Heroin and Ibogaine
At the time of writing, the ibogaine had seemed to work. Guion’s story reported eight months of post-treatment sobriety. Her daughter had even begun making plans to travel and teach. But tempering the good news, Guion confronted the fact that addiction is also made up of people and habits and can rise up again if old patterns are not broken. Three years later, Guion and her daughter’s story continues.
Last winter my daughter Abby spent nearly two weeks in the ICU. She received a cocktail of IV antibiotics for an abscessed spleen. A spleen infarcted by IV heroin use. The flow of blood occluded—bacteria or fungi had burrowed deep into the rich agar, germinated and swelled to unwholesome proportions leaving her febrile and disoriented.
I wish I could say that our lives, after Abby’s first ibogaine treatment, were a succession of triumphs and joys but we have taken the more common road, a serpentine path through relapse and recovery.
In four years she has had three ibogaine treatments, each leading to varying lengths of abstinence—three months, eight, six.
Thomas Kingsley Brown in his study “Ibogaine in the Treatment of Substance Dependence” reports that 32 of 33 IV heroin users showed no signs or only mild symptoms of opiate withdrawal 72 hours after being treated.
Ibogaine physically detoxes people 99% of the time. But detoxing is just the first step in the process of recovery. A miraculous beginning— but the elusive keys to building a sober life are hidden in the small acts of day-to-day living.
Culturally, we have been hypnotized by the mainstream model of addiction treatment. Ideas inherited from pop psychology—tough love, co-dependency, enabling—leave families stranded and hopeless. Popular programs like Dr. Phil, Dr. Drew and The Interventionist perpetuate myths about addiction treatment. What they don’t say, while they suggest we run out and get our loved one checked into a 90-day inpatient rehab immediately, is that the cost can be tens of thousands of dollars. Insurance rarely covers inpatient treatment for opiate addiction. Yet many people go to rehab again and again, the implication being that the client has somehow failed, not the system. National spending on a system whose relapse rates are 40-60% within the first year is estimated to be $35 billion in 2014.
Annie M. Fletcher in her book Inside Rehab cites a confounding survey that suggests seven out of 10 people who do recover actually do it on their own by attending self-help groups or working with an independent therapist. We must radically change the paradigm of addiction treatment.
As the mother of a child addicted and as an emergency room nurse, I watch helplessly as desperate families bring their addicted loved ones to the hospital pleading for help. Our medical system has nothing to offer. Usually the most effective treatment I can give is my empathy.
Relapse is a sleeping serpent; it wakes slowly, heaving its gargantuan body from the center of the addict’s brain revealing its supernatural proportions. All of my daughter’s treasures fall away as it consumes everything—friendships, family, her beautiful life destroyed.
There are alternatives, dynamic approaches that are more accessible because they are not as cost-prohibitive as inpatient treatment. Their efficacy in supporting and maintaining sobriety may be more beneficial than our current one-plan-fits-all model. We must be creative and follow our intuition while ferreting out these therapies. With each round in our battle with addiction, we glean what has worked, discard what hasn’t and try new ideas—piecing together a mosaic of therapies, a framework around which a sober life can be built.
Ibogaine will always be our first step in recovery because it detoxes without the need for opiate replacement medications such as Suboxone which, Abby complains, keeps her tied into the mentality of addiction. Suboxone can be a life-saving option but it can be difficult to get an appointment with a prescribing doctor, is costly and at least in the beginning, requires frequent urine drug tests and follow-up appointments.
Active addiction holds hostage the body’s ability to produce the feel-good neurotransmitters serotonin and dopamine, leaving the recovering addict feeling a monotone gloom. Exercise is vital during recovery, bathing the jumpy nervous system in varying degrees of tranquility and well-being.
Phoenix Multisport is a nonprofit organization based in Colorado with chapters in Boulder, Denver and Colorado Springs. Phoenix’s goal is to expand people’s sober community while creating a safe environment. They host daily events which are all free of charge—rock climbing, cycling, kayaking—the only requirement is sobriety. I have considered helping Abby, who had been a competitive snow boarder in her early teens, relocate to a sober living house in Colorado where she could build a new life around a supportive and active community.
In the past Abby has tried antidepressants. The list of possible side effects is often longer than the list of rewards. Psilocybin mushrooms may be an alternative to antidepressants. Research from Imperial College London suggests these little fungi, after one psychoactive trip, may potentiate a sense of well-being for months afterward.
* * *
When Abby finally calls, it has been three months since I’ve heard from her. She has no address and no ID as far as I know. I’ve combed through the last cell phone bill we’d paid when she was living at home and called or texted every number she’d dialed more than once—”If you see Abby, will you please let her know her mom loves her and to call when she’s able? Thank you.”
I’m at work when she calls. I offer to bring her lunch. We meet somewhere off State Street and sit by Big Cottonwood Creek—a culvert of concrete and chain link fence.
She has the most beautiful mane of chestnut hair. It’s matted and dusty, tucked under a baseball cap. Her hands are swollen and red—I worry there may be an abscess festering under her sleeve. She wears a green bandana tied around her neck but I catch a glimpse of the angry vein of scabs following her external jugular vein. I try not to look. If it just weren’t so close to her airway, her carotid, her heart—a welcoming mat for infection.
We sit together on the bank eating Crown Burgers. A pair of Canada Geese swim below us. We feed them bits of French fries. She tells me stories of fights with friends and the law. I offer ideas for our next do-it-yourself rehab. I suggest she consider smoking heroin rather than shooting up in her neck. Recognition skitters across her face. Our eyes meet and she blinks. The shadow of our mythic opponent moves between us. I put my arm around her shoulder, pull her toward me and kiss her forehead. She listens. We don’t fight and I’m grateful.
* * *
Traditionally, addiction treatment has focused on the abstinence-only model. Another option for reducing the dangers of IV drug use is called harm reduction therapy—a set of strategies whose most elemental tenant is to minimize the harmful effects of drug use. For Abby, for now, that may mean smoking heroin rather than shooting up.
Dr. Andrew Tatarsky is a pioneer in the development of Integrative Harm Reduction Psychotherapy—a therapeutic model based on the sound public health principles of harm reduction. Addicts aren’t stigmatized, abstinence isn’t required, and there are no deadlines for sobriety. It’s a therapy model that “meets the addict where they are.”
Evidence on drug treatment suggests a supportive, gradual approach is more effective than a harsh, confrontational one. The Community Reinforcement Approach (CRA) is a cost-effective outpatient one-on-one therapeutic model that strives to improve the addict’s social skills, enhance relationships, increase positive social interactions, eliminate substance use problems and help develop tools for navigating stressors. Community Reinforcement and Family Training (CRAFT) uses the core ideas of CRA and also teaches family and friends effective strategies for helping their loved one to change. CRAFT works to affect the loved one’s behavior by changing the way the family interacts while avoiding detachment, confrontation or humiliation.
* * *
In early spring, I spent a cold rainy day at the planetarium with my youngest son. Clouds hung low on the foothills; the streets were empty. I sat on a bench reading while the kids played with artificial clouds, learned about tornadoes and discovered the phases of the moon. A black haired little girl in a red dress with crinolines and black patent leather shoes toddled toward me, picked up the book I’d been reading, put it in her mouth and drooled down the spine.
I see my daughter at the same age. She’s standing on the top bar of an old one-speed cruiser we named ‘Clouse’ looking into the camera, squinting into the bright sun, leaning into the curve of her dad’s arm, fearless and trusting, pigtails suspended in air.
“She loves books,” the little girl’s dad says, taking it out of her mouth and holding it toward me. “Oh! So does my daughter,” I want to say but can’t. The tears are sudden, earnest and unexpected. I smile and take the book from his hand. I fumble for equilibrium. I call this the Ouroboros wheel of grief—a feedback loop through relapse and recovery. A hollow ache defines her absence in my life.
* * *
In his book Amazing Grief: A Healing Guide for Parents of Young Addicts, Reverend Charles F. Harper writes, “The grief of a parent of an addict can be far more difficult to cope with than the grief of a parent whose child has died. Psychologically, no matter how tragic the loss, the human spirit can adjust to certainty far more readily than it can adjust to uncertainty.”
Pauline Boss elaborates, “With death, there is official certification of loss, and mourning rituals allow one to say good-bye. With ambiguous loss, none of these markers exist. The persisting ambiguity blocks cognition, coping, meaning-making and freezes the grief process.”
I moved deep into my silence. My husband and I separated. Sound and music became irritants. The radio caused an electrical storm in my brain that interrupted coherent thought. I left everyone and everything. With our youngest son I moved to a cabin, surrounded by national forest, with only a wood stove for heat.
I didn’t know I was grieving until I found the most beautiful book, The Grieving Garden: Living with the Death of a Child. I pulled up a seat next to parents in the book, listened to their stories, buried my face in my hands and wept cathartic elephant tears for all I’d lost. In the silence, I began to heal.
Ayahuasca came into my life. She holds my hand and we dive into the darkness together, each time rising to the surface with a new gem we lift toward the light. It is not easy work, and I am always terrified, but I am learning to trust. When I become afraid, I chant, “Be gentle with me, Momma, I trust you, thank you for healing my heart,” and with great conviction she says, “You be gentle with you!”
Early in my life with addiction, the goal was to get Abby clean. If she could just get sober, my life would return to normal; I’d pick up where I left off. But that is no longer the goal. My family has been reshaped by addiction—relationships unraveled; a marriage frayed and mended, a tangle of thread that was once a familiar tapestry. I’ve moved closer to town, but not too close. For Mother’s Day, I asked my husband for the new Natalie Merchant CD, my first music in 10 years.
We are made of the same matrix, my daughter and I, and when I miss her, I close my eyes and send filaments of myself weaving through the cosmos, searching for her, and I whisper, “I love you, baby girl. Please come home.” This is my mantra, my prayer. Every impulse I have is to keep her safe. This is the plight of parenthood—a biological urge for our children to live, to thrive and experience success and joy. Active addiction is a wicked force, lawless and hungry. It will devour everything. When Abby calls and says she’s ready to try—we will try again. u
Paige lives on the Weber River where a pair of Great Horned owls, in early January, moved into an abandoned nest at the top of a tall pine tree. She is hoping to see the fledglings, just once, before they leave the nest for good. If you have any questions about ibogaine or just want to talk you can contact her at email@example.com.
Editor’s note: In March 2011, CATALYST published Paige Guion’s story of her daughter’s fight against heroin addiction. She and her daughter had found some hope for recovery with ibogaine, an extract from an African shrub used clandestinely as a medicine for overcoming addiction cravings. Ibogaine is listed by the USDA as a Schedule I substance (illegal and dangerous). It is unregulated in many other countries, including Canada.
Tabernanthe Iboga: The Iboga shrub is native to Western Central Africa. The root bark contains ibogaine, a powerful hallucinogen, which is used as a sacrament in the practice of Bwiti in Cameroon and Gabon. There is a plethora of empirical data that suggests ibogaine can physically detox people addicted to opiates, stave off symptoms of withdrawal and circumvent the need for opiate replacement medications such as methadone and suboxone.
PubMed has 352 scientific articles pertaining to ibogaine: ncbi.nel.gov/pubmed/
Ayahuasca: A psychedelic brew of various plant infusions. Employed for divinatory and healing purposes by the native peoples of Amazonian Peru.
Reverend Charles F. Harper.
Amazing Grief: A Healing Guide for Parents of Young Addicts
Suzanne Redfern & Susan K. Gilbert.
The Grieving Garden: Living with the Death of a Child
Anne M. Fletcher. Inside Rehab:
The Surprising Truth About Addiction Treatment—and How to Get Help That Works
Pauline Boss. Ambiguous Grief: Learning to Live with Unresolved Grief
Ricky Boggs. Alcohol and Addiction—How it Affects the Brain
Integrative Harm Reduction.
The Community Reinforcement Approach and Family Training (CRAFT). Community Reinforcement Approach (CRA). www.robertjmeyersphd.com
Harm Reduction Project.
Phoenix Multisport, a supportive physically active community.
The Fix. Addiction and recovery, straight up. thefix.com
The Ibogaine Dossier. Information galore.
Alternative treatment centers
Peru—Center for the Rehabilitation of Drug addicts and for Research on Traditional Medicines. takiwasi.com
Costa Rica & Thailand—Eric Taub, Ibogaine Treatment Center. ibeginagain.org
Mexico (Rosarito Beach Baja)—Dr. Martin Polanco, Ibogaine Treatment Center. crossroadsibogaine.com
Mexico (Puerto Vallerto)—Claire Wilkins, Ibogaine treatment center.
Mexico (Merida), Belize (San Pedro)—Mark Winkle. firstname.lastname@example.org