The Political Economy of Ibogaine (why Cinderella Does Not Get to the Ball)

For those interested in research into altered states of consciousness and the healing properties of psychedelic drugs, we live in exciting times. The wave of decriminalisation/legalisation of marijuana across the globe (despite evidence-free resistance from countries such as the UK) has created a backdrop for normalising personal and scientific research into more profound technologies of consciousness, such as LSD, psilocybin and dimethyltryptamine (DMT) from plant sources such as ayahuasca.
The psychedelic renaissance is now in full bloom, with conferences such as Psychedelic Science in California and the recent Breaking Convention in London attracting thousands of participants from different backgrounds and psychedelic societies popping up across the world. We are a long way from psychedelic usage being associated with a certain segment of society: the great unwashed.
At last, mainstream psychiatry can emerge from the dark ages of electro-convulsive therapy and lithium treatment with a new and genuinely enlightening toolkit. MDMA will, in just a short few years, be an effective prescription drug for those with post traumatic stress disorder, thanks to the incredible efforts of Rick Doblin and the folks at MAPS. Psilocybin will follow in its wake, for those suffering from depression or end-of-life anxiety, thanks to the quiet wisdom of the team at Heffter Research Institute and Johns Hopkins. We also have the Beckley Foundation to thank for the research into LSD at Imperial College London, under the leadership of Robin Carhart-Harris and Professor David Nutt.
But there is a problem.
Arguably the most healing plant of them all, ibogaine, an alkaloid sourced from the shrub Tabernanthe iboga, is curiously absent from the conversation and from the research. Even though ibogaine has a unique mechanism of action that works on a range of brain receptors to deliver powerful anti-addiction outcomes and is potentially effective against neurodegenerative disorders such as Parkinson’s Disease and Alzheimers; even though there are at least 80 clinics providing ibogaine across the world, panels on ibogaine are somewhat sidelined at psychedelic conferences and research funding is scarce.
This is odd, considering more people have undergone treatment for drug addiction through ibogaine in recent decades than any other psychedelic by far (probably over 10,000 people). Its odd that, apart from a brief moment in Homeland, ibogaine has been absent from popular media, despite the attention placed on the opioid epidemic and opioid celebrity deaths such as Michael Jackson and Prince.
The shoe fits, so why does Cinderella not get to go to the ball?
Why has ibogaine not come up once as a topic in mainstream media regarding the opioid crisis, despite 59,000–65,000 Americans dying from opioid medicine overdoses in 2016? Why again has ibogaine not surfaced as a topic for exploration through Trump’s Commission on the Opioid Crisis, chaired by Governor Chris Christie? Why are questionably effective (and expensive) conventional therapies such as Vivitrol — which blocks the opioid receptor in the brain — being mentioned and not ibogaine?

One obvious reason is that, with some notable exceptions, celebrities prefer not to be explicit about their trips to Ibogaine clinics in Mexico or Costa Rica, for fear of being associated with bad news.
Perhaps also it is because ibogaine’s provenance is Africa’s armpit: Gabon. Maybe there is too much of the dark continent’s shadow cast across the molecule for it to be redeemed to the light. This wouldn’t be surprising. The question of race perhaps unsurprisingly haunts the progressively liberal field of psychedelics research, with the lack of racial diversity at the conferences: its mostly white middle class guys on the podium after all.
In common with ayahuasca, ibogaine’s source material, Tabernanthe iboga cannot easily be synthesised in the lab. Combined with a problematic supply chain that may be endangering the shrub, ibogaine partially resists the scientific gaze. The beginning of all ibogaine research requires powder from an African tree to enter the lab.
However, this is all but to scratch at the surface. A stronger reason for the rejection of ibogaine comes from those with career interests in conventional harm reduction models, focused around needle exchanges and substitution therapy. At least some of leading voices in the harm reduction community point to the lack of scientific research on ibogaine (“no second phase trials”) and deaths from ibogaine. However, while the lack of clinical trials data has been a problem in the past, this lacuna is being gradually addressed. There is all the same a considerable body of research literature on ibogaine. An ibogaine conference last year in Mexico marked the beginnings of a more productive dialogue between harm reduction advocates and the ibogaine provider community.
This prompts discussion of another assumed problem with ibogaine: its association with death. This turns out to be a somewhat lazy linkage. From research by Dr Ken Alper, Associate Professor of Psychiatry and Neurology New York University School of Medicine, there were 19 known deaths from ibogaine between 1990 and 2008. In 12 of the 14 cases where there was adequate postmortem data, death was due to “advanced preexisting medical morbidities”. The reason for the other two deaths may be related to alcohol or benzodiazepine withdrawal. Ibogaine can hardly be blamed when the causes of death are a result of the prior addiction regime of the patient. Ibogaine has also conclusively proven to not be neurotoxic at low to medium doses (up to 25mg/kg). .
At this point, we should compare data for ibogaine with other drugs. There were, for instance, 8,758 recorded alcohol-related deaths in the UK in 2015 alone and 78,000 smoking-related deaths in the UK in 2014. 240 people died taking Tramadol in 2014 in the UK. Meanwhile, some of the leading providers of ibogaine have treated thousands of people each, with no mortalities. Ibogaine treatment can be perfectly safe, when good clinical practice is followed. Which drugs are the real killers in our society?
Another challenge for research is the unusual mechanism of action mentioned above. Ibogaine does not work in the brain in the same way as LSD, MDMA or psilocybin. As Gary Rudnick, a professor of pharmacology at Yale University states,
“Ibogaine has a lot of effects on many different proteins. It’s not a very clean drug. We’re not sure which targets are responsible” for its addiction-interrupting ability versus its other effects.”
But surely, the complexity of ibogaine’s workings inside the liver and the brain are an exciting challenge for scientific research, rather than a constraint?
A far more powerful reason than all the above musings is that ibogaine directly challenges powerful vested interests. The global heroin business is estimated at $65bn annually. Meanwhile, the global opioid painkiller market is worth approximately $35bn a year. $100bn is more than the GDP of 128 countries.
Within thirty minutes of consuming a flood dose of ibogaine, heroin addicts commonly report their withdrawal symptoms have disappeared. After 24 hours, patients often weep with joy, their bodies and brains liberated from the torment of addiction.
Ibogaine challenges the political economy that grants sustenance to the strange bedfellows of narco-traffickers, Big Pharma and of course the CIA…
Did you just raise your eyebrows?
Perhaps you have forgotten about Gary Webb. Do you remember watching Kill The Messenger a few years ago? Its scarcely controversial to discuss the CIA’s role in distributing crack cocaine to African American ghettos to fund the Contras’ fight against the Sandanista government in Nicaragua.
Now consider that the production of opiates in Afghanistan has risen dramatically in recent years and ask who benefits?
We also have to consider the degree to which western pension funds rely on pharmaceutical stocks for stability. The investor logic of Big Pharma demands drugs that require repeated (preferably daily) use, preferably over extended periods and ideally, a lifetime. There is therefore simply no incentive for the pharmaceutical to research for cures, let alone for cures for addiction. Ibogaine, with its one treatment every few months at most, is therefore anathema. The molecule threatens the very order of things.
What happens when we situate ibogaine in the grand scheme of the human condition and human progress? Arguably, the deepest enquiries here come from the Four Noble Truths of Buddhism. The first Noble Truth of Buddhism is that life involves suffering (dukkha). We will die and those we love will die. Everything in our world is transient. The second Noble Truth is the discovery that this suffering is caused by craving. We find ourselves clinging to things that must always slip away: existential pain is therefore inevitable.
Place this timeless insight into the human condition in our contemporary context and we see that our craving has morphed into addiction across the human surface of the planet. As Bruce Alexander puts it, addiction has now globalised, and we are all living in rat park. Whether its the latest social media update, the next sugar rush, pornography or amphetamines we crave, we suffer from not being able to sit quietly with ourselves. Its as if, in the framework of contemporary global capitalism, we are stuck in the second Truth; separated off from each other, we lack the means to transcend our locked-in craving by living a more balanced life: ethically grounded, mindful and wise.
Consumption of ibogaine in a professional medical setting gives patients a window of 3–6 months to move on from the second Noble Truth, to consider the freedom of a balanced and joined-up life. Not only is this antithetical to those running the heroin and opioids markets, but it is inimical to capitalism itself.
The risk is that if ibogaine were much more widely available through legally regulated means (the nirvana of a clinic in every town, assuming the sustainability issue can be solved), we might lose our sense of craving for those things that must slip away. The hallmark of capitalism — as Karl Marx understood it — is for commodities to become fetishised; with ibogaine, we return to the simpler world of things that we need to stay well and balanced. After all, we only need one tatami mat to eat, sleep and pray.
It was not always so with ibogaine. Research on the molecule began in France in the early twentieth century, and ibogaine was a prescription medication in France under the name of Lambarène, and widely used as a mental and physical stimulant.
Ibogaine experiments began in the US in the late 1950s at the Addiction Research Center in Lexington, Kentucky, under the direction of Harris Isbell. Howard Lotsof’s revelation in 1962 that ibogaine could end addiction led to decades of activity, culminating in NIDA sponsoring animal trials in the 1990s.
NIDA funding eventually stopped due to a study finding neurotoxicity in rats at high doses that no one would ever think of prescribing to a human. Dr. Stanley Glick, then chief of the pharmacology department at Albany College of Medicine in New York and one of the leading ibogaine researchers said at the time, “There’s no question that there’s a political barrier. Why it’s there I really don’t understand, but I received advice from people I know at NIDA, who were acting in my best interest, advising me to work on something else.”
Is this really where the story must end? Is the mysterious political barrier to ibogaine research in the US still in place?
The good news is that ibogaine is now approved medicine in New Zealand, South Africa and Brazil.
But what hope for Ibogaine legalisation in the US and Europe? So long as the order of things remains as it is, it might feel that there is none, despite what happens at the edges. Capitalism must continue producing desire and fetishising product. Anything that tampers with the stimulation of desire, the background hum of collective addiction and the global heroin-and-opiates trade must be dismissed, ostracised, or dealt with by any means necessary.
Trouble is, if we cannot release our species from its collective craving, the planet will spit us out as it tracks back to homeostasis. Our atomised desires are out of whack with the earth. Ibogaine could be part of the remedy, for those languishing in the extreme varieties of addiction, but also for the rest of us who get by on our daily indulgences. Its “high” time the psychedelic research establishment — and those who fund it — had a more open mind.
