Chapter 1: The hot new psychedelic on the block
Hi, I'm Wendy Zukerman, and this is Science Vs, the show that pits facts against fast-track drugs. Today, we are talking about ibogaine.
Before we dive in - this episode discusses substance abuse and also mentions interpersonal abuse. So please take care while you’re listening. We’ll put some resources in the show notes.
Ibogaine - It's the latest psychedelic drug to hit the headlines. The Trump administration is very excited about it because people are saying it could be groundbreaking for mental health, and that ibogaine could cure things like opioid addiction or PTSD, which got senior producer Meryl Horn, PhD, very curious. Hey, Meryl.
MH Hey, Wendy. Yeah, I wanted to see what this was all about, and so yeah, I started looking into ibogaine. Wendy, have you tried ibogaine?
WZ I have not tried ibogaine. I, I mean, it's, it's real... It's funny when a new psychedelic hits the headlines, right? We've had so many, and ibogaine kind of felt like it came out of nowhere.
MH That's what it felt like to me, but then as soon as I started getting into it, I realized, oh, there's like a whole kind of underground community of people who are very into this drug. Uh-huh. And so I, I immediately kind of wanted to talk to people who have actually tried this- Yeah ... um, to see what it actually feels like.
WZ Great.
So meet Retz Chapman. He's from Arkansas, and he's, he's always been a, a daredevil.
RC I was always an adrenaline junkie my whole life. Uh, I really did anything with a board, snowboard, skateboard, long board, uh, wakeboard.
WZ Not chessboard, though.
MH He didn't mention. Okay. Uh, but yeah, so one day about 15 years ago, he was hill bombing in the Ozark Mountains, which is basically longboarding super fast down a steep hill, and he crashes.
WZ Oh, gosh.
RC Pretty sure like a, a rock or a pebble. Got into my ball bearing and just, just. Messed everything up and I got all wobbly and yeah, I just ate the pavement.
MH So after that crash, he gets taken to a hospital, and eventually he needs surgery, like a spinal fusion.
WZ: oooh
MH And re- the c- recovery from that was hard. He gets prescribed painkillers, um, but then he gets hooked on opioids, and then over the next several years, things kind of ratchet up. Um, he eventually starts using fentanyl.
RC Once I was on that, I, I really couldn't do anything. I, I couldn't get out of bed without, you know, doing a little line.
MH And he said withdrawal was super rough - there was physical stuff, puking, cold sweats …
RC But it was the psychological part that got me the most. Um, just I was never content. Yeah, it was just always chasing something to get out of that negative feeling that I had.
MH It was about a year ago - he told me he was in this really terrible place.
RC my life had completely become unmanageable. Um, you know, I, my family, they didn't trust me. My friends didn't want to hang out with me. Um, I was hanging onto my relationship with my girlfriend by a thread, and it was at that point where I was like, all right, it. It's time to try something.
And that something — was ibogaine. So Retz had heard about ibogaine, you know, that it could do amazing things for people struggling with addiction.
RC I was intrigued. I mean, from what I had researched, it was almost like it was too good to be true.
So he decided to give it a try.
WZ mmhmm
He, um, he went to a clinic in Mexico outside Tijuana.
RC It overlooked the Pacific Ocean. Um, there was a big, uh, statue of Jesus with his arms held out wide overlooking the ocean[1]. Uh, so that was, that was nice. Reassuring.
MH Okay, so he gets taken to this room. He lays down, and he's given these capsules with, like, white powder[2] inside, and then he's given, um, some eye shades and lays down.
WZ Down the gullet.
MH Yeah. So here's what happened.
<<Soundscaping>>
RC It was all kind of coming on, and the first thing I noticed was a a, a loud buzzing noise, kind of like in my ears.
H There's a buzz. You, I start to hear something. Like a almost a static electricity kind of sound that becomes kind like comes to you and then it's there. It lives in your head the whole time.
RC I would see visions that didn't really make sense. Kind of just like dolphins walking on land and elephants with wings and just really off the wall things. Uh, yeah, it, it was very comparable to an intense dream.
Then, they start to get a little more intense.
RC It was almost like, like visions and downloads of my life. Uh, going through my peripheral vision and I could almost like drive the experience. Like I could kind of take control and I would see one, one vision. And when I was done with that, I would be like, okay, now let's, let's take me to the next one. Like a movie reel. Hmm. Of memories going through my vision…
MH was it like a normal memory
RC Oh, no. Uh, it was memories that I deeply tucked under the rug my whole life.
I. And once I hit about the eight hour mark, that's when it, it really got intense and that's when I started vomiting and, um, got real nauseous[3] and was honestly wanting it to end.
WZ So when does it end?
MH Well Ibogaine trips are looong. That intense phase can last 20 hours[4]
Whoa ...
Mhmm
And this is the drug that Trump seems to be pumped about. Joe Rogan, who's sort of an ibogaine super fan talked about this during a big event at the oval office… so apparently he and Trump had this text exchange, um, and after he told Trump about how great ibogaine is-
<< I sent him that information. The text message came back, Sounds great. Do you want FDA approval? Let's do it. It was literally that quick.>>[5]
WZ: No… was it really that quick??
MH Yeah, I mean it's not FDA approved yet ... but a month ago Trump signed an executive order[6] fast-tracking research into ibogaine and other psychedelics, because of the potential they show for treating serious mental illness.
WZ Uh-huh.
MH So today on the show, what do we know about this drug? Something like 16 million people worldwide struggle with opioid addiction,[7] and even more people have PTSD at some point in their lives.[8] Could ibogaine be the solution? And we'll find out if it helped Retz.
WZ Coming up.
BREAK
Chapter 2: Can ibogaine help with opioid addiction?
WZ Welcome back. Today, we’re looking at ibogaine. And leading us through this trip of the science is senior producer, Meryl Horn.
MH Hi Wendy!
WZ Hello. So ibogaine … can you tell me more about this drug?
MH So ibogaine is a chemical that comes from the root of the iboga plant,[9][10] which is native to Western Africa. The plant is interesting. It kind of has these, like, orange fruit[11].
WZ Oh, yeah. I’m looking at a picture of it. It's beautiful. Yeah. And the roots are gorgeous as well, so that's where the- ibogaine comes from
MH Mm-hmm. Yeah, and it's been used, um, by people there for a long time in indigenous medicine, uh, by people who practice the Bwiti religion.[12][13] And so for example, it's taken during an initiation ritual that happens around the time someone becomes a teenager[14]
WZ Mm-hmm. And do we know how it creates a trip? Like, what it's doing in your brain?
MH SO the way all psychedelic drugs work is by latching on to proteins in the brain and that will change the way neurons communicate. Maybe some parts of your brain will like relax a little and maybe other parts of your brain will kind of start talking to each other that don't normally talk so much. So, like, for psilocybin, the thing that's in magic mushrooms, we see tons of changes in activity all over the brain.[15][16] And so presumably ibogaine works in a similar way since it also makes us, like, hallucinate.
Uh-huh.
MH But scientists are still working out the details for ibogaine, like what brain regions or neurotransmitters are involved. [17]
WZ Uh-huh. Okay. So we don't know what it's doing in our brain, but clearly it's doing a lot. We know it's doing something.
MH We know it's doing something. Yeah. We just don't know exactly how.
WZ Yeah. Right. And then, so, but there are a lot of drugs out there that we don't know the complete mechanism of how they work. Yeah. So one of the big claims is around opioid addiction, like Retz's story. Right. Mm-hmm. Do we have any data here on whether it helps people? We do. Yeah. Um, so let's talk to Alan Davis. He's an associate professor at the Ohio State University.[18]. We've talked about psychedelics with Alan before.
MH It's nice to talk to you again. It's been like seven years.
AD Yeah, Gosh. Has it been that long while?
MH Yeah. 'cause I interviewed you first in 2019
AD and somehow that feels like 10,000 years ago.
MH It does, it really does.
WZ Aw, Alan.
MH We first talked to Alan about psilocybin[19]. He's also done research on DMT.[20] So I wanted to check his temperature about ibogaine.
MH If all psychedelics were superheroes, would ibogaine be more like Captain America or someone kind of darker like Wolverine?
AD Certainly on the darker side. Um, you know, these are, uh, the experiences that ibogaine brings about in people are typically referred to and, and discussed as very challenging and difficult experiences. I almost, you know, in fact when you started to bring up the metaphor of superhero, actually the first person that came to my mind was Loki.
MH Wait, I'm sorry, I'm no a big enough nerd. Who is that?
AD Well, Loki's actually more of like a villain.
MH Oh, okay.
AD In the superhero universe. Uh, but the reason that comes to my mind is because it is a rather, you know, it can be a rather dark experience for people[21]
MH And for Retz - he did have a hard trip. He said that all of these traumatic memories came up… like this period when he was getting abused, actually.
WZ Oh gosh
MH Yeah — and that’s not uncommon - to relive the darkest periods of your life while on ibogaine. But still, all the things that Alan heard did make him curious about this drug. Because he started meeting people at, um, conferences, this is back in 2013, who had taken ibogaine for addiction, and they were telling him that it really helps them.
So Alan figured, like, "Okay, let's study this," 'cause he was on the hunt for something that could really help people- ... um, struggling with opioid addiction.
WZ Mm-hmm. So what did he do?
So he, like, went out and found a clinic, an ibogaine clinic in Mexico that was willing to team up with him and do a study on ibogaine together.
WZ Oh, was it the same one that Retz went to?
MH No. It, it was in Tijuana[22] but it was a different clinic.
WZ Uh-huh.
MH This one had been around for a while. It was one of the first clinics to treat people for, uh, addiction with ibogaine.[23] And the clinic kept all this contact information of the people who had gone there.
Uh-huh.
So it was kind of perfect 'cause then Alan and his team could get in touch with them and get them to fill out a survey[24] about what happened.
WZ Right. So what happened?
MH Well, so they got 88 people to do the survey. Hmm. Here's what he found.
AD Well, people report that it has a, a pretty profound impact on their craving and their withdrawal symptoms. And so 80% of the people in our study said that there was a large decrease. In those, um, components of their detoxification,
MH 80% of them said that it was like way better or gone.
AD Oh, yeah. That it was, it was much better or, or eliminated completely.
WZ Wow. How many people did they reach out to? So 88 folks responded to the survey, but I'm wondering- Hmm ... if they-
MH If it was, like, just finding the people where it worked?
WZ Yeah, yeah, just because with surveys like this, if you have an opioid addiction and you go to a clinic in Tijuana and you- Mm-hmm try this drug and it doesn't work for you, and two years later some researchers contact you and say, "How was that?" Yeah. I feel like if it didn't work for me- And then it's like- ...
MH I'd go- ... F you. Right. I don't wanna -
WZ I don't wanna spend more time on this. It didn't work. Exactly.
MH OK, so in this study, they reached out to 285 people, and only 88 of them got back.[25]. So - yes, valid concern. But there have been other studies too that didn’t seem to have this issue to me. Like a study[26] that just got all the charts of a bunch of people who went to an ibogaine clinic and looked at how well it worked, or studies that followed people along as they tried ibogaine for opioid addiction….[27][28][29] And all those studies, 5 of them including Alan's, found similarly impressive results - most people said ibogaine really helped their withdrawal symptoms after taking it.
WZ Wow
MH So it seems like this is a real effect.
WZ: OK!
I asked Alan about what he thought at the time, when he saw his results.
AD Well, it was pretty profound, you know, at the time to, to see that, you know, so many people had said that there was this huge impact on their functioning really quite immediately. Um, you know, especially coming from where I came from with my, you know, experience in substance use treatment and, and, and trying to help people in that space.
MH So had you ever seen anything that worked that well to just like - Bam?
AD No. Mm-hmm.
MH Wow.
AD No. Yeah.
WZ Mm. And what happened to Retz?
MH Okay, yeah. Let's go back to Retz's story. So even though he said that, you know, his trip was, like, extremely hard to, like, revisit these traumatic things that happened to him, doing all that did kind of, like, change the way that he looked at that part of his life and that person who abused him.
RC After this experience, after revisiting that memory, I kind of forgave myself and that person, um, to where there was no more shame and guilt attached to that ex- to, to that memory.
MH And so yeah, after this was all over, he said he felt really good.
RC I came out of there just so happy, and I, I felt like I wouldn't wanna trade my life with anyone else's.
WZ Woah. But then what happened with his opioid addiction?
MH Yeah, I asked him.
MH So what happens to the like cravings and the withdrawal symptoms and all and all that?
R Yeah. I mean, it all dissipated like it was non-existent. It was just magical.
MH They were just gone like, you just didn't want to do opiates anymore?
R I didn't want to do anything like Advil, repulsed me, like anything that I put in my body, like I was just totally cool with just living life on life's terms.
And I did talk to one other person who tried ibogaine to break an addiction- Holly. Leading up to it, she had an abusive partner. She started using opioids, just kind of casually at first … And then one of her kids was diagnosed with muscular dystrophy … he would end up dying from it
WZ oh my gosh
MH … and during his illness … that’s when Holly found herself needing drugs to cope …
H It's the worst kind of pain. And it, it was a, it is a pain I couldn't escape. And, um, I, I really think that's what kind of kept me in my cycle. Um, that where I had to kinda stay numb to function.
MH This went on for years.
WZ oof
MH Ultimately, she found a new and supportive partner, but was still struggling with drugs. So she gave ibogaine a go. and it was also a hard experience for her, she felt like she was sort of confronting the darkest parts of herself... But then, going through that, really changed something in her.
MH so what was it like coming out of this experience?
H haha, so if the experience itself is like going down to the depths of your shadow self, coming out that other side is like shooting to the top of your best self. That’s how I felt. I came out of it like, OK. I’m here. I’m not in danger. I'm not that little girl anymore. I'm not that battered wife. I can, I can feel the pain and, and process it and let it move through me, and I can be OK. I can come out on the other side OK. And, and better off.
WZ Wow
MH So I asked Holly, what happened to your withdrawal symptoms and cravings after the ibogaine?
H Gone. No interest. I had no memory of what it felt like to be high. There was no, it's like I had a memory of doing it and struggling with it, of course, I remembered everything, but I had no, I guess you could, like the analogy would be like muscle memory for it. It did not feel natural to wanna go pick it up. I had an aversion.
MH Your face almost looked like you were, you were disgusted even thinking about it.
H Disgusted. That's how I felt like, ugh, that's not for me.
Chapter 3: How does ibogaine help people?
WZ That's an incredible story…. So we don't really know what ibogaine's doing in the brain, but do we have any sense of why it might be able to have this effect on people?
MH Well, we actually do know more about how it might be helping people. Like we, we know more about that than how it just makes us trip.
WZ Oh, okay.
MH Um, so basically it, it could be encouraging neuroplasticity, and scientists think that maybe because the trip is so long, it could be opening up this like big window where the brain can remake itself.[30] And we have animal studies backing this up… researchers have found that injecting ibogaine into rats can lead to the release of growth factors[31][32] - proteins that can encourage neurons to make new connections[33] - and they’ve found that this was happening in parts of the brain that are rewired during addiction - like the reward centers of the brain[34].
WZ oh cool
MH And we don’t have a lot of research on human brains yet … but I did find a study on this in veterans with traumatic brain injuries[35] … so, scientists gave them ibogaine - and looked at what sorts of brain changes happened ... And they found that after the vets got ibogaine, parts of their brains were thicker[36]. So just like the rat studies, they think it might be enhancing neuroplasticity.
WZ Wow. And so there's something about addiction where your brain is wiring in this way that's really not good for you that's creating this need for the drug more and more.
MH Mm-hmm.
WZ And by shaking it up, by encouraging new pathways to form, you're really loosening up those neural connections.
MH Yeah. Yeah, and you know, we've been talking a lot about addiction, but there is, um, also promising research on PTSD and anxiety too,[37][38] so showing that it might help there for, for veterans.
WZ Which you could also imagine if with ruminating thoughts and- around PTSD and-
MH Yeah, and, and, like, revisiting traumatic memories, you know?
WZ Yes.
MH Maybe it's opening up this, like, period for, like, a rewiring around those memories.
WZ Yes.
MH But, you know, a lot of what we have right now, all these studies are looking at the short-term benefits, like right after people take this big dose of ibogaine.
WZ mmmm.
Chapter 4: How long do the benefits last?
WZ Yeah, so what happens over time? Does your brain go back to what it was before, or is this rewiring permanent?
MH Well, so that's, that's the big question, right? So there actually were a bunch of studies[39][40] like Alan's finding these, like, amazing short-term, uh, like, results.
WZ Yeah
MH And that's kind of why Alan actually was doing his study, was he wanted to see how long that lasted. And, you know, the study that he was doing was actually, like, sometimes years after people had their trips. So he, he asked them, "Okay, when you first took it, how did you feel?" And that's where we got that 80% figure from.
WZ Okay.
MH But then he was also asking, "How do you feel now?" You know, one or two years later. Um, are you, are you still off opioids? And so I asked him what he found.
MH How well did it work to like, help people to stay off opioids?
AD Well, you know, our, the main finding was that about 30% of people were still completely abstinent from opioids, um, up to two years later.
WZ 30% of the 88.
MH Yeah, 30% of the whole group said that they never had opioids again.
WZ Mm-hmm.
MH Was it a little bit of a letdown?
AD I, you know, I don't think it was a letdown necessarily, but I think what it did for me is it really further solidified, um, the point that, you know, this is not going to be a magic bullet for people.
MH Alan wasn’t actually that surprised at this figure… since after people go to these clinics, they still have to go home to their normal environments… So in light of that - he was like it’s actually pretty impressive that it worked for 30% of people.
WZ Yeah
MH And Alan said that even with that 70% of people who did go back to using opioids, a bunch of them were using less than they had used before the ibogaine.[41]
AD it's kind of amazing.
MH Yeah.
AD Right. It's kind of amazing
MH Yeah.
AD That, that was possible.
WZ And what about Retz and Holly? How did, how are they doing now?
MH Yeah, so I asked them how things went for them longer term, and they both said that the cravings did eventually come back.
WZ mmm
RC Like, I don't wanna say that I felt the ibogaine wear off, but physiologically I almost did to the point to where like my body knew. And, um, it just, it required me to really take action and, you know, start talking to my therapist more, um, and start putting in the work because like they, they say Ibogaine will open the door for you, but you still have to walk through it.
MH So now it’s been about a year, and Retz has managed to stay off opioids since he first went to the clinic.
WZ Amazing
MH And with Holly, I asked how long the ibogaine worked…
H Months, and then It started to, and I relapsed and, and that was the first little wake up call. Like, yeah, you knew this. You knew it wasn't gonna last. It's not a magic bullet. That really taught me that, OK, I need to be prepared to maintain my recovery.
What does that look like? So actually both Retz and Holly still, as part of their recovery, do Ibogaine regularly. Um, they both take smaller doses, what Holly calls tune-ups. She does them maybe once a year.
H It, it is working. I'm, I'm sick of doing ibogaine.
MH yeah? You wish you didn't have to do the tune ups?
H I hate it. Like I, I don't hate, I don't, that's strong, I don't hate ibogaine. I, I'm so grateful. I'm so grateful.
MH No but what is it about needing to do it every once in a while that is like -
H because it makes me physically sick. I throw up every time
MH uh huh
H so now my husband has to put the powder in the capsules because just even looking at it. Oh, makes me even thought about a pill, a capsule. I would get nauseous.
MH Oh, wow.
H I've, I've had the worst sickness on Ibogaine.
WZ So these tune-ups, this kind of microdosing. Ibogaine, i- is there any science on whether that helps?
MH I haven't seen any research on that, no.
WZ Mm-hmm.
MH But, you know, for Holly and Retz, they say it definitely helps. And, you know, it almost gives them a similar sort of therapy as that original, the bigger dose. It's, it's, it like gives them a shorter version of that same experience.
WZ Uh huh. Interesting… I mean these experiences people are having, I can understand where the excitement around this drug is coming from… And also some promising research, but now that I think about it, Meryl, none of those studies you talked about had a placebo control right?
MH No, they didn’t…
WZ It was just, they followed people who tried ibogaine. So do we have any actual clinical trials comparing it to a placebo?
MH We actually do.
WZ Oh.
MH Yeah. So that's what I'll tell you about after the break. Plus, is it safe?
WZ mmm. What are the risks here? Coming up!
<<BREAK>>
Chapter 5: What are the risks?
Welcome back. Today we are looking at the latest psychedelic wonder drug, ibogaine. And Meryl, you've promised to give us a clinical trial, some real hardcore research we can sink our teeth into.
MH Mm-hmm. Yeah, so let me tell you a story actually because there was supposed to be a clinical trial back in the '90s, uh, that the NIH was gonna do-
WZ mm ...
MH … on ibogaine, uh, specifically NIDA, the part of the NIH that does drug addiction research. And, you know, it got started, they had even given ibogaine to some patients.[42][43] But then, the trial was stopped.
WZ Why?
MH Well, ibogaine can kill you.[44]
WZ Oh, gosh. Some of the people died in the study?
MH Not in that trial, but they had heard about a death that happened in the Netherlands from ibogaine, and that seemed to spook the people running the trial,[45][46] so they, they pulled the plug on it.
WZ How do you die from ibogaine?
MH Well, I mean, we know ibogaine, of course, goes to the brain, and that's why you, you trip, but it also goes to the heart, and that's where it can cause trouble. Um, so in particular, there's a little channel in the heart that lets ions go through it, potassium[47] specifically, and when ibogaine gets into the body, even at pretty low levels, it latches onto this channel like a magnet, which is really bad because this channel is really important for making your heart pump blood properly.[48]
WZ So you get basically a heart attack?
MH Sort of. It's, um, technically an arrhythmia. Uh-huh. Paul Glue, a professor at the University of Otago in New Zealand,[49] is the one who explained this to me: what this can all lead to, when things really go south.
PG You are getting much less blood sent around the body, and there's a risk that your heart will just stop. Um, unless you've got somebody sitting right next to you with a, some epinephrine and, and a set of paddles, you are officially dead,
WZ And ibogaine can do this or does-- We know for sure if you get high enough doses of ibogaine, you have a very high chance of, of dying this way?
MH We don't know how likely it is that you'll die from taking ibogaine. Like yes, we have documented deaths from people taking ibogaine- Mm-hmm ... um, because of this, this thing that happens with the heart. Um, researchers have been kind of collecting case studies here and there to try to figure out how often it's, it's happening, so you can kind of add up all these documented deaths.
Mm-hmm.
PG And they're probably about somewhere between 30 and 40 deaths.[50]
WZ That's not per year. That's when you search the literature for case studies of anyone dying from ibogaine-
MH Mm-hmm ...
WZ over decades.
MH Yeah, since we've been researching this. Yeah, yeah. And f- and this is in the West, or this includes, are people dying in West Africa as well?
MH It's both. There have been a couple documented deaths, um, from people taking it in West Africa. And this is generally a known possibility among people who practice Bwiti and take iboga during rituals, though it is rare.[51][52]
Chapter 6: Is there a safe dose that can help people?
And so Paul wanted to know, like, can we get around this? Can we get the benefits of ibogaine without this risk? Um, like, is there a dose we can give that's safe? Right. So he did a study. He's the one who did this, you know, placebo-controlled randomized clinical trial.[53] Okay, so what did he do? So he teamed up with a pharma company that was interested in making this drug. Mm-hmm. They actually used a slightly different version of the chemical. Uh, ibogaine itself, you know, no drug company is interested in making that into a drug because it can't be patented since a researcher did that, like, years ago already.[54]
Okay. Sort of, um, like a pharma cock-block. So- ... Paul's team just tweaked it slightly and made something else called noribogaine.
WZ Okay.
MH Which is what your body turns ibogaine into as it breaks down the chemical.[55]
WZ Mm-hmm.
PG But, but in general, noribogaine should do exactly what Ibogaine does.
Okay. So they got their noribogaine.
They recruited 27 people, um, who were addicted to opioids,[56] and they were on methadone, wh- which they weaned off before they started the trial. And they brought them into a hospital. So imagine a big room with a bunch of beds.
PG Um, we, we had a lot of staff on board, so it was, it was a very busy ward and then gave them either noriboga or um, placebo, and we waited to see how quickly they went into opiate withdrawal.
And it was really easy for them to do this because there are these telltale signs that someone's gone into withdrawal.[57]
PG their pupil start to dilate. They get the sniffles, they get goose pimples all over their arms. Um, their blood pressure goes up, their heart rate goes up. And, and there are these great scales[58] where you can show how, how bad the withdrawal is by, by just sort of totting up all these symptoms and, um, and getting a score on them.
WZ Okay. So what we've got here, they got a bunch of people who were dependent on opioids, brought them into the hospital, gave half this I can't believe it's not ibogaine.
MH The placebo, you mean?
WZ No, the noribogaine or whatever. You know, I can't believe it's not butter.
MH Oh, the noribogaine.
WZ Yes, yes. You know? It was noribogaine. Right. And, uh, the other half got a placebo, and now Paul is waiting for pupils to dilate, goose pimples to show up, signs of withdrawal.
MH Basically, except they also try, um, a bunch of different doses because they're trying to look for, okay, like, w- as they're also monitoring their hearts, how high up can we go before we start to see, like, bad things start to happen to the heart? So now he can check, okay, at the highest dose they could give was safe, what happened to the withdrawal symptoms?
WZ Got it
MH And so he tried these different doses- Mm-hmm ... and he could see this heart problem getting worse and worse the higher and higher the dose they gave.[59]
WZ Right.
MH And so he- they had to stop at a pretty low dose. And he checked to see, did it help? Did people's withdrawal symptoms, like, get any better compared to the placebo? And?
PG There was no difference between placebo and uh, and, and noribogaine.[60]
WZ So based on this study, even at fairly low doses, doses that we don't think, based on the limited information we have, would help with your opioid addiction, you still get evidence of heart problems.
MH Yeah. Yeah
WZ The beginnings of what could become heart failure.
MH And Paul knew based on, like, what other drugs have been approved, that with those effects that they were seeing, there's no way a drug that was having those effects on the heart would ever fly.
PG is is a non-starter. FDA simply wouldn't approve it.
MH Yeah, it is kind of a bummer, huh?
PG Uh, it's, it is what it is.
WZ Well, FDA wouldn't have approved it several years ago. We live in a different world today, Meryl …
MH Yeah. We'll see. and I did find one other small, um, trial,[61] placebo-controlled trial looking at ibogaine, and when I first saw that one, I was like, "Oh, this is great," because they found that it was really working for people. In that case, um, it was on people who were addicted to cocaine. Hmm. And they had less cravings. But, then I chatted with Paul about the dose that they were giving.
MH It says that they received a dose of 1,800 milligrams. So that's like 10 times more than what you were giving?
PG Yep. Okay. No, that's, that's 30 milligrams per kilogram.
MH So that's, would you say that was actually pretty dangerous?
PG It’s just, it's reckless. It's just crazy. It's, it's a really high dose. Um, and, uh, I'm, I'm pleased that no one died in that experiment. But, um, let's say it's not one of science's high points.
MH Btw … I did reach out to those researchers to ask about the danger here - didn’t hear back.
WZ But the fact that people didn't die, I mean, we still don't know why it is that some people can tolerate high doses like Retz and Holly and- Mm-hmm other people who are going to these Tijuana clinics. Everyone who's in Alan's study obviously- Mm-hmm ... survived to fill out the survey. Um, we don't know why those people are fine, and yet you've people who died.
MH Yeah. In, in about half of those deaths, um, it looked like there was some other issue that had, like a comorbidity[62]- Hmm um, that might explain, like, that predisposed people to, like, cardiac, um, risks. But in the other half, th- they, you know, they didn't see that, so we're still not sure why it's sometimes killing people. Hmm.
MH And you know, I think scientists might find a way to get that benefit for addiction without the cardiac risks. Like, I talked to a different scientist who's doing clinical trials right now to find out if maybe we can, like, space out the dosing- Hmm ... to find a sweet spot, and Paul's als- also hopeful that something like that can work,[63] but we're not there yet. And on top of all that, there's, there's another issue that came up while I was doing this research. Hmm. I found that in some of those observational studies that work with ibogaine clinics, like the one Alan worked with- Hmm they're, they're actually giving people another psychedelic along with the ibogaine.
WZ Oh. Two for one. Mm-hmm. What are they giving them?
MH So yeah, a couple days after their ibogaine trips, they'll often get DMT.[64] [65]
WZ Oh. Did, is that what happened with Holly and Retz?
MH Well, Holly didn't go to one of these clinics and didn't have DMT. Mm-hmm. But yeah, Retz got DMT also a couple days later. [Specifically, Retz was given 5-MeO-DMT.]
And, you know, it seems like maybe they do this because DMT might give you, like, a softer landing after that, you know, dark, intense ibogaine trip. Mm-hmm.
WZ The old hair of the dog using DMT. Okay. Yeah.
MH Yeah, I talked to Alan about this, and he said that DMT-
AD It’s more likely to bring about an experience of, of euphoria and mystical experience and kind of almost like a positive transcendent experience. It's almost like you can take someone now they've been broken down by I beginning and give them this other thing. They'll kinda lift them back up and kind of propel them forward.
MH And yeah, Retz said that, you know, he felt really good after getting the DMT. Yeah. But it does make the science messier, you know, trying to figure out, like, what drug is actually helping.
AD we've tried to disentangle a little bit, but it's been incredibly difficult because usually these treatments that they give them are within a couple days of each other. And so it's almost impossible to know, you know, which one contributed to the overall effect.
WZ So if you are struggling with addiction or PTSD or someone you love is, based on all of this research, would you recommend they give ibogaine a go?
MH Well, yeah, that's what I wanted to know. Like, I asked, um, Paul about this, and he said that for, for people who still wanna try this, you should at least go to, like, a, a clinic that's monitoring your heart when you're on ibogaine- with someone who knows how to use that equipment, like a cardiologist. That's actually what Retz did. Holly wasn't at a clinic though, like I said.
WZ Yeah.
MH Um, she did, she did get her heart, like, checked first, but I asked her how she felt about this risk.
MH Had you heard that there had been some deaths from taking ibogaine. Before taking it yourself.
H Yes.
MH And so, yeah. Why did you decide to do it anyway, knowing that that could be a risk?
H I was dying. I felt like a dead walking person. I mean a walking dead person. I, I was not living, let's put it that way.
MH Mm-hmm.
So, brings up this point of - sure, ibogaine might kill you, but so can opioids. Something like 55 thousand people die from opioid overdoses every year in the US alone.[66][67] So it feels like the calculation may be different depending on who you are.
WZ yeah. And if you have any known heart risks.
MH But one thing that now feels really sketchy is that some of these ibogaine clinics aren’t just marketing themselves to people who are suffering from a serious condition like substance abuse or PTSD. I saw a comment online from one of them saying “Many healthy people choose to do it for cognitive enhancement, neurogenesis, more clarity, peace…” [68] [69].
WZ Of course
MH And that clinic charges between 10 and 20 thousand dollars for this peace[70] -
WZ Whoa - Who’s - That’s, and then they’ll What?!
MH Yeah.
WZ Uh-huh. Um, yeah, I mean, it's a drug, right? People wanna take, people t- people take drugs all the time- ... for peace and, uh, clarity.
Yeah.
WZ Um, uh, so Meryl- It's- ... you're ducking the question. You recommending it to a friend or not?
MH Well, so, all right, well, bottom line, I also asked Alan- Uh-huh ... um, the same question. Here's what he said. I'm ducking it again.
WZ Yeah, I can see that.
MH Here's another scientist.
MH So what would you say to, to someone who is thinking about trying ibogaine for, for addiction?
AD Well, you know, not surprisingly, you know, because of the research that I do, people actually do email me with this question. Oh yeah. And, and, and, you know, I've heard of this research. What should I do? My son is struggling, my daughter is suffering, my parent is suffering. Um, should I go to Mexico? Is that the answer? And I almost, you know, I, I always tell people, um, this is not a choice I would make. It's expensive, it's risky, you know, I would much rather, um. Encourage someone that I cared about to fly to Colorado and get a psilocybin therapy session.
MH Yeah.
AD In a, in a regulated market, um, where we know where the psilocybin’s coming from and we know who the providers are that are doing it, they're licensed professionals. You know,
MH We do have a lot more research on psilocybin, and it is safer.
WZ So Meryl, here is where we are at with the research on ibogaine. Um- Okay some people who are really struggling with opioid addiction and PTSD have had amazing experiences on ibogaine- Mm-hmm ... and it's really helped them. But it doesn't last forever. Mm-hmm. And in the meantime, while ibogaine is doing some cool stuff up in your brain, it is also potentially doing scary stuff to your heart. Mm-hmm … And at the moment- we don't know what that risk is. Even though it's probably not super high, we don't know. Mm-hmm. So if you are struggling and you really wanna try a psychedelic, at the moment give magic mushrooms a go.
Yeah.
WZ All right. Thanks, Meryl.
MH Thanks, Wendy.
That’s Science Vs.
And before we get to the citations, we have a sponsored segment … where we answer listener questions from you! Here it is …
Ask Wendy Anything segment
WZ OK, now it’s time for citations - how many do we have in this week’s ep Meryl?
MH We have 70 cites! So go to our show notes, and click on the transcript to see all of that ibogaine science. In our show notes is also where we’ll put resources related to mental health and substance use.
WZ Thank you
CREDITS
This episode was produced by Meryl Horn with help from Rose Rimler, Ekedi Fausther-Keeys, Michelle Dang and me, Wendy Zukerman. We’re edited by Blythe Terrell. I'm the executive producer. Fact checking by Diane Kelly. Mix and sound design by Bobby Lord. Music written by Bobby Lord, Bumi Hidaka, So Wylie, Emma Munger and Peter Leonard. Thanks to the researchers we spoke to about this, including Rafael Santos, and a special thanks to those who talked to us about their ibogaine experiences we really appreciate you - thank you.
Science Vs is a Spotify Studios Original. Listen for free on Spotify or wherever you get your podcasts. Follow us and tap the bell for episode notifications.
[2] https://www.drugscience.org.uk/ibogaine Ibogaine hydrochloride is a shimmery white powder, which is put into capsules, ingested orally or diluted in liquids.
[3] The most commonly reported adverse effects after ingestion of ibogaine are nausea & vomiting.
[4]Patients experience several different phases that may be categorized into acute, evaluative, and residual stimulation stages. The first phase (acute phase) is experienced within first 1–3 h after exposure and lasts 4–8 h. During this phase, patients report panoramic delivery of long-term memory, mainly visual; “visions” or “waking dream”states experiencing contact with transcendent beings, passage along a lengthy path, floating, etc. Although visual experiences are not reported by all patients and seem depend of drug exposure, it is also noticed that they were associated and enhanced with eye closure. Unfortunately, differences between these dreams and hallucinations are not clear enough. The second phase (evaluative phase) starts approximately 4–8 h after ingestion and lasts 8–20 h. During this phase, dreams decreased slowly and the emotional tone is generally described as neutral and reflective. Patients reflect that their attention is focused on inner subjective experiences (i.e., by evaluating the experiences of the acute phase). The third phase (residual stimulation phase) starts 12–24 h after exposure and lasts 24–72 h. Patients regain normal attention to the external environment.
[6] https://www.whitehouse.gov/presidential-actions/2026/04/accelerating-medical-treatments-for-serious-mental-illness/ Psychedelic drugs, including ibogaine compounds, show potential in clinical studies to address serious mental illnesses for patients whose conditions persist after completing standard therapy.
[7] This activity focuses on the critical evaluation and management of opioid use disorder (OUD), a pervasive condition significantly diminishing patients' quality of life and contributing to a widespread epidemic in the United States. With over 16 million affected globally and 2.1 million in the United States,
[8] https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder An estimated 3.9% of the world population has had post-traumatic stress disorder (PTSD) at some stage in their lives. [world population = ~8.2 billion, = 319,800,000]
[9] The perennial rainforest shrub T. iboga, commonly known as iboga, is native to central western Africa. The plant reaches about 1.5–2 m in height and has yellowish or pinkish flowers that turn into sweet fruits which do not contain psychoactive alkaloids. The plant is a sacrament and symbol of power in the Bwiti religion, with the roots used in religious ceremonies as a ‘bridge to the ancestors.’ In small amounts (up to 5 mg kg−1), the root is chewed by locals to reduce hunger and fatigue, but larger amounts (10 mg kg−1 or greater) will cause hallucinations and have even caused death.
[10]1969: The roots of T. iboga contain several indole alkaloids, of which the most important, ibogaine, is a central stimulant and in large doses an hallucinogen.
[12]In Gabon, the Bwiti is both a cult and a traditional ritual aimed at healing the sick….The Bwiti is one out of several religions in Africa and through it, it is believed, that the members can be connected to the world of the ancestors. There is also the ritual of healing in Bwiti. In this ritual, participants are invited to take iboga. They fall into a trance and after this phase, which in principle lasts three days; those who were sick recover the health in many cases.
[13] Discussion of the drug in a journal from 1895!
[14] The therapeutic and oneirophrenic (dream-like) effects of iboga roots have been described in the ethnobotanical literature for centuries, where ingestion of Ibogaine root preparations ceremonial and medicinal use (Goutarel et al., 1993; Samorini, 1995). In Africa, approximately 2–3 million members of the Bwiti religion in Gabon, Zaire, and the Cameroun take large doses for “the ‘Bwiti initiation ritual’ – a powerful ‘rebirth’ ceremony that group members typically undergo before the commencement of their teenage years” (Fernandez and Fernandez, 2001).
[15] The group level results (Fig. 2) revealed significant CBF decreases in subcortical (bilateral thalamus, putamen, and hypothalamus) and cortical regions [the posterior cingulate cortex (PCC), retrosplenial cortex, precuneus, bilateral angular gyrus, supramarginal gyrus, rostral and dorsal anterior cingulate cortex (ACC), paracingulate gyrus, medial prefrontal cortex (mPFC), frontoinsular cortex, lateral orbitofrontal cortex, frontal operculum, precentral gyrus, and superior, middle and inferior frontal gyrus] (Fig. S1). The decreases were localized to high-level association regions (e.g., the PCC and mPFC) and important connector hubs, such as the thalamus, PCC and ACC/mPFC....results strongly imply that the subjective effects of psychedelic drugs are caused by decreased activity and connectivity in the brain's key connector hubs, enabling a state of unconstrained cognition.
[16] KP Study Psilocybin: Across time, Psi-induced hypo-connectivity was observed across subcortical areas as well as cortical associative networks. Furthermore, hyper-connectivity was induced in sensory areas. Virtually identical to LSD …. These results are consistent with the hypothesis that this pattern of hyperconnectivity in sensory and hypo-connectivity in associative regions is induced by different serotonergic hallucinogens and may therefore underlies the psychedelic state
[17] https://www.jsatjournal.com/action/showPdf?pii=S0740-5472%2821%2900443-8 While ibogaine and noribogaine interact with several central nervous receptors, studies have reported the strongest affinities of ibogaine for the sigma2-receptor, the opioid receptors, SERT, and DAT (Preedy, 2016; Ray, 2010). However, Antonio et al. (2013) demonstrated that opioid agonism does not seem to account for the observed effects of the iboga alkaloids in opioid withdrawal. κ-opioid receptors (KOPR) may also play a specific role.
[19] Show notes: Magic Mushrooms
[20] A comparison of reactivation experiences following vaporization and intramuscular injection (IM) of synthetic 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) in a naturalistic setting
[21] Category II consists of six themes, including: (d) buzzing and/or vibration sounds at onset of experience; (e) entering into specific settings; (f) cyclical/organizational imagery in visions; (g) mix of dark/scary and joyful/peaceful imagery; and (h) the experience is difficult to describe.
[22] [This clinic isn’t open at this location anymore. Here is the old website:] Crossroads Ibogaine Treatment Center is one of the first Ibogaine addiction facilities in the world. It was started by Dr. Martin Polanco, who has more than 15 years of experience helping people heal addiction with Ibogaine.
[23] https://about.me/ibogainetreatmentcost Crossroads Ibogaine Treatment Center is one of the very first Ibogaine addiction facilities worldwide.
[24] The final sample was comprised of the remaining 88 participants….Most (80%) indicated that ibogaine eliminated or drastically reduced withdrawal symptoms. Fifty percent reported that ibogaine reduced opioid craving, some (25%) reporting a reduction in craving lasting at least 3 months. Thirty percent of participants reported never using opioids again following ibogaine treatment. And over one half (54%) of these abstainers had been abstinent for at least 1 year, with 31% abstinent for at least 2 years.
[25]This contact list included 336 individuals who received ibogaine treatment at Crossroads between 2012 and 2015; however, only 285 had active e-mail addresses and/or telephone numbers.
[26] Malcolm et al 2018 https://www.tandfonline.com/doi/full/10.1080/02791072.2018.1447175
This study examined opioid withdrawal and drug craving scores in 50 participants with OUD undergoing a week-long detoxification treatment protocol with ibogaine…. COWS (Wesson and Ling 2003), SOWS (Handelsman et al. 1987), and Brief Substance Craving Scale (BSCS) (Somoza et al. 1995) scores were collected by a clinic physician at 48 and 24 hours prior to ibogaine administration, as well as 24 and 48 hours after ibogaine administration… At 48 hours following ibogaine administration, withdrawal and craving scores were significantly lowered in comparison to baseline: 78% of patients did not exhibit objective clinical signs of opioid withdrawal, 79% reported minimal cravings for opioids, and 68% reported subjective withdrawal symptoms in the mild range.
A retrospective chart review of participants admitted to a single residential ibogaine treatment center in Mexico during 2015 was conducted.
[27] Mash 2001 https://ibogaine.mindvox.com/wp-content/uploads/2019/06/Ibogaine-in-the-Treatment-of-Heroin-Withdrawal.pdf
The study was conducted in a 12 bed freestanding facility in St. Kitts, West Indies .. Overall, the sample of 32 patients… Two physicians rated as present or absent 13 physical signs typically associated with opiate withdrawal, based on a 10-minute period of observation… also did a "The Opiate-Symptom Checklist (OP-SCL) was developed for the present study as a subtle assessment ofwithdrawal symptoms,” See figure 3 for graphs - Physician ratings demonstrate that ibogaine administration brings about a rapid detoxification from heroin and methadone…Self-reports of withdrawal symptoms shortly after recovery from ibogaine treatment (< 72 hours) were significantly decreased from the pre-ibogaine rating obtained 12 hours after the last use of opiates and were comparable to the level of discomfort reported at program discharge approximately one week later”
[28] Alper 1999 https://pubmed.ncbi.nlm.nih.gov/10506904/ The cases presented in this paper are a subset of 41 cases of patients treated with ibogaine between 1962 and 1993 that were presented at the Ibogaine Review Meeting held by MDD-NIDA in Rockville, MD…Thirty-three of these cases were selected according to the following criteria: All patients in this study retrospectively met the DSM IV criteria28 for Opioid Dependence with Physiological Dependence at the time of their treatment..(2) Having been directly observed by either or both co-authors H.S.L. and/or G.M.N.F., continuously at the scene for at least 48 hours following treatment with ibogaine. … Thirty-three cases of treatments for the indication of opioid detoxication performed in non-medical settings under open label conditions are summarized involving an average daily use of heroin of .64 ± .50 grams, primarily by the intravenous route. Resolution of the signs of opioid withdrawal without further drug seeking behavior was observed within 24 hours in 25 patients and was sustained throughout the 72-hour period of posttreatment observation. [25/33 cases = 76% of people]
[29] Noller 2017 https://www.tandfonline.com/doi/full/10.1080/00952990.2017.1310218
This observational study measured addiction severity as the primary outcome in 14 participants.. Subjective Opioid Withdrawal Scale (SOWS) was collected before and immediately after treatment to measure opioid withdrawal symptoms.
Participants who independently sought treatment were recruited through two ibogaine providers offering treatments on a fee-for-service basis (hereafter Provider 1 and Provider 2). .. Consistent with preceding studies, evidence showed significant attenuation of withdrawal, sustained reduction in drug craving/use, and cessation of use in some cases.
[30]The duration of acute subjective effects and the durability of the therapeutic response vary considerably across psychedelics. For example, in humans, the acute subjective effects of ketamine last 30–120 min, whereas its antidepressant effects last for 1 week. By contrast, the subjective effects of psilocybin and MDMA last for 3–6 h, whereas the acute effects of LSD and ibogaine persist for 8–10 h and 36–72 h, respectively; these long-lasting subjective effects correspond to highly durable therapeutic effects that last months to years, see Fig. 3: The durations of acute subjective effects in humans are proportional to the durations of the critical period open state in mice.
[31] Microinjection of ibogaine into the ventral tegmental area (VTA), but not the substantia nigra, reduced self-administration of ethanol, and systemic administration of ibogaine increased the expression of glial cell line-derived neurotrophic factor (GDNF) in a midbrain region that includes the VTA.
[32] expected that the observed effects found at 24 h, would be due to long lasting mechanisms elicited by the drug which remain after it has been cleared from the brain, but not from the acute effects of ibogaine/noribogaine….These results show for the first time a selective increase of GDNF specifically in the VTA for I40 but not for I20 after 24 h of administration, which agrees with the effective dose found in previous self-administration studies in rodents…. Both doses elicited a large increase in the expression of BDNF transcripts in the NAcc, SN and PFC, while in the VTA a significant effect was found only for I40.
[33] Brain Derived Neurotrophic Factor (BDNF) signalling contributes to the formation, maturation and plasticity of Central Nervous System (CNS) synapses….We hypothesize that several converging mechanisms contributed to the up-regulation of excitatory synapses following chronic treatment with exogenous BDNF. We documented an increased survival of neurons in BDNF-treated cultures and, in particular, the doubling of survived pyramidal neurons, usually displaying a higher ratio in excitatory glutamatergic synapses than other cells
[34] The ventral tegmental area (VTA) is well known for regulating reward consumption, learning, memory, and addiction behaviors through mediating dopamine (DA) release in downstream regions.
[35] we report a prospective observational study of the Magnesium–Ibogaine: the Stanford Traumatic Injury to the CNS protocol (MISTIC), provided together with complementary treatment modalities, in 30 male SOVs with predominantly mild TBI. MISTIC resulted in significant improvements in functioning both immediately (Pcorrected < 0.001, Cohen’s d = 0.74) and 1 month (Pcorrected < 0.001, d = 2.20) after treatment and in PTSD (Pcorrected < 0.001, d = 2.54), depression (Pcorrected < 0.001, d = 2.80) and anxiety (Pcorrected < 0.001, d = 2.13) at 1 month after treatment. (n = 30)
[36] Thirty Special Operations Forces veterans with prior blast-induced TBI participated in an observational study in which they received ibogaine co-administered with magnesium. Structural MRIs were collected at baseline (n = 25), initial post-treatment (n = 25), and 1-month post (n = 22)....Magnesium-ibogaine therapy was associated with increased cortical thickness, subcortical expansion, and reduced pBA at
1 month. Although T1s are sensitive to nonstructural changes, the overall direction of effect is consistent
with neuroplastic change.
[37] Results indicated significant and very large reductions in retrospective report of suicidal ideation (p < .001; d = -1.9), cognitive impairment (p < .001; d = -2.8), and symptoms of posttraumatic stress disorder (p < .001; d = -3.6), depression (p < .001; d = -3.7), and anxiety (p < .001; d = -3.1)... (n = 51)
[38] https://www.nature.com/articles/s41591-023-02705-w MISTIC resulted in significant improvements in functioning both immediately (Pcorrected < 0.001, Cohen’s d = 0.74) and 1 month (Pcorrected < 0.001, d = 2.20) after treatment and in PTSD (Pcorrected < 0.001, d = 2.54), depression (Pcorrected < 0.001, d = 2.80) and anxiety (Pcorrected < 0.001, d = 2.13) at 1 month after treatment. T
[39] At 48 hours following ibogaine administration, withdrawal and craving scores were significantly lowered in comparison to baseline: 78% of patients did not exhibit objective clinical signs of opioid withdrawal, 79% reported minimal cravings for opioids, and 68% reported subjective withdrawal symptoms in the mild range. Ibogaine appears to facilitate opioid detoxification by reducing opioid withdrawal and craving in participants with OUD. (n = 50)
[40] Self-reports of withdrawal symptoms shortly after recovery from ibogaine treatment (< 72 hours) were significantly decreased from the pre-ibogaine rating obtained 12 hours after the last use of opiates and were comparable to the level of discomfort reported at program discharge approximately one week later… Perhaps the most important observation was the ability of a single dose of ibogaine to promote a rapid detoxification from methadone without a gradual taper of the opiate. (n = 32)
[41]almost one third (30%) of the full sample reported that they never returned to using opioids after being treated with ibogaine, and approximately one half (54%) of these abstainers had maintained abstinence for at least 1 year, and almost one third (31%) had been abstinent for 2 or more years. Approximately, one half of the full sample (48%) reported that although they relapsed after treatment, their consumption had decreased from pretreatment levels.
[42] Mash et al. 1998 We have initiated a rising tolerance study using single administration to assess the safety of ibogaine for the treatment of cocaine dependency. The primary objectives of the study are to determine safety, pharmacokinetics and dose effects, and to identify relevant parameters of efficacy in cocaine-dependent patients. Pharmacokinetic and pharmacodynamic characteristics of ibogaine in humans are assessed by analyzing the concentration-time data of ibogaine and its desmethyl metabolite (noribogaine) from the Phase I trial, and by conducting in vitro experiments to elucidate the specific disposition processes involved in the metabolism of both parent drug and metabolite. The development of clinical safety studies of ibogaine in humans will help to determine whether there is a rationale for conducting efficacy trials in the future.
[43] In 1993, the United States Food and Drug Administration (FDA) approved an investigator-initiated Phase 1 trial in ibogaine-experienced patients to study the pharmacokinetics (PK) and safety effects of ibogaine (IND39,680; University of Miami). This study enrolled a small number of patients before being placed on voluntary hold due to a non-study-related death that was reported following ibogaine administration in Amsterdam, Netherlands. This academic study was amended following a second in-person meeting with the FDA in 1995 to include cocaine-dependent patients. However, the United States National Institute on Drug Abuse (NIDA) opted not to fund the human Phase 1 study of ibogaine in 1995. …See Table 2: University of Miami… n = 9
[44] Cardiotoxicity and QT prolongation, which increases the risk for Torsade de Pointes, pose a significant problem. Ibogaine's modulatory action upon Human Related Ether-` a-go-go Gene (hERG) channels seems to cause a reduction in electrical currents via potassium channels. This results in a delayed cardiac repolarization
[45] Unfortunately, during the first half of the 1990s, following the death of a patient in the Netherlands, trials of ibogaine in humans were all stopped. The National Institute on Drug Abuse (NIDA) chose not to fund the proposed phase I/II clinical trials [96], and the FDA blocked the Phase I clinical trial on the use of ibogaine in recently abstinent patient volunteers [37, 97].
[46] editorial… In 1993, the U.S. FDA permitted a clinical trial to evaluate the safety and efficacy of (−)-ibogaine 1 in humans. (16) The unexpected death of a female participant curtailed subsequent interest in clinical development.
[47] Ibogaine inhibits various cardiac voltage-gated ion channels, including human ether-a-go-go-related gene (hERG) potassium, Nav1.5 sodium, and Cav1.2 calcium channels [105,106]. Ibogaine has been
reported to induce QT interval prolongation [107], but systematic studies of ibogaine’s electrocardiographic effects have not been conducted to date.
[48] Koenig and Hilber (2015) suggest the likely sequence of events that explains ibogaine's cardiotoxicity is as follows: "(1) blockade of repolarizing hERG potassium channels; (2) retardation of the repolarization phase of the ventricular AP; and (3) concomitant prolongation of the QT interval in the ECG, ultimately paving the way for life-threatening TdP [Torsades de Pointes] arrhythmias," leading to cardiac arrest.
[50] A detailed update is provided of the 33 deaths known to have occurred…since 1990 (published in 2018)
[51] https://www.sciencedirect.com/science/article/abs/pii/S030698770600209X And also in Gabon, where people to be initiated are usually young healthy men and women, the risk of death is well known and part of the initiation-myth [6], [7], [8]. To protect the person to be initiated, Gabonian healers perform a long, complicated ritual that lasts between several days and many weeks.
[52] https://www.samorini.it/doc1/sam/sam-bwiti%20initiation.pdf The novice must vomit and if there is a delay or it does not happen at all, this causes a strong concern. Generally, it is thought that the lack of vomit is caused by the fact that the novice has concealed some serious sins during confession and for this reason he/she is urged to complete the confession. If the vomit takes too long, it may be decided to immediately stop the iboga ingestion and the whole initiation rite. It is one of the cases acknowledged by Bwitists in which there would be the risk of death for the novice… Although very rarely, still today cases occur in which the novice does not awaken and dies.
[53] Noribogaine showed a nonstatistically significant trend toward decreased total score in opioid withdrawal ratings, most notably at the 120-mg dose; however, the study design may have confounded evaluations of time to resumption of OST. Future exposure-controlled multiple-dose noribogaine studies are planned that will address these safety and design issues.
[55] https://accp1.onlinelibrary.wiley.com/doi/abs/10.1002/cpdd.254 This was the first clinical trial of noribogaine, ibogaine's active metabolite,
[56] 2016 In this randomized, double-blind, placebo-controlled single ascending-dose study, we evaluated the safety, tolerability, and pharmacokinetics of noribogaine in 27 patients seeking to discontinue methadone OST
[57] When the person stops taking the drugs the body needs time to recover. This causes withdrawal symptoms. Withdrawal from opiates can occur any time long-term use is stopped or cut back. Early symptoms of withdrawal include: Agitation, Anxiety, Muscle aches, Increased tearing, Insomnia, Runny nose, Sweating, Yawning
[58] The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale designed to be administered by a clinician. This tool can be used in both inpatient and outpatient settings to reproducibly rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time. The summed score for the complete scale can be used to help clinicians determine the stage or severity of opiate withdrawal and assess the level of physical dependence on opioids.
[59] Noribogaine caused dose- and concentration-dependent QTc prolongation, which reached clinically concerning levels in the higher-dose groups.
[60] Likewise, pupil diameter increased by 1 mm overall, with a 0.5-mm increase in 2 hours prior to OST resumption. These changes appear to be quantitatively similar to the acute changes reported in morphine-treated subjects undergoing naloxone withdrawal. Nearly identical times to OST resumption were observed for individuals receiving placebo versus active drug within each cohort (Table 2, lower panel).
[61] 2014: A double blind, placebo controlled study was conducted with 20 patients (N=20), split in 2 groups: the ibogaine group received a single dose of 1800 mg of encapsulate ibogaine extract, and the placebo group received a single capsule of sugar powder…. There were significant reduction in severity of symptoms at first evaluation and after the 72 hour intervention period in the ibogaine group (MCCS score intensity at time zero = 7,4 ± 0,70 ; intensity at time 72 h = 2,6 ± 0,84 ; p< 0,0001, ANOVA test for repeated measures). There was a statistically significant improvement between the ibogaine group
at time 72 hours and at 24 weeks analyzes (p = 0,0047, t paired test). No such improvement was observed in the placebo group. Conclusions: Ibogaine is an effective treatment for cocaine dependence, and more studies with larger samples are necessary in order to establish its efficacy and validity.
[62] https://www.jsatjournal.com/action/showPdf?pii=S0740-5472%2821%2900443-8 Eighteen of 33 previously analyzed fatality reports had preexisting medical conditions, such as coronary sclerosis or cardiac arrythmias.
[63] E.g. see this case study https://www.akjournals.com/view/journals/2054/1/1/article-p29.xml Case report of a female on MMT for 17 years who performed a self-treatment with several low and cumulative doses of ibogaine over a 6-week period…. The patient successfully eliminated her withdrawals from methadone with ibogaine. …No serious adverse effects were observed, and at no point did the QTc measures reach clinically significant scores. Twelve months after the treatment, she was no longer on MMT.
[64] Alan’s study (Crossroads clinic in Tijuana) https://www.akjournals.com/view/journals/2054/1/2/article-p65.xml Finally, the clinical procedures at Crossroads changed approximately half way through the 2012–2015 time frame to include 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) following ibogaine treatment in order to help patients integrate and consolidate their ibogaine experiences.
[65] This study was done in 2015 at Crossroads Treatment Center https://www.tandfonline.com/doi/full/10.1080/02791072.2018.1447175 “A retrospective chart review of participants admitted to a single residential ibogaine treatment center in Mexico during 2015 was conducted.
[66] 2024 (2025 data is still incomplete): reports around 55,000 deaths due to opioids.
[68] https://www.tiktok.com/@beond.us/video/7586495195248659742?q=ibogaine%20experience&t=1777646246131 “You don’t need to struggle to do ibogaine. Many healthy people choose to do it for cognitive enhancement, neurogenesis, more clarity, peace, love, life optimization.”
[69] One more example https://ambio.life/program/foundational “Ibogaine isn’t just for healing either - it’s for anyone ready to reset, realign, and reach new levels of clarity, performance, and purpose.”
[70] https://beondibogaine.com/ibogaine-treatment-cost/ Our industry-leading acute care program pricing starts at $12,500 for complete therapeutic care.