In the United States, ibogaine is a Schedule I controlled substance, right alongside heroin, marijuana, and LSD. It’s also a potentially powerful tool for addiction treatment: For decades a worldwide underground network has administered the psychotropic drug, derived from a West African bush, to people in need. Now, in a split-level house in a small town in British Columbia, ibogaine may be nearing recognition as a legitimate medical treatment.

Iboga Therapy House is often a last hope for people wishing to free themselves from addiction to heroin, cocaine, prescription painkillers, or other substances. It was founded in 2002 by Marc Emery, an infamous marijuana activist, who delivered ibogaine for free, funded by seed sales. Two years later, when financial and legal troubles forced Emery to shut down, he encouraged Sandra Karpetas, a comrade in the project, to continue the work.

Karpetas, who has a background in harm-reduction counseling, first heard of ibogaine in the late 1990s. At the time, she found herself moving in two different worlds; in one, she saw people using psychoactive substances for therapeutic, self-explorative purposes; in another, she saw people inflicting great harm on themselves through drug abuse. Ibogaine seemed to bridge the two worlds, a substance that could fight addiction by awakening the mind.

Karpetas professionalized Emery’s operation, reopening Iboga in 2006 as a nonprofit. Treatment is no longer free—a five-to-seven-day course costs $5,000—although the clinic does sometimes donate services. In addition to being screened for a variety of medical conditions and psychiatric problems, candidates must submit a general medical evaluation from a doctor, along with details on their social support network and their plans for recovery.

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If they are accepted into the program, clients wait at least 12 hours from the last dose of their drug and then take a test dose of ibogaine to ensure that they will have no adverse reactions. The full dose, administered an hour later, causes a temporary loss of coordination but minimizes withdrawal symptoms, which can include diarrhea, stomach cramps, leg restlessness, inability to sleep, extreme agitation, and depression. Once they are dosed, clients experience a dreamlike state that lasts anywhere from 24 to 36 hours. Many people report that, once the intense rehabilitating trip is completed, their cravings are gone.

Because of ibogaine’s murky legal status, there are few official studies of its effectiveness. In the 1990s Ken Alper, then an assistant professor of psychiatry and neurology at New York University School of Medicine, conducted research into ibogaine detoxification. In one study of 33 opioid users, 25 were found to be free of withdrawal symptoms 24 hours after treatment and showed no drug-seeking behavior 72 hours later.