By Juliana Mulligan

I have put together these guidelines, utilizing input from others in the field, to support people in finding the clinic that’s right for their needs. Safety and experience is of the utmost importance with ibogaine treatment as there are serious medical risks involved. Since there is no way to enforce safety standards in the clinics and providers working worldwide, which are mostly functioning outside of any regulatory or legal body, many of these facilities are not offering treatment safely. Use this guide carefully and thoroughly to ensure you end up in a safe and effective facility.

Before proceeding to the questions I also want to note, that when planning for an ibogaine treatment it's important to understand that what you do before and after is just as important as the actual ibogaine experience. I recommend planning to be in a place afterwards where you will be surrounded by safe and supportive people, which sometimes may mean planning for some big changes. It’s also crucial to begin work with a therapist or counselor before and after treatment, regardless of why you are seeking ibogaine treatment. This is how you can make the best use of the insights and realizations gained from this medicine. Focusing on a healthy diet, regular exercise, and activities that bring you joy are integral elements in transforming your life as well. If you have a therapist, or even a really supportive friend or relative available, sit down with them and come up with a pre and post treatment plan together as a first step.

1.) When calling a clinic or provider, ask questions to get a sense for who these people are, why they are doing this, and for how long. The main provider on the staff, or the head doctor, should have at least three years of experience.

Question: Who did you train with and how long have you been facilitating treatments post-training?

2.) What type of treatments do they do? If you are seeking a detox treatment, they should have most of their experience in this type of treatment. Their dosing protocol should be flexible and based on your specific health conditions and your response to a test dose as viewed on an EKG.

Question: How do you approach dosing and what kind of flexibility is built into your treatment schedule if I am sensitive to ibogaine or if other issues arise?

3.) What type of treatments have they done? If you are seeking a detox treatment, they should have most of their experience in this type. Do they have a set dosing protocol and what is it?

4.) What medical tests do they ask for? They must ask for at least an EKG and liver panel blood work.

5.) Are they asking detailed questions about your full medical history, prescribed medications, and drugs that you use?

Cardiac history is of the utmost importance, and if they aren’t asking about this, or for an EKG, that is a definite red flag. They must also ask about seizure history, liver functioning, head injuries, and diabetes.

If the provider suggests doing a treatment directly after regular use of psychiatric medications (such as SSRI's) or amphetamines, this would be a red flag. Many medications are contraindicated with ibogaine and require a few weeks of being out of your system.

It's important that the provider on the phone is doing a full screening to determine if the individual is a good candidate for treatment. Treatment bookings shouldn't be rushed since substantial amounts of time and preparation should go into the entire process in order for it to be safe.

6.)What medical staff do they have? They must have doctor who they consult with and who is present for the treatment. There should also be an RN present to assist.

7.) If staff members previously had a substance use issue and used Ibogaine successfully to deal with this themselves, how long has it been since their treatment? A one year minimum for peripheral staff and for the main provider(s) 3 years+ since their own treatment. (Keep in mind that these are just numbers I have come up with as rough guidelines. You should ultimately trust your intuition through the interactions that you have with the staff ahead of time to assess their stability.)

8.) What is the experience of each staff member and who are they? Do they have any references (past clients that could be reached out to)?

9.) What is their treatment preparation protocol? How will they prepare you for treatment? Important aspects to listen for are proper hydration, electrolyte supplementation, monitoring of any medications or supplements, monitoring for regular bowel movements, and monitoring of diet.

10.) What do they cleanse your bowels with before treatment? It should be something gentle like psyllium or an herbal based supplement. It's important to have normally functioning bowels prior to treatment. Fasts, enemas, and Kambo in the three days prior to Ibogaine can be dangerous because of the electrolyte depletion that occurs. If any of these are a part of the protocol of the clinic I would say this is a red flag. Eating healthy normal meals and staying hydrated is crucial to prepare your body.

10.) What medical equipment is on site? There should be an ECG machine, an AED, and benzodiazepines in case of seizure. An I.V. line and oxygen should either be on site or readily available nearby.

11.) What is their emergency protocol? The closest hospital must be under a 15 minute drive away. The clinic should have a relationship with the hospital so that they are prepared for the specific circumstances of an Ibogaine related emergency.

12.) How long do they keep people for observation and stabilization before the actual treatment? (This mainly pertains to those who are seeking Ibogaine for alcohol or drug detox purposes.) They should stabilize you for four days minimum before Ibogaine. (This also varies depending on your tolerance and what drugs you are coming off of. Some people require more stabilization time depending upon their health and drug usage.)

13.) How long do they keep you afterwards? What is the post-treatment integration time and what support is offered? The minimum time for being kept afterwards is four days post-Ibogaine, but this should be flexible (and extendable) depending on the process of each individual. A licensed counselor or therapist should be available post-treatment on all days.

14.) Do they offer the option of IV fluids for hydration? (not essential but good to have as an option in case of excessive vomiting).

15.) Ibogaine dosing: If the clinic does ‘intuition’ dosing or doses everyone the same milligram per kilo this is concerning. Dosing should be based upon the EKG, blood pressure, and other health signs. The status of the vital signs after the first, and subsequent doses, should guide the provider as to how much more medicine should be given.

16.) If they claim they can detox you directly from alcohol or benzodiazepines with Ibogaine this is a major red flag and I would seriously question their Ibogaine knowledge. For alcohol, the person must do a medically supervised detox prior to Ibogaine at least one week ahead of time. Detoxing off of benzos requires a long slow taper under medical guidance. Because this can be a lengthy process, many take benzos during Ibogaine treatment and taper off of them later after their Ibogaine treatment. It is not uncommon for people on benzodiazepines to continue taking them throughout their Ibogaine treatment.

17.) If the clinic says they can treat you directly from long term use of Suboxone or methadone in less than 4 weeks after last taking those medications, then be prepared for serious withdrawal symptoms post-Ibogaine. (The exception to this rule is a low dosing clinic that provides longer multi-week treatments. Low dosing protocols can be effective coming directly from Suboxone and Methadone.) Ideally one would be off of Suboxone or Methadone for at least four or more weeks before Ibogaine depending on the length of time on those medications and the dose. (Many people switch to a short acting opioids for those weeks.)

18.) How often will your vital signs (pulse, blood pressure, and oxygen) be checked during treatment? They should be taken every 30 mins. How long are clients monitored after ingesting Ibogaine? They should be monitored a full 24 hours following ingestion of the first Ibogaine dose.

19.) What do they suggest for post treatment continuing care planning? A clinic that has a variety of suggestions or program recommendations is ideal.

20.) If a potential clinic is pushy or pressures you to book or pick a date, this is a serious red flag. Treatment should always be centered around the prospective clients needs and motivations.

Most importantly use your intuition and get to know the people well through a series of phone calls and emails.