Ali McGhee, Ph.D., is a a member of the Chacruna Chronicles editorial team. She lives, writes, and teaches in Asheville, N.C.
When and why did ibogaine experiences start including toad medicine?
Ibogaine, the psychedelic compound derived from the West African iboga shrub, has emerged as a dark horse darling of psychedelic research and legislation. In the past few years, it has soared from relative obscurity to garnering increasing attention and funding, including the passage of $50 million for research funding in Texas.
Often, though, people who receive ibogaine choose to follow it with another psychedelic that has its own potent qualities: Five-MethOxy-N, N-Dimethyltryptamine, (5-MeO-DMT), also called bufo. Found in the venom of the Sonoran Desert toad (Incilius alvarius) as well as some plants, the intense, short-acting psychedelic is now commonly offered after the ibogaine experience.
While this was not always the case, the current prevalence of the pairing had led to assumptions that every ibogaine experience includes a session or two of 5-MEO-DMT. The practice is so common now that some retreat centers include statements in their materials about why they offer only ibogaine, rather than both. We contacted several retreat centers who offer 5-MeO-DMT as part of the ibogaine experience as part of the research for this story, but none responded within the publication timeline.
Funding for ibogaine research does not also include 5-MeO-DMT research, and much of the data we have now on ibogaine is from people who also took 5-MeO-DMT, muddling results.
How did two psychedelics from very different parts of the world come to be used together? And how did the pairing become an expectation for many people looking into the treatment?
How did two psychedelics from very different parts of the world come to be used together? And how did the pairing become an expectation for many people looking into the treatment?
The Ibogaine Experience
Most often derived from the West African Iboga tabernanathe, ibogaine produces a long-lasting acute state with effects lasting 12-24 hours or longer. The experience can include ataxia, nausea, life reviews, and audiovisual hallucinations. Side effects include cardiac complications that can be fatal and which are screened for and monitored.
Ibogaine, like other psychedelics, is a Schedule I drug in the United States. Legal with a medical prescription in Canada and unregulated in Mexico, ibogaine’s potential for treating opioid use disorder and other substance use disorders, PTSD, traumatic brain injury, and other neurological and mental health conditions has contributed to a rise in retreat centers offering healing experiences with the potent psychedelic.
In study participants with PTSD, Ibogaine improved executive function, lowered PTSD symptoms, and meliorated depression and anxiety. Funding for ibogaine research has increased dramatically in the last year, with several states passing bills that would fund research into medical uses and bolstered by the veteran lobby.
Toad Medicine’s Strange Trip
Synthesized by two Japanese scientists in 1936 – decades before it was discovered in toads in the 1960s – 5-MeO-DMT came into its own in the underground psychedelic movement with the publication of the 1983 pamphlet, Bufo alvarius: the Psychedelic Toad of the Sonoran Desert. The pamphlet describes the venom collection process and means of ingestion through smoking (the author notes that the venom is “extremely hallucinogenic when vaporized by heat and taken into the lungs in the form of smoke”).
The pamphlet also describes the “almost overwhelming” effects of smoking 5-MeO-DMT, which include ego collapse, a flood of thoughts and perceptions, and “loss of the space-time continuum,” followed by pleasant visual and perceptual distortions and euphoria. All of this, it notes, plays out in the space of approximately 15 minutes.
The pamphlet’s publication shot 5-MeO-DMT into the psychedelic spotlight. In the 1990s, Dr. Andrew Weil and Dr. Wade Davis published two articles of their findings of its psychoactive effects.
Like other serotonergic, or classic, psychedelics (including psilocybin, DMT, and LSD), 5-MeO-DMT acts as an agonist on the brain’s serotonin receptors, stimulates the 5-H2A receptor, and modulates large-scale brain networks like the default mode network and salience network. But unlike these, 5-MeO-DMT also has much greater activity on the 5-HT2A and 5-HT1A receptors and is more potent than DMT. It also has features distinct from other classic psychedelics, including, typically, a lack of visual elements.
5-MeO-DMT is not orally active, but is activated through routes including smoking, injection, sublingual administration, and nasal administration. Practitioners also often offer synthetic 5-MeO-DMT, which they say supports conservation of the toad population.
The complex history of 5-MeO-DMT may not even include Indigenous people at all in Mexico, where people often associate it with traditional practices rooted in spiritual tradition. Rather, a non-Indigenous man, Octavio Rettig (known simply as Octavio) became convinced that the Seri tribe, an Indigenous community in Mexico, had once used it as part of a lost Mesoamerican ritual erased by colonization.
According to The New Yorker, after Octavio administered toad to tribe members as a treatment for rising drug addiction, several elders had visions that informed them of this lost history. While not unverifiable, too few records exist to confirm or deny the accounts either way. Following the experience, Octavio was granted permission to administer toad to the tribe – status which has since offered him protection against serious accusations of causing physical, mental, and spiritual harm to clients.
“This is something that has proliferated”
Ibogaine and 5-MeO-DMT were not historically offered together and are from different parts of the world. No traditional or Indigenous precedent exists for the pairing. In fact, 5-MeO-DMT’s murky history also offers no insight into how it came to be used with ibogaine. “I don’t know that we have an answer as to how they work together,” says Dr. Alan Davis, Associate Professor and Director of the Center for Psychedelic Drug Research and Education at The Ohio State University. Davis has spent a decade researching ibogaine.
Ibogaine and 5-MeO-DMT were not historically offered together and are from different parts of the world. No traditional or Indigenous precedent exists for the pairing.
In the years before research interest in ibogaine grew, Davis collected early data through surveys of people who had done it in natural environments outside of clinics. With co-author Joseph Barsuglia, they retrospectively surveyed patients from the now-closed Crossroads Treatment Clinic in Mexico to assess treatment outcomes, publishing two papers. “At that time, the majority of people treated with ibogaine were civilians with a history of opioid addiction,” Davis says.
While Davis and Barsuglia worked on the study, the clinic also disclosed that everyone treated there received another psychedelic: 5-MeO-DMT – a confounding factor that they included as a limitation in that study “and in studies since then,” Davis says, “because most people get both at any of the clinics that now operate. This is something that has proliferated.”
Davis does not have an answer to how the psychedelics work together. “At the time, I remember asking the clinic about what the reasoning was, because there is little clinical trial evidence about either one, and nothing about the combination of both.”
Ultimately, they note, “there isn’t any strong scientific evidence to understand why they are combined.”
Dr. Bruno Ramos Gomes, a psychologist with a PhD in Public Health, has studied the use of ibogaine in Brazil for the past 16 years. He also does screening sessions, preparation, and integration for ibogaine patients. He has not seen an uptick of 5-MeO-DMT use with ibogaine in Brazil. “It’s not that common,” he says. “It’s not connected with iboga or ibogaine. In traditional use in Gabon, the plant is the tool to connect a person with their ancestors and visit the iboga realm, where you get healing and the message you need.”
He notes that practitioners may bring in other plants to support purging, but that iboga is not used in conjunction with other visionary plants. “The visionary aspect is not the main way people get meaning from the experience and work on trauma.” He recognizes that people may like the addition of a more classically visionary psychedelic like 5-MeO-DMT. But ibogaine’s long window of effect, which has many different phases, means that people’s experiences up to two weeks before, during, and for up to a month after an ibogaine session could be complicated by other substances.
“We respect the temporality of ibogaine,” he says. “I’ve seen patients afterwards who say they didn’t review their trauma during the experience or think it didn’t work, while in fact they are too attached to one specific expectation. If we can help them to respect this time, they notice something different.”
He notes that a few patients who took another psychedelic within a month after an ibogaine session have experienced some adverse effects, including increased sensitivity and episodes of anxiety or panic. “That’s another reason why we tend to respect this time. It’s important for the patient to have time to integrate this experience. We suggest people notice their sensitivity and how they feel, so they can truly integrate this experience in a healing way.”
Discover the Indigenous Reciprocity Initiative of the Americas
“What were their intentions?”
Theories do exist about why these psychedelics are used together. Davis says the dominant theory is that ibogaine is considered to be a harsh, more paternalistic medicine. “It’s a little more in your face and confrontational in terms of trauma reprocessing, memory, and thinking about difficult things. People refer to it as challenging.”
Davis notes that 5-MeO-DMT can bring up all of these things as well, “but as a more classic psychedelic, it has other properties of euphoria and connection to something bigger. The theory at one time was that ibogaine tears you open and 5-MeO-DMT closes things back up to bring you back into a more mystical experience you can leverage as a positive direction forward.”
The pairing also has marketing power. “People have either read our papers, or have heard from someone who went to a clinic where both were offered, or they heard about it and now they want it,” says Davis. “So now clinics are incentivised to market it and patients are coming in demanding it. There are a lot of business and corporate interests in this space.”
“People have either read our papers, or have heard from someone who went to a clinic where both were offered, or they heard about it and now they want it … So now clinics are incentivised to market it and patients are coming in demanding it. There are a lot of business and corporate interests in this space.”
Dr. Alan Davis, Associate Professor and Director of the Center for Psychedelic Drug Research and Education at The Ohio State University
Davis cautions people to remember that these psychedelics exist in a grey area of regulation and business in Mexico, and there is neither consistency across clinics nor regulation governing practice. “It’s a strange gray area of the corporate, ideological, and the mythological,” they say. Bringing in the problematic lore of where 5-MeO-DMT comes from both further complicates the pairing and means that people are more intent on experiencing it.
Davis’s studies of clinic patients found “significant and large improvement across lots of different mental health indicators.” But, they note, “we have heard anecdotally that there are people who don’t feel comfortable participating in the surveys, because they don’t want to counter the narrative that’s been promoted. They didn’t fill out the survey because it didn’t work for them and they don’t want to mess it up for other veterans, or they had a terrible experience but don’t want to stand in the way of someone else maybe not getting it that it could work for.”
“We can’t underestimate the number of people whose voices haven’t been heard,” they continue. They cite a recent death at Ambio Life Science Clinic in Mexico, and conjecture that deaths are higher than reported. “It’s a major concern because it’s not regulated.”
Davis notes their own research contributes to the rising interest of pairing ibogaine and 5-MeO-DMT. “Somehow this has become the de facto standard practice, and people think it should be available to them,” they say. “My research is somewhat complicit because we have published reports showing that there are overall improvements when these are packaged together, but there are big caveats. We are missing all of these other voices.”
Davis critiques the corporate interests in the space for not communicating that much of the research done up to this point has been based on both 5-MeO-DMT and ibogaine administered together. “Legislators hear from advocates who are largely incentivized by the corporate desire to capitalize,” they say, noting that promoting two psychedelics without clinical trial evidence would likely halt funding efforts.
“I would love to really understand the people who created this new protocol” combining ibogaine and 5-MeO-DMT, says Gomes. “What were their intentions?” He expresses concern that the continued popularity of the trend and clients’ expectations around it may be a way the global north colonizes these practices, “not necessarily because they are trying to, but because it’s so widespread that people think it’s normal.”
Davis would like to see psilocybin approved before ibogaine. “If you want a quicker, more direct impact on addiction and mental health, put the energy into psilocybin and get it approved for these indications,” they say, noting that it has a “decades-long history of safety data. We understand why it works and what it’s doing. Ibogaine will take 10 years to get through the research pipeline, and ultimately might still be unsafe. It’s harder to study and will cost more once available because of how long the effects last. There are so many reasons to suggest we should put this money in another area.”
Research does show that “there’s something here that’s important and meaningful that is helping people,” says Davis. “But we need to be more careful and considerate and not rush this because of risks,” which also include the impacts of extracting 5-MeO-DMT from a dwindling toad population and extracting ibogaine, an Indigenous medicine, from a resource-poor environment. Currently, says Davis, “there is no current plan or process to reciprocate any of the potential income from this technology.”
Art by Fernanda Cervantes.
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