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"[There are] no true controlled studies to give evidence as to its safety and effectiveness," he says. "There is a strong advocacy group [in New Zealand] for ibogaine, and it may turn out to have a place alongside conventional therapies for the addictions, but I'm afraid we are a few years away from that goal."
Last month, dozens of ibogaine researchers, activists, and treatment providers gathered for a conference in Barcelona, where topics included safety and sustainable sourcing of ibogaine from Africa. Alper was among the attendees who gave a presentation on the benefits of ibogaine to the Catalan Ministry of Health. The NYU prof believes ibogaine's most likely path to prominence in the United States will be as a medication for meth addiction, for the simple reason that doctors and treatment providers have found that small daily — and thus drug-company friendly — doses seem to work better for meth addiction than the mind-blowing "flood doses" used on opiate addicts.
Alper says no one thought to try nonhallucinogenic quantities of ibogaine until recently. Ibogaine treatment providers tend to have been former ibogaine users, and most assumed that the introspection brought on by tripping was key to overcoming their addictions. "That's just how it evolved," he says, noting that the large doses do seem to work best for opiate detox. "You're talking about a drug that has been used in less than 10,000 people in the world in terms of treatment. It's not surprising that's how it evolved."
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"The visions have some psychological content that is salient and meaningful," he adds. "On the other hand, there is no successful treatment for addiction that's not interpreted as a spiritual transformation by the people who use it. It's the G-word. It's God. We as physicians don't venture into that territory, but most people do."
Wilkins draws the same parallel between conventional rehab programs and ibogaine, but she's quick to emphasize that there are distinct differences. For one, her program is never court ordered. Those who seek out ibogaine come of their own volition. "People are really over the whole model of 'I'm an addict, and I'm an addict for life unless I do these twelve steps,'" she argues. "Even though it works for a lot of people, there are a lot of people who come to us and say it doesn't work. We have to listen to them. Our approach is allowing them to go in and find themselves, which is what the twelve steps preach anyway. They're hungering for a spiritual experience."
Recently Wilkins has been experimenting with small daily doses of ibogaine for people with heart conditions or other health problems that make the "flood dose" unadvisable. The nonhallucinogenic regimen seems successful, she says, citing the case of former bodybuilder Price in particular.
Price first came to Tijuana for ibogaine in 1996 and has been back six times, including his October stay. "Every time I feel like I'm getting out of control, I come here," he says, his voice a gruff mumble. "The very first time, I had a bit of visuals. It's supposed to take six months to get off methadone. With this, it was one day. It was incredible. I haven't had a craving for methadone since then."
That first time, he took a "flood dose," enough to keep him tripping for hours on end. During this stay, Wilkins started him off with a tiny dose and gradually increased the amount he ingested each day. At the same time, she was weaning him off OxyContin. "We reduced your Oxy dose from 240 milligrams to 120 milligrams, in what, two weeks? That's rock 'n' roll!" she says encouragingly.
"He was fantastic," she adds proudly. "He developed a routine in his day. He was getting up and watering the garden, and not staying in bed and watching TV. He was walking the dog and wanting to go out — he was eager to go home, not scared."
Now, seated at Pangea's kitchen table, Price reflects on what has been most helpful during his time in Mexico. The ibogaine lessened his cravings for drugs and alcohol, he says, but eventually the effect will wear off. "It's no magic thing," he says pensively. "It's creating good habits and creating a support system. Ibogaine just strips you of the cells and walls you build up for yourself. It allows you to go AA meetings — which I'll do when I get home. It at least gives you a fighting chance to make your own decision."