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As a reporter covering psychedelic medicine for the Health and Science bureau at The New York Times, the drugs that often catch my eye are familiar to any veteran psychonaut: ketamine. LSD? psilocybin, or “magic mushrooms”? and MDMA, also known as Molly or Ecstasy.
Many of these psychoactive substances have been the subject of research for years, if not decades. And a growing body of scientific evidence suggests that these drugs have the potential to treat a number of mental health problems, including depression, substance abuse and eating disorders.
But psychedelic research has largely ignored ibogaine, a drug derived from a plant native to the rainforests of Central Africa.
Over the past three years at this pace, I have interviewed researchers who have occasionally referred to ibogaine, often in tones that hint at both promise and danger. The few experts who have worked directly with the drug consider it a powerful addiction breaker — something that can quell the excruciating symptoms of opioid withdrawal and tame the urge to use again. According to a number of small studies, many patients report that they can achieve long-term sobriety after just one treatment session. (In the United States, the drug remains illegal; many patients will travel abroad for ibogaine treatment.)
But there are also disadvantages. An ibogaine trip can be exhausting. Some patients can feel the effects for up to 24 hours.
From 1990 to 2020, more than 30 ibogaine-related deaths have also been reported – some of them attributed to severe arrhythmia or irregular heartbeat, which in rare cases can lead to fatal cardiac arrest. These risks were enough to prompt the Food and Drug Administration in the 1990s to end further study of ibogaine’s potential to treat crack cocaine addiction.
Many psychedelic researchers simply left ibogaine alone.
But then came an initiative in Kentucky that electrified the tight-knit world of psychedelic research. In 2023, a committee convened by the state’s Republican attorney general was considering a proposal to spend $42 million on ibogaine drug research and development. The money would come from funds the state was expected to receive in opioid camps from drug companies.
A friend of a friend, Adriana Kertzer, a lawyer in New York whose firm specializes in psychedelic medicine, invited me over for coffee to talk about the proposal. In November, Ms. Kertzer put me in touch with W. Bryan Hubbard, the chairman of the committee. Mr. Hubbard had little experience with psychedelics, but became fascinated with ibogaine after reading reports of its potential to treat opioid addiction.
“I was desperate and felt like I needed to explore all the options that could be promised,” said Mr. Hubbard, who grew up in Appalachia near the West Virginia-Kentucky border, a region of the United States that has been ravaged by an opioid epidemic. “I have seen the carnage first hand.”
With the number of fatal drug overdoses in the United States expected to top 112,000 between May 2022 and May 2023 — and opioids like fentanyl contributing to the record high — the time was right to take a closer look at ibogaine.
In late November, I traveled to Louisville, Ky., to meet with harm reduction workers, recovering opioid users, and those still in addiction. Among those I met was Jessica Blackburn, 37, who started using Oxycodone in high school and later turned to heroin. Ms Blackburn spent time in five different treatment clinics and tried medical interventions, such as Suboxone, to deal with her addiction. Nothing helped her stay sober until she tried ibogaine eight years ago. He has not touched opioids since.
Given the limitations of existing treatment options, many people I spoke with in Louisville agreed that any treatment with promise should be considered.
But what about the heart risks of ibogaine?
Mr. Hubbard was confident that the risks could be mitigated. He put me in touch with scientists working on the subject. They included Dr. Deborah Mash, a veteran ibogaine researcher at the University of Miami who has used ibogaine to treat more than 300 patients with opioid use disorder. Dr. MartÃn Polanco, the medical director of Mission Within, a program that has used ibogaine to treat more than 1,000 veterans with traumatic brain injury and addiction problems. and Dr. Nolan Williams, a Stanford University neuroscientist who was preparing to publish a study highlighting measures to reduce the cardiac risks of ibogaine.
All were adamant that ibogaine-related deaths could be effectively managed by screening people with cardiovascular problems and ensuring that ibogaine was administered in a medical setting.
Covering psychedelic medicine can be nerve-wracking, given the relatively nascent state of the field, the paucity of large studies, and the occasionally breathless reinforcement of its proponents.
Reporters on the Times Health and Science team are careful about letting hope get ahead of science. When writing the article, my editors and I took care to balance ibogaine’s apparent promise with its clear risks.
The article, published this month, drew a largely positive reaction from experts. In the comments section, more than 100 readers, including people who had been treated with ibogaine, expressed hope that federal regulators might one day approve the study of the drug.
Kentucky Attorney General-elect Russell Coleman doesn’t share their optimism. On March 13, Mr. Coleman effectively killed the committee’s ibogaine initiative.
Mr. Hubbard remains undeterred. Last month, he began working for the Ohio state treasurer’s office on a similar initiative to use opioid settlement money to fund ibogaine research. Half a dozen other states, he said, have expressed interest in doing the same.
I too will be keeping a close eye on this exciting psychedelic in the coming months and years.
