Back in January of this year, experienced ibogaine 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 Ibogaine 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 Tabula Rasa Retreat’s Founder Alvaro De Ferranti to delve a little bit deeper into what administering ibogaine to dozens of clients has taught us thus far, and how we have learned to address each issue to minimise the risk.
1) Safety First
Nothing is more important than the safety of our clients. There are often difficult choices to be faced in determining ibogaine 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 Ibogaine use has been preventable, and we will do whatever it takes to keep our clients alive and well.
How do we at Tabula Rasa Retreat 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) Plan for the worst
Emergency planning is absolutely vital. We at TRR 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 Ibogaine 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 Tabula Rasa Retreat’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 was 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 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) Flood dosing: Erring on the side of caution
Flood dosing does not work for everyone. Some brains and bodies can withstand a heavy dose of ibogaine (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 Tabula Rasa Retreat always defer to qualified medical staff when determining ibogaine dosage, regardless of what clients might request:
“Clients do not determine doses. This is a medical decision. I must stress, 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) Managing expectations through transparency
It’s important to be realistic and honest about what Ibogaine can and can’t do. Like many in the community, we’ve been outspoken advocates for Ibogaine’s utility in treating addiction. But we’ve learned that it’s essential to let our clients know that Ibogaine is an addiction interrupter and not a cure. We always emphasize that other tools are necessary to maintain sobriety over the long term. We are also aware that the ibogaine journey is not widely understood, and that misinformation about ibogaine 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 Tabula Rasa Retreat, we’ve learned to provide all the information we can and let our prospective clients make their own decision about whether our programme is right for them.
Here’s how we address fear-based skepticism about ibogaine 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 that was a skeptic by the time they entered the doors of Tabula Rasa Retreat. We have several testimonials online to vouch for the effectiveness of our programme. Ibogaine 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, their self limiting beliefs, and help remove those blockages to open up the door to the ‘good life’.”
5) Holistic approaches yield the best results
Experience has taught us that we can fight addiction most effectively by combining Ibogaine 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 Ibogaine therapy, we feel that combining all three methods is the most effective way to end the cycle of addiction. Taking ibogaine 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 Tabula Rasa Retreat 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 actually implement into their essential daily practice, their lifeline.”
6) Prepare yourself
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 ibogaine 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 ibogaine treatment experience:
“Pre-treatment therapy, although not a mandatory prerequisite to join our programme, it is an essential component for the client to get the most out of their Ibogaine treatment. As we’ve said many times, Ibogaine 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 is crucial
The importance of aftercare for those who’ve completed ibogaine treatment cannot be overemphasized. One of our favourite 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 Ibogaine.
Here’s how 12-step fellowships can help to keep one’s recovery journey on the right path:
“During their time at Tabula Rasa Retreat, clients are informed on what support groups are out there. From 12 Step to SMART (there are so many these days). We don’t recommend, we simply inform on what is on offer. Support is support, if it works for you, then great, if it doesn’t, look for another group or organisation. 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 Ibogaine remains stigmatised in many 12-step circles, something Alvaro hopes will change in the very near future:
“Some of our clients have indeed suffered from skepticism, judgement 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, Ibogaine 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!”
A Final Word about Tabula Rasa retreat (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 dis-ease and requires tackling from multiple angles. As mentioned earlier, Ibogaine is an important tool in the tool box of addiction. 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.”
For further information visit www.tabularasaretreat.com or call PT +351 965 751 649 UK +44 7961 355 530