The Extraordinary Value of Ibogaine Therapy for Treating Opiate Addiction

(Note: ibogaine and all entheogens can be of great value in the treatment of all addictions, since the condition is, at the core, fundamentally the same however it is expressed, as I describe in my book Climbing the Holy Mountain of Recovery.  However, ibogaine is especially effective in the treatment of opiate addiction.  This essay is a reflection on what I learned from my experience, the study of biomedical research on ibogaine by people like Dr. Mash and Dr. Alper, and other scholarly and/or therapeutic experiences shared through GITA, the Global Ibogaine Therapy Alliance)

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The ibogaine experience lasts much longer than all other naturally-occurring psychedelic/ entheogenic sacred medicines.  Additionally, the experience includes two distinct periods: the initial, acute phase of intoxication; and the prolonged, sub-acute yet influential period attributable to the long-lasting action of noribogaine, the form into which ibogaine is metabolized not long after ingestion.

The phenomenal experience of the acute phase may be likened to psychedelic therapy in the scheme of Grof; where the therapist is, however, Plant Teacher or Doctor.  This phase is reported to last from eight to 36 hours; it was about 18 hours in my case.  The second phase, during which one is under the prolonged, milder influence of noribogaine, may last from two to eight weeks after the initial, acute intoxication.  This period can be clinically measured in terms of whether the subject is a rapid or slow metabolizer of ibogaine/noribogaine.  The phenomenal effects of the “teachable” period can generally only be assessed during the period externally by therapists or other observers; subjective assessment on the part of the subject must wait for hindsight.

Assessment of the value of the acute phase for addiction treatment may be achieved by such qualitative methods as narrative analysis and heuristic evaluation of self-reports and post-treatment interviews; and case studies.  These can be conducted by outside researchers upon live or archival interview or self-reported material.  But only an addict in recovery can conduct autoethnographic assessment of their own experience of addiction and its treatment with respect to the socio-cultural milieu in which they lived, based on their life story.

Jacques Mabit has experimented with using ayahuasca for the therapeutic treatment of opiate addiction and this practice has been taken up by Gabor Maté.  Also, it is well known the Native North Americans have used peyote with good effect both to treat and prevent alcoholism, another devastating substance abuse addiction.  So what difference exists between ibogaine and ayahuasca or other sacred medicines in the treatment of opiate addiction?

Dr. Maté told me that he preferred ayahuasca because he can treat a larger number of people at a time, being involved in guiding and helping those being treated; whereas ibogaine is a more singular, personal experience where a guide or therapist can only work with one person at a time.  Yet I feel this difference is a major reason why ibogaine is so effective: the human agent is removed and replaced by Plant Teacher.  Of the several shamanic views of healing, one major category is that the shaman acts as a conduit for spirit helpers who come through them to do the healing; the shaman does not directly do this work.

While some therapists like Claudio Naranjo have written of their experience using ibogaine as a psychotherapeutic adjunct, they used lower doses of ibogaine than the “flood” dose typically used in addiction treatment.  Again, this refers back to Grof’s distinction between psychedelic psychotherapy, where the patient is give a large dose, has an experience, and then the therapist works with them after that and in reference to it; and psycholytic psychotherapy, where the patient is given a lower dose so they remain relatively coherent and the therapist can work with them while they’re under the influence of the psychedelic agent.  With ibogaine, a massive dose is administered and therapeutic work has to wait till the subject has recovered themselves; therapy then refers back to the recovering addict’s experience and helps them to clarify its value for them.

I have analyzed addiction as passing through three phases: early, middle, and late, or terminal.  No work of an overtly “addiction therapy” nature can be done in the early phase because it is partly characterized by the addict’s lack of awareness of their condition, and typically by their vigorous denial of it to others and to themselves.  I propose that ayahuasca may be most effective in treating middle phase addicts, who know they’re addicted and have tried various tactics to control or escape it on their own, but have failed and are finally ready to seek outside help.  Ibogaine would work here too; but in my scheme, it is superlative in the treatment of late, terminal phase addicts.  Their condition is essentially morbid in all respects and the addict is virtually without personal resources to mobilize on their own behalf.  In this stage, the addict is fully aware that they are killing themselves, but can’t stop anyway.  This state does not lend itself to therapy because the subject can’t inaugurate change in their life.  Supernatural help is required: enter Plant Teacher/Doctor.

One outstanding characteristic of addiction is the near-total cessation of maturation processes, a rigidity of thought process, and the suppression of vital, emotional, heart-centered input to perception and the decision-making process.  The acute phase of an ibogaine experience has the effect of abruptly reversing all of these impediments to the addict’s adaptation to their environment and to their personal growth.  Despite its duration, this phase of ibogaine treatment can be characterized as Maslow’s peak experience.  Huston Smith and others have observed that the effects of this experience may be lost over time without integrative efforts.  I have personally known addicts who were treated with ibogaine and reported having had very positive experience, yet who relapsed anyway.

The value of ibogaine’s prolonged, sub-acute phase for addiction treatment cannot be over-emphasized.  It amounts to a prolongation of the flexibility and impactful memory of one’s broadened and/or entirely new perspectives induced by the acute phase.  Also the new or newly-resuscitated experience of a vital (re)awakening – and thus, of emotional input to the recovering addict’s enhanced ability to evaluate and respond to relational and other social situations – must be given time to develop or revive in order to persist.  This way of knowing the world typically requires a more gradual developmental process, because it is a more intuitive and less rule-oriented one.

For addicts recovering from the terminal stage of addiction, mental rigidity and emotional shutdown are deeply-ingrained; or in terms of Sheldrake’s morphic resonance, those creodes are deeply engraved.  Thus there is a very real danger of falling back into them, despite the extraordinary liberation from them experienced in the acute phase of ibogaine intoxication.  Despite its relatively long duration with respect to other sacred medicines, it constitutes only a brief interruption of mental rigidity etc. relative to an addict’s lengthy entrapment in those states for years or even decades.

Thus the prolonged sub-acute phase of noribogaine “support” continuing the beneficial effects of the acute phase is of inestimable value.  It provides an opportunity for the recovering addict to establish new behavioral motifs and begin to adapt to them; to carve new creodes deeply enough that they can, by both personal effort and communal support, remain in them without slipping back into the old, deeply-etched ones.  Then, when the long-term effects of noribogaine finally wear off, the recovering addict has had a chance to be actively engaged in healthy new behaviors long enough to begin noticing rewards from them, which is necessary to convince them that recovery is, in fact, possible.

My own experience of that period involved immersion in a holistically constructed treatment program.  During the dangerous and critical early phase of recovery, I had a one-on-one psychotherapy session once a week; two or three group psychotherapy sessions at least five days a week; a 12-Step meeting once each day, varied in type and location; and special treatments such as sauna, acupuncture, physical exercise of different sorts, exposure to Universalist Unitarian meetings on Sundays, and attention to nutrition—typically long-neglected by opiate addicts.  Finally, I lived in a ¾ house maintained by the program, which produced a sort of “pressure-cooker” intentional community where, quite naturally, discussion of various treatment experiences was commonplace—but also such normal social behaviors as cookouts, music, TV watching (with others), and games could be reintroduced in a lightly-controlled fashion.  As a result of this treatment milieu, I never noticed when the noribogaine wore off.

Such a program constitutes a comprehensive use of this invaluable period during which the post-acute “iboganaut” is in a “teachable,” or receptive and flexible, state.  From a pragmatic perspective, it may be regarded as an effective capitalization of the monetary and time investment represented by an ibogaine treatment; but this is only a base and wan characterization of the almost inconceivable benefits to a human being who has suffered prolonged enslavement in a dehumanizing situation.  The retrieval of such invaluable human characteristics as hope, trust, faith, and the belief that more is possible and that the future can be better—indeed, that there may be a future—constitutes such an improvement in the subjective quality of the recovering addict’s life that they have significantly improved chances of maintaining the newly-established behaviors which will prevent them from relapsing, the baseline measure of recovery success.  This, however, is assuredly only the beginning of a full description of successful recovery.

 

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