The use of ibogaine in the treatment of substance use disorders: integrating psychoactive experience as part of the recovery journey

Abstract

Ibogaine is a psychoactive alkaloid found in the West African plant Tabernanthe iboga. Although controversial, evidence suggests that ibogaine may be effective in the treatment of substance use disorders (SUD), specifically opioid use disorder (OUD). This body of research examines the use of ibogaine and its psychoactive effects. By exploring the therapeutic potential of ibogaine, the study seeks to understand its role in treating SUD, its potential for psychological transformation, and its function in the long-term recovery journey. The body of research comprises multiple studies, including a Literature Review, a Small-Scale Research Project, an Applied Research Project, a Report on Professional Practice and a Reflective Account.

The Literature Review (LR) analyses existing research on ibogaine’s pharmacological properties, its cultural significance and the psychological factors that contribute to its reputed effectiveness. Although the exact pharmacological mechanism for ibogaine is still speculative, the literature highlights its role as an NMDA antagonist in the treatment of SUD. The cultural aspects associated with using ibogaine prompt questions about the participants' worldviews as experienced in the traditional and Western contexts. From a psychological perspective, the classification of the ibogaine experience as oneirophrenic seems inadequate as it only describes the first phase of the ibogaine experience, overlooking the remaining two phases. This prompted an investigation into whether the ibogaine state of consciousness reveals similarities consistent with holotropic states of consciousness.

The Small-Scale Research Project (SSRP) explores the phenomenology of the ibogaine-induced state of consciousness. Previous research focused on the stream-of-consciousness of the ibogaine journey. The project complemented this foundation by focusing on structural aspects of the ibogaine state of consciousness, mapping participant experiences by using the Phenomenology of Consciousness Inventory, a tool that has been used to explore holotropic states of consciousness. The results suggest that the visual experience is focused on the personal narrative, and that the visual experience cultivates self-awareness. The results also indicate that self-awareness during the ibogaine journey is not cultivated as a result of internal dialogue, but rather that the visual experience and the experience of an altered state in terms of altered body image, time, perception and meaning is what fosters self-awareness. Considering that the visual experience is focused on the personal narrative, further research into the self-concept seemed logical.

Building on the implications from the SSRP, the Applied Research Project (ARP) explores whether ibogaine impacts the narrative self. It considers research suggesting that psychedelics can have a transformative effect on the self-concept of the participant. The self-concept, which includes the narrative self, creates meaning by providing order, consistency and unity to experiences. There is currently no research available on whether ibogaine transforms the narrative self and, if so, how. Using a framework developed from existing research on the narrative self and a mixed methodology approach, the results suggested that ibogaine can adaptively transform aspects of the narrative self. Following this finding, the ARP also considers suggestions for how transformed aspects of the narrative self can inform a framework for psychological integration protocols specific to ibogaine.

The Report on Professional Practice (RPP) examines a single-participant case study of someone who achieved recovery for 32 months from OUD following ibogaine treatment. The results highlight how religious trauma and associated guilt and shame were significant contributing factors in the participant developing OUD, along with exposure to substances and other substance users in multiple treatment facilities. Ibogaine treatment represented a turning point for the participant, who describes various physical, psychological, and transpersonal strategies used in recovery. From a psychological perspective, self-insight emerges as a potential mechanism of action for the effectiveness of ibogaine in this case. Ibogaine also increases mindfulness and self-compassion, which are all adaptive aspects of transforming the narrative self. Metacognition is also an important adaptive aspect of the participant's recovery journey. From a transpersonal perspective, the role of death themes and associated fear during the ibogaine journey and the symbology of ibogaine as a rite of passage medicine are adaptive aspects of the participant’s recovery journey.

Finally, the Reflective Account (RA) considers the experiential learning process when compared with an existing model of learning. This component also reflects on how this programme of study makes a significant contribution to our understanding of the psychological aspects of ibogaine as it relates to the ibogaine state of consciousness and how ibogaine adaptively transforms the narrative self. It also reflects on how the programme of study contributes to the development of professional practice by suggesting specific protocols for the psychological integration of the ibogaine experience.

The research conducted through the sequence of studies reported here contributes to understanding the effects of ibogaine on a person’s state of consciousness and their construction of self. A further contribution explores how the effects created by ibogaine may have an impact in the treatment of SUD.

Date of Award	2025
Original language	English