A psychedelic plant from Africa has sparked an underground revolution in medicine.
The first time I heard former Yippie activist Dana Beal mention ibogaine I couldn’t have cared less what he was talking about. I had booked him to speak on political theater and creative resistance...you know, Yippie shit...as one of a dozen speakers featured at an all day Green Party rally we held in Washington Square Park during the Square Park during the 2004 Republican National Convention. Beal is a shady, self-promoting character. Instead of offering something useful to the crowd, he gave a rambling sermon on the miracles of this obscure drug that cured junkies of addiction. Holding up a collection of papers no doubt meant to imbue his message with gravitas he ranted through a byzantine cosmology of all the evil forces that were arrayed against this miracle substance becoming a mainstream treatment.
I had no idea what ibogaine was nor that Beal was a member of the “ibogaine underground,” an ad-hoc network of doctors, researchers, activists, shamans and lay-providers who believe that this substance is the key to not only treating but unlocking an entirely new paradigm in the understanding of addiction. This network is underground because ibogaine and the iboga root from which it is made are illegal in the U.S., designated Schedule 1 with a “high potential for abuse or addiction and no known medicinal applications.” Anyone in the underground will tell you that’s patently ridiculous, “patently,” they say, because the real root of ibogaine prohibition is not that it causes addiction but that it might cure addiction, sometimes with a single dose, and that sure is bad news for an industry built around a so-called “chronic” disease.
The numbers are still small. Of the 26 million estimated addicts in the United States, only a few thousand have tried ibogaine, and there are only a handful of active practitioners around the world who are giving treatments, so few that they all know each other. But this underground is on the move, growing at a rate of some 30% a year. The reason for this is quite simple: The War on Drugs is over, and drugs won.
None of the medically sanctioned forms of addiction treatment have any success rate to speak of, particularly those for hard-core addictions to opiates, alcohol, cocaine and meth. 90% of all those who enter treatment will use again within five years, and half go right back to active addiction within a year. Worse, with the ever-increasing amount of drug-related arrests each year, what starts out as a fixable public health issue becomes a lifelong socio-legal handicap.
Ibogaine smashes through all of this orthodoxy. Since its inception in the 1980s, the ibogaine underground has been building an alternative treatment infrastructure that completely redefines the approach to addiction. Aside from the novelty, and irony, of a psychedelic drug containing a potentially single-dose cure for drug addiction, ibogaine therapy is also attractive because it redefines success not as abstinence but as a measurable improvement in an addict’s quality of life, and this is because ibogaine is not about prohibition or substitution, it’s about spiritual evolution. Like other plant medicines, if you’ll pardon the pun, iboga is about gettin’ at the roots of the sickness. Consequently, it is leading a kind of awakening, and it will only be a matter of time before millions begin to seek it out.
Hitting the Reset Button
The story of ibogaine begins with addicts trying to help other addicts, but along the way we find it's also about the conflict between natural and Western medicine, and the moral bankruptcy of the pharmaceutical industry, who are interested in developing maintenance drugs, and not cures. And like any tale of revolution, this story is about the internecine battles, personal perils, and professional pitfalls of trying to change the paradigm. What sets this movement apart from others is the unanimity of purpose: everyone involved in the underground wants to heal.
Ibogaine works a mysterious voodoo that combines the spiritual and the biochemical. More than anything else, it challenges the legitimacy of the “disease” model of addiction, and no one anywhere on the health care food chain wants to hear that, especially if they are profiting from the immiseration caused by drug abuse.
So what is ibogaine? The two-volume reference bible Psychedelic Medicine classifies ibogaine as a naturally occurring alkaloid of the Tabernanthe Iboga plant native to West Central Africa. The iboga root bark contains a powerful psychedelic that has been used as a religious sacrament for centuries. In the colonial era, iboga served as a vital instrument of psycho-spiritual resistance for the indigenous population against the encroachment of the white man.
Today iboga is used primarily by the Bwiti religion of Gabon in their initiatory rites of passage, like those described by Daniel Pinchbeck in Breaking Open the Head (credit the Bwiti with the title, it's their term for what happens when one takes the drug). During the ritual large amounts of iboga are consumed and the initiates are known to enter visionary states where they meet their deceased tribal elders -- what they call “the work of the ancestors” -- and confront their shadow selves as a means of becoming aware of negative behavior patterns and character traits which cause illness and impede spiritual growth.
The person credited with introducing iboga to the U.S. is the Godfather of the movement, Howard Lotsof, a former heroin addict turned ibogaine evangelist who died last month of liver cancer at the age of 66. In 1962 Lotsof stumbled across ibogaine’s effectiveness with addiction when he found that after one dose he had lost his craving for heroin, and had miraculously leapfrogged the brutal and potentially fatal withdrawal process.
Lotsof tirelessly lobbied public officials and dogged researchers and pharmaceutical companies to investigate his claims about iboga’s miraculous properties. By the 1980s he was lay-administering the alkaloid ibogaine in capsule form to addicts in the Netherlands and was given a U.S. patent. Lotsof felt ibogaine’s true significance was in unlocking the mysteries of the neurobiology of addiction. By virtue of its origin he also believed it could serve as a means of reconnecting shamanic medicine to Western medicine. Secretly, he and his inner circle harbored fantasies of a revolution in consciousness, and ibogaine was one of their most viable Trojan Horses.
Here’s how the miracle works. The conventional approach to treating opiate addiction is to employ a substitution therapy like methadone or suboxone, maintenance drugs that keep the addict addicted to a less potent, more manageable opiate analog. This means that the only available treatment does not actually stop the addiction. So what’s the point?
Ibogaine works, it is believed, by filling in the receptor sites that the opiate molecules once sought, ending the craving for the drug, while at the same time metabolizing in the liver into noribogaine, which is thought to have powerful detoxifying and anti-depressant properties. The million dollar jackpot is that ibogaine can eliminate the exceedingly painful and dangerous opiate withdrawal process, sometimes in a single dose. In effect, it has the power to hit the reset button on the brain’s neurotransmitter mechanism.
Ibogaine has never been popular as a recreational drug regardless of its legal status. There is not a single recorded case of ibogaine addiction anywhere. Those who use it do so infrequently, because, like ayahuasca or peyote, it takes a toll on the mind, body and spirit, never mind that most folks don't consider vomiting and diarrhea to be particularly social activities. Only two iboga-related arrests are known to have occurred in the U.S., and 20 people are on record as having died within 72 hours of taking ibogaine, mostly due to either heart complications or drug contraindications.
This specific focus on the treatment of addiction is what distinguishes the ibogaine underground from other psychedelic subcultures, like the rapidly growing ayahuasca community. Writing on the “ibogaine medical subculture” for the Journal of Ethno-Pharmacology, Alper and Lotsof describe the underground as, "...homes, hotel rooms and private clinics in North America and Europe, [where] individuals in increasing numbers are taking ibogaine in what has been termed ‘a vast uncontrolled experiment.’”
Because a safe and legal alternative is not available in the U.S, the ibogistas have been forced on to more tolerant legal climes in Canada, Mexico, Costa Rica, and Europe in order to avoid becoming de facto criminals. For those who remain in the states as lay-providers, they role the dice every time they take an addict’s life into their hands, but they feel, unequivocally, that the medicine is safe and the risk is worth it.
Alper and Lotsof claim that the ibogaine subculture is not a counterculture because “its identity is not defined on the basis of opposition to conventional medicine” and it “shares with the conventional medical culture the common goal of providing treatment, which it emulates in the medical model.” This is partially true, and really more a matter of opinion. To many, the ibogaine underground is very much a counterculture, and its hard to argue that it is not defined on the basis of its opposition to the disease model of addiction. Additionally, the “medical model” they refer to --in which licensed physicians conduct treatments that usually take place in a hospital or clinic -- is only one of five elements of the ibogaine underground that make up the full typology of the subculture. These include evangelizing addicts and lay providers, activists, and ritual/spiritual shamans.
The Addict as Healer
Tijuana is a junkie that is hitting bottom. She’s dying. Strung out, desperate, unable to kick, her streets are empty and decaying, her shops are closed. All across this sprawling border city of more than 1.5 million you see the shaky, splintered shells of abandoned developments. It’s as if everyone just up and vanished. It’s a ghost town, replete with a legion of narcotic zombies shuffling to and fro.
We talk about a drug war in the United States, but south of the border this war is real. It’s a shooting war that has decimated this once thriving city. In the four years since Felipe Calderon became Mexico’s President and sent in the Federales, over 16,000 people have been killed, 7,000 in the last year alone, 1400 of them in Tijuana where three different cartels battle for control. Tourism and development have evaporated, and Tijuana starves.
The American model of fighting the drug war has failed miserably in Mexico. As is usually the case, the arrest of several high-profile traffickers has done nothing to impact supply or demand. The much-maligned $1.4 billion Merida Initiative, a kind of Mexican “Plan Columbia,” has also been a dismal failure. So Mexico got creative, and decided to try something new.
Despite much wailing and gnashing of teeth from politicians in Washington, the Mexican government finally decriminalized personal drug possession in August of 2009 (four days later, Argentina did the same, releasing 150 million Latin Americans from the criminalization of their lifestyles). This was done to shift law enforcement priorities away from the users to the cartels, which is good because business is booming. The streets are filled with junkies shooting up in plain sight as you drive along the Segunda Benito Juarez border highway. There is much poverty and suffering here, and no one should be surprised that people want to escape. And if they can’t escape across the border, all they have left is to escape into dreamland.
Yet it is here, in the dark center of Mexico’s drug war, where a powerful ray of hope shines in the battle against addiction. Tijuana is home to Pangea Biomedics, more commonly known to those in the underground as the “Ibogaine Association,” one of only a handful of ibogaine treatment centers in the entire world.
Pangea’s facilities are located in an enormous home inside a secure gated community that’s situated in the Costacoronado hills high above La Playas de Tijuana. Yeah, it’s true, Tijuana is dangerous, and you can’t take too many precautions these days. But Pangea’s owner Clare Wilkins swears they’ve never felt anything but welcome and blessed in their relationship with their host city.
Born in South Africa and raised in Los Angeles, Clare first learned of ibogaine at age 30. She had been addicted to opiates since she was 15, half her short life, and she was entering her eighth year on methadone. Her sister Sarah, another former opiate addict who is now Pangea’s chef and nutritionist, gave her a copy of “Tripping on Iboga,” Daniel Pinchbeck’s 1999 Salon.com article. It took Clare a few years to build up both the courage and the cash to afford the $3500 treatment fee, but in 2005 she eventually made her way down to Tijuana to the Ibogaine Association, which was then owned by a man named Martin Polanco.
Polanco was a fixture in the ibogaine underground for many years, particularly in Mexico. He is credited with breaking open many heads, including Rocky Caravelli, the owner of the “Awakening in the Dream” ibogaine therapy house in Puerto Vallarta. Pinchbeck did his second journey with iboga at Polanco’s, where he met Randy Hencken of the Multidisciplinary Association for Psychedelic Studies (MAPS), who had just started overseeing a MAPS ibogaine program and would later collaborate with Polanco on a study, only to have things go terribly wrong.
MAPS tapped Valerie Mojieko to design the study and sent her down to undergo the treatment. Unbeknownst to her, Polanco was developing a bad reputation for being a provider who gave poor-quality treatments. Consequently, Mojieko had a very stressful and unpleasant experience, at one point believing she was having major heart complications. Her bad trip was made worse by the language barrier of Polanco’s staff and, ironically, their lack of training in how to care for people having difficult psychedelic experiences, a major focus of Mojieko’s work. Shortly thereafter someone died while being treated by Polanco, and the clinic had to be shut down. The MAPS study was dead in the water.
Around that same time Clare Wilkins came to Polanco for treatment and she had a similarly alienating experience. Although as an addict she respond well to the medicine, she was unable to connect with either the setting or the treatment staff on hand. None of them were addicts, and none of them had ever taken ibogaine.
“I was left completely alone when I did my treatment,” Clare says, making sure I understand how un-kosher this is. “I was the only person in the clinic at the time. It was terrifying. I didn’t want to ever see another addict go through that if I could help it.”
Intending only to volunteer for Polanco in order to have at least one other addict present who knew what the patient was going through, Clare, who has no formal training in addiction, psychology, or medicine, ended up buying the Ibogaine Association from Polanco when he ran into trouble. A chance meeting with MAPS founder Rick Doblin at the 2006 Burning Man festival led to a renewed relationship with the organization, and a new study.
Clare proved to be an autodidact, an honorary Ph.D in addiction like Howard Lotsof, but she also knew that if she really wanted to understand this medicine she needed to reach out to Lotsof in person, to pay her respects to the Godfather.
“I called and introduced myself to Howard when I bought the clinic. He asked me for my C.V. which I didn’t have, so I felt embarrassed. But he understood. He faced the same challenges in life, not having any formal training (Lostoff had a degree in film from NYU). He treated me like a colleague and told me that the underground was vital to the success of this medicine. He was right. I’ve learned more from the underground than anyone else.”
In a span of less than four years Lotsoff would become Clare’s friend, mentor, and spiritual father. She loved his compassion and drive and the way he seemed to lack judgement, which she felt made him the perfect advocate for addicts. She started booking treatments immediately, modeling her approach after Lotsof’s and mostly learning on the fly. Within six months she moved Pangea into a new space, and paid off the purchase to Polanco in only eighteen months. To date she has given over 400 treatments.
They are not cheap. A full 10-day detox program runs about $7500, not including travel. The marked increase over Polanco’s fee reflects improvements Clare made in the treatment protocols in the wake of Valerie Mojieko’s bad experience, and deaths at Polanco’s clinic and others within the underground, even at Pangea under Clare's supervision, which caused everyone in the ibogaine underground to take a good hard look at their own protocols. As a result, many of them, including Clare, implemented more medical safeguards.
Pangea’s comprehensive treatment is a complete holistic integrative health plan, and the price tag reflects the doctors, nurses, EMTs, massage therapists, and nutritionists she employs, a staff of twelve with monthly expenses of around $30,000. Ultimately, though, the medical staff are subordinate to Clare, who is the lead therapist and “guide” during sessions. Unlike Polanco, who was often absent, Clare is present for every one of her client’s sessions.
Clare is quick to point out that half of the 400 treatments she has given were either subsidized or free, which she says is common in the underground. She also mentions that three of her former clients formed a not-for-profit called “The Healing Experience” that raises money to provide free treatments for those who can’t afford them. Lots of former addicts pay for treatments for others, or assist with sessions, she tells me. It’s part of their healing process.
“The only way this message is received is if its carried on the backs and in the hearts of addicts,” she says with utter conviction. “It only works if addicts help each other.”
Bringing it Home
It pains me to think about what my life might be like today had I only known Clare Wilkins ten years ago. As my book, Exile Nation, chronicles, I spent nearly a dozen years in flagrante delicto with a brutal crack addiction, which I managed to kick the hard way shortly after 9/11. After two decades of abuse and recovery, I prided myself on knowing as much or more about addiction than any specialist, and the one thing I was clear on was that the existing methods of treatment left a lot to be desired. I am deeply cynical about the medical establishment’s position on addiction. I firmly believe, like Carl Jung did, that addiction is a spiritual sickness, and that it is not chronic, but can be cured. One does not have to saddle oneself with the “addict/alcoholic” label for the rest of their lives. It’s a permanent, and unnecessary, handicap.
At the same time, however, I began to have some ambivalence about taking ibogaine. Since I did not need detox, the technical term for the type of treatment I was going to take is called “Psycho-Spiritual.” But let’s be frank, I also knew that there was fifteen odd years of hairy addiction shit to cull through as well, and since I had heard iboga was a harsh taskmaster and didn’t pull any punches, I was growing afraid of what I was going to have to face.
After nearly four months of trying to coordinate our schedules, Clare and I finally settle on the second week in February for me to travel to Tijuana (of course, those who have taken iboga will tell you that the medicine makes itself available to you when the time is right, and not one minute before). I was in Los Angeles preparing for the trip when we all got word that Howard Lotsoff had died. Clare was distraught and headed off to his funeral in New York and didn’t know if she’d be back in time for my visit.
I spent the week prior to the treatment on a strict diet of mostly fruits, greens, and nuts. I had no alcohol, very little caffeine, and drank gallons of detox tea. I crossed the border on the morning of February 8th with my close friend Kristin, a psychotherapist specializing in addiction and PTSD who works part-time at Pangea. There was no traffic going into Mexico, and nearly a two-hour line cued up on the other side waiting to get out. The night before at her place in San Diego, Kristin showed me Ibogaine: Rite of Passage, an eight-year-old film set in a Bwiti medicine ritual in Gabon, and at Polanco’s clinic in Tijuana, that featured Howard Lotsof and Randy Hencken. Kristin takes great care to point out that Clare’s protocols are nothing like what I was seeing in the film.
“You’re probably not going to take the medicine right away,” Kristin tells me, “you’re just going to get your intake work done, and prepare your system. You also need to acclimate to the setting. When the moment is right, Clare will appear out of no where and tell you its time. It could be days.”
I went through a comprehensive intake that included a clinical history, complete blood and urine panels, cardiac enzymes, the whole enchilada. I found out I was healthy as a pack mule, albeit slightly anemic. Later that night I was given the most sublimely painful two-hour deep tissue detox massage by a Thai man named Neil who had worked with ibogaine for psycho-spiritual purposes and told me it helped him heal wounds stemming from his childhood in Thailand when he was abandoned by his family, and as a result, could not experience intimacy with anyone, including his wife and children.
“The med-cine keep working with you for many year,” he said in broken English. “It working when you not know it working, and den one day you say, ‘Ah, now it make sense!’”
There were two other clients at the clinic, a 26-year-old Orange County princess strung out on Oxys, and a poly-addicted guy in his early thirties from Detroit who was as magnificent a shit-talking addict as I have ever met. When you’ve been an addict and spent your life around them, at home, in school, at work, in bed, you very quickly come to see who’s serious about cleaning up and who’s not. I had strong doubts about both, particularly the kid from Detroit, about whom I would prove correct. Both of them screamed I’m enabled, what’s your name?!
Clare and her sister Sarah show up at the house a couple hours after I arrive. They both stand just over five feet tall, and have no physical resemblance beyond that. Bespectacled Clare resembles a hippie accountant, while ink-and-bleach Sarah is more skate punk. They both project substantial presence.
Later that afternoon Chris Bava and his wife, Cat, stop by. Both are artists and former clients who are renting a beautiful beach house just down the hill from Pangea. Chris was a Category 5 poly-addicted mess, hooked on heroin, ketamine, crystal meth, and methadone. He had done three years in a federal joint for a drug related offense, and was clean and sober for a number of years before falling back into addiction. Clare had saved both of their lives through ibogaine therapy, and they now paid their respects, as many former clients did, by volunteering their time at the clinic.
“You can’t really use me as an example, though,” Chris says, waving me off. “I’m not an an ibogaine success story, it didn’t work on me the first couple of times.”
Cat quibbles, “After the second treatment he went on a ketamine rampage and we had to commit him. That was when he was ready to quit, that third time. And it worked.”
Later the three of us are walking on the beach together while Jeff, another former addict who is part of a provider training program, is keeping an eye on the guy from Detroit, who is throwing balls to Chris and Cat’s dogs. Jeff is making sure Detroit doesn’t try to cop dope from someone on the beach or street. The addicts who come to Pangea often need constant monitoring, like this guy. Within a day he is caught with a smuggled set of works and it becomes apparent to the staff that he has broken into the med closet and stolen methadone and valium. After hanging around for a week, on his parents dime, without undergoing the treatment, he eventually decides to leave, and Clare ends up having to drop him across the border.
Cat pulls up alongside me as we shuffle through the sand.
“I wasn’t expecting anything when I took ibogaine,” she says in a thick Aussie drawl, “but I found it cured me of smoking, and nicotine was definitely my drug of choice. I smoked for 35 years! I expected to die of lung cancer. I can’t tell you how surprised I was not to crave a cigarette. I was simply baffled.”
The next day I fast after gagging down a handful of supplements with a macrobiotic vegetable juice Sarah makes me, part of Pangea’s neurotransmitter replacement therapy regimen. The supplements are meant to prep the brain for the ibogaine, and most of the addicts coming in for treatment have depleted neurotransmitters and are suffering from various degrees of depression, chronic fatigue, liver issues, or viral infection. In some cases patients have to be stabilized with benzodiazapines before they can undergo the treatment, hence the valium on site. For the more benign cases, marijuana is provided for anyone who wants it, to combat anxiety, nausea, and depression. It’s also available because it’s considered medicine, and it's not illegal. This small detail alone would be considered radical, and most likely dangerous, across the border, where just up the road in San Diego legal medical marijuana clinics are raided on a weekly basis. To be honest, the weed makes for a nice vibe, and in a place like this -- a trip factory, a healing center -- vibe is everything.
The last step in the preparation procedure is for me to take it in the ass, literally, with a 48oz coffee enema, what Clare calls a “crappuccino.” She takes me into the bathroom to explain to me how to do it properly.
“This significantly helps with absorption and detoxification. You need to hold it in for 15 minutes. That’s optimal because the liver cycles out toxins every 5 minutes, so we need you to hold it in for three full cycles. Just don’t take it in too fast or you’ll get involuntary contractions and it will come back out even faster and we’ll have a hell of a mess to clean up.”
We don’t get around to beginning the procedure until nearly 10pm. While I settle into my bed, Joaquin the EMT hooks me up to a cardiac pulse/ox monitor and inserts an IV port into my arm in case of emergency. I’m given one last dose of aminos along with omeprazol and metoclopromide to combat nausea, and then Clare appears with the ibogaine.
Part II of this story will appear tomorrow.
March 16, 2010