<H3>Introduction</H3> Ibogaine is a psychoactive indole alkaloid derived from the rootbark of an African plant - Tabernanthe iboga. In recent years it has been increasingly noted for its ability to treat both drug and alcohol addiction. Both scientific studies and widespread anecdotal reports appear to suggest that a single administration of ibogaine has the ability to both remove the symptoms of drug withdrawal and reduce drug-craving for a period of time after administration. In addition, the drug's psychoactive properties (in large doses it can induce a dreamlike state for a period of hours) have been widely credited with helping users understand and reverse their drug-using behaviour. Studies suggest that ibogaine has considerable potential in the treatment of addiction to heroin, cocaine, crack cocaine, methadone, and alcohol, with some suggestion that it further be useful in treating tobacco dependence. It has also been suggested that the drug may have considerable potential in the field of psychotherapy, particularly as a treatment for the effects of trauma or conditioning. A single administration of ibogaine typically has three effects useful in the treatment of drug dependence. Firstly, it causes a massive reduction in the symptoms of drug withdrawal, allowing relatively painless detoxification. Secondly, many users report, and scientific studies confirm, a marked lowering in the desire to use drugs is experienced for a period of time after taking ibogaine, typically between one week and several months. Finally, the drug's psychoactive nature is reported to help many users understand and resolve the issues behind their addictive behaviour. Ibogaine can be easily administered, in capsule form, and has no addictive effects itself. It is essentially a "one-shot" medication and, used in a clinical setting with proper client screening procedures, the drug thus far appears to be safe to use. Whilst it is rare for an individual to stop using drugs permanently from a single dose of ibogaine, as the initial component in an overall rehabilitation programme the drug would appear to offer much potential. Although approved for clinical trials (trials on humans) for the treatment of addiction in the US in the early 1990s, problems with financial backing have so hindered the development of ibogaine that, as of mid 2001, it remains undeveloped and thus unavailable to the majority of addicts worldwide. There are however a couple of private clinics, located around the Caribbean and in Mexico, that offer ibogaine treatment at prices starting around £4,000, and some lay treatment providers offer lower cost treatment, without medical facilities, in Europe. In addition, ibogaine, either in pure form or as a plant extract, has become available from some lay sources on the internet. Ibogaine's current legal status in the UK, and much of the rest of the world, is that of an unlicensed, experimental medication, and it not therefore an offence to possess the drug, though to act as a distributor may be breaking the law. Ibogaine is a restricted substance (possession is illegal) in some countries, including the US, Switzerland, Sweden and Belgium. <A name=two></A> <H3>Ibogaine</H3> Of the various substances that have, at one time or another, been proposed as being useful in the treatment of drug or alcohol dependence, ibogaine would certainly appear to be the one offering the greatest real potential. A slightly psychoactive indole alkaloid derived from an African plant, the drug, in plant form, has been used by indigenous groups for millenia. The Bwiti, a Central African religious group, use the rootbark of the Tabernanthe iboga plant for a variety of social and religious purposes, most notably as the central component of a "rite of passage" initiation ceremony intended to confer the status of adulthood upon new group members. In the West, ibogaine is usually administered in the form of the hydrochloride - a fine off-white powder either lab synthesized or chemically extracted from the rootbark. When administered to persons seeking to beat addiction to heroin, methadone, cocaine or alcohol, a single dose of ibogaine typically achieves the following. Firstly, the complete removal or severe attenuation of the symptoms of drug withdrawal, allowing painless detoxification (occurs with approx. 90% of subjects). Secondly, the removal of the desire to use drugs for a period of between one week and three months (occurs with approx. 60% of subjects). Finally, the revealing of personal issues underlying drug-using behaviour, leading to long-term drug-abstinence (occurs with approx. 30% of subjects). Ibogaine is not itself addictive and the drug may be taken a second time to help preserve a drug-free state. It should be noted, however, that relatively few people permanently beat addiction solely through using ibogaine, and the treatment should thus be regarded as simply an initial component in an overall rehabilitation strategy. The discovery that ibogaine could treat drug addiction is usually credited to Howard S. Lotsof - a New York based former heroin user who first took ibogaine in 1962. Lotsof took ibogaine believing it to be a new recreational drug but, 30 hours later, suddenly realized he wasn't experiencing heroin withdrawal, and had no desire to seek drugs. Subsequent casual experimentation by addict friends revealed that this effect was common to others. Some 20 years later, Lotsof returned to his discovery and set about trying to bring it to the market. He initially set up a charitable foundation with the aim of promoting and developing ibogaine as an anti-addiction medication but, dismayed by the lack of interest shown, later decided to form a company, NDA International, believing a business concern would more likely attract the necessary financial backing. NDA filed patents for the use of ibogaine in the treatment of addiction and began to carry out treatments to better evaluate the drug's potential. Because, by this time, ibogaine had been made a Schedule 1 restricted substance in the USA (ibogaine was banned along with LSD and psilocybin in the early seventies) NDA chose to carry out experimental ibogaine treatments in Holland. Jan Bastiaans, a highly-regarded Dutch psychotherapist, partnered him and, over the early years of the nineties, they treated some 30 addict volunteers, the results of which were later medically assessed by Dr Ken Alper in a scientific paper (see How Ibogaine Works for ref). The nineties, after a promising start, proved to be a tough time for ibogaine. In 1991, the US National Institute for Drug Abuse (NIDA), impressed by case reports and animal studies, began studying ibogaine with a view to evaluating its safety. They constructed protocols for the treatment of addiction. In 1993, the US Food and Drug Administration (FDA), who oversee the development of new drugs, approved clinical trials with ibogaine, to be carried out by Dr Deborah Mash of the University of Miami School of Medicine, on behalf of Howard Lotsof's corporation, NDA International. It was at this point that things started to go astray. The death of a young female heroin addict during treatment in Holland brought an abrupt end to the Dutch project. A subsequent inquest did not find the project organizers guilty of negligence but the lack of scientific knowledge about the effects of ibogaine hindered the establishing of an actual cause of death. (It was believed that the surreptitious smoking of opiates during treatment may have been responsible). The approved clinical trials commenced but contractual and funding problems that arose between NDA International and the University of Miami brought the trials to a close before completion, (the drug's safety was not an issue). A lengthy legal battle between the two ensued, and developmental work came to a standstill. In March 1995, after several years spent progressively becoming more interested in ibogaine, a review committee at NIDA suddenly decided to greatly reduce further activity with the drug, apparently having been influenced by critical opinions from the pharmaceuticals industry. Officially, it was reported that the death in Holland was of concern, and that NIDA were disappointed that ibogaine was only shown to keep people off drugs for a period of months, not forever. Howard Lotsof has subsequently pointed out that the death, whilst tragic, was likely caused by concurrent opiate usage and, with regard to the second point, that any drug that could put, say, cancer or AIDS into complete remission for a period of months would be being developed as a matter of national urgency. Over the last five years, very little has happened. The escalating legal battle between NDA International and the University of Miami, each suing the other for alleged breaches of contract, appears to have ended with the bankruptcy of the former. Yet, as of mid 2001, the precise outcome is not clearly established. Meanwhile, widening knowledge of the effects of ibogaine has resulted in casual treatments being provided by various individuals in different countries. Though usually undertaken with good intentions, these treatments have frequently been carried out by people with little medical knowledge, and this may have resulted in further tragic incidents. A couple of small countries, notably Panama and St Kitts, have made ibogaine treatment legally available at private clinics, but only at prices starting around UK£7,000 per treatment (approx US$10,000. Unlicensed medical clinics in Mexico currently offer the treatment slightly more cheaply). As of mid 2001, ibogaine remains in a legal nowhere-land, desperately needed by millions of addicts worldwide, but, tragically, little closer to becoming easily available. <A name=three></A> <H3>The Problems of Developing Ibogaine</H3> Ibogaine development has been beset with hold-ups for years. The existing legal disputes may now be close to resolution, but ibogaine still needs the participation of a pharmaceutical company for it to make it to the mass market. The business of developing new medications is solely in the hands of the private sector - the pharmaceutical corporations - and the problems that drugs companies appear to have with ibogaine are many. Firstly, as a drug derived from a natural source, patent options are more limited than they would be for a drug that can only be created in the lab. Potentially, this greatly reduces the level of financial return that the drug could provide, of serious concern considering the degree of backing needed to bring a new drug to the market. Whilst, in the West, there are governmental provisions in place to encourage companies to develop drugs that could be socially useful, to date no one seems interested in taking advantage of them for ibogaine. Secondly, ibogaine is not a maintenance drug - it is not taken repeatedly over a short period of time - and is usually administered only once. As a general rule, medications developed by the drugs companies, for whatever purpose, are maintenance drugs, for only maintenance drugs allow sufficient financial return to justify the necessary prior outlay on research and development. Thirdly, industry insiders relate that there are public relations concerns when developing medications for groups that are negatively socially marginalized in the way drug addicts have become. Drug companies, like most modern corporations, are acutely image-sensitive and there are thus concerns that developing medications for addicts could bring about a deterioration in their overall market value. Finally, some believe that bringing an addiction medication of ibogaine's potential to the market may present "conflict of interest" problems, of dubious moral worth, to other corporate bodies involved with the sale of licensed recreational substances such as alcohol or tobacco. The root of the problem that ibogaine faces in becoming available is that our society lacks any mechanism by which a substance of this nature, offering high social benefits but only marginal direct financial return, can be developed. Drugs companies are shareholder based, and so can only develop medications that offer sustained, direct financial return. Whilst ibogaine potentially offers immense savings to government in terms of reduced spending on social welfare and crime prevention, there is no mechanism by which this saving at a public level can be used to induce a corporation to develop the drug. Assuming the absence of corporate backing, about the most likely route by which ibogaine might become legally available is via projects carried out by local government drug dependency units. Projects of this nature, once started, would allow addicts access to safe, low-cost treatment and, as each project generated more knowledge and data, so drug treatment centres in other areas could make use of the same to develop their own ibogaine protocols. As of mid 2001, however, no projects of this nature are underway, although East European countries appear to be at the forefront of those interested. In addition, the medical laws of some countries allow registered practitioners to prescribe an unlicensed medication like ibogaine, usually providing the subject has given their "fully-informed consent." <A name=five></A> <H3>Casual Ibogaine Treatment</H3> With ibogaine treatment not legally available for most addicts, a number of non-medically qualified individuals have started either treating addicts themselves or selling the drug for addicts to self-treat. Whatever the moral wrongs or rights of doing this, anyone considering either self-treating or getting treatment in this manner should be aware that ibogaine treatment is, without doubt, a risky business. I include in the next chapter some information about casual treatment but, before reading, the following should be borne in mind: - Ibogaine's principle use is in the bringing about of pain-free drug withdrawal. Any other claims made for the drug, such as those of promoting long-term drug abstinence or removing the effects of trauma or conditioning in either addicts or non-addicts, are a great deal less substantiated and not likely to occur with any degree of reliability. Ibogaine will get an addict clean and may help reduce drug-craving for a brief period. After that, it is up to the individual to stay off drugs. Entering rehabilitation will therefore be a necessity for the majority of addicts. The use of ibogaine without doing rehab afterward has led to the circulation of many stories that "ibogaine doesn't work," unfair in that no one has ever responsibly suggested that using ibogaine alone was a cure for addiction. In short, addicts seeking ibogaine treatment should ensure they can enter rehab as soon as the session is over. - There is an inherent level of risk in using ibogaine. Four people are known to have died in connection with taking the drug or related substances, and there may in truth be many more given that ibogaine is frequently administered in surroundings where people may be reluctant to contact the authorities in the event of something going wrong. Despite medical reports claiming ibogaine was not responsible for the deaths, there is simply inadequate data to rule out the possibility that the drug may have been a factor. Taking too much of the drug, vomiting excessively, using stepped doses, (ie. half a gram followed by another later on), being excessively thin, or suffering from liver or heart problems have all been touted as dangers, but the truth is - no one really knows why people sometimes die when taking ibogaine. No deaths are known to have occurred in clinical settings. - There are dangers in listening excessively to the advice of just one individual when deciding whether or not to take ibogaine. Because ibogaine's effects can be life-changing, it is common for someone who has had a very positive experience to do their utmost to spread the word about the drug, sometimes allowing their enthusiasm to override the very real concerns about safety. Claims that ibogaine is no more dangerous than drugs like LSD or psilocybin are inaccurate. Taking ibogaine is often an acutely physical experience, with muscle tremors, spasms, and feelings of internal energy shifts all commonly being reported. The drug therefore bears little resemblance to so-called recreational hallucinogens and should not be confused with them. The risk factor for using ibogaine is likely far higher than that for recreational substances. - If you are thinking of taking ibogaine for personal development and haven't yet been involved in proper therapy (ie. therapy where there's an open admission by the individual of the presence of emotional problems) be aware that this may be because your mind is simply being attracted to a "quick fix" strategy that avoids really dealing with the underlying issues. If this is the case, ibogaine could well make things worse. For some, using psychoactive substances can invoke disturbing reactions as the mind's defences struggle to keep down rising repressed material. Drugs like ibogaine, ketamine, LSD, and MDMA (Ecstasy) have been used in the past as elements in the therapeutic process, but only by qualified psychiatrists as an integral component of an overall strategy. Using the drug out of this context is well recognized as frequently causing more harm than good. <A name=six></A> <H3>Ibogaine Treatment</H3> (This article has been reproduced for interest value only). Ibogaine, an indole alkaloid derived from an African plant source, has for many years been recognized for its ability to interrupt drug dependency. Specifically, it can be effective in the treatment of withdrawal from heroin, methadone, cocaine (inc. crack cocaine), amphetamine, and alcohol. Although it is slightly psychoactive, ibogaine should not be confused with drugs like LSD or psilocybin. Ibogaine's effects are far longer lasting and can be intensely physical in some users. The drug should be treated with respect and not administered by persons unfamiliar with basic medical procedures. Because vomiting can be a problem with ibogaine treatment, persons administering should ensure especially that they are fully familiar with resuscitation procedures and have rapid access to the emergency services should they be required. It is important persons interested in receiving ibogaine treatment are properly screened. Failure to do so may have resulted in previous tragic accidents. PREPARATION OF THE CLIENT - The prospective client should attend several informal interviews to ensure he or she is fully aware of the following information relating to ibogaine treatment: (i) - that ibogaine is principally a detox tool and that, whilst it can help with drug-craving for brief periods as well as help a person understand why they started using drugs, it will still be up to them to stay off. As a general rule, addicts who regard ibogaine as simply something which is supposed to "cure them" rarely have success. (ii) - that ibogaine is an experimental medication, not recognized as a licensed medicine anywhere in the Western world, and that other options for treating their addiction exist. (iii) - that deaths have occurred in association with ibogaine treatment, and that it must therefore be regarded as containing some basic level of risk, though proper client screening procedures should be able to keep this to a minimum. (iv) - that, for opiate addicts using ibogaine for the first time, the treatment will be safer if they can stop using for 24 hours (48 hours for methadone) prior to taking ibogaine. See section on Dosage below for more details. A basic level of physical and psychological screening is essential prior to a person being considered suitable for ibogaine treatment. A blood test should be undertaken to check for liver abnormalities and to ensure general health is good. An EKG should be undertaken to check heart function. Problems with the liver, heart or lungs should result in exclusion from treatment unless subsequent professional medical opinion advises to the contrary. Many long-term addicts may have developed medical health problems which would make ibogaine treatment in a non-clinical setting dangerous. These tests can be often be organized by drug dependency units or private doctors. Attention should also be paid to the clients' mental state. Persons exhibiting signs of significant mental disorder should be excluded from treatment. DOSAGE - Assuming the client is sufficiently well to be treated, their bodyweight in kilos should be measured, and a suitable dose of ibogaine calculated. Pure ibogaine HCl is typically administered at doses of around 10 milligrams per kilo bodyweight (mg/k) for men, and 9 mg/k for women. To calculate the dose, multiply the client's bodyweight in kilos by either 10 (for men) or 9 (for women) and you will have the dose in milligrams. Example: An 8 stone female alcoholic will require about 460mgs of ibogaine HCl, a little under half a gram. (8 stone x 14 = 112 lbs. 112 / 2.2 = 50.9 kgs. 50.9 x 9 = 458mgs) Note that this is for pure ibogaine HCl, one of two forms of the drug commonly available in Europe. The other is the "Indra iboga extract," which is believed to be approximately one quarter the strength of pure HCl, meaning clients will require roughly four times the amount. Although the "Indra" product is becoming increasingly available in Europe, it is known to induce more vomiting than the HCl. In January 2000, a 40 year old heroin addict died in London after vomit clogged his airways some 40 hours after taking a dose of this extract. For opiate addicts, such as those using heroin or methadone, the dose of ibogaine HCl is typically doubled, to around 20mg/k for men, and 18mg/k for women. This is because the opiates in a person's system partially block ibogaine's effect. However, it should be understood that this dose is likely nowhere near as safe as the lower dose. If at all possible, it is safest for opiate addicts to detox themselves for 24 hours (2 days for methadone) prior to ibogaine treatment and then take the lower dose of about 10mg/k (9mg/k for women). The deaths that are known to have occurred during ibogaine treatment all occurred with doses of 20mg/k or higher. Valium, or similar benzodiazepines, may safely be taken to reduce anxiety prior to taking the main dose of ibogaine. It is recommended that ibogaine only be given as a single dose, in the range of 9-10 mg/k. From what is known, this appears to be the safest way to take the drug, bearing in mind that higher doses can always be taken in subsequent sessions if necessary. When re-dosing, it is recommended to wait at least one month as ibogaine and its metabolites linger in the body. TREATMENT PREPARATION - It is very important that the client's drug intake be regulated for 24 hours prior to taking the main dose of ibogaine. This will prevent the ibogaine from reacting with any other drugs still in the body, which research indicates may lead to adverse reactions. This means that no heroin, no cocaine and no other drugs should be taken for a minimum of 12 hours prior to taking the main dose of ibogaine. No methadone for a minimum of 24 hours. Drug use for the days prior to treatment should therefore be planned in advance to ensure this is possible. In addition, no stimulants should be taken for at least 24 hours prior to taking the main dose of ibogaine. Normal doses of benzodiazepines like valium can safely be taken prior to ibogaine to assist in reducing anxiety or to help the client sleep if necessary. Ibogaine is recognized as having the ability to potentiate other drug reactions, meaning it is very important persons under its influence do not get access to drugs. Any level of opiate or cocaine usage whilst on ibogaine could be very dangerous. 24 hours prior to taking the main dose of ibogaine, a test dose of about 100mg of the drug should be taken. Allergic reactions have not been reported to the best of the writer's knowledge but, in the event of one occurring, the treatment should not proceed. Some minor level of ataxia, (difficulty in standing upright), nausea, and aural amplification may be experienced at this dose level. This is quite normal. Food consumption should cease about 12 hours prior to the main dose of ibogaine being taken. To make this easy to bear, many people take ibogaine first thing in the morning, as a replacement for their morning fix. 1 hour prior to taking the main dose, an anti-nauseant such as domperidone (or similar travel sickness medication) may be taken to try and reduce nausea. The treatment setting is important in that the client should feel relaxed and relatively easy in themselves. This will help to limit anxiety. Noise should be low throughout (ibogaine causes sounds to be heard much louder than usual), and the light level adjustable. Remember that ibogaine incapacitates some people for several days, so make sure that peaceful, dimly lit conditions can be maintained. A "sitter" should be present with the client for the duration of the experience, which usually lasts between 20 and 30 hours, but in some cases has been known to go on for 3 days. This should ideally be someone experienced in ibogaine administration, or otherwise a close friend. It is unlikely much communication will be attempted in this time and the client should therefore be attended in peace. Requests for water may be fulfilled but nothing else should be taken. THE EXPERIENCE - The client will likely experience the drug taking effect after between 30 minutes and 2 hours. Withdrawal symptoms should be eliminated or easily manageable. There will likely be ataxia (problems getting upright) accompanied by a buzzing noise in the ears. Sounds will become louder, bright light hard to bear. Some people report feeling nauseous and there may be a sensation of pulsing in the body, rather as though it were being "cranked up to a new frequency." These sensations are quite normal. Vomiting within 3 hours of taking the main dose may result in some of the ibogaine leaving the body before it can be absorbed. In such circumstances, giving more may be considered or perhaps the treatment aborted. Examining the vomit may reveal if the drug has left the body. Be aware of the dangers of both overdosing and using stepped doses if considering giving more ibogaine to make up for that lost in vomit, especially if this is the first time someone has used the drug. The experience of taking ibogaine varies so much from person to person, it is difficult to prejudge just what will happen for any one individual. However, there are generally two, distinct phases to the experience. First, the "oneirophrenic" or "dream-creating" phase. This generally lasts several hours and usually consists of the user experiencing dream-like visions with eyelids closed, which disappear once the eyes are open. The visions may appear to be actual memories running, rather as though a film of one's life was being shown inside the head, or may take the form of characters acting out roles, rather as though a play was taking place inside the head. However, many people report no visual sensations and this is not a problem. People may experience feelings and sensations associated with childhood and early life. Secondly, the "processing" phase, which follows once the first stage is concluded. This phase is characterized by high levels of mental activity - interiorized processing that allows the material revealed in the first phase to be assimilated and interpreted. People frequently experience comprehending for the first time the reasons why they became involved with drugs. Though ibogaine affects different people in different ways, the oneirophrenic phase typically starts 1-2 hours after taking the main dose, and the processing phase about 3-6 hours later, usually lasting for between 8 and 14 hours. People sometimes experience very negative feelings on ibogaine. If this appears to be happening, the person attending could try to give them reassurance that things are OK. Whatever arises will pass. What is described above is a typical session but it is by no means unknown for people to be up and moving around within a few hours of taking the main dose, apparently having experienced very little. Alternately, some remain in bed for half a week. In addition, opiate addicts frequently experience little or nothing of the "oneirophrenic" phase. Sessions that are over quickly are usually less effective, and ibogaine does appear to have very little effect on some individuals, regardless of dose level. Potential treatment providers please note: It is important to realize just how variable the drug's effects can be on different people. Tragic incidents can occur if safety procedures become lax after a string of successful treatments. Because, when ibogaine works, its effect can seem quite miraculous, it is very easy for people who are not medically experienced to start to relax pre-treatment screening procedures in their keenness to treat people and this is dangerous. POST IBOGAINE - If the treatment has been successful, the client should be clean having experienced little or no withdrawal. In addition, many experience no desire to use drugs for a period of weeks afterward. Furthermore, some users report gaining insights into their drug-using behaviour. As a general rule, ibogaine is most effective for older addicts, a casual study indicating that those over 35 have a far better chance of staying clean than those in their twenties. In cases where the treatment has been successful, but the client begins to experience the desire to use drugs again after some weeks, repeat dosing with ibogaine can be undertaken. Remember that persons not currently using opiates require ibogaine at a maximum dose of around 10mg/k. Re-dosing with ibogaine at less than one month intervals may be risky, as metabolites of the drug can remain in the body for this length of time. Melatonin and B vitamins have been suggested as useful after using ibogaine. Some believe they help sustain the drug's effect. POST IBOGAINE REHAB AND THERAPY - A single dose or multiple doses, given over a period, of ibogaine will occasionally be enough to keep someone off drugs permanently. But for most the truth is that, unless suitable post-ibogaine work is undertaken, a fairly rapid relapse to old ways is likely. It is simply not possible to give guidelines that will be valid for everyone, for we are all different. However, for many, the addict should ideally enter rehabilitation as soon as possible after the treatment. In the writer's opinion, the best rehab program, and likely the one most suitable for those who have just taken ibogaine, is the Residential Addiction Foundation (RAF) program run by the Humaniversity in Egmont-aan-Zee, Holland, see www.humaniversity.nl for further details. Other alternatives include any long-term (six months and up) residential rehab program available locally. Where residential rehab is not desirous, or not an option, suitable therapy should be seriously considered. Observations of the ethnic, religious use of the drug and first and second hand experience indicate to the writer that the most suitable types of therapy will be body-based and work around catharsis, confrontation and emotional release. "Talking only" type therapy, such as counselling may be effective in some cases but usually less so. Encounter therapy is often highly suitable for recovering addicts, as is primal therapy, bioenergetics, and indeed anything that sets out to assist the individual contact and release repressed emotions, frequently the root cause of addiction. More gentle, integrative work may also be useful. Dance structures such as 5 Rhythms or Biodanza may be helpful, either as a back-up to deeper work or on their own. Attention should also be given to pleasure. Long term drug use will have likely had the effect of causing the addict's dopamine system to have been "hard-wired" to associate pleasure with drug use. This is the reason why many who have beaten addiction in the short term frequently relapse. A brief period of exposure to drug-using stimuli, especially at a time when a former addict feels vulnerable, often results in a return to addiction. Everyone needs pleasure and so the recovering addict must take steps to ensure they can get enjoyment out of life without using drugs. For the majority this will mean work on their sex lives. Sexual stimulation, and particularly orgasm, is the principle means by which the healthy body gains pleasure and releases tension. Work to increase the former user's ability to be intimate, both socially and sexually, is very important. Tantra workshops, touch therapy, or other intimacy-focussed processes are an excellent idea. POST IBOGAINE PROBLEMS - Feelings of deep contentment - although less common with long term heroin users, many people using ibogaine feel in very high spirits for a period of days or sometimes weeks after taking ibogaine. Clients report feeling that their life is now totally straightened out, they don't need to do rehab, and everything is going to be just wonderful. Unfortunately, this feeling usually passes after a week or so. It is important to remember this as some people feel so good for a week or so after using ibogaine, they barely notice when they start to get the urge to use drugs again and so quickly relapse. Learned behaviour or conditioning - ibogaine is widely noted as having the ability to "reset" a persons learned behaviour patterns, leaving them free from compulsive urges, drug-related or otherwise. Again, this usually only lasts for a period of days or weeks, and so attention should be paid to any drug-using stimuli in one's environment after this time. Feelings of anxiety or paranoia - for some users the experience can prove quite harrowing. The drug can have the effect of radically altering the way a person looks at themselves and the world around them. Deep-rooted feelings of insecurity that may have been present since childhood can be uprooted and, when this happens, it can leave a person feeling disorientated and anxious for some time afterward. This will clear and is actually an indication that the drug has worked well. Sleeplessness - many people find they require less sleep for a period of time post-ibogaine. This is quite normal. RETURNING TO DRUG USE - If a return to drug use is anticipated post-ibogaine, it is imperative the client does not restart at the dosage level they were using prior to treatment. Ibogaine "resets" many brain functions relating to drug usage and to return to heavy usage could easily result in overdosing, and possibly death. <A name=seven></A> <H3>How Ibogaine Works</H3> Just how ibogaine works is a long way from being completely understood. However, enough work has been done for it to be possible to present some insights from the fields of neurology and psychology. Neurology - Animal studies have revealed ibogaine to be active at many receptor sites associated with drug dependence and its treatment. These include the kappa and mu opiate receptors, serotonin receptors, dopamine receptors, sigma receptors and the NMDA ion channel. Being active at so many sites, ibogaine does not lend itself to easy scientific evaluation, and it is thus likely to be years before scientists develop a good understanding of just how the drug works. However, basic conclusions have been reached by some scientists, and interesting new lines of research uncovered by others. Through analysing the urine of people undergoing ibogaine treatment in Holland and St Kitts, Dr Deborah Mash believes she has identified the powerful role played by the metabolite, noribogaine. Noribogaine remains in the body for much longer than ibogaine itself and has a higher affinity for many of the receptor sites mentioned above, including the opiate receptors. It may be that an individual's ability to metabolize this substance from ibogaine, which takes place via enzyme activity in the liver, is important in determining just how successful treatment will be long-term. In addition, scientists at the US National Institute of Drug Abuse (NIDA) have also studied the way that drugs, like ibogaine, which are active at the n-Methyl-d-Aspartate (NMDA) receptor apparently have addiction-interrupting effects. Other psychoactives are also known to be active at this site. Ibogaine's effect on the dopaminergic system, known to be influential in addiction, has also been studied in animals. Some have commented that the drug appears to have a kind of "reset button" effect, temporarily overwhelming craving and learned behaviour patterns. In total, around 170 studies of the effects of ibogaine on animals have now been published. The conclusions of these papers are well summarized in Chapter 3 of the of the 1999 edition of The Alkaloids - Pharmacology of Ibogaine and Ibogaine-related Alkaloids, Piotr Popik and Phil Skolnick, (1999). In addition, four clinical studies of the effects of ibogaine have been published. They are: Luciano, DJ. (1998). Observations on treatment with Ibogaine. (American Journal of Addictions 7, 89-90). Alper, KR, Lotsof, HS, Frencken, GMN, Luciano, DJ, and Bastiaans, J (1999). Treatment of Acute Opioid Withdrawal Syndrome with Ibogaine. (American Journal of Addictions 8, 234-242). Luciano DJ, Della Sera, EA, and Jethmal, EG (2000). Neurologic, electroencephalographic and general medical observations in subjects administered ibogaine. (Bulletin of Multidisciplinary Association for Psychedelic Studies 9, 27-30). Mash DC, Kovera CA, Pablo J, Tyndale RF, Ervin FD, Williams IC, Singleton EG, Mayor M (2000). Ibogaine: complex pharmacokinetics, concerns for safety, and preliminary efficacy measures. (Ann N Y Acad Sci 2000; 914:394-401). In the last paper, online at color=#0000ffwww.ibogaine.co.uk/mash.htm, Dr Deborah Mash presents data demonstrating ibogaine's effectiveness in the treatment of opiate and cocaine withdrawal and subsequent drug craving in a case study of 27 patients. As of early 2001, she has treated over 100 people with ibogaine at the Healing Visions clinic in St Kitts. In attempting to sum up the scientific research that has thus far been done, it might be said that the role of the metabolite noribogaine is likely important in achieving elimination of drug withdrawal syndrome, that activity at the NMDA receptor may be significant in understanding ibogaine's psychoactive effects, and that the drug's effect on the dopaminergic system is likely very influential with regard to the reduction of drug craving and alterations in learned behaviour. Psychological - Psychologists attached to drug-dependency units have frequently noted that substance abusers very often show signs of having suffered considerable childhood trauma or conditioning. Research in this field has well summarized by Jane Wilson of the University of Stirling in her paper Childhood Trauma, Adult Psychopathology and Addiction. Trauma is usually a single negative event, the memory of which and associated feelings are repressed. Conditioning is the process by which parents seek to alter their child's behaviour by repeatedly punishing certain acts, usually to try and ensure the child's successful integration into society. One problem in treating the effects of both trauma and conditioning is that, because the original traumatic event or act of conditioning is repressed, the individual has no conscious memory of it having taken place and a person's defences may make any entry into this area difficult. Ibogaine treatment has frequently been reported to assist in the recall of repressed memories and further aid their processing, thus potentially giving the drug a major role in psychotherapy. However, whilst the cognitive retrieval of repressed material may take place, in the writer's experience most users do not experience a significant degree of emotional connection to the repressed event or events either at the time of ibogaine ingestion or later. It is therefore recommended that ibogaine not be administered in isolation, but rather as simply one stage of an wider therapeutic strategy. In addition, it is recognized that, regardless of the degree to which the processing of repressed material has taken place, ibogaine does open up virtually all users to open and frank discussion of personal problems for a period of at least a week or so after use, an effect which may be put to good use in therapy. Psychologically, the drug is essentially "oneirogenic" in that it induces dream behaviour with the ego perspective relatively intact. Modern theories of dreaming often relate that dreams appear to be pseudo-sensory experiences that serve to diffuse the stresses resulting from unresolved emotional conflicts of the day before. In a similar way, it seems to be that ibogaine induces dreams that serve to try and reduces stresses whose origin is much earlier. Ibogaine visions frequently lend themselves well to the principles of dream analysis derived from Jung and others. With regard to concerns over ibogaine's psychoactivity, it should be noted that, unlike LSD, psilocybin, or DMT, ibogaine is not active at the serotonin 2 receptor (5HT2), and thus may validly be regarded as not being hallucinogenic. <A name=eight></A> <H3>The Bwiti</H3> The Bwiti are a Central African religious group whose usage of Tabernanthe iboga, the plant source of ibogaine, forms an integral part of their culture. The rootbark of the plant is known colloquially as "iboga" or "eboka." It contains approximately 12 different alkaloids, of which ibogaine is merely one. Others, such as tabernanthine or ibogamine, are also likely psychoactive. The word "Bwiti" refers both to the religion - the Bwiti religion, and the group that practice it - The Bwiti. There are estimated to be approximately 2-3 million Bwiti members scattered in groups throughout the countries of Gabon, Zaire, and the Cameroun. Most are from the two principal tribal groups of the area, the Fang and the Mitsogho. Fang Bwiti and Mitsogho Bwiti may be distinguished by their ritual practices and beliefs. It is generally believed that iboga use only spread to these local tribespeople over the last few centuries, having originated with pygmy groups in the jungles of the Congo basin many thousands of years earlier. This migration is understood by the plant's indigenous users as resembling its function, Bwiti myths frequently using images of the lightly wooded grasslands and the dense Congo jungle as symbols of the conscious and the unconscious mind. Iboga is used for an assortment of purposes within the group, notably as an aid to concentration and to stimulate recovery from illness. Its principal sacramental use is as the central component in the so-called "Bwiti initiation ritual" - an intricate 3-day "rebirth" ceremony, the completion of which is a necessity if one is to become a member of the group. Both sexes are initiated, typically between the eighth and thirteenth birthday, and the ceremony usually begins on the Thursday, ending Sunday morning. Prior to the ritual's commencement, certain preparatory exercises are undertaken for the purpose of reinforcing the experience. These include the writing and symbolic burning of a "confession" - a written record of all one's moral transgressions, and the undertaking of various rituals, notably one in which the initiate crawls through the legs of local women whilst immersed in a nearby stream, an exercise intended to symbolically reproduce the journey of the sperm to fertilization. During the ritual itself, iboga is eaten on the first night and may be further consumed on subsequent nights should it be deemed necessary. The initiate's consumption of iboga is supervised by the "nganga," a priest of the Bwiti religion who, being knowledgeable of the effects of iboga, can tell when the initiate has had sufficient. The overall aim of the ritual is to cause the initiate to be both emotionally and spiritually "reborn," such that they may take their place within the group as a true adult. The consumption of a high dose of iboga is intended to help achieve this by bringing about a deep, dreamlike descent into the world of the unconscious with the effect of both bringing into awareness repressed material and causing a reconnection to the world of the ancestors. If the initiation proceeds well, it is believed that the initiate will actually "meet the Bwiti," envisioned as the primordial male and female originators of the religion, residing in the depths of the unconscious. The Bwiti initiation ritual, as this "rebirth" ceremony has come to be known, has in recent years attracted the attention of some Westerners who find themselves romantically drawn to the notion of travelling to the region and undertaking it themselves. Anyone considering doing this should be aware of three things. Firstly, that both the Cameroun and Zaire, two of the three countries where the Bwiti are located, are now regarded as being acutely dangerous for Westerners (Zaire especially). Secondly, that, in Gabon, the remaining country, only the least reputable groups would usually consider initiating Westerners, and then almost certainly only undertake the task for financial gain, likely in a half-hearted fashion. Finally, it should be remembered that each year some local initiates are believed to die during the ceremony, bizarre court cases between parents and priests frequently resulting. <A name=nine></A> <H3>Ibogaine for Self-development</H3> The use of ibogaine is not restricted to those seeking to beat drug or alcohol dependence. Individuals seeking personal development, access to more "spiritual" sides of their nature, or a breakthrough in overcoming a psychological block may also find the drug useful. What is especially interesting about ibogaine is that it allows the user access to the unconscious with the ego perspective relatively intact, that's to say, in relatively normal consciousness. In addition, the intensity of the experience can usually be regulated to some degree, the dreamlike visions normally ceasing once the eyes are opened. Another interesting aspect is that, despite its origins, the visions that occur with ibogaine do not appear to feature the "plant teacher" figures common to the visionary experiences associated with entheogens like ayahuasca or peyote, but rather appear to consist of a more direct encounter with one's self. These benefits have resulted in ibogaine being used as an adjunct to therapy by a handful of psychotherapists over the years, most notably Chilean psychiatrist Claudio Naranjo, who details some sessions in his book, The Healing Journey. The objective of an ibogaine session is invariably to allow the individual to become aware of unconscious processes that may be blocking their personal development. Ibogaine appears particularly suitable for this task with users frequently reporting that the drug gave them a "hotline to their own personal guru." Whilst ibogaine may seem like an ideal "personalized high-speed psychotherapy" to some, there are however problems with using ibogaine for personal development work, especially outside of the professional psychotherapeutic context. The dose for therapeutic use is usually around 5-8mgs per kilo bodyweight, and whilst this is undoubtedly a far safer amount than the 20mg/k dose sometimes used to treat opiate addiction, the experience can still prove both physically and emotionally gruelling for some. It is important that the individual's physical and psychological integrity is reliably assessed prior to taking the drug, or, when ibogaine is being considered as a "last ditch" strategy, a risk-benefit assessment made with regard to any potential gain or loss that may occur. For those thinking of taking ibogaine for personal development who haven't yet been involved in therapy, it is important to be aware that using the drug may appear attractive simply because it represents a treatment that avoids the formal psychotherapeutic process. If this is the case, there is a possibility that ibogaine could make problems worse. When a lot of repressed material is present, and for many brought up in the West this will inevitably be the case, psychoactive drug usage can sometimes invoke dangerous reactions as defence mechanisms struggle to keep down rising painful material. This can result in delusional or neurotic beliefs that persist long after the session is over. It is also important to realize that using ibogaine alone will unlikely be sufficient to bring about deep personal transformation. The drug typically gives people mental insights into repressed aspects of their psyche, but without significant emotional connection. Other therapeutic work, ideally something with a strong cathartic element, is highly recommended to allow the experience to be properly processed. <A name=ten></A> <H3>Iboga Visions</H3> Interpreting the dreamlike visions of the ibogaine experience can prove a fascinating yet difficult task. The "oneirophrenic" phase of the session frequently throws up much material from the unconscious, and whilst the later, "processing" phase of the session, characterized by many hours of frenzied mental activity, may shed light on the meaning of what has been seen for some, as often as not the individual emerges from the session little wiser as to the significance of what they have experienced. Because ibogaine visions frequently reveal the presence and nature of deeply sensitive issues, cloaked in symbolism, their subsequent misinterpretation is understandably common. This section will therefore cover some basic aspects of the iboga visionary experience such that individuals using the drug might better benefit from the experience. It is worth remembering that, no matter what they may appear to be about, ibogaine visions invariably contain much personal content. One symbolic device that often appears to be used by the drug is the cloaking of personal issues as world affairs, frequently either political or ecological scenarios that appear to threaten the planet. One example of this is that of the opiate user who experienced being shown that mankind was an evolutionary mistake that was now destroying the world - the revealing of deep-rooted feelings of lack of self-worth. Another example is the individual, whose father had exerted a excessively controlling influence over his childhood, who experienced being shown that the world was under the control of elite banking groups. Whilst the scenario experienced may appear valid to the individual, and may indeed even be valid, it should be remembered that there will invariably be much personal significance. Psychologically, the action of ibogaine is always to attempt to bring repressed material to light - to make conscious what is unconscious. This it does at a rate frequently too fast for an individual to fully process and integrate during the session itself. Experience also indicates that for many this release appears to continue long after the drug has left the system. Consequently, even when little has been experienced visually, it is common for the individual to emerge from the session with their defences overwhelmed by rising unconscious material. It is for this reason that I recommend that the drug only be used by those regularly involved in therapy, and particularly therapeutic structures revolving around the cathartic release of emotions and their bodily integration - Bioenergetics, Primal Therapy, Dynamic Meditation, Lowen Technique, Humaniversity Therapy, or similar. Where this is not undertaken, the inexperienced user may find themselves drawn to bizarre belief patterns or perhaps excessively concerned with issues of "control" for a period of time, perhaps even years, after taking ibogaine. Issues relating to mother or father may be projected onto younger women or older men and there may be a tendency to retreat "into the head," to avoid confrontation with issues of sexuality and personal power. All such patterns should pass with time, and the process of integration may be considerably speeded up by undertaking suitable therapy. <A name=eleven></A> <H3>Bibliography</H3> Ali, S.F. (editor) (2000). The Neurochemistry of Drugs of Abuse: Cocaine, Ibogaine, and Substituted Amphetamines, New York Academy of Sciences. Alper, K.R & Glick, S.D. (editors) (2001). Ibogaine: Proceedings of the First International Conference, Academic Press, San Diego, California. Beal, D & DeRienzo, P. (1997). The Ibogaine Story, Autonomedia 1997. Bureau, R. (date unknown). Péril Blanc, publisher unknown. Fernandez J.W. (1982). Bwiti: An Ethnography of the Religious Imagination in Africa, Princeton, Princeton University Press. Fernandez J.W. (1972). Tabernanthe iboga: Narcotic Ecstasis and the Work of the Ancestors, in: P.T. Furst (Ed.), Flesh of the Gods. The Ritual Use of Hallucinogens, Praeger, New York & Washington. Mary A., (1983). La naissance à l’envers. Essai sur le rituel du Bwiti Fang au Gabon, Paris, L’Harmattan. Naranjo, C. (1973) The Healing Journey, Ballantine. Popik, P & Skolnick, P. (1999). Pharmacology of Ibogaine and Ibogaine-related Alkaloids in: The Alkaloids, Academic Press.