The visionary cure of the addiction war? Ibogaine: social context, subcultural identity, and implications for drug policy

Purpose: Existing treatments for alcohol and substance dependence are of limited efficacy and acceptability to users. Since such dependence is associated with high co‐morbidity and mortality rates, alternative treatments should be urgently evaluated. Ibogaine, a hallucinogenic alkaloid, derived from Tabernanthe Iboga, a plant unique to the rainforests of West Africa, is already associated with a large underground treatment scene. This paper aims to explore this issue. Design/methodology/approach The paper draws on the comparative ethnography of magicoreligious Iboga use in West Africa alongside contemporary accounts of ibogaine addiction treatment, and contextualizes these within the neurobiology and anthropology of addiction and treatment provision.

Findings: While the exotic otherness of ibogaine no doubt contributes to interest and hope, the impact of the medicine, not just on craving and withdrawal, but on the perceived acquisition of psycho‐spiritual insight, may validate such anticipation. Both West African and Western Ibogaine use are explored in the context of oppression, resistance and a re‐asserted morality. Successful ibogaine treatments appear to respect but transform existing subcultural meanings and identities, while promoting realism and psychosocial integration. Practical implications Existing treatment programmes might learn from the inherent critique of conventional treatment enacted in ibogaine treatment scenes. Social implications Lack of mainstream investment may partly reflect the cultural positioning of drug‐users (and of this drug‐class) yet the scale of underground ibogaine use demands urgent funding for research to optimise safety and further understanding/development. Originality/value An understanding of how addicts seeking ibogaine are culturally positioned, and position themselves, illuminates the specific attraction of ibogaine treatment for this group, and has important implications for practice, drug policy and treatment development.