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Over the past 15 years, Jonathan Dickinson has become one of the world's leading experts on ibogaine. And now that Texas has committed $50 million to developing it as a medicine, suddenly a lot more people are paying attention.

We asked Jonathan what he’s learned straddling the ibogaine clinic and lab, what lesser-known protocols and applications (*ahem* microdosing) he’s excited about, and how he’d bring ibogaine through FDA approval while honoring the medicine’s Bwiti roots.

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What first drew you to psychedelics, and how did ibogaine become a central focus of your work?

I first became interested in psychedelics after I was prescribed antidepressants in high school. I took them for about two years, but I was one of the 20-25% of people who have a very difficult time with withdrawal. The medication gave me what you would call depersonalization or derealization. Both being on SSRIs and coming off of them, I realized that I wasn't in a normal state of consciousness compared to everyone else.

When I first tried mushrooms, it helped me come out of that antidepressant funk and rediscover what it was like to feel alive and feel real, to see how I connected to other people and have passion for learning again. I became so compelled by that experience that I learned everything I could about psychedelics. At the time in Canada, the only connection I could make was through drug policy advocacy groups, so I started working with Canadian Students for Sensible Drug Policy.

People eventually told me that I needed to go learn about iboga, so I did. I came down to Mexico in 2009 because the clinics were already here and operating. I just had a youthful curiosity. I started at a clinic in Tijuana, making smoothies, sweeping floors, and doing small administrative tasks. That evolved into a six-year apprenticeship with leading iboga providers, until I realized I needed to go back to school and formally study psychology.

You have a unique vantage point as someone who’s contributed to research but is also running a clinic that treats 100 patients a month. What differences have you noticed between what shows up in research and what happens in the real world?

One of the things that I became really interested in was how researchers are not very well equipped to describe the ibogaine experience. They just don't have the personal and clinical experience reference points to identify what's going on internally when someone takes ibogaine. They're describing certain elements of what people relay, but passing over other clues.

For example, the "life review" is one of the misnomers we hear a lot in the ibogaine narrative. Many people actually have experiences that have no superficial relevance to their personal histories. However, by looking at what patients do experience, ibogaine can help us to better understand the mind-body interface.  We have to test our assumptions by listening closely to raw experiential data.

On the flip side, the research can tell us things that we can't immediately see or experience. For example, it's really hard for practitioners to do follow-up with every patient when we're treating a hundred people a month. I don't know what's happening to everybody a year later. When we get research that tracks people long-term, it's very informative for us and helps us to improve the care we offer.

It's been valuable to inform laboratory study of ibogaine with the subjective data we collect through direct experience. I've found that I can help to focus the direction of preclinical studies, which creates a feedback loop that helps us improve Ambio's treatment protocols.

In 2015, when we wrote clinical guidelines, our goal was to reduce mortality and morbidity because there are risks with iboga. It has effects on the heart, and there are drug interactions. If you look at Ambio's medical protocols and our safety patent filings, you might think ibogaine just needs to be administered in an ICU. But that's only one layer of the environment we create. In practice, we have the functionality of a cardiac ICU, but you wouldn't think you're in one. Our clinics run like a hospital and feel like a spa, incorporating everything else we know about how to navigate the experience.

Tell us about IBEX011 and what you're trying to accomplish with Terragnosis. What makes your method of ibogaine production different?

Terragnosis received the first and only export license from Gabon to be able to bring iboga out of the country and use it in a research setting. Prior to that, there have been a lot of issues historically. In the late ’80s, the president of Gabon provided 40 kilos of iboga that ended up being the raw material used for tons of research throughout the ’90s. Many people filed patents based on that research, and there's been an effort since Gabon became aware of that to try to control exploitation and ensure benefit sharing.

The way they've chosen to do that is through the Nagoya Protocol, which is designed in such a way that traditional practitioners can still access iboga for their ceremonies and Gabon can enjoy the benefits of everything going on outside the country. Sometimes people think of it like a fair-trade thing or a royalty, but the reality is it's more like Gabon's desire for co-development of the industry. It’s a partnership that unfolds over time.

Terragnosis is working with Blessings of the Forest and communities in Gabon to build a supply chain that takes raw material into a chemical product. In the near term, the goal is to bring this Nagoya-compliant product through FDA clinical trials. Ideally, we can develop it as a botanical drug, so that we don’t lose all the other valuable alkaloids iboga contains besides ibogaine. We notice a difference clinically when we're working with the plant versus the single alkaloid.

I know that Texas is interested in ensuring some sort of reciprocity with Gabon. Terragnosis has modeled what reciprocity looks like through Gabon's chosen mechanism. For those reasons, I think we're the best candidate for the public-private partnership Texas has outlined in its $50 million ibogaine development plan, especially when we tie in Ambio's robust clinical experience.

Most people associate ibogaine with opioid detox and addiction treatment. What's your take on microdosing ibogaine or other applications that aren't getting as much attention?

Ibogaine has been disseminating itself through culture by way of stories, and studies only make up the backdrop of that narrative. What's happened only recently is that veterans started telling different stories about ibogaine and what it can do, and those stories are gradually opening up further. We are seeing a lot more interest from people with different conditions like Parkinson's and MS.

When we treat people, we can adjust our approach based on our primary desired outcome. If we're treating opioid detox, the dosing has to be higher to treat the acute withdrawal. If we're looking for a psychological gestalt, we take a slightly different approach to how we think about dosing. But for these neurodegenerative conditions, we're primarily trying to achieve a cellular regenerative effect. We’ve found in these cases that people get more benefit from lower dosing.

The model we've settled on is a lower loading dose followed by prolonged microdosing. That's where we see the most long-term benefit for people. The microdosing can be 1% or 2% of the larger dose, and for most people it's typically sub-perceptual. With microdosing, we're looking for a buildup of ibogaine and its metabolite noribogaine. It's just a daily dose to maintain exposure.

How do you balance honoring the Bwiti tradition and developing ibogaine as a medical treatment? Is there any tension there?

When I've talked to people in Gabon about what we're doing, the general feeling is that Westerners simply don't know that much about how to navigate the ibogaine experience, and I think they're right. They are very advanced in this regard, and many of those teachings are very practical when we're looking to achieve therapeutic outcomes.

There are certain traditional elements that we incorporate at Ambio because I've come to understand their universal value. For example, we work with mirrors. Mirrors powerfully present us with something that amplifies the effect that's unique to ibogaine, where we become observers of something that’s presented to us and enter into dialogue with it.

Bwitists view the iboga initiation as just the beginning of a journey of learning. It's not so much a fixed system of knowledge, but a set of tools for how to move forward in our life and how to understand what we encounter. I find that I can follow my curiosity, even with Western methods, while maintaining a relationship with the tradition, because I continue to follow a path of self-directed discovery. I don't see tradition and innovation as contradictory as long as I am listening and maintaining that relationship in a good way.

Want more from Jonathan?

Explore the Foundational, Neuroregenerative, and Detoxification programs at Ambio.

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DISCLAIMER: This newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice. The use, possession, and distribution of psychedelic drugs are illegal in most countries and may result in criminal prosecution.