Can an experimental drug cure opioid addiction? Andrew Jacobs, who writes about psychedelic medicine for The Times, explored the “promise and peril” of ibogaine.

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As a reporter covering psychedelic medicine for the Health and Science desk at The New York Times, the drugs that often command my attention are familiar to any veteran psychonaut: ketamine; LSD; psilocybin, or “magic mushrooms”; and MDMA, also known as Molly or Ecstasy.

Many of these psychoactive substances have been the subjects of research for years, if not decades. And a growing tranche of scientific evidence suggests these drugs have the potential to treat some mental health issues, among them depression, substance abuse and eating disorders.

But research on psychedelics has largely ignored ibogaine, a drug that’s derived from a plant native to the rainforests of Central Africa.

Over the past three years on this beat, I have interviewed researchers who have occasionally mentioned ibogaine, often in tones that hinted at both promise and peril. The handful of experts who have worked directly with the drug cast it as a powerful addiction interrupter — one that can quell the excruciating symptoms of opioid withdrawal and tame the cravings to use again. According to a number of small studies, many patients report being able to 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 downsides. An ibogaine journey can be grueling. Some patients can feel the effects for up to 24 hours.

From 1990 to 2020, more than 30 ibogaine-related deaths have also been reported — some of them ascribed to severe arrhythmia, or an irregular heartbeat, that in rare cases can lead to fatal cardiac arrest. Those risks were enough to prompt the Food and Drug Administration in the 1990s to end further study on ibogaine’s potential to treat crack cocaine addiction.

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