Beond co-founder Talia Eisenberg chats with a nurse inside one of Beond's treatment rooms.
You might be familiar with psilocybin mushrooms, ayahuasca, and MDMA, but a lesser known (and rather misunderstood) psychedelic substance, ibogaine, is gaining attention thanks to the proliferation of ibogaine treatment clinics south of the border.
Ibogaine is derived from the root of the iboga shrub, which grows in Central Africa and is indigenous to Gabon. There, it is used among people who practice Bwiti, a spiritual discipline that has been passed down for hundreds if not thousands of years. In Bwiti traditions, iboga is used in initiation rites, and is thought to allow those who take it to meet with deceased ancestors and diagnose illness. When administered safely, ibogaine can have profound, life-altering effects.
While people living in North America may not be as familiar with ibogaine as they are with other psychedelic drugs, those that do know about this powerful alkaloid tend to consider its primary indication as a treatment for substance use; more specifically, the use of opiates. Ibogaine has been shown to help opiate users detox without experiencing the distressing symptoms associated with opiate withdrawal.
Ibogaine is a Schedule I substance in the United States, but it is unregulated in Mexico, where dozens of ibogaine clinics have opened in recent years in response to the ongoing overdose crisis. Nearly 108,000 Americans died of drug overdoses in 2021 alone, about a 15 percent increase from the number of deaths the year previous.
While clinic operators are eager to help with the crisis, few have the right training and experience, and are sometimes unfamiliar with ibogaine’s contraindications (ibogaine is not recommended for people with cardiovascular conditions and cannot be combined with certain medications). Without proper screening and prior medical care, ibogaine can be dangerous, and has in some cases resulted in cardiovascular events such as heart attacks, and even death.
Changing the Ibogaine Treatment Paradigm
Dr. Felipe Malacara is the Chief Clinical Operations Director at Beond. He has been working with ... [+]
At Beond, an ibogaine treatment center in Cancún, Mexico, the aim is to eliminate risks to patients by providing the highest level of personalized medical care, offered by a team of doctors and nurses who have been working with the substance for decades. (Full disclosure: I visited Beond earlier this year as part of my research for an upcoming book.)
Dr. Felipe Malacara, MD, is Beond’s chief clinical operations director, and has been working with ibogaine for 17 years. In the late nineties, he was trained by the team that worked at the world’s first medical ibogaine clinic under Dr. Deborah Mash, on the island of St. Kitts. Most recently, Malacara was the attending physician at Clear Sky Recovery, where he supervised all clinical operations and treated more than 1,200 patients with ibogaine.
Malacara says his move to Beond was motivated by the opportunity to offer more than what he calls “cookie-cutter” ibogaine treatment: “It was the opportunity to produce new protocols, new approaches, and to have a vision to treat patients as individuals, adapting a general protocol to be flexible to the needs of every single patient,” he says.
“Everyone has different needs and different backgrounds. Here, we are trying to make ibogaine assisted therapy more individualized, more humanized, more effective, and to improve the range of success that ibogaine has.”
Misconception #1: Ibogaine is a Hallucinogen
According to Malacara, there are several misconceptions about ibogaine. The first, he says, is that ibogaine is a true hallucinogenic.
“Ibogaine is an alkaloid that comes from a plant, and it definitely produces an altered state of perception,” he says. “But what I have been observing over the last 17 years, is that it never withdraws you completely from reality. It’s not like LSD or mushrooms, which drop you in Wonderland and leave you alone to play with Alice,” he jokes.
The opportunity for a patient to be aware of their current reality, he says, is always there in ibogaine treatment. People who take ibogaine often experience visions, however they are generally seen behind closed eyes, or in what some call, “the mind’s eye.” While patients at Beond are encouraged to wear an eye mask during their treatment, all it takes is a peak from behind the mask to be reminded of where they are physically situated.
“If patients feel overwhelmed or that they are losing control, they can always take off the mask and recognize their surroundings. They will be able to recognize the treatment room, the nurse, the physician, the heartrate monitor,” he says. Things may look and feel weird, but patients can regain a sense of presence.
Misconception #2: Ibogaine Is A ‘Miracle Drug’
Another misconception is that ibogaine is a “magic bullet” or miracle drug that can deliver the same results for all who take it, says Malacara.
“Ibogaine treatment is a process. It’s something that requires a pre-treatment process, and a post-treatment process,” he says.
To help patients who plan on undergoing ibogaine treatment at Beond, the center works closely with a team of integration and recovery coaches through an organization called Being True To You. Coaches meet with patients by phone at least twice prior to their arrival at Beond, and at least three times after they complete treatment.
A guest room at Beond, an ibogaine treatment center located in Cancún, Mexico.
While in Cancún, an on-sight psychologist is available at all times, and patients are encouraged to meet with them daily. Adjunct therapies like yoga, meditation, Qigong, art therapy, aquatic therapy, and massage are also offered daily, often poolside.
Misconception #3: Ibogaine is Only Useful for People Struggling with Opiates
Yet another misconception, according to Malacara, is that ibogaine is only useful for people who are struggling with opiate use.
“When it comes to chemical addictions, it can help with alcohol abuse, with certain stimulant use such as amphetamines, methamphetamines, and cocaine, and, of course, for opiates,” he says.
Ibogaine for problematic cannabis use remains understudied, and while clinical studies on ibogaine for nicotine dependence are lacking, the preclinical research in rodents is promising. Malacara notes that some patients find success in ceasing their use of these substances with ibogaine.
While substance use is generally the primary focus of patients who opt for ibogaine treatment, some who attend Beond arrive with the intention to work on other concerns, such as post-traumatic stress disorder, depression, anxiety, or grief.
“There is a small amount of literature out there that has shown ibogaine can be helpful for psychological issues as well,” says Malacara. “What we’ve decided here at Beond with advisors involved in this project, is that, if there is a chance for ibogaine treatment to be helpful for these sorts of patients, we want to prove it right.”
Safety is Beond’s Top Priority
No matter what a patient is dealing with, Malacara stresses, the goal is to offer treatment that is safe, and that meets each individual exactly where they are at. As such, every patient is visited three times a day by a nurse for blood pressure, temperature, and heartrate checks, while meals are carefully prepared to suit their nutritional needs and preferences. Ibogaine treatment is only scheduled when Dr. Malacara determines that it is safe for the patient to move forward.
“In 17 years of treating people, almost none of my patients have suffered an adverse event, and I want to keep it that way,” he says. “I want Beond to produce scalable safety protocols, methods that that are reproducible, that are scientifically proven, and that help to minimize the possibility of adverse events as Beond scales to many more locations across Mexico—and we help address a growing addiction and overdose epidemic.”
Inside the common area at Beond, in Cancún, Mexico.
Malacara’s advice to those who might be considering ibogaine treatment is simple and straight-forward: “You need to be convinced that you want to do it, and you have to know exactly what for. Leaving things to chance will not give you the opportunity to obtain the best result,” he says.
Beond co-founder Tom Feegel adds that setting intentions in the preparation for one’s treatment can lead to better results. Staff use a five-phase delivery model called insight oriented ibogaine, which spans from medical evaluation through to preparation, treatment, acute aftercare, and long-term after care.
“The goal is to cultivate awareness and understanding of the whole person, to set a personal agenda, and then go into the ibogaine experience with that agenda seeking insights,” says Feegel. Post-treatment, those insights can be put into a plan of action that is both purposeful and meaningful to the patient.
“What’s interesting is, we see people come with one set of ideas, go through the experience and sharpen their awareness around those ideas, and then be able to extend them into the different areas of their life,” he says. “It is truly remarkable.”
