Colorado’s Decriminalization of Ibogaine Comes With Unique Risks

In what may be the most underappreciated aspect of the passing of Colorado’s Natural Medicine Health Act, also known as Proposition 122, ibogaine, known for its addiction interrupting effects particularly for opioid use disorder, is now accessible for limited personal possession, use and uncompensated sharing in the state of Colorado.

Despite Governor Jared Polis’ formal proclamations that officially declared Proposition 122 law on December 27th, there’s no shortage of confusion over the limits of the new statewide protections. The laundry list of questions may be decided either through enabling legislation, executive order, future case law, and federal interference in the months and years ahead. Coloradans are now in the early days of an experiment to see if, at long last, the pleas from public health centered drug policy reform advocates to remove the dominance of law enforcement can be successful.

One of the more vulnerable aspects of this experiment involves the new legal context now surrounding ibogaine. Prop 122 took a bold step beyond Oregon’s more gradual approach to setting up a regulatory system for psilocybin, as demonstrated by the lengthy and extensive rules making process for over two years since Measure 109’s passage. While Colorado’s Department of Regulatory Agencies (DORA) will go through a slightly more expedited process for similar rule-making around psilocybin, the now active personal use and possession protections for ibogaine, as well as DMT, psilocybin, and mescaline have created a legal gray area.

The Tabernanthe iboga shrub, whose traditional use central to the practice of Bwiti, contains in its root bark its most well-known alkaloid ibogaine, known in the west for relieving the suffering of some of the most severe symptoms of physiological withdrawal from the acute detoxification of opiate dependency. This fascinating effect in humans was first discovered serendipitously by Howard Lotsof in 1962, who for decades advocated for rigorous scientific investigation and prescription drug development. 

Resulting in part from Lotsof’s outreach to biomedical researchers, evidence from animal models suggests ibogaine’s potential efficacy for sustained relief of post-acute withdrawal for substance-related addictions in humans. This is likely driven by an active metabolite, noribogaine, shown to persist in the bloodstream for weeks to months following treatment. These phenomena have often been included in arguments suggesting ibogaine as a possible “cure” for addiction and the opioid epidemic.

Despite the dangerous and misleading sentiment implying ibogaine as a magic bullet for addiction, I have personally experienced profound and transformative healing effects from ibogaine firsthand. I sought ibogaine treatment after a traditional abstinence-based, 12-step oriented month-long residential intervention failed to facilitate an interruption of my addiction to oxycodone, heroin, and fentanyl. I relapsed to what had become a dangerous, adulterated heroin supply, thanks in part to the reformulation of OxyContin that cut off my access while I was inpatient. Ten months later, in a moment of desperation, my family offered their generous financial support allowing me to travel to Mexico for ibogaine treatment.

Safety, Expectations, and Desperation

It’s too soon to gauge the extent of the new implications of the yet unregulated market for psychedelic substances now possible in Colorado under Proposition 122. This is true on both the personal level and around forthcoming businesses navigating their interpretations of what qualifies as “bonafide professional services” for the facilitation of ingesting psilocybin, ibogaine, mescaline (excluding peyote), DMT and 5-MeO-DMT. Regulations being developed in the next 18 months will only be toward regulated psilocybin “healing centers.” While there is reason to celebrate any drug policy reform victory, Coloradans need to be aware of the unique risks particular to ibogaine.

Iboga is not for the faint of heart, literally, as unlike with other naturally-occurring psychedelics, ibogaine’s effects on the electrical rhythm of the heart has been shown to increase risk of cardiac arrest in people with pre-existing conditions, or on medications known to prolong the QT interval (which includes opiates). The QT interval refers to the brief pause between heartbeats where an electric impulse is required to resume the next heartbeat – a critical period of a steady heart rhythm that is sensitive to alteration. Ibogaine itself prolongs the QT interval, so any further prolongation significantly elevates risk.

Detox can also be a complicated treatment even when handled more traditionally. This varies depending on the type of opiate dependence, whether it’s to short acting drugs like morphine or heroin, the longer acting methadone, or fentanyl. Apart from opiates, detox from alcohol and benzodiazepines involves risk of seizure, and ibogaine has not been indicated by medical providers for acute detox of these classes of drugs.

It is therefore crucial that anyone planning to work with ibogaine before DORA’s consideration for regulated access licensed facilities in 2026 has assembled a team of highly trained and experienced medical professionals. This cannot be emphasized strongly enough. Given the desperation in which I sought ibogaine treatment, I can certainly empathize with those stuck deep in the trenches of addiction. I have advice for anyone who’s received none or at best partial relief from more traditional treatments and are now strongly considering ibogaine since travel outside of the country is no longer required, stay far away from those acting as solo facilitators.

Even those offering a team in the current unregulated market who have an appropriate level of medical training and experience must remember that they are working with individuals both desperate for treatment but also vulnerable to relapse. These providers need to remain aware that most documented deaths associated with ibogaine treatment involve people seeking help, but often withholding their medical history and the extent of their substance use. Sufficient safety protocols must also be in place to protect people from overlooking their own safety concerns. These might include seeking corroboration from family members and loved ones, verifying medical history through lab tests and physical examination, and monitoring for ongoing additional drug use both up until the time of treatment and throughout the most active duration of ibogaine’s effects.

Sustainability and Reciprocity

Synthetic ibogaine is notoriously difficult to manufacture, and only a small handful of international labs produce large amounts which are mostly for use in research settings. Iboga itself grows in the wild only in western equatorial Africa in the modern day countries of Gabon, Cameroon, and parts of the Democratic Republic of Congo. Some state protections and pathways toward export licensing of iboga exists thanks to government recognition of the various practicing sects of Bwiti. Nevertheless, non-discerning international buyers using online sources may be unwittingly contributing to unregulated markets with ties to Africa’s widespread iboga poaching problems.

Rather than relying on sourcing ibogaine or total alkaloid extracts from the root bark of the T. iboga shrub, alternative sources of semi-synthesized ibogaine can be produced from an extraction of the voacangine alkaloid made from the bark of the Voacagna africana tree. More recently extractions of alkaloids from Tabernaemontana arborea and T. crassa have been used. These abundant sources could keep up with demand while improvements in synthetic ibogaine manufacturing are made.

Bwiti elders have built cultural traditions around a millennia-long lineage of ritualistic veneration of iboga for a host of spiritual, medicinal, and community-centered applications. Their enthusiasm for the spread of their practices is understandably complex. With increasing attention toward ibogaine as a western medical intervention primarily administered in the context of drug detox, psychospiritual applications have also emerged in more recent years. 

Perhaps the most popular use of iboga is among veterans seeking healing from combat-induced trauma, primarily at established facilities.Other retreat centers catering to more Bwiti-adapted ceremonial approaches are also growing. An important topic throughout the broader discourse around psychedelic drug reform goes beyond merely acknowledging indigenous roots of plant medicine uses, but involves real reciprocity and relationship that tangibly respects elder traditions.

The Blessings of the Forest organization, founded in 2015, centers the Gabonese people in their mission to preserve, research and share knowledge and indigenous traditions around iboga and other medicinal plants. Their primary approach to achieving this is through planting iboga trees and highlighting the Nagoya Protocol, a doctrine meant to more broadly address profit-driven medicalization by compelling companies to practice fair and equal profit sharing without opposing the broader access to inherited resources.

As excitement around the Natural Medicine Health Act’s victorious campaign shifts to the realities set forth in the new law, responsibility now sits on those attempting to establish safe containers for plant medicine. For the first time in nearly a century, Coloradans have an alternative to a prohibitionist model of drug policy that is moving toward broad access to psychedelics. I sincerely hope that these responsibilities are prioritized around ibogaine, so that the experiences that benefited me can be safely available to all.