5th September 2019 • Sticky Post

Iboga Therapy: Here's What We've Learned

Back in January of this year, experienced iboga aficionado and Global Ibogaine Therapy Alliance Executive Director Jeremy Weate sat down with Third Wave to discuss important lessons learned during the opening of our premiere ibogaine treatment facility in Portugal.  

Having experienced the realities of providing Iboga treatment to persons in varied states of physical/mental health, and knowing the dangers inherent in our chosen field, we felt, it was worth recounting the hard-won lessons we’ve learned for all those who might follow in our footsteps.

That’s why we’ve decided to revisit 7 of the most important lessons we’ve learned with Iboga Tree Healing House Founder Alvaro De Ferranti to delve a little bit deeper into what administering iboga to dozens of clients has taught us thus far, and how we have learned to address each issue to minimize the risk.

1) Safety

Nothing is more important than the safety of our clients. There are often difficult choices to be faced in determining iboga dosage. Experience has taught us that conservative dosing is a must, even if clients are sometimes disappointed in the lack of a visionary experience. We feel that every death associated with Iboga use has been preventable, and we will do whatever it takes to keep our clients alive and well.

How do we at Iboga Tree Healing House determine ibogaine dosage for our clients? We’ll let Alvaro take it from here:

“There are recommended doses in the GITA literature (www.ibogainealliance.com) which we use as a guideline. We tend to dose women less than men, and clients in poor physical shape less than those who are in good form. However, dosing has a lot to do with factors that go well beyond body weight which tends to be the standard marker for dosing. We look at the individual holistically. We aim to understand their whole physical condition, their medical history, their family medical history, their experience (if any, with entheogens), the substance(s) they consume, and of course their psychological state. Safety being our priority, dosing, although medical in its approach, is intuitive, and only experience can forge this relationship with our dosing regimen." 

2) Emergency Planning

Emergency planning is vital. We at ITHH quickly learned the importance of thoroughly going through our emergency plan before treating every single client. If a cardiac incident occurs, every second is vital, and we need to be ready to jump into action. It doesn’t feel good to call an ambulance, but we’d rather call a million ambulances than a single hearse. The Iboga community is understandably anxious about publicizing adverse health outcomes, but medicalization, regulation, and legitimization should be our goals, and transparency is the best way to achieve them.

Here’s how Alvaro and Iboga Tree Healing House's medical staff have planned for potential emergencies to ensure that we are prepared for any medical eventuality:

“Safety being our primary concern, we take emergency planning very seriously. On treatment day, we undertake an emergency drill as if it were our very first drill. We do this without fail. The on-duty team get together, each person is handed a role, and we act out our emergency plan. Whenever we have had any issues, our emergency plan has kicked in and we have managed to avert disaster. We will never compromise on the importance of our emergency plan. The planning is client-centric and starts well before this drill. By this time, we understand the client fully, and are clear on what issues we may face, and as a result, we prepare accordingly.

In the room, we have a continuous heart monitor, defibrillator, pacer, oxygen, oximeter, blood pressure measuring machine, supporting oral and iv medication (like diazepam), crash cart, and all ACLS medication and supporting items like geddels for non-invasive assisted breathing.

We have safety covered.”

3) Cautious Dosing

Flood dosing does not work for everyone. Some brains and bodies can withstand a heavy dose of iboga (20mg/kg and up) but others can’t. Re-setting the addicted brain doesn’t require a flood dose, and you can experience the benefits of treatment without taking unnecessary risks.

Here’s why we at Iboga Tree Healing House always defer to qualified medical staff when determining iboga dosage, regardless of what clients might request:

“Clients do not determine doses. This is a medical decision. I must stress, that even if a client has had an iboga flood in the past, it doesn’t necessarily mean they will react the same way as their previous time, and they may well not be suitable for a flood the next time around. Again, experience will determine what is best.”

4) Honesty

It’s important to be realistic and honest about what Iboga can and can’t do. Like many in the community, we’ve been outspoken advocates for Iboga’s utility in treating addiction. But we’ve learned that it’s essential to let our clients know that Iboga is an addiction interrupter and not a cure. We always emphasize that other tools are necessary to maintain recovery over the long term. We are also aware that the iboga journey is not widely understood, and that misinformation about iboga is all too common. While skepticism is often indeed a healthy reaction to a new idea, it can also hold one back at times. At Iboga Tree Healing House, we’ve learned to provide all the information we can and let our prospective clients make their own decisions about whether our program is right for them.

Here’s how we address fear-based skepticism about iboga treatment:

“Skepticism is often based on fear. Fear of the unknown. We provide tools and information to help clients get over their fears. By the time we have helped the client understand their pending ‘initiation’, skepticism is a faded memory. We have never treated anyone who was a skeptic by the time they entered the doors of Iboga Tree Healing House. We have several testimonials online to vouch for the effectiveness of our program. Iboga is one of many tools we use to help people move forward in their lives, to help them discover the deep-rooted issues that trigger their addictions, and their self-limiting beliefs, and help remove those blockages to open up the door to the ‘good life’.”

5) The Holistic Way

Experience has taught us that we can fight addiction most effectively by combining Iboga treatment with holistic therapies and conventional modalities. We’ve seen firsthand the benefits of talk therapy and peer support, and while we’re enthusiastic proponents of energetic, holistic treatments and Iboga therapy, we feel that combining all three methods is the most effective way to end the cycle of addiction. Taking iboga by itself and shirking the other aspects of a robust, holistic recovery plan will accomplish very little.

Here’s how a holistic program of recovery can help to ensure long-term recovery:

“Often, the lingering memories of a client’s stay at Iboga Tree Healing House revolve around what happened in the therapy room and beyond. Our therapies, even if there may have been resistance at the beginning, are the disciplines clients take home with them, not just as memories, but to implement into their essential daily practice, their lifeline.”

6) Preparation

Pre-treatment is an essential building block for success. We’ve learned that postponing treatment when our clients aren’t ready is a necessary step for achieving positive results. We employ a narrative approach to lead our clients away from their addicted selves and portray the iboga experience as a hero’s journey. We feel this helps clients establish and entrench their vision of a substance-free life and gives them their best chance at success.

Here’s why Alvaro believes pre-treatment to be an integral aspect of any successful iboga treatment experience:

“Pre-treatment therapy, although not a mandatory prerequisite to join our program, it is an essential component for the client to get the most out of their Iboga treatment. As we’ve said many times, Iboga is not an instant cure-all but is the most profound catalyst to change. It is unrivaled in its ability to take away withdrawals and create a pre-addicted state brain reset, however, its success is dependent on how one prepares for and integrates the ibogaine experience. Pre-therapy is conducted by our in-house therapy team. We know, those that undertake pre-treatment, are more likely to benefit from the experience.”

7) Aftercare

The importance of aftercare for those who’ve completed iboga treatment cannot be overemphasized. One of our favorite parts of conventional addiction treatment is the fellowship and peer support created by 12 Step group meetings and mentorships. We’ve tried to build a similar structure with our own weekly support meetings. Our goal is to build and sustain a self-supporting community of people who have recovered through Iboga.

Here’s how 12-step fellowships can help to keep one’s recovery journey on the right path:

“During their time at Iboga Tree Healing House, clients are informed on what support groups are out there. From 12 Steps to SMART (there are so many these days). We don’t recommend it, we simply inform of what is on offer. Support is support, if it works for you, then great, if it doesn’t, look for another group or organization. We help them research which fellowships are available close to home so they can hit the ground running. Other than this, every client is invited to join the IRM for life. The IRM is our very own online fellowship, the Ibogaine Recovery Movement. And, like all grassroots movements, it is building momentum.”

It’s worth noting, however, that Iboga remains stigmatized in many 12-step circles, something Alvaro hopes will change in the very near future:

“Some of our clients have indeed suffered from skepticism, judgment, and hostility at 12 Step and SMART meetings. Unfortunately, some attendees are rather closed-minded. I’ve found, however, that if you persist, keep showing up, share your story, gradually it all turns to acceptance.

Funnily enough, I got sacked by my one and only NA sponsor for not informing him that I had taken a ‘drug’ to get off drugs. Little did he know, Iboga is not a drug, it’s a medicine. At the time I was full of resentment, but now I understand that education is so important, and slowly slowly, some of the more closed groups will gradually open up. It won’t be long before there is an ‘iboga initiate’ in every meeting! This is why we are exhibiting at the iCCAD conference in London, to educate, to inform, to make some noise!”

Iboga Tree Healing House (Alvaro’s 2 cents) 

“Tabula Rasa Retreat is not just an Ibogaine treatment centre, it is so much more. We have worked tirelessly, from first-hand addiction experiences to in-depth medical research, to speaking to leading experts around the world, to learning on the job, to find that magic formula. We discovered, there is no magic formula! Addiction is a complex disease and requires tackling from multiple angles. As mentioned earlier, Iboga is an important tool in the toolbox of addiction treatment. As we research further and learn more, we will keep adding to that box. Not one client is the same; it makes perfect sense that a bespoke approach is required to help in the best way we can. We never rest on our laurels.”