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The experience was so profound that she elected to stay on at the clinic as a volunteer. Confident and chatty, with long brown curls and a disarming smile, Wilkins feels she has a knack for guiding patients through their ibogaine-induced spiritual awakenings. "On ibogaine, all your walls come down," she says. "You can't lie. You get an opportunity to look at yourself honestly and see how you respond. My role is to be there as a comfort. People compliment me by saying, 'You knew exactly when to hold my hand.'"
In 2006, Ibogaine Association director Martin Polanco offered Wilkins a full-time job. She'd heard rumors that he was considering selling the clinic in the coming year, and on a whim she offered to buy the operation from him outright. "It was one of those 'Can I put that back in my mouth?' moments," she recounts with a laugh. "I didn't have the money, I didn't even have a car." She borrowed $3,000 from her mother for a down payment, changed the clinic's name to Pangea Biomedics, and made monthly payments to Polanco for the next year and a half.
Stays at Pangea — located in a lavish home in Tijuana's upscale Playas neighborhood — aren't cheap. For the standard 10-day detox, Wilkins charges $7,500, travel not included. She employs 10 staff, including two Mexican physicians, a paramedic, a masseuse/acupuncturist, and a chef. The chef, her sister Sarah, is a recovering addict who credits ibogaine for kicking her drug dependence.
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Aaron Aurand, a live-in volunteer, feels the same way. "I did eight months of court-ordered inpatient treatment before I came here," says Aurand, a native of Spokane, Wash. "I got more therapy here in five days than I did in that entire time. Lots of junkies don't want to look inside themselves. With this, you'll get shown."
To date, Wilkins says, she has treated more than 300 patients. "Sixty-two percent of our clients are chronic pain patients. ... You're not talking IV [heroin] addicts or crack addicts. You're talking grandmas on OxyContin."
Some people come for "psychospiritual" purposes. Ken Wells, an environmental consultant from Santa Rosa with a neatly trimmed gray mustache and wire-frame glasses, says he underwent conventional counseling for depression for 15 years before trying ibogaine as a last-ditch effort to save his crumbling marriage. Three days after taking it for the first time, he compares the experience to "defragging a computer hard drive." He experimented with psychedelics decades ago in college, but says ibogaine is like nothing else.
"It was outrageously powerful," Wells says. "It was like the inside of my eyeballs was an IMAX screen. It was all-encompassing, just a multitude of images, like 80,000 different TVs, all with a different channel on — just jillions of images, shapes and colors." Did the experience help him find what he was looking for? "I think I'm different," he says. "But I don't know."
It's easier to track ibogaine's effect on hardcore addicts. Wilkins, who keeps tabs on former clients, estimates that one out of every five stays off his or her "primary substance" for six months or more. Tom Kingsley Brown, an anthropologist at UC San Diego who describes his area of study as "religious conversion and altered states of consciousness," recently began recruiting Pangea patients for an independent assessment of ibogaine's long-term efficacy. He follows up monthly with opiate addicts during the year following their treatment, to gauge whether their quality of life has improved.
"People I've interviewed at the clinic have had really good results, especially in the first month or so," reports Brown, who has enrolled four study subjects to date and hopes for a group of 30. "We know ibogaine interrupts the addiction in the short term, but what we're really curious about is: Does that translate into long-term relief from drug dependence?"
Participants in the study fill out questionnaires that ask them to rate the intensity of different aspects of their trip, on a scale of one to five. "People have been circling a lot of fours and fives," Brown says. "One of the things we're trying to look at is if the intensity of the ibogaine experience correlates with treatment success. I strongly suspect there's some sort of psychological component. I doubt it's just a biological phenomenon."
Some scientists beg to differ. Foremost among them are Deborah Mash and Stanley Glick. "The hallucinations are just an unfortunate side effect," Glick asserts, explaining that ibogaine works on the brain like a "hybrid" of PCP and LSD. "Part of the problem is that when you go through this thing, it's so profound you've got to believe it's doing something. In part it's an attempt by the person who's undergoing it to make sense of the whole thing."
Generally speaking, Glick's research on rats has shown that ibogaine "dampens" the brain's so-called reward pathway, reducing the release of neurotransmitters like dopamine, which cause the highs associated with heroin as well as sugary foods. The compound has also been proven to increase production of GDNF, a type of protein that quells cravings, and to block the brain's nicotinic receptors, the same spots that are stimulated by tobacco and other addictive substances. In other words, ibogaine doesn't work in any one particular way or even on one specific part of the brain, and it's these multiple "mechanisms of action," researchers say, that make it so effective for so many different types of addiction.