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As a reporter covering psychedelic medicine for the Health and Science desk at The New York Times, the drugs that often command my attention 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 subjects of research for years, if not decades. And a growing tranche of scientific evidence suggests these drugs have the potential to treat some mental health issues, among them depression, substance abuse and eating disorders.
But research on psychedelics has largely ignored ibogaine, a drug that’s derived from a plant native to the rainforests of Central Africa.
Over the past three years on this beat, I have interviewed researchers who have occasionally mentioned ibogaine, often in tones that hinted at both promise and peril. The handful of experts who have worked directly with the drug cast it as a powerful addiction interrupter — one that can quell the excruciating symptoms of opioid withdrawal and tame the cravings to use again. According to a number of small studies, many patients report being able to achieve long-term sobriety after a single therapeutic session. (In the United States, the drug remains illegal; many patients will travel abroad for ibogaine therapy.)
But there are downsides. An ibogaine journey can be grueling. 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 ascribed to severe arrhythmia, or an irregular heartbeat, that in rare cases can lead to fatal cardiac arrest. Those risks were enough to prompt the Food and Drug Administration in the 1990s to end further study on ibogaine’s potential to treat crack cocaine addiction.
Many psychedelic researchers just left ibogaine alone.
But then came an initiative in Kentucky that electrified the close-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 research and drug development. The money would come from the funds the state was expected to receive in opioid settlements from pharmaceutical companies.
A friend of a friend, Adriana Kertzer, a lawyer in New York whose firm specializes in psychedelic medicine, invited me for coffee to talk about the proposal. In November, Ms. Kertzer put me in touch with W. Bryan Hubbard, the commission’s chair. Mr. Hubbard had little experience with psychedelics, but he became fascinated with ibogaine after reading accounts about its potential to treat opioid addiction.
“I was desperate, and felt that I needed to explore all options that might show promise,” said Mr. Hubbard, who grew up in Appalachia near the West Virginia-Kentucky border, a region of the United States that has been devastated by the opioid epidemic. “I’ve seen the carnage first hand.”
With the number of fatal drug overdoses in the United States topping more than 112,000 between May 2022 and May 2023 — and opioids like fentanyl contributing to the record high — it felt like the right time 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 the throes of 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 inpatient treatment clinics and tried medical interventions, like Suboxone, to treat her addiction. Nothing helped her remain sober until she tried ibogaine eight years ago. She 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 ibogaine’s cardiac risks?
Mr. Hubbard was confident that the dangers could be mitigated. He connected me with scientists working on the issue. 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. Martín Polanco, the medical director of the Mission Within, a program that has used ibogaine to treat over 1,000 veterans with traumatic brain injury and addiction issues; and Dr. Nolan Williams, a Stanford University neuroscientist who was preparing to publish a study that highlighted measures to reduce ibogaine’s heart risks.
All were adamant that ibogaine-related fatalities could be effectively managed by screening out individuals with cardiovascular problems and ensuring ibogaine was administered in a medical setting.
Covering psychedelic medicine can be nerve-racking, given the field’s relatively nascent state, the paucity of large studies and the occasionally breathless boosterism of its advocates.
Journalists on The Times’s Health and Science team are cautious about allowing hope to get ahead of science. When writing the article, my editors and I took care to balance the seeming promise of ibogaine against the clear risks.
The article, which was published this month, elicited a largely positive reaction from experts. In the comments section, more than 100 readers, among them people who had undergone ibogaine therapy, expressed hope that federal regulators might one day approve study of the drug.
Kentucky’s newly elected attorney general, Russell Coleman, doesn’t share their optimism. On March 13, Mr. Coleman effectively killed the commission’s ibogaine initiative.
Mr. Hubbard remains undaunted. Last month, he began working for the Ohio state treasurer’s office on a similar initiative to use opioid settlement money to fund research of ibogaine. A half-dozen other states, he said, have expressed interest in doing the same.
I, too, will be keeping a close eye on this fascinating psychedelic in the months and years to come.