Resets & Relapses: Ibogaine's Role in Combating Opiate Addiction

The iboga plant

In a recent TED Talk, journalist Johann Hari suggested that “the opposite of addiction is not sobriety. The opposite of addiction is connection”. In other words, drug misuse often occurs as an attempt to fill the void when the social bonds that give meaning to our lives are missing or broken.

To highlight his point, Hari cites Bruce Alexander's Rat Park experiment, in which rodents kept in solitary confinement displayed a high propensity for drug misuse, while those with social stimulation did not. Naturally, this experiment is unlikely to ever be repeated using human subjects, although having spent the past year working at an ibogaine treatment centre, my experiences all point towards a very similar conclusion.

By way of introduction, ibogaine is a highly psychoactive alkaloid found in the root bark of a West African shrub called iboga. Because of its potent hallucinogenic effects, the plant has been used in spiritual healing and initiation rituals by indigenous communities for centuries, and in 1962 somehow found its way into the hands of a heroin-dependent New Yorker named Howard Lotsof. 

After ingesting the substance and undergoing an intense psychedelic trip, Lotsof was astounded to discover that his opiate withdrawals and cravings had completely vanished -- an effect which has since been confirmed by a number of small-scale clinical studies.

As a consequence, an underground network of global ibogaine providers has sprung up over recent decades in places like Mexico, Costa Rica and New Zealand. However, with the substance being outlawed in several countries (including the US) and totally unregulated by the mainstream pharmaceutical industry, it remains off the table as an official treatment option.

Therefore, while some have labeled ibogaine a “magic bullet” for addiction -- citing the many anecdotal reports of people who have managed to end years of drug misuse with just a single dose of ibogaine -- the reality is that research into its long-term effects has been stunted, making it hard to separate the facts from the hype.

Yet if there's one thing I've learnt from working with ibogaine, it's that it doesn’t “cure” addiction all by itself. Rather, as the following case studies* highlight, when combined with the healthy restructuring of someone’s social environment, it can provide a unique and powerful tool in the quest of those seeking to tackle their addiction.

Erika's story

“I saw myself shrink into oblivion and just disappear off the face of the Earth, before re-emerging as a new-born baby. It's like I've been given the chance to start again as a completely new person -- like a second opportunity.”

This was how Erika described her ibogaine experience immediately after her treatment. Like almost all patients, she felt her withdrawals completely disappear soon after ingesting the substance, while at the same time undergoing an intense physical and psychological detox, which manifested itself as a vision of her own death. She described the sensation as a kind of bodily and mental “reset”.

However, within two months of her treatment, Erika relapsed. Trying to come to terms with how this happened, she explained that although she “didn't feel any physical cravings,” she simply did not know how to live without drugs, and was unable to occupy the social world of people not suffering from addiction.

“I tried to make new friends so that I could leave all my old contacts behind and start again, but none of them really understood me,” she said. “So in the end I had nowhere to go with this second opportunity that ibogaine had given me.”

As a result, she soon found herself back at the house of her ex-boyfriend, who had always been her main supplier of heroin, and it wasn't long before she began using again.
Summing up, Erika stated that “ibogaine can give you the chance to start over, but if you go back to all your old places and your old people, it won't work. You'll just become your old self again.”

Erika's story exemplifies Hari's point, illustrating how tackling addiction requires more than just physical sobriety; it involves the construction of a new lifestyle, supported by new social relations.

By allowing users to temporarily shed parts of their “ego” along with their withdrawals, the ibogaine-reset effect represents just the first step of this process: it offers a doorway out of the world of addiction, but doesn't necessarily provide anywhere else to go; it breaks a person’s bond with a drug, but doesn’t replace that bond with a new and healthier one.
Therefore, as the following case demonstrates, successfully leaving addiction behind can more often than not only be achieved by connecting to others.

David’s story

“I visualised all the bad relationships in my life, and realised I had to end them. Then I saw myself covered in black horns, which began falling off one by one. It was like the old me was dying and I was becoming a new person – like a total reset.”

David's description of his ibogaine experience bears many similarities to that of Erika’s, with the main difference being that one year later, he hasn’t relapsed. This he attributes to his ability to develop his identity as a “new person”, not only in his own eyes but those of others as well.

“Since my treatment, everyone says I’m a different person”, he explains. This has enabled him to repair many of his broken relationships and transform his social environment. For instance, he claims that “even my mother, who previously wanted nothing to do with me, says I’m completely different now, so she’s accepted me back into the house. We’ve even gone into business together.”

Thus, while ibogaine provided David with the tools to overcome his cravings and face his demons, it was the support of those around him that ultimately helped. Unlike Erika he had somewhere else to go. His final assessment of ibogaine subsequently mirrors Hari's opening sentiments: “ibogaine gives you that reset that everyone talks about, but it only works if you have a support network which you can integrate into the process. As long as you can do that you’ll be OK afterwards.”

*Those mentioned in this article have been given pseudonyms.