Interview with Jeremy Weate, PhD, Ibogaine Pioneer and Expert
"You can be the hero of your own story." - Jeremy Weate, PhD
In my last post, The Magical Mystery Tour, I shared our family’s experience with plant medicines, especially ibogaine. Now I want to introduce you to Jeremy Weate, PhD, an expert on ibogaine, who helps us understand how it works, how best to work with it, and some thoughts on why it is still a Schedule 1 substance in the US.
Moms for All Paths: Can you give us some background on who you are, what you do, and how you got interested in ibogaine?
Jeremy Weate:
I'm Jeremy. I'm British and 54 years old. I have a PhD in philosophy from many moons ago in the 1990’s. After my studies, I started work in the early days of the commercial internet into the early 2000’s. I was working in London, mostly on pioneering e-commerce websites.
I never wanted to have a conventional life, so I left all that behind in 2003, and moved to Africa. First, I was working in private sector consulting in Nigeria. Then I fell sideways into development consulting, which is usually funded by entities such as the United Kingdom government or the American government ( USAID), or the World Bank or the European Union. Most of my work over the last 20 years has been focused on the governance of the extractive industries, whether that's mining or oil and gas. I work on trying to get an equitable balance between the money and benefits to government, the benefits to communities and the benefits to companies. Oftentimes, it's a very tricky balance.
I'd say I've had a general interest in mental health going back to my adolescence. I've been fortunate not to suffer from significant mental health issues myself, but I think it's partly due to my interest in philosophy that I'm interested in the nature of the mind. From my early teens, I’d ask myself the big philosophical questions about who we are and what we should be doing. A subset of that is: how do we stay happy and how do we stay balanced within ourselves? What constitutes a good life?
I've also been very adventurous and experimental all the way along. I've been fortunate to have lived and worked in many countries and experienced many different cultures and societies. My interest in psychedelics goes back to my late teenage years when I first began experimenting with LSD. I had some incredible, mind opening experiences, as well as some very challenging ones.
Around twenty years ago, I was on a London bus chatting about psychedelics with a friend of mine, Nick, and he mentioned iboga. I'd never heard of iboga at the time. Nick said, “This is a psychedelic from Gabon in Africa. You should look into it.” I had already spent some time living in Nigeria, and I thought, Gabon is not that far as the crow flies from there, to the east and south. So I investigated, and became very interested in what I found.
Iboga is the root bark of a shrub that is used in a kind of coming-of-age ceremony. Part of that experience involves meeting the ancestors and finding out about your role within the community. That resonated with me in many ways. I've long felt that in the West, we've become de-ritualized, and we are all the poorer for it. Jews have Bar and Bat Mitzvahs, but Gentiles, what do we have? I think marking the passage from childhood to adulthood is incredibly important.
I was also interested in the psychedelic aspect and the fact that this tradition has been quietly there for centuries, or longer. The pygmies who live deep in the rain forests are the knowledge keepers. They were only exposed to the outside world through colonialism and the hunt for rubber and other resources in the nineteenth century. So, they may well have been working with the plant for eons. All of that led me to go to Gabon and go through an initiation process myself. It was quite an incredible experience.
Moms for All Paths: That’s some great background! Let’s get into some specifics. Why is Ibogaine so impactful for opioid use disorder as opposed to other plant medicines?
Jeremy Weate:
Not to diminish the efficacy and benefits of other plant medicines, but it's a very simple pharmacological issue. No other plant medicine as effectively targets, among other things, the opioid receptors in the central nervous system. Without going too deep into the neuroscience of specific receptors, we can say that ibogaine effectively resets the opioid receptors. It does this very rapidly upon consumption. From my experience, it's just within a few hours that the main resetting work is done. The initial pharmacological work is quite fast, but the ibogaine experience is much longer than that. Withdrawals are taken away within the first few hours.
If you are addicted to heroin, fentanyl or another opioid, your physical opioid dependency is taken away, miraculously, in this short space of time. There's nothing else that can do that, synthetically or from the plant kingdom, that we know of. Psilocybin has fantastic potential as a medicine for depression. There are all kinds of properties of LSD which we've yet to fully explore. People talk very positively about 5-meO-DMT and DMT. You could go on through the pharmacopeia of psychedelics, but there's nothing known to humans like ibogaine in terms of its efficacy, specifically against opioid dependence.
There is a long history of ibogaine both in France and also in America. It is absolutely riveting. Ibogaine was used in Kentucky in the Addiction Research Centre on African American prisoners who detoxed from heroin in the 1950’s under the watchful eye of Dr. Harris Isbell. Then in 1962, the kind of Genesis Chapter One event in North America was Howard Lotsof accidentally discovering the anti-addictive properties of ibogaine in New York. I became very familiar with that story, and ultimately I helped set up an ibogaine healing center or retreat in Portugal. It is thriving today and is called Tabula Rasa Retreat.
There's another side of the story, which I really don't understand, but it's something like a calling to work with the plant. Once you have connected with the medicine, it's sort of like an umbilical link. So regardless of what you think or do, you're connected. People often talk these days about plants having consciousness so it might be connected to that. Or maybe it's a more practical matter of the molecules interacting with your brain and leaving some kind of neurological traces. I don't know what it is, but I feel a loyalty and a commitment towards working with iboga and ibogaine and protecting it. This translates to avoiding harm with it, doing well to other people with it. Also, using my skills and experience to advocate for its best possible medicalization seems to me like a good life, a life well worth living.
Moms for All Paths: What needs to be done to minimize cardiotoxicity?
Jeremy Weate:
This issue was very much exploited in the Kentucky hearings last year. You can't brush under the carpet the potential cardiotoxicity of ibogaine. Ibogaine can and often does extend the QT interval of the heartbeat. At the moment, we don't have a medicine that you can take to reduce that impact. There is research on second generation analogs that may mitigate the cardiac risk, but these projects are quite a few years ahead of us in terms of availability to humans. I think there will ultimately be in perhaps ten or so years a new version of ibogaine that doesn't have those properties. But even at the moment, given proper procedure and stringent screening guidelines, I'd be confident to say that ibogaine is perfectly safe. Cardiac risks can be perfectly well managed in a clinical environment with appropriate training and safeguards in place.
For starters, there’s a long list of exclusionary criteria, including any heart issues such as arrhythmia or having had heart bypass surgery.
You also need to be treated in a hospital type environment. You don’t want to treat someone for addiction only in a hospital environment, but for the actual window of 36 hours post consumption, a hospital type environment is the safest treatment setting. Note that I did not say hospital: I said a hospital type environment. That means that a trained medical professional, preferably a doctor, and trained cardiac nurses with ACLS certifications who are trained on how to run a Code Blue are present. You have the kind of machinery that you would have in an ER, such as an oxygen tank and monitoring equipment. If someone died under these highly monitored and equipped circumstances, it would not be because of the ibogaine, it would be due to underlying circumstances.
In the era of fentanyl analogues, carfentanil, people in treatment centers have become more conservative with dosing. Now that's a positive because it reduces risk, but it's a negative because it may also reduce efficacy. A trend in ibogaine provision over the last few years is to move away from what's called a “flood dose” – that is, to hit them hard with a single single set of pills - toward more of a cumulative dose or a saturation dose. That is a small dose (not a microdose but a small dose) across several days. During that process, professionals are measuring the EKG and vital signs, increasing the dose or paring back based on how the patient is feeling and the data. The advantage of that is you're far more in control of the situation. The disadvantage is it's more labor intensive, but it's ultimately safer. I think people who have adopted the cumulative dose protocol are the safest providers out there. It is much harder work for the client but ultimately they end up with more noribogaine, the active metabolite, on board, and I think that can lead to stronger treatment outcomes.
Moms for All Paths: What do you mean by “it’s more labor intensive?”
Jeremy Weate:
It’s physiologically more demanding to go through a treatment that lasts ten to fifteen days where you're in an altered state of consciousness the whole time. Buried psychological material is coming up that you're having to work through during that time. With a flood dose, it's 24 hours to 36 hours, and then you're slowly coming back to life. With a cumulative dose, it’s up to two weeks of working through issues. It's a deeper and a harder clean but I think more effective cleaner ultimately.
Moms for All Paths: Why is it still Schedule 1 in the US? (Schedule 1 means it has been classified as having no medical uses.)
Jeremy Weate:
It's not for rational reasons to classify ibogaine as having no medical benefits and be schedule 1. Obviously ibogaine has many healing properties, beyond addiction as well. The full plant extract is prospectively protective against neurodegenerative disorders like Parkinson's. There's been some very interesting work done on this, showing that in not all cases of Parkinson’s, we have evidence it can actually reverse the disease. There’s also some very interesting recently published research being undertaken at Stanford on ibogaine for traumatic brain injury (TBI) and Post Traumatic Stress Disorder (PTSD) under Dr. Nolan Williams. Dr. Williams’ research findings will give ibogaine a place alongside MDMA as a very favorable form of treatment for veterans with PTSD and TBIs.
So why is it still Schedule One? I think it has been outlawed, not for medical or scientific reasons, just alongside other psychedelics, because it’s not understood. What is annoying about the mainstream media coverage of ibogaine is that articles never talk about it again without saying “the controversial…” Why is it controversial? Because somebody else said it was controversial, and then it's like an echo chamber. I don't think it's too conspiratorial to say that ibogaine has been marginalized and demonized by pharmaceutical companies. Even the saturation dose protocol doesn't fit the pharmaceutical model. It's not a regular treatment that fits the pharma business model.
Even though it looks like the Kentucky opportunity will not now go forward, I think it's only a matter of time before another state government takes up the baton because of the scale of the opioid crisis in the US. To be blunt about it, what else is there? Existing state-based maintenance programs with suboxone and methadone are just awful. They take the criminality out of it, which is very important, but what a dull, monotone, sexless life. Is that as good as we can do as humans? Surely we can do so much better than that.
Moms for All Paths: Do you think that the treatment industry could have anything to do with American hesitancy to adopt ibogaine as a useful treatment for addiction?
Jeremy Weate:
I definitely think mainstream addiction treatment is one of the blockages to acceptance of ibogaine. People's lives and professions and beliefs in the addiction industry have been built around the 12 Steps. That’s a very different ethos from ibogaine treatment. They are similar in that there is a sense of community, and I’m not wholly disparaging 12 Steps because it works for some. But ibogaine facilitates a sense of individual autonomy and a bootstrapping sense of self discovery. Community and connection are always important post-addiction, but ibogaine encourages you to be independent, not dependent on a group or institution for the rest of your life. With 12 Step programs, you replace dependence on the substance with dependence on the group and the program. I think intrinsically the therapeutic opportunity of ibogaine is to do things differently. It begins with the individual setting the intention for safe treatment. It is very different from a 12 step type scenario because it's all about empowering you to be a loving citizen with no dependencies on any institution or support body forevermore. You don't need to be a victim, ashamed of what happened in your life. You can be a free-standing individual, good citizen, good family member. And you don't need to have this crutch that's reminding you that you're an addict and always will be an addict, and that's just your cross to bear. There is no need to identify as an addict and be ashamed or dependent. It’s a totally different ethos.
Moms for All Paths: What should a person trying to end their opioid dependence do to be most successful with ibogaine?
Jeremy Weate:
The reality is for people with substance use issues, even if they have a very strong intention and want to change their lives, have family support and everything possible in their favor, it’s still extremely hard. It's still likely statistically that it will take more than one go at it with ibogaine. It typically takes two years and several treatments (two or even three). The first time around it's such a profound experience, but maybe the person hasn't cut ties enough with the old world and their old habits. All the phone numbers were not deleted. Then a stressor or trigger hits. It can be hard to resist calling those old numbers. The second time around, with deeper intention, people often think to themselves, “I’m not going to mess it up this time.” I think that’s pretty standard route through.
Ibogaine is not a wonder drug. Anything the client or patient can do to strengthen and consolidate their intentions ahead of time will help. Again, it's even more important that you don't go back to the old world in any way. If you can possibly spend months somewhere else, picking apples or working as a lifeguard, somewhere preferably in nature where there's community, to really lock in the new habits, you’ll have the best chance of success. During the first weeks, maybe a few months, after the treatment, you have the benefit of increased neuroplasticity, and it's a great time to kind of bed down new habits and ways of thinking about yourself. You can create a new narrative of self, new possibilities and new connections and perhaps new loves. So you really need that time post treatment time to be a time when you're in a place of connection and feel welcome. You're not back to the nagging spouse or the noise or the job with the boss and the office toxicity. All of that will just bring back stress responses, and the synaptic nervous system will snap back to the old ways of soothing and protecting yourself against psychic attacks.
Moms for All Paths: How can we afford to make safe ibogaine treatment scalable?
Jeremy Weate:
There's enough money for clinical trials, and it's not just the opioid restitution funds, which are vast. There's investor money out there. You might ask, what's the interest of an investor? I think the interest from a capitalistic investor perspective is not to make money out of whacking big profit margins onto the cost of the drug, but in the treatment. And it's not about providing expensive, exclusive treatment. It's about having a clinical model for provision at scale. Given the size of the opioid epidemic and other drugs epidemics, not just in America, but around the world, it presents a huge opportunity to provide affordable, accessible treatment and still be a profitable business.
Moms for All Paths: Do you have any final words for us?
Jeremy Weate:
If someone reading this gets interested in ibogaine: don’t just buy it off the internet. You don’t know what you’re buying. Don't take it at home alone. If you’re going to go to Mexico or a clinic elsewhere, do your research. Ask them about their safety provisions, their guidelines, ask them whether they have a doctor and a nurse, their proficiency with and equipment to handle any cardiac events. If you're stuck in the throes of your substance problem, a loved one should do the research to help you make a good choice. I wouldn't recommend any particular clinics but be confident that you've done your research before you select and then work on your own intention.
You have to be extremely focused because it is a hero's journey that you're going to be walking along. But you can be the hero of your own story. It's perfectly possible to be the hero of your own story.
Part of my commitment to ibogaine is to never give up, never give in. Ibogaine gives you this warrior energy. There's just no falling down. If you get pushed down, you dust yourself off and you’re back on your feet the next day. I'm one of a group of people that never ever gives in for as long as I'm breathing. There's plenty of people like me who will never ever give in in terms of ibogaine medicalization. You can’t bury the warrior energy of bereaved mothers and fathers fighting for their children. Ibogaine treatment will find a way into America.
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