Exploring the Use of Ibogaine in Opioid Recovery: Insights from Lived Experience

Opioid dependence is described as a persistent public health problem in New Zealand, with limited treatment options beyond opioid substitution therapy (OST). The paper notes that although methadone and related treatments have improved retention and health outcomes, some service users report physical discomfort, lower life satisfaction, and difficulties that may be related to treatment restrictions, wider lifestyle factors, or the medication itself. Against this backdrop, ibogaine is presented as a legally available but unapproved medicine in New Zealand that has been associated in earlier research with reduced withdrawal, cravings, and, in some accounts, spiritual or psychological change. At the same time, the paper emphasises that evidence remains limited and that serious cardiovascular risks have been reported, including QT interval prolongation, arrhythmias, and sudden cardiac death. The study set out to explore the lived experiences and practices of opioid-dependent people who used ibogaine for detoxification. The authors were particularly interested in motivations for treatment, understanding of health risks, use of pre-treatment medical screening, and the effects of ibogaine on later opioid use. They also aimed to use New Zealand’s legal prescribing context to better understand ibogaine use in a setting where users could discuss treatment more openly and receive medical input, rather than relying solely on clandestine or unregulated use.

Walker and colleagues used a qualitative collective case study design to examine the experiences of 10 opioid-dependent people in New Zealand who had used ibogaine specifically to treat their dependence. Ethics approval was obtained from the University of Otago Human Ethics Committee. Participants were screened for mental health diagnoses other than opioid use disorder during recruitment, and none were excluded on that basis. Participants were recruited through ibogaine networks, a Christchurch OST service, and snowball sampling. The sample included people aged 27 to 53 years, with ages at ibogaine treatment ranging from 21 to 49 years. The extracted text states that the sample was evenly split by gender and that all respondents identified as New Zealand European; it also notes that nine had histories of illicit opioid use and one had problematic opioid use related to chronic pain. Eight were on OST at the time of ibogaine treatment, and one had never used OST. Two participants received treatment overseas, while the rest were treated in New Zealand. Semi-structured interviews were conducted in locations chosen by participants, such as homes, cafés, and libraries. Interviews lasted about 45 to 90 minutes, were audio-recorded with consent, and transcribed verbatim. After each interview, participants completed a short questionnaire to capture demographic information, opioid use history, duration of dependence, prior treatment history, and opioid use after treatment. Participants received a $20 petrol voucher. The researchers analysed the transcripts using inductive thematic analysis. They generated 22 initial codes and then clustered these into seven higher-order themes through an iterative, interpretive process. The first author led coding and theme development, and discussion with two academic supervisors, an audit trail, and use of illustrative quotations were used to support rigour and credibility.

The 10 interviews produced seven themes: desperation to be opioid free; motivations for using ibogaine; safety conscious and support seeking; improving ibogaine practices; effects of treatment on depression and anxiety; effects of treatment on dependence; and the spiritual effect. Overall, participants’ accounts suggested that ibogaine was experienced not only as a detoxification aid but also as something that could influence mood, meaning-making, and later recovery trajectories. A strong desire to escape opioid use, including methadone, was a major driver. Participants described negative effects on mood, anxiety, and physical wellbeing, together with repeated unsuccessful detoxification attempts. Many were motivated by the hope that ibogaine would provide faster and more durable detoxification than conventional treatment, with less time away from work and family. Several had prior experience with hallucinogens or cannabis, and four explicitly sought spiritual healing or a deeper psychological change. The most persuasive motivator for some was seeing a peer who had used ibogaine and appeared markedly improved. Safety-related behaviour was prominent. All 10 participants sought medical testing from a general practitioner before treatment, and those working with an ibogaine provider generally completed the provider’s recommended screening and follow-up processes. Participants without a provider sometimes underwent tests that were less relevant to ibogaine safety. Half of the sample reported needing ongoing information, support, and in some cases booster doses after treatment. Participants also described what they saw as better practice, including the use of therapeutic dosing, hydration, sleep support, nausea management, and, for some, switching from longer-acting opioids such as methadone to shorter-acting opioids before treatment. They noted that vomiting or low dosing sometimes reduced the psychedelic effect or made the dose uncertain. Many still valued the hallucinogenic experience. Mood and anxiety improvements were reported very consistently. Participants said ibogaine reduced depression and anxiety, sometimes even at low doses, and that these benefits could persist for one to six months. Seven out of 10 reported remaining opioid-free, and five of these seven also reported abstinence from other substances. Three participants relapsed between three and six months after treatment. Two participants used booster doses around three months later for pain management with good effect. Some participants described spiritual or visionary experiences, including encounters with an African shaman-like figure, while others did not achieve the spiritual effect they had hoped for yet still obtained opioid abstinence.

The authors interpret the findings as showing that ibogaine experiences were shaped by an interplay of desperation, motivation, safety practices, treatment preparation, mood change, and spiritual meaning. They argue that dissatisfaction with OST, especially its unwanted mental and physical effects, increased hopes for ibogaine as a faster detoxification pathway. They also suggest that the reported benefits were not limited to withdrawal suppression but extended to improvements in anxiety and mood, sometimes described by participants as a psychological reset lasting weeks or months. Walker and colleagues position their findings as consistent with earlier research noting limitations of OST and the potential appeal of psychedelic or spiritually meaningful treatments. They also point out that booster doses, though mentioned in guidance, have limited evidence behind them. In their account, participants who used experienced providers, underwent recommended screening, and accessed post-treatment support tended to report smoother detoxification, fewer complications, and more sustained abstinence. By contrast, independent use without provider guidance was associated with less relevant screening and weaker follow-up, which the authors suggest may increase safety risks and reduce effectiveness. The authors highlight several limitations. The sample was small and hard to recruit, which constrained diversity and means the findings cannot be generalised to all ibogaine users. Participants were all New Zealand European, limiting wider inference. All outcome data were based on retrospective self-report, so recall bias, selective reporting, and unverified claims about abstinence, relapse, withdrawal, and mood changes are possible. The authors also note that theoretical saturation was not formally assessed, although later interviews reportedly continued to reinforce the same themes. In terms of implications, the authors argue that future ibogaine provision in New Zealand should prioritise professional oversight, comprehensive medical screening, symptom management, and sustained psychosocial support. They suggest that the legal prescribing context may have allowed more open discussion with general practitioners and better access to care. They also note that low-dose booster treatments were valued by participants, but formal prescribing guidance remains absent. More broadly, they present the study as adding context-specific evidence that may inform clinical practice, policy, and future research on safer ibogaine use.

The authors conclude that participant experiences ranged from highly supported treatment under a specialised ibogaine provider to more independent use with less appropriate screening and follow-up. They state that preparation, planning, and recovery time were central to whether ibogaine was experienced positively and whether opioid abstinence was achieved. The study is presented as offering novel insight from a legal prescribing environment, and the authors conclude that ibogaine may have potential as a detoxification tool when paired with professional oversight, medical screening, symptom management, psychosocial support, and, where appropriate, booster dosing.