“I would never relapse when I was actively sick with withdrawal. The horribleness is exaggerated—certainly not as bad as a serious illness,” says addictions expert Maia Szalavitz, who is also a former heroin and cocaine addict. “It’s more like giving up the love of your life. You feel you will never have safety and comfort again.”

Howard Lotsof, who first discovered and popularized ibogaine’s application to addictions in the 1960s, later found there was more to the problem. Having had an intense trip and kicking his own withdrawal, he gave it to a couple of friends. They marveled at how their withdrawal symptoms had disappeared, then decided to go and buy some more heroin.

Physical dependence is only part of addiction, and not even part of its definition. Above all, it is a psychiatric problem. Cocaine, for instance, is powerfully addictive without dependence. Drug addiction is defined as the compulsive use of drugs despite negative consequences. That’s why tough love approaches don’t work; resistance to punishment is an intrinsic part of the condition.

After an ibogaine trip, users tend to describe experiences with a powerful other who describes to them how the world works, including the steps they must take to align themselves to their true paths. Those profound insights may figure prominently in recovery stories, but as Szalavitz argues in Unbroken Brain: A Revolutionary New Way of Understanding Addiction, about 10 percent of addicts are basically ready to quit at any given time and will respond to whatever they try.

“In my experience, I had an insight and went into recovery the next day,” she says. “But those people relapse a lot.”

Szalavitz frames addiction as a developmental disorder. Fewer than 10 percent of addicts develop their habits after their early 20s, when the cortex finishes developing and introduces an adult aversion to risk. Additionally, addicts are usually dealing with some other mental health problem or trauma that makes them vulnerable, and contrary to popular belief, most opiate addictions are not lifelong. They are resolved within five years—a little longer for heroin. The real task is mostly a matter of keeping addicts alive and otherwise healthy (Hepatitis C- and HIV-negative) until they can age out of addiction, preferably without a criminal record.

The best way to do that is well established. Methadone and other long-term maintenance treatments cut mortality in half. They create physical dependence but not addiction, and they form a foundation for a stable life.

Ibogaine was briefly picked up for testing by the pharmaceutical industry, in the early 1990s, but dropped after some cardiac problems emerged. Available on a gray market in Canada and Mexico, it is a Schedule 1 controlled substance in the United States, a list that includes LSD, pot, and, yes, heroin. Perhaps this contributes to its appeal among drug users, who often gravitate to underground culture anyway.