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Did the experience help him find what he was looking for?
“I think I’m different,” he says. “But I don’t know.”
* * *
It’s easier to track Ibogaine’s effect on hardcore addicts. Wilkins keeps tabs on former clients and estimates that one out of every five stays off his or her “primary substance” for six months or more.
Tom Kingsley Brown, an anthropologist at UC San Diego who describes his area of study as “religious conversion and altered states of consciousness,” recently began recruiting Pangea patients for an independent assessment of ibogaine’s long-term efficacy. Brown follows up monthly with opiate addicts during the year following their ibogaine treatment to gauge whether their quality of life has improved.
“People I’ve interviewed at the clinic have had really good results, especially in the first month or so,” reports Brown, who has enrolled four study subjects to date and hopes for a group of 30. “We know ibogaine interrupts the addiction in the short term, but what we’re really curious about is: Does that translate into long-term relief from drug dependence?”
Participants in Brown’s study fill out questionnaires that ask them to rate, on a scale of one to five, the intensity of different aspects of their trip.
“People have been circling a lot of fours and fives,” Brown says. “One of the things we’re trying to look at is if the intensity of the ibogaine experience correlates with treatment success. I strongly suspect there’s some sort of psychological component. I doubt it’s just a biological phenomenon.”
Some scientists beg to differ. Foremost among them are Mash and Glick.
“The hallucinations are just an unfortunate side effect,” Glick asserts, explaining that ibogaine works on the brain like a “hybrid” of PCP and LSD. “Part of the problem is that when you go through this thing, it’s so profound you’ve got to believe it’s doing something. In part, it’s an attempt by the person who’s undergoing it to make sense of the whole thing.”
Generally speaking, Glick’s research on rats has shown that ibogaine “dampens” the brain’s so-called reward pathway, reducing the release of neurotransmitters such as dopamine, which cause the highs associated with everything from heroin to sugary foods. The compound has also been proven to increase production of GDNF, a type of protein that quells cravings, and to block the brain’s nicotinic receptors, the same spots that are stimulated by tobacco and other addictive substances. In other words, ibogaine doesn’t work in any one particular way or even on one specific part of the brain, and it’s these multiple “mechanisms of action,” researchers say, that make it so effective for so many different types of addiction.
People who’ve taken ibogaine say it can have the unintended consequence of temporarily turning them off a substance other than their drug of choice. Lauren Wertheim traveled from her hometown of Omaha, Nebraska, to a rehab center called Awakening In the Dream House near Puerto Vallarta, Mexico, and used ibogaine to kick her meth habit. “Ibogaine resets all your [tolerance] levels to zero, like you’ve never done drugs,” she says. “Even coffee—the first cup set me off like a rocket launcher. That’s when I was like, ‘This stuff is for real.’”
Mash is convinced ibogaine works long-term because it is stored in fat cells and processed by the liver into a metabolite called noribogaine that possesses powerful detoxifying and antidepressant properties. “If you gave somebody LSD or psilocybin, and they were coming off opiates or meth, they’d go right back out and shoot up,” Mash says. “There’s evidence that it’s not the visions that get you drug-free; it is the ability of the metabolite to block the craving and block the signs and symptoms of opiate withdrawal and improve mood.”
Though they don’t question its effectiveness, both Mash and Glick believe it’s unlikely ibogaine will ever be widely accepted in the United States. It’s not just that ibogaine makes people hallucinate; it can be fatal.
Since 1991, at least 19 people have died during or shortly after undergoing ibogaine therapy. Alper examined the causes of death in the fatalities, which occurred between 1991 and 2008, and his findings suggest that ibogaine itself was not the culprit; the patients died because they had heart problems or combined the hallucinogen with their drug of choice. (By way of comparison, a study published last year by the Centers for Disease Control found that between 1999 and 2006, more than 4,600 people in the United States died from overdoses involving methadone.)
“It’s knowing who to treat and who not to treat,” Alper contends. “None of [the 19 fatalities] appear to have involved a healthy individual without preexisting disease who didn’t use other drugs during treatment. Two deaths occurred when they took ibogaine in crude alkaloid or root-bark form—they didn’t know what they were taking or how much.”