Treating hard drug abuse with another drug, a psychedelic? The answer may be ibogaine - an alkaloid derived from the root of the African plant Tabernanthe iboga. In The Netherlands, all official medical tests on the effect of ibogaine on addictions in humans were stopped 13 years ago. The only refuge that ibogaine enjoys here today is a private treatment center at the suburban home of Sara Glatt, a devoted believer in the psychedelic's miraculous effects. Dozens of addicts go through Sara's hands every year, many reporting of the therapy's success.
There is something of a fairy-tale in this place. In the typical Dutch countryside, amidst pastoral scenes of newborn sheep playing in the grass and swans swimming in narrow creeks, there stands a slightly run-down house, which to many desperate souls has become the last resort. We are sitting at a large family table by the kitchen window overlooking the sun-lit endless flat landscape. The hostess, Sara Glatt, mother of five children, is nursing two adult patients today. One of them, a middle-aged Dutch man named Robert with a thirty-year-long dependency on methadone has just received his first gel-capped portion of iboga root extract.
Robert: Most of the time I'm quite down in the morning, because I have to wait for methadone to kick in. Only 5 mg, it's still a lot. I'll wait till eleven, half past eleven, and then I feel ok. Then I start breakfast, get my son out of school, do my stuff. I'm on the computer all day, I have my own website to run. It's part of me. I don't want to rely on any other stuff but myself, I just want to be myself. This is so difficult to get rid of. So this is why I do it. I don't know what to expect. This is all new to me, too.
Neurologists believe that the most crucial component of ibogaine is a metabolite called 12-hydroxyibogaine, which connects to certain receptors in the brain influencing the dependency syndrome. It is also responsible for an increased serotonin production and therefore acts as a remedy against the withdrawal depressions. The latest research on the effect of ibogaine on rats addicted to alcohol has shown that ibogaine boosts production of a protein in the brain tissue that blocks alcohol cravings. Dr. Roel Kerssenmakers of Jellinek, a large addiction treatment and prevention center in Amsterdam, argues that even if there are scientific tests carried out involving ibogaine, there are not enough reliable publications in established medical journals to give it a break-through.
Roel Kerssemakers: There aren't many people who believe this could work. It's the same with cannabis as a medicine. There is no strong theoretical basis that it's something that would work. That is then the reason why big pharmacological companies, who want to earn money and who want to earn profits, before they start developing and experimenting with new medicines, they want to be sure that it will be successful, that there are some criteria that it will be successful in the future. And this is lacking, lacking with ibogaine. Also the fact that ibogaine is a plant, this always means that it is always difficult to determine exactly the percentage of active substance - and that is something that doctors and pharmacists don't like.
Besides drug and alcohol abuse, Sara Glatt uses ibogaine to treat any other form of addiction. One of her clients was a sex addict. She has also given ibogaine to patients with chronic depression and even bulimia.
Sara: I had a girl with bulimia, she was twenty-eight. And she said to me, no, it did not work for me. And I said, so, how many times did you vomit? And she said, not once. She was tripping and she forgot that she was not vomiting, and was eating in the night. And afterwards she wanted to buy more iboga,. But I said no. And then she wrote me an e-mail saying was sorry that she said iboga did not work for her, because it did.
One treatment session at Sara's house lasts three to four days and costs 1,500 euros - a reasonable price considering that similar procedures at the few other ibogaine centers scattered around the globe are priced several times higher. Competent statistics on the ibogaine success rate are scarce. Ibogaine is believed to have a 5 to 10 percent absolute cure rate and helps the rest of the patients to significantly lower their dependency. Proper statistics, however, can only be obtained through proper scientific design, Dr. Kerssemakers says.
Roel Kerssemakers: What you need is a real scientific design. Which means that you have 100 people who get it and 100 people who don't get it, and they don't know whether they get it or not. And if, given such a perfect design, you then can prove that it works, then you have a chance that it will start. It should be published in a high quality magazine. That's the way it works. If it's continuously in the kind of alternative circuit, it will never, never work.
Sara Glatt does not believe in traditional statistics when it comes to drug abuse treatment, because such statistics does not provide a clear picture of relapsing or switching to other toxic substances.
Sara: No, I don't keep statistics, because
you can manipulate statistics. Every researcher can say, ok, he did not relapse
to heroine, but he did relapse to alcohol, but they are not going to say it.
I mean, if a person has quit using heroine, but has switched to methadone
or to alcohol, it's just the same, it's not like they changed their life.
They say I don't want to spend money on heroine, and alcohol is leagal. That's
easy. A lot of people want an easy way out, an iboga is an easy way out. That's
why a lot of people abuse it as well. They think, I take it, I quit heroine
and then I'm clean, so instead of using two or three grams a day, I'll use
only a quarter. It's abuse, and there are people like that. I had one girl,
whose mother said, please help my daughter. I did not even get paid for it,
she stole my money. But the girl came to me because her mother sent her. But
she was a prostitute. She was making more money on the street. It may have
happened once or twice, but now I'm seriously checking who are my clients
and whether they are seriously determined to stop.
Sara: I have successful stories about people who have been on a hundred and eighty mg of methadone, and quit it after nineteen years of addiction and are still clean since 2002.
And yet, if more of Sara's clients came forward with their stories, it might help to resume official ibogaine testing, says Dr. Kerssemakers.
Roel Kerssemakers: Well, I think there should be a lot more - if there is no good scientific research - there should be a lot more people who tell us: I tried it and it helped me. And I don't know why but it helped me. And if you have a number of cases, and you have a theoretical basis why it can work, that can maybe be the basis for an application to convince friends and to start a big research project. Because that's what you need.
A hallucinogenic substance used in initiation ceremonies in the West-African Bwiti cult, iboga root was first brought to Europe at the end of the 19th century. Its first use as a medication to ease drug withdrawal is credited to an American named Howard Lotsof. Because as virtually any psychedelic, ibogaine fell under the restricted substances act in the US, Lotsof came to The Netherlands and worked together with prominent Dutch psychotherapist Jan Bastiaans, known for his research on the medical effects of LSD. Here the tests continued until 1993, when a young German woman died during the ibogaine session. Although her death was never proven to have any connection to ibogaine, all official ibogaine treatment tests on human volunteers were discontinued and since then, never resumed. As the time goes on, there is less and less interest for ibogaine as a medicine against heroine addiction in The Netherlands, Dr. Kerssemakers says.
Roel Kerssemakers: First of all, in The Netherlands, the group of heroine addicts is getting smaller and smaller. In Amsterdam we used to have about ten thousand heroine addicts, and now we have about four to five heroine addicts. Secondly, the group is getting older and older, and there are no young people joining the group any more. People are using drugs, but not heroine. They are using cannabis, and ecstasy, but not heroine any more. So the group is getting smaller and there is no need to start with a new medicine.
Sara: It is very difficult to say what is typical, because each person is individual, and it is true that every individual reacts differently. But in general, most people go lie down in bed, and they have these visions. You cannot connect to those visions, you are observing them. You are not part of the game but you are an observer of the game.
Robert walks into the kitchen again and asks whether he should go lie down in bed. Go lie on your back, Sara replies, breathe deeply and try to relax.
Roel Kerssemakers: Treatment is a very complicated matter. It has to do with physical addiction and it has to do with mental addiction. And medicines are always just a small part of the treatment. You have to change your mind. And that's of course just what people say, but there is no theoretical basis that ibogaine would change your mind.
Maybe with no theoretical basis, but epithets like "brain re-set" are attributed to ibogaine by many. "Ten years of psychoanalysis in one day", "blood transfusion", "some sort of exorcism" - these are only some names former addicts sharing their testimonials on the web call ibogiane. African shamans call those who have been initiated with ibogaine "baanzi", which means "he who has seen the beyond". Most reports on ibogaine trips include encounters with a guide - to whom Africans refer as "the spirit of iboga" - who reintroduces one to one's own self through parading most intimate, most sacramental memories in front of one's eyes throughout the whole trip.
Sara: You hardly can walk, you feel like
you are sea-sick, you vomit very easily - you don't vomit very easily with
LSD. With iboga the vomiting comes like a ghost, suddenly, coming and taking
things out of you. It's like looking in the mirror and then looking back.
When you look back you can see what you've done wrong to yourself. When you're
in the middle of it, it's very difficult to be judgemental to yourself. So
when you are under iboga, it's like looking back and saying, "oh, I should
have done it differently". It's like the spirit, the mind and the body
disconnect from each other, and then connect again. The spirit is the healer
of the body and the mind. And the spirit is showing you - hey, look at your
mind, look, what you thought then and how wrong you were, and how good you
can be - I am giving you a chance to change your attitude towards yourself.
Herself, Sara has never been an addict. She took her first ibogaine trip out of sheer curiosity. When the trip was over, she discovered she suddenly finally had the courage to file for divorce with her husband and started a treatment center.
Sara: By accident, really. Because it was meant to be for somebody else, but he did not show. And when he did not show up, I thought, well, then I take it. And then I got this vision, and that was it. I was living in this house, everything happened here. I was convinced when I was tripping and I went to Africa in this journey, and I saw people laughing at me. They told me, you you're not going to do it, you're going to die. If I am not going to provide people with iboga treatment, I would not be myself and live a life that I would not be happy with. It is a mission. I've treated many people who don't have any money as well.
Robert, who has been having trouble lying down and relaxing, complains he experiences a strange buzzing in his ears.
Robert: Buzzing in both of my ears. I was
just wondering if it's normal.
Sara: Yes it's normal and it will go away.
Sophia Kornienko: You are crying as well. Do you see anything if close your eyes?
Robert: No. I'd rather keep them open.
Sara: It's just starting. It's very slow. Iboga is coming to your feet...