asks patients to arrive at his clinic a day early and that he now has an in-house doctor in the clinic and is installing ECG monitors in each room. He said he’s concerned about non-medically trained ibogaine providers. “Ex-addicts take ibogaine and afterwards they need to save the world and help people,” he told me. “That’s where the problems are coming. These guys don’t have any medical background.”

Jeewa, who trained as a dentist and is himself a former addict, said that from his experience mainstream doctors are sceptical of ibogaine and fear they’ll lose their medical licenses if they prescribe it to patients: “We have had ibogaine deaths but this is because of charlatans and because people are treating themselves at home with ibogaine they’re buying from the net.”

At the moment people with no medical qualifications account for the lion’s share of ibogaine providers. I spoke to another man who, like Jay, had researched ibogaine treatment on the internet before settling for one in Europe. Aden, who lives in Luton, paid €5,000 (£4,400) to send his brother to an ibogaine detox centre on the continent, but he says his sibling nearly died. His brother, who is in his early 30s, flew there with their mother. When he arrived at the clinic he was given a cup of magnesium and told it would clear his stomach out. “They asked Mum to leave, and locked him in his room,” Aden said. “He was left there defecating and urinating on himself all night.”

The next morning, Aden said his brother was experiencing stomach pain and told the staff at the centre that the ibogaine wasn’t working and that he was still suffering withdrawal.

“By the next evening it was the same – he wasn’t responding and was having really bad hallucinations. In his mind he kept seeing our uncle, who had taken his own life, and it was freaking him out. So they started giving him THC oil [the active ingredient in cannabis that produces a high]. It was a really unprofessional, bodged-up place.”

Aden said his brother was given more and more ibogaine because they couldn’t work out why he was still withdrawing. On the fourth day, his mother told the clinic they had to take Aden’s brother to a hospital. “When they got there the doctors were livid with Mum,” he said. “They knew the clinic because its patients were admitted to that hospital all the time. They gave my brother charcoal to clean him out of all the junk they’d put in him and started him straight back on methadone.”

Aden said his brother, who had trouble breathing, was diagnosed with chronic obstructive pulmonary disease (COPD or lung disease) and a stomach ulcer on the verge of perforating. If his brother had undergone a proper medical assessment beforehand and been treated by medical professionals, he said, this wouldn’t have happened. The ibogaine clinic returned half the money before the people running it stopped responding to Aden’s emails altogether.

“Ibogaine, I believe, is only successful if a lot of factors are met,” Aden told me. “But I now realise why it’s so heavily licensed and prohibited in some countries.”

Anwar Jeewa, the Darwin-based provider, told me ibogaine works with short-acting opiates like heroin, morphine and opium, but that it doesn’t work with synthetic opiates, like methadone or buprenorphine. He said the quality of ibogaine varies, too, and he’s even seen fake iboga bark being sold. “There’s no quality control, no consistency,” he said.

Jeewa insisted that ibogaine would not have made Aden’s brother’s COPD or stomach ulcer worse, but that as he was a drug user before he took ibogaine, his body was compromised. “When you use heroin it takes a toll on your body – and some people end up with stomach ulcers because of the damage caused by opiates.”

He said opiates are essentially painkillers so you may not feel the symptoms of those stomach ulcers (or other conditions), but that once you stop taking them – and then take ibogaine to treat the addiction – those ulcers can flare up.

In the US ibogaine is a Schedule 1 substance which, like heroin, is described as a drug “with no currently accepted medical use and a high potential for abuse”. It’s a similar situation in a handful of other countries, but in most it’s unregulated – neither illegal nor officially sanctioned. In the UK the situation is a more complicated. According to the Home Office, if ibogaine is administered for its psychoactive effects, a supplier can be prosecuted (with a maximum sentence of seven years) under the 2016 Psychoactive Substances Act. But the act includes exemptions for approved scientific research “and for healthcare professionals acting in the course of their duty”.

The General Medical Council, which sets standards for doctors in the UK, recommends that if they prescribe unlicensed medicines, they should be satisfied that there is sufficient evidence of their safety. Professor Colin Drummond, chair of the Addictions Faculty at the Royal College of Psychiatrists, said that while it would be technically possible to prescribe an unlicensed medication, such as ibogaine: “It is an experimental drug so is not recommended as a treatment.”

Jeremy Weate, a British development consultant whose own experience led to him helping organise the latest ibogaine conference in Vienna, believes the hysteria over the war on drugs led to a blanket-ban approach in the US, while in the UK the Psychoactive Substances Act has failed addicts who could benefit.

Weate, who is not an addict but is interested in the healing properties of plants, wanted to experience ibogaine for himself, but through the bwiti ritual in Gabon. Last year he paid €3,000 to fly to Libreville to take part in an eight-day ceremony. It consisted of ritual bathing, inhaling the smoke from burning herbs for several hours and consuming iboga bark (“It tasted worse than sawdust”) after which he said he was in a dreamlike state for more than a day and saw “photographic-quality faces that seemed to be from the past, in conversation with a female higher spirit who seemed to know everything about me.”

“There are risks with ibogaine,” he said, “and you have to take it very seriously, but it’s the most successful drug to treat opioid addictions – methadone or heroin. Prohibition doesn’t work, and this is a chance for the government to get a step ahead of the game.”

Not everyone is convinced. Edward Conn, a counsellor now based in the north of England, used to administer ibogaine at his house in London before the Psychoactive Substances Act left the drug in a sort of legal limbo, and today he is far from the cheerleader he once was. “Treatment-wise the scene is a shambles at best,” he told me, adding that ibogaine was vastly over-hyped, risky, and pursued by extremely vulnerable individuals. “There is no shortage of people wowed by reports of ibogaine cures; I’ve seen it for 20 years. How many official clinics exist? None. Ask yourself why.”

Ibogaine, Conn said, was now being offered for every malady under the sun “from low mood to bereavement to anxiety to ADHD to pure self-interest”. He takes particular aim at those who believe it somehow teaches people about their addictions, giving them a deep dive into their psyche, saying: “Ibogaine is a chemical, not the embodiment of an anthropomorphic spirit,” which, he said, is “the position taken by pre-rational new agers and their magical thinking”.

But, Conn said, in the best of cases, ibogaine can change the direction of an individual’s drug-using behaviour and that it gives the user a window of opportunity to get clean. “For some, ibogaine does work. It’s most effective for individuals who have stopped their drug-using lifestyle and are stable on low-dose methadone, and least effective on individuals still engaged in drug use.”

So what’s the answer for people like Jay, who see ibogaine as the only solution? One American pharmaceutical company thinks it might know. Savant HWP has begun developing a drug that replicates the effect ibogaine has on addiction, but without its hallucinogenic properties or dangerous side effects: 18-MC is due to undergo human trials early next year.

“When we did the first in-human testing there was no evidence of the psychoactive effects or arrhythmia,” Savant’s CEO Stephen Hurst told me. He said they chose Brazil so they didn’t have to deal with the red tape involved in testing a Schedule 1 drug. But what about the addicts I’d spoken to who doubted 18-MC would work because, as they said: “Ibogaine without visions is like wine without alcohol”? Hurst said that in animal trials 18-MC appears to reverse the underlying brain disease that is at the heart of addiction.

“No treatment approved today does this,” he told me. “All treatments today are substitution therapies – methadone substituted for heroin, for example.” But, he said, 18-MC displaces dopamine in the reward-pleasure centres of the brain. In other words, your brain will tell you that you’ll get nothing pleasurable from a fix.

“It’s completely novel, and this is critically important. We’re still working at raising money and all my retirement has gone into the programme,” said Hurst. “We have the potential here to make a big difference. I just wish patients didn’t have to keep waiting.”

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  • rllayman

    Even though I live in the US, for awhile in the mid-1990s I was getting copies of the Independent. They ran a similar story, c. 1996.

    Ibogaine for alcoholism

  • User487418

    the second paragraph “he got hooked on the powerful painkiller Tramadol following an unrelated operation on his stomach”

    If he received painkillers following a stomach operation it is not unrelated.
    No hospital or doctor will prescribe so much tramadol that you become addicted.
    Tramadol is not such a strong pain killer – it id not work for me -I was on the highest dose – I had to switch to oxycondone which I still take and do no get addicted.

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