Ethical sidenotes on the "Ibogaine Boom"

As interest in Ibogaine treatment grows: what should we all keep in mind?

Recently, we’ve seen a surge in applications for ibogaine treatments. For many years, ibogaine providers have functioned somewhat underground and the substance was not very well known, but this is slowly changing as attitudes toward psychedelics and plant medicines in general are shifting. In the 1960s, substances such as psilocybin, LSD, peyote (mescaline), MDMA, and ibogaine were classified as Schedule I drugs under the Controlled Substances Act in the United States. And they were later internationally regulated through the 1971 United Nations Convention on Psychotropic Substances. Despite early research indicating their therapeutic potential, they were cast away as having a high risk for abuse, being extremely dangerous and having no known value for medical use.

In hindsight, it’s becoming clear that the decision to ban these substances was influenced more by political agendas, corporate interests, and the social climate of a tumultuous era than by their actual risks. Decades of prohibition stifled research and fostered a lingering stigma, but in recent years, there has been a resurgence in the study of these substances' therapeutic capacities, reaffirming what earlier research in the 1940s and 1950s already suggested. Substances like psilocybin, cannabis, and MDMA have demonstrated promise in treating conditions such as PTSD, depression, and anxiety.

Ibogaine, also long dismissed due to its reputation as dangerous and addictive, is now too gaining recognition for its therapeutic properties. Its healing properties were first rediscovered by Howard Lotsof in the 1960s, who, despite its taboo status, identified its remarkable ability to interrupt heroin addiction. Lotsof, along with an expanding network of underground advocates, has since worked to share knowledge about its safe use and its capacity to not only be a powerful tool for addiction treatment but also for healing PTSD, depression and assisting in the recovery from traumatic brain injuries.

Looking at the present moment, the lasting effects of decades of political and legal mismanagement of medicines and substances are undeniable. Since the 1990s, aggressive pharmaceutical marketing campaigns in the United States, enabled by government policies, downplayed the addiction risks of opioid painkillers, leading to widespread overprescription.

This facilitated a surge in opioid misuse and dependency. As regulations started to tighten and prescription access is becoming more restricted, many individuals are turning to cheaper and more potent illegal opioids, such as heroin and, more recently, fentanyl, a synthetic opioid responsible for a dramatic rise in overdose deaths. Today, the opioid crisis remains a severe public health emergency, claiming over 100,000 lives annually.

Although the victims of this crisis are diverse, certain groups are disproportionately affected, including veterans struggling with chronic pain or PTSD, workers in physically demanding jobs prone to injury, and economically disadvantaged communities with limited access to healthcare.

In response to the opioid epidemic, there has been a renewed interest in reclassifying certain substances and plant medicines that are currently listed as a Schedule 1 drug. So that clinical research can be done with them, and they can become legal for therapeutic use. Ibogaine being one of them. Unlike psychedelics that are known to be recreational, ibogaine's effects are both physically and mentally intense and often deeply uncomfortable.

Treatment generally requires medical supervision due to cardiovascular risks, potential toxicity, and many contra-indications that need to be carefully managed. However, when administered safely, it is currently the most powerful addiction interruptor known and has the ability to reduce withdrawal symptoms and cravings for substances like opioids, alcohol, and stimulants. What sets ibogaine apart is its unique action on the brain and body, and its apparent capacity to "reset" neurochemical pathways disrupted by addiction, but also by long term depression, PTSD or brain injuries.

Nature Magazine, Joe Rogan and the Republicans:

How new advocates are causing a wave

In January 2024, Nolan Williams, associate professor of psychiatry and behavioral sciences at Stanford University and director of the Stanford Brain Stimulation Lab, published his first clinical trial on ibogaine in Nature Medicine. Dr. Williams and his team examined the effects of ibogaine combined with magnesium (to mitigate its cardiac risks) on U.S. Special Operations veterans suffering from traumatic brain injuries. The study revealed significant reductions in PTSD, anxiety, and depression symptoms, as well as improvements in cognitive function and overall disability scores. As interest in ibogaine's therapeutic potential continues to grow, studies like this one have been making a significant impact on the ibogaine community, as more people are starting to seek treatment, advocate for it, or are becoming interested in providing it.

Joe Rogan’s recent podcast, released on January 2, 2025, featuring the Republican former Texas governor Rick Perry and legal expert W. Bryan Hubbard, is further fueling this growing interest. On the podcast both men shared their personal stories of witnessing ibogaine’s transformative effects and advocated passionately for increased research and access to safe treatment, particularly for U.S. war veterans struggling with PTSD and addiction. This rising interest in ibogaine as a powerful healing tool has its merits, as it opens up possibilities for more research into its safe use, efficacy, and accessibility, potentially connecting more individuals with a life-saving and life-changing substance. However, this growing attention does not come without ethical concerns and challenges on multiple fronts.

The "Magic Bullet" mentality and the illusion of a quick fix

When discussing ibogaine, terms like "miracle drug" and "complete reset" are often thrown around. However, this focus on immediate and dramatic results tends to overshadow the long and often challenging journey of recovery that follows treatment. Ibogaine can bring unresolved wounds, emotional turmoil, and repressed memories to the surface. Initiating a process that requires time, patience, and a safe space to process, reflect on, and integrate the treatment. Established ibogaine clinics with years of experience know that true recovery can take months or even years after treatment and that it is a journey that demands ongoing support as individuals are learning to confront and feel their feelings, cultivate self-compassion, reflect on old emotional patterns, build healthier environments and learn to make better lifestyle choices for themselves.

The intensity of this post-treatment phase is often underrated. Genuine and long-term healing does not come with a quick fix or an overnight transformation. It requires deep and sustained personal work. And that work demands time, effort, patience, and a holistic understanding of how the body, mind, and spirit are all interconnected. Ibogaine can be a powerful ally in this journey, but is not a cure-all medicine, and will not eliminate all of life’s struggles, whether personal or societal.

Beyond focusing only on the best “quick fix” to address the damage, it’s important to also look deeper at the root causes of the problem. How has society come to produce such large numbers of individuals suffering from mental distress and addiction? What flaws in healthcare, education, political and financial systems drive people to such profound despair, and prevent access to healthy, nurturing, and healing environments? Why is there a lack of support systems that foster genuine connection, both with ourselves and with our wider community? And how did we lose our way to the wisdom and resources needed for sustainable well-being?

The importance of a broader perspective is often overlooked, especially in recent advocacy efforts, which fail to address the decontextualization of plant medicines from their roots. For example, in the recent Joe Rogan podcast, there was no mention of the risks associated with the commodification of substances like ibogaine, nor what it means to strip them of their intrinsic cultural, spiritual, and historical significance and reducing them to mere tools for purposes such as addiction treatment. This extractionism ignores the deep traditions these plants are tied to. Traditions and systems of knowledge that often do see the bigger picture of health, and recognize that well-being is not only a personal matter but also a spiritual, communal, and ecological one, grounded in a deep relationship with nature that emphasizes harmony, reciprocity, and respect.

Advocates like Natalia Rebollo, a Mexican attorney specializing in international human rights, have been vocal about the urgent need to decolonize the use of plant medicines. Rebollo works with ICEERS (International Center for Ethnobotanical Education, Research, and Service), a nonprofit organization focused on the responsible use study and use of plant medicines. And calls for legislation that not only respects the cultural and therapeutic significance of sacred plants but also safeguards the ancestral knowledge and rights of the communities that have long stewarded them.

Rebollo stresses the importance of engaging with these traditions in a way that honors their holistic wisdom, urging those in the West to learn from what these plants and cultures have to teach, and moving beyond the mindless extraction of a single component for our specific purposes, and instead embrace a deeper, more respectful relationship. One that considers the entire ecosystem of knowledge, spirituality, and interconnectedness that these practices embody.

In the case of ibogaine, for example, this would mean acknowledging and honoring the Bwiti tradition, from which the use of this plant medicine originates. Practiced primarily by the Fang and other Bantu-speaking peoples in the rainforests of Central West Africa (particularly in Gabon, Cameroon, and Equatorial Guinea), Bwiti involves the ceremonial use of iboga for spiritual purposes, rites of passage, and healing.

The tradition comes from a worldview that integrates health, community, and nature, and recognizes the deep connection between the individual, the collective, and the spiritual realm, with iboga serving as a bridge between ancestral wisdom and personal insights. The communities that have long safeguarded and cultivated this knowledge hold a deeper understanding of the plant than any Western provider ever will. If we are to respect this substance fully, it is important to form an equitable and reciprocal connection with the people and lands that have preserved its use.

Rise of ibogaine clinics: things to keep in mind

It is understandable that there is a huge wave of interest in ibogaine, as many people are potentially helped by it, people desperately seeking to escape severe addiction or immense suffering. And it’s true: ibogaine is a powerful substance with the potential to change lives. However, this rise in interest comes with the inevitable growth of profit-driven parties. Ibogaine clinics are popping up like mushrooms, especially in countries like Mexico, near the US border. While some clinics have been around for a longer time, many of the newer ones are jumping in - with little experience - to capitalize on this growing market.

Ideally, they will recognize the critical importance of medical safety, an experienced team, and the need to set realistic expectations. And it’s essential for more people in this growing field to understand the significance of aftercare and the deep personal inner work that follows treatment. The more we learn about what constitutes a comprehensive therapeutic container, one that goes beyond a simple clinic visit, the better. This remains an area in need of further research and exploration, as people would benefit from providers that prioritize not only safe medical practices but also offer proper psychotherapeutic support and, when necessary, spiritual or philosophical guidance.

Another critical issue that demands greater attention is the politicization of ibogaine sourcing in the rainforests of Central West Africa. With the rising global demand for iboga, concerns have emerged about overharvesting and its potential environmental impact. In response, organizations like Blessings of the Forest have collaborated with local governments to regulate the cultivation and commercialization of iboga to address these challenges.

However, more recent critiques have challenged these regulations, arguing that overharvesting may not be the primary issue. Instead, they highlight the unequal access to permits for cultivating and commercializing iboga, particularly for certain communities. This issue remains a point of contention within the international ibogaine community, where discussions are abundant, but few participants possess direct, on-the-ground knowledge or experience.

While it seems tricky to evaluate the exact situation on the lands where iboga is grown. What is evident, is the pressing need to address potential inequities in fair compensation and reciprocity for the communities directly involved in iboga production. These concerns need further examination and meaningful action to warrant ethical and sustainable practices in iboga sourcing.

As interest in ibogaine and other plant medicines continues to grow, it’s essential to ensure these substances are approached with caution, respect, and an understanding of their roots. Healing, whether for individuals or communities, is a complex and ongoing process that requires more than just one “intervention”. It calls for a holistic approach, one that recognizes the deep connection between the body, mind, and spirit, as well as the broader cultural and ecological contexts these substances come from – and we are embedded in.

For providers, legislators, and those considering ibogaine treatment, it’s important to keep these concerns in mind. Where people speak of miracles, one needs to pay attention. Miracles are often miraculously more complex than we so desperately want to believe. The healing power of ibogaine is undeniable, but it must be handled with respect and awareness of a bigger picture and its implications. True transformation, both individual and societal, requires deeper work and understanding than we often want and expect.

Written by Nienke Berkenbosch

(as published on: https://substack.com/@aporialab)