A psychedelics reporter with a changing perspective
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As a reporter on psychedelic medicine for The New York Times Health and Science Desk, the drugs that often catch my attention are familiar to any seasoned psychonaut: ketamine; LSD; psilocybin, or “magic mushrooms”; and MDMA, also known as Molly or Ecstasy.
Many of these psychoactive substances have been the subject of research for years, if not decades. And a growing body of scientific evidence suggests that these drugs have the potential to treat a number of mental health problems, including depression, substance abuse and eating disorders.
But research into psychedelics has largely ignored ibogaine, a drug derived from a plant native to the rainforests of central Africa.
Over the past three years, I have been interviewing researchers at this pace who occasionally bring up ibogaine, often in a tone that suggests both promise and danger. The handful of experts who have worked directly with the drug consider it a powerful addiction suppressor — one that can quell the excruciating symptoms of opioid withdrawal and tame the urge to use again. According to a number of small studies, many patients report that they can 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 disadvantages. An ibogaine journey can be grueling. Some patients may feel the effects for up to 24 hours.
From 1990 to 2020, more than 30 ibogaine-related deaths Cases have also been reported, some attributed to serious cardiac arrhythmias or irregular heartbeat, which in rare cases can lead to fatal cardiac arrest. These risks were enough to prompt the Food and Drug Administration in the 1990s to halt further research into ibogaine’s potential to treat crack cocaine addiction.
Many psychedelic researchers simply left ibogaine alone.
But then an initiative came along in Kentucky that turned the tight-knit world of psychedelic research upside down. In 2023, a committee convened by the state’s Republican attorney general considered a proposal to spend $42 million on ibogaine research and drug development. The money would come from funds the state was expected to receive in opioid settlements from pharmaceutical companies.
A friend of a friend, Adriana Kertzer, a New York attorney 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 committee’s chairman. Mr. Hubbard had little experience with psychedelics, but he became fascinated with ibogaine after reading stories about its potential to treat opioid addiction.
“I was desperate and felt I had to explore all options that might be promising,” said Mr. Hubbard, who grew up in Appalachia, near the border between West Virginia and Kentucky, a region of the United States devastated by the opioid epidemic. “I saw the carnage firsthand.”
With the number of fatal drug overdoses in the United States more than 112,000 between May 2022 and May 2023 – and opioids like fentanyl contributed to the record high – it felt like the right time to take a closer look at ibogaine.
In late November, I traveled to Louisville, Kentucky, to meet with harm reduction practitioners, recovering opioid users, and those still in the grips 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, such as Suboxone, to treat her addiction. Nothing helped her stay sober until she tried ibogaine eight years ago. She hasn’t touched opioids since.
Given the limitations of existing treatment options, many people I spoke with in Louisville agreed that any promising treatment should be considered.
But what about the cardiac risks of ibogaine?
Mr. Hubbard was confident that the dangers could be reduced. He put me in touch with scientists who were working on this subject. Among them were 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 disorders; Dr. Martín Polanco, the medical director of the mission within, a program that has used ibogaine to treat more than 1,000 veterans with traumatic brain injuries and addiction problems; and dr. Nolan Williams, a neuroscientist from Stanford University who was preparing for this publish a study which highlighted measures to reduce the cardiac risks of ibogaine.
All believed that ibogaine-related deaths could be effectively controlled by screening individuals with cardiovascular problems and ensuring that ibogaine was administered in a medical setting.
Covering psychedelic medicine can be nerve-wracking, given the relatively young state of the field, the paucity of major studies and the sometimes breathless boosterism of its proponents.
Journalists from The Times’ Health and Science team are cautious about letting science get the better of them. In writing the article, my editors and I made sure to weigh ibogaine’s apparent promise against its obvious risks.
The article, which appeared this month, elicited largely positive responses from experts. In the comments section, more than 100 readers, including people who had undergone ibogaine therapy, expressed hope that federal regulators would one day approve the study of the drug.
Kentucky’s newly elected attorney general, Russell Coleman, does not share their optimism. On March 13, Mr. Coleman effectively killed the committee’s ibogaine initiative.
Mr. Hubbard remains undeterred. Last month, he began working for the Ohio state treasurer on a similar initiative to use money from opioid settlements to fund ibogaine research. About half a dozen other states, he said, have expressed interest in doing the same.
I too will be keeping a close eye on these fascinating psychedelics in the coming months and years.