Richard Dilley had tried everything by the time he traveled to Mexico and agreed to ingest a drug derived from a hallucinogenic African shrub bark that, he was told, would alter his brain. All for the bargain price of $10,000.
While terrifying in a way, the drug known as ibogaine (or Tabernanthe iboga in its natural state) was, at this point, less of a horror than the drug Dilley had been addicted to since his teen years.
Ibogaine, he understood, would fix him, would remove that insurmountable urge for a high that had destroyed his once-promising life.
It was his last hope.
Ibogaine comes from the iboga plant that is primarily found in Gabon, on the Atlantic coast of Equatorial Africa, where those of the Bwiti religion use the drug as part of puberty initiation rites.
While it is illegal in the United States, proponents have been working to legalize it for decades, saying it's a miracle treatment that wards off withdrawals, not only from heroin, but from drugs in general.
That makes it completely unique, as no other drug does what ibogaine appears to do — fix dopamine regulation in the brain that's been thrown out of whack by addiction.
This isn't just a claim being touted by enthusiastic former heroin addicts. The drug has been the subject of many scientific studies and was even approved for Phase I clinical trials with the U.S. Food and Drug Administration in the early 1990s, though the tests were never completed. Scientists are now testing a drug made from ibogaine that someday could be a legal treatment for drug addiction in the United States.
In the meantime, clinics exist around the world, dispensing the not-risk-free drug, often paired with a variety of other treatments from massage to hyperbaric chambers. But addicts have to know about ibogaine to get it, and then they must be able to afford treatments that generally cost thousands of dollars.
All of this is playing out at a time when heroin use has reached epidemic levels, with easier availability in Colorado Springs and the West (see "Heroin highways," p. 18). In fact, Gov. John Hickenlooper was among the nation's governors to sign a compact this month to fight opioid addiction by better controlling prescription opioids, educating the public about opioids and addiction, and helping addicts recover.
By the time Dilley flew to an ibogaine clinic, he already had tried the traditional path, going to doctors and taking Suboxone, a maintenance drug for opioid addicts similar to the more well-known Methadone.
But Dilley's addiction was deep, its roots stretched back to his childhood.
"When I was a kid," says Dilley, now 28 and living in Colorado, "we were taught there were two kinds of drugs: the good drugs that the doctors prescribed and the bad drugs that you should never do."
Dilley never had tried drugs or alcohol when, at age 14, he suffered a broken arm skateboarding near his home in McFarland, Wisconsin. His doctor gave him 30 Vicodin and sent him on his way without further comment.
The drug felt amazing. After the pills ran out, Dilley sometimes would sort through medicine cabinets when he was at other people's houses, snatching any painkillers.
When he was 17, his parents kicked him out of the house after he hosted a party at which expensive glassware was broken and some items were stolen. Dilley stayed for a few days with friends before returning to his parents' home.
It was then that he first snorted Oxycontin.
A year later, he was living nearby with his brother, who was six years older, and a friend. That's when the pills really became a problem. He was using them and selling them, until a friend warned him that the cops were casing his house. When he stopped selling, he no longer could afford his habit. Besides, it was getting expensive.
When he was a teenager, Oxy had been everywhere, and cheap — $20 for an 80-milligram pill that would wreck you.
But when he was 18, a switch was flipped. Oxy wasn't everywhere anymore, and it wasn't cheap. The same high that had cost $20 before now cost $80. (The change is likely attributable to doctors recognizing the addiction problem, and more closely controlling pain pill prescriptions, something that's happened nationwide.)
Dilley's friends began switching to heroin. At first, he says, he didn't want to follow their example. He kept flashing on that scene in Pulp Fiction where Uma Thurman ODs and blood is flowing from her nose. But Dilley's friends said that was just a movie, that it didn't really happen like that. And they weren't dead.
He started by snorting it. It was familiar because he had done the same thing with the painkillers. A week later, Dilley and his friends were with a guy who had hemophilia and a familiarity with needles.
The kid taught them to shoot up heroin.
"Once you do that, there is no turning back," Dilley says.
Dilley wasn't one of those guys that you have to peel off the floor of a seedy motel. He functioned as an addict, in a way.
He went back and forth between living in his parents' basement and living with his brother and friends. He delivered pizzas for a living. He went to technical college, but dropped out in his second semester and blew the refund on drugs. Heroin was a $100-a-day habit, and it wasn't always working out.
Once, before a family dinner, Dilley's dealer was late. When Dilley finally got his heroin, he took it all at once. He woke up next to his car with a frantic woman standing over him. Dilley had to fight her off and drive away, so she wouldn't call the cops.
In his early 20s, Dilley's brother discovered his stash and ordered him to go to treatment. He complied. Doctors put him on Suboxone and into a support group, and they told him he'd need to be on maintenance drugs for the rest of his life.
"They would constantly tell you that you're a worthless piece of shit, and that you're incurable, and that you've got to submit yourself to God," he remembers.
Years passed. Dilley's father died in June 2011. A year later, he heard about ibogaine for the first time in a news story. Then he ran into an old friend and former addict who had taken it.
"He wasn't on any drugs, and he had goals — and I wanted that," Dilley recalls.
With the help of his friend, Dilley convinced his mother to use part of his father's life insurance to pay for ibogaine treatment. In June 2013, he hopped on the plane to go to an ibogaine clinic. He was following a path many desperate addicts have taken for decades.
Ibogaine may be illegal in the United States, but it's readily available in many countries, complete with the risks and the hallucinations.
And a lot of the people who are in the ibogaine business object to removing its psychedelic properties, saying the trip is a part of the healing process. The claim isn't completely out of left field — some research is showing promise for the medical use of psychedelic drugs. In 2014, for instance, the first study on LSD approved by the U.S. Food and Drug Administration in 40 years, showed that 12 terminally ill patients given LSD and psychotherapy showed relief from end-of-life anxiety.
According to those who have tried it, the trip on ibogaine is a spiritual journey like no other.
Las Vegas DJ Justin Hoffman, 47, says the party lifestyle led him to become a heroin addict more than 20 years ago. He originally got clean the traditional way, using Methadone and Suboxone and attending Alcoholics Anonymous classes, where he says the late DJ AM (born Adam Michael Goldstein) was his sponsor. Hoffman credits DJ AM with saving his life.
But when DJ AM died in 2009 of a drug overdose, Hoffman says he fell off the wagon. And then there were all the antidepressants, anxiety medications, bipolar medications, sleep medications and ADD medications.
"I was sick of it," he says. "I was like, I feel like a pharmaceutical dumpster."
Then he heard about ibogaine, and went to Mexico to try it. He says the blockage of the withdrawals was one part of his recovery, but the trip was just as important.
"There [are] real spirits involved with this medicine that come to you and actually talk to you and answer questions," he says. "If it was just me, I'd say, whoa, that's a hallucination. But it's not. Everybody has the same experience and has the same black, tribal African guy coming to them. You know it's not just a hallucination. There's something real happening here. I would have never believed any of this. Four years ago, I would have laughed at it, but now I know the truth."
The other part he says, is that the hallucinations extract memories. He recalls seeing himself being abused as a 2-year-old during his trip. Once you deal with those root causes, he says, you don't feel the need for the drugs. The spirit, he says, "acts as a therapist."
Many describe ibogaine's trip as a "waking dream." Interestingly, the hallucinations are known to be more intense when the eyes are closed.
When Hoffman returned from ibogaine therapy — which he says got him off all drugs, prescription or otherwise — he says he knew he needed to help others. He began by using his fame (both as a popular DJ and as the nephew of famous anti-war activist Abbie Hoffman) to get word of the drug to others, particularly fellow DJs, and help them access what he believed to be the most reputable ibogaine clinics in Mexico.
A year ago, he says, he was given the free use of a mansion in Las Vegas, where he opened an after-care program for addicts, Holistic House Las Vegas.
Now, he refers addicts to Mexican ibogaine clinics — ones that he says medically screen patients to ensure the drug won't be dangerous for them — then he cares for them for a month or more after their return in an effort to heighten their chances of kicking drug abuse for good.
"Ibogaine's a miracle, there's no doubt about that," Hoffman says, "but people need more."
For prices ranging from $8,394 for 30 days in a standard room to $21,000 for 60 days in a master suite, Hoffman says he helps addicts continue their physical and spiritual healing. He's had 40-50 patients in the aftercare program, and says that of the people he's helped (both in aftercare and with referrals) he thinks about 70 percent are still clean.
While many clinics offer aftercare, there are no established norms for it, and the programs tend to be colorful. At Holistic House, for instance, patients are engaged in a variety of yoga practices, boxing, gym workouts, nature hikes, flotation tank sessions, Reiki, consultations with healers and western therapy, among other things. He even gives patients frog venom that he believes heals a variety of ailments, including HIV and cancer.
"We do all these things in order to get them feeling better as quick as possible," he says. "Because addicts will use any excuse. If they're having diarrhea for too long, they're like, I've gotta use some dope, I can't take this diarrhea. It's absolutely ridiculous. So, if I get them feeling good within two days, they then develop some trust with me and they realize that I know what I'm doing, and they let go, they're like, 'You tell me what to do.' Those are the people who really succeed with it."
One of the Mexican clinics that Hoffman refers patients to is Rosarito's Medicine Heart Recovery Collective, co-founded by Mark Winkle, a respiratory therapist and former heroin addict.
Winkle says he was addicted to heroin, pain pills, Suboxone or Methadone for 10 years before he heard about ibogaine and headed to Mexico for treatment. He had, interestingly, worked in medicine for several years at that point, mostly in emergency rooms, but says he couldn't manage to deal with his own health. Winkle had just become a father when he heard about ibogaine, and he didn't want to live his life on drugs. Ibogaine promised a way out.
"It changed my life," he says. "It was the greatest thing to happen to me since my son was born."
Over the next few years, Winkle, now 47, researched how to treat patients with ibogaine and began secretly treating patients in the United States. But his dream was to open his own clinic. He started by treating patients in a Mexican hotel, and less than a year ago, he purchased two houses on the beach and opened his clinic. He still travels between Mexico and Los Angeles, where his family lives.
Winkle says he's had about 40 patients so far. He and his staff treat them for seven days, at a cost of $7,000, and then urge them to go to after-care with Hoffman. Winkle says he tests every patient for medical conditions before administering ibogaine and, like Hoffman, his program features many other treatments including: body work, shamanic healing, sweat lodges, Tai chi, yoga, Reiki, therapy and something called family constellation therapy, where patients access their ancestors' spirits to heal their traumas. Winkle says getting a euphoric high off Bufo alvarius toad venom is also an integral and healing part of the treatment.
The overall experience, he says, is a spiritual one, and the hallucinations caused by ibogaine are a central part of that. For those who choose this spiritual path, he says the program is very successful, freeing addicts of a life of addiction.
"It's amazing," he says. "I have the best job in the world."
Ibogaine has been illegal in the United States since 1967 and the federal government lists it as a Schedule I substance. That means it is thought to have a high potential for abuse, it currently has no accepted medical use in treatment in the United States, and there is a lack of accepted safety for use of the drug under medical supervision.
Other Schedule I drugs — or drugs considered the most dangerous — include heroin, marijuana and LSD. Interestingly, cocaine and methamphetamine have the lower classification of Schedule II drugs. Ketamine is a Schedule III drug.
However, ibogaine clinics abound in many other countries where the drug is variously legal, unregulated or available by prescription or has a murky legal status.
That includes our neighboring countries, Mexico and Canada, where a quick internet search brings up a multitude of clinics. Ibogaine is also known to be available for purchase easily on the internet.
There have been some efforts to bring ibogaine to the U.S. legally.
In 2015, a bill in the Vermont House of Representatives sought to create a pilot program to try ibogaine on addicts. It was referred to the Committee on Human Services, but does not appear to have gone any further. The state of New York, similarly, had a bill introduced in 2015 directing more research into the uses of the drug. In April, it was referred to the committee on alcoholism and drug abuse, but records show no votes have been taken on the bill.
The problem with the maze of worldwide clinics is that it's difficult to tell the responsible ones from the irresponsible ones, and ibogaine comes with real risks. The 2016 case report, "Ibogaine-associated cardiac arrest and death: case report and review of the literature," written by Jessica A. Meisner, Susan R. Wilcox and Jeremy B. Richards (which is listed on the National Center for Biotechnology Information website), notes that one ibogaine user "suffered acute cardiac arrest leading to cerebral edema and brain death," which was "consistent with ibogaine-induced cardiotoxicity and ibogaine-induced cardiac arrest."
It wasn't the only recorded death associated with the drug — the report states that 19 deaths were recorded between 1990 and 2008 worldwide, with the cause attributable at least in part either to detoxification or cardiac complications.
The risks haven't been ignored by Global Ibogaine Therapy Alliance, which describes itself as "a not-for-profit corporation dedicated to supporting the sacramental and therapeutic uses of iboga, as well as its alkaloids and their analogs, through sustainability initiatives, scientific research, education, and advocacy." Its site includes a long list of conditions that should be checked for before the administration of ibogaine. With some conditions, ibogaine should not be given at all, it notes, while in other cases the patient should be made aware of the heightened risk and be supervised by a medical professional, or the drug should only be administered under certain conditions. The group strongly advises against self-administering ibogaine.
Doug Greene, GITA's patient advocacy coordinator, says ibogaine patients need to ensure that all these risks are being considered before taking the drug.
"We tell them it's a drug that certainly has potential physical and psychological risks," he says.
"This is why, last year, we came up with clinical guidelines for its use. But we also tell people that it is something that has great potential as a tool in conjunction with other treatment modalities."
GITA would like to see ibogaine and related alternatives continue their FDA trials, but can't afford to foot the bill.
Nevertheless, it continues to raise money for further studies of the drug, and to track studies that are being done. One thing it's trying to show is that clinically, it appears ibogaine is very effective.
"Two studies being conducted by the Multidisciplinary Association for Psychedelic Studies (MAPS) [a nonprofit psychedelic pharmaceutical company founded in the 1980s to study uses for MDMA, otherwise known as Ecstasy], attempt to track the long-term efficacy of ibogaine-assisted detox for opiate dependence," it notes on its website. "The studies, in Mexico and New Zealand, have reported preliminary results of 20% and 50% respectively, for clients remaining free from their primary substance of abuse for at least 12 months."
Before Dilley went to Mexico, the clinic asked him to go on a raw, organic diet for seven days. He tried, but says he failed.
The clinic also asked him to get off Suboxone for 30 days. He did manage that — by shooting up heroin. In fact, before he got on the plane from Wisconsin to Los Angeles, Dilley shot up heroin and took Xanax. By the time the plane landed, and he met up with the clinic staff, the withdrawals were already kicking in.
He was driven to Mexico and taken to a doctor, who screened his health to ensure ibogaine would be safe. Then he was taken to the clinic.
Really, he says, it was a Baja resort, with beautiful views of the ocean. Initially, he was given IV amino acids, after signing a bunch of waivers. Then he was told to lie down, which he did, until the withdrawals left him kicking and screaming.
He first was given a test dose of ibogaine, which he threw up. Then he was given the pills with water. He thinks it was about 15 minutes before the pain went away "like a wave."
"It was just this whole body vibration and warmth, and there's no pain, all of that just kind of washed away," he says. "And that was the last time I felt any withdrawal symptoms."
He stayed in bed for the next day and a half, blindfolded to encourage hallucinations and discourage nausea.
Dilley didn't see any tribal guys in his hallucinations. Instead, he saw himself as a fish, trying to protect an egg that kept on breaking. Then he was a god of sorts, creating nations, armies and castles.
"I don't know if that was the drug telling me that I can do whatever I want and create whatever I want in real life," he says.
When that ended, Dilley was exhausted and initially hated the routine of massage, jacuzzi pools, hyperbaric chambers, organic food, and amino acids that he was subjected to.
But after a couple days, it felt like a vacation.
The first year that he was back in Wisconsin, he says, he kept to himself. He was making $2,000 a month delivering pizzas, still living in his mom's basement, skateboarding, biking, and learning to cook. He was taking care of himself. But he wanted something more.
The massage therapist at the ibogaine clinic had said he should become a massage therapist, and he felt drawn to it.
So, two years ago, he packed up and moved to Denver, where he's in his last semester of earning his associate degree from the Colorado School of Healing Arts.
He says his own life made him want to heal others — he hopes that one day he may even work at an ibogaine clinic in some other country, assuming it remains illegal in the United States.
Dilley's arms now feature two tattoos, one of the chemical structure of the hallucinogen DMT, which he took once after returning to Wisconsin for spiritual purposes, and one of the chemical structure of ibogaine, with the word "freedom" in script under it.
"Whenever I talk to anyone about anything about my life, it is a pivotal point in my timeline," Dilley says of ibogaine.
"It's either everything before that point, or everything after that point."
(Next week: Part 2 of "Psychedelic miracle" explores the history of ibogaine's use as a treatment for addiction, followed by decades of research and efforts to bring it to the mainstream, leading to fresh hope now for developing a new solution.)