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The Ibogaine Dossier

The Herald U.K.

March 15, 2004.

Alive and Kicking

Roz Paterson

He is genuinely afraid. It has taken two years and all the money he had to get here – and now, suddenly, he is afraid. Last night he got a taste of what lay ahead. Half an hour after taking the capsule, the light twitched and the sound began to throb. He saw inklings of a long-distant childhood. Something happened with his hand; it rose up in front of his face like some kind of primordial totem. He felt physically numb yet weltering in emotion. There was a sense of deep truths, of important things about to be said. And that was all fuelled by nothing more than the test dosage.

David Graham Scott has been a heroin and methadone addict for much of his adult life. Now 41, he feels frustrated by his addiction. His last relationship ended years ago and he lives alone, isolated, short of money, plagued by depression, a promising career as a film-maker still on the starting blocks. He would do anything, pay anything, to be rid of the chemical dependency that blights every day of his life.

This Friday morning, his hand shakes as he applies the last touches of white face-paint to his already ashen skin. When he comes out the other side, he hopes some part of him will be gone. Right now he wonders if all of him will be gone. Recently the press has been going to town with articles claiming Scott is risking his life; that, in filming this experience, he could in fact be filming his own death. Those warnings now clamour in his ears.

His mother phoned. She sounded anxious. Outside, the distant, tidal sounds of London traffic, the soft shale of rain. The streets he walked along to get to this small flat recede abruptly like a speeding train.

Too late. The journey has begun.

David Scott's films have grown out of personal obsessions with death, drug addiction and marginalisation. They are impassioned, remarkable stories, intensely felt. This time, however, his focus is himself. He has set up the camera to film what he hopes will be one of the most remarkable events of his life: his 36-hour transition from addict to non-addict.

The substance that will take him there is ibogaine, a derivative of the West African shrub Tabernanthe iboga, used for centuries in the initiation rites of the Bwiti tribes of Gabon. Chewing the iboga root prompts visions, more dream-like than hallucinogenic, in which the initiate is said by the tribe to develop a profound understanding of their place in the world, in history and in relation to God. This curious drug was appropriated by early colonialists and touted in the West as a cure for fatigue and sleeping sickness. It clearly wasn't a big hit – references to ibogaine barely spot the annals of the 19th century – and it only really emerged in the West during the 1960s, when drug activists in New York's Lower East Side began to explore its potential as a cure for opiate addiction. This movement gathered pace in the 1980, when the Reagan government took a zero- tolerance stance on drugs while crack cocaine and heroin swept unabated through predominantly black and working-class communities, devastating thousands of lives.

Yet few in the pharmaceutical world were interested in ibogaine. It was viewed as either another take on LSD or as some hippy placebo. By the mid-eighties, ibogaine had been classified as a schedule one drug in the US – one with "a high risk of abuse" and "no currently accepted medical use" – effectively ruling out above-board experimentation.

In Scotland, where ibogaine was and still is virtually unknown, GPs had begun scrabbling for solutions to the rising epidemic of illegal drug use and its attendant risks, including HIV, hepatitis C and lethal overdose. The launch of a methadone programme in Edinburgh in 1988 was the first comprehensive attempt to stem this tide.

Dr Laurence Gruer, now a public health consultant for the NHS in Scotland, was instrumental in establishing a methadone programme in the the west of Scotland in 1994. Then an addictions specialist with Greater Glasgow Health Board, he says the project was "one of the very few treatments shown to consistently work, in that it enabled drug addicts to stop injecting". Because it removed addicts from the loop of illegal drug use, it also engendered enough stability to help them hold down jobs and address the problems that prompted their addiction in the first place or arose as a result of it. Its success was always going to be limited, though, he says. "They remained addicted to opiates, so it's not a cure. It's just an intermediate stage, to enable them to move on. Our experience in Scotland at least suggests that, in some cases, this can take a very long time."

There are an estimated 56,000 opiate addicts in Scotland. Although there are no official figures for the number of people on methadone, Neil McKeganey, professor of drug-misuse research at the University of Glasgow, says the total could be as high as a quarter of that number. Like many methadone users, David Scott felt it had taken up enough of his time. The question was: could ibogaine be his way out? Since the sixties, some campaigners have been hailing it as the answer, a one-off treatment that pulls the addiction out by the root, leaving the patient not only chemically clean but liberated from any psychological hankering for mood-altering substances.

Scott's addictions began in the 1980s, when he encountered the heroin and methadone subculture as an intriguing, alternative universe to the one he found untenable. "I was quite happy till I was 11," he says, carefully explaining how a boy from a relatively secure background in Caithness had become immersed in a world of drugs. "I'd been completely stable as a child and felt loved and cared for. My mum and dad weren't that close – but it was nothing to do with them that caused this."

"This", he explains, was something that came over him at adolescence, a feeling that "all sense of safety [was] lost. I felt like I'd been thrown into a disordered, aggressive world." Even so, he remained "pretty straight" until he left university in 1983 and returned to Caithness – to a series of what he calls "petty, crappy jobs" and to friends who were experimenting with heroin.

Drug addiction is often mundane. It is rarely triggered by great events and has no great rhyme or reason to it. It is not known why some people can dabble all their lives and avoid addiction while others take a drug twice and become hooked. "It seemed quite a bohemian thing," remembers Scott, "where people were relaxed, not aggressive. By the time I moved to Edinburgh a couple of years later, I wanted to become a junkie, which may sound strange. But I felt I was part of a generation that would never achieve and that had nothing to aspire to. When I took heroin I'd be sick with it, and I'd wonder, why did I go and do it again? But I had an admiration for people who didn't aspire to anything beyond mutilating themselves. Sticking a needle in your arm – it's a very bloody process, you hit an artery and the blood hits the ceiling – is self-mutilation."

Today, however, sitting in the Glasgow flat he shares with his girlfriend – with whom he has recently reunited after a long, heroin-fuelled breach – he seems anything but morbidly obsessed. He appears optimistic, even. His tiny dog, who turns in hysterical, happy little circles all across the floor, seems attuned to the new, post-ibogaine lightness in his mood. "She does that," he says, as she twirls to a temporary full-stop on my foot.

Coupled with Scott's fascination for junkie culture was an intense mental distress, a chronic leadenness. "My life's been marred by depressions and suicidal thoughts," he says, an orange winter sun lighting the lower reaches of the living-room windows. His little dog has snuggled, exhausted, into a cushion. "I've been obsessed with images of violent death. I'd watch violent films, read graphic novels; I had this recurrent feeling of the world as predatory and aggressive. I don't know why I tortured myself. But I do know that I used opiates for self-medication. To deal with the depression."

In time, though, it became difficult to distinguish the cure from the disease. In 1987 he realised he was addicted. "My needle fixation was very strong. It was an obsession," he says. Yet at the same time his desire to progress in life was beginning to grow. One year later, he says, he couldn't handle it any more. "I wanted to aspire to more," he says. "I'd started working on a provincial newspaper in Edinburgh, taking photographs. I wanted to move on."

First, though, he had to make the momentous decision to leave behind the people he knew and cared for, who were less interested in overcoming their addictions. "They were still immersed in the junkie scene," he says. "They didn't want to do anything else. They were stoned all the time. I'd been fascinated before – but even then I'd get a glimpse of reality. A friend trying to find a vein in her foot and someone coming round with their kid and she's still at it, trying to get the needle in."

Through work as a projectionist at an Edinburgh cinema, his interest in film-making began to develop. He watched as many short films by first-time film-makers as he could, and decided he could do the same thing, only better. "They were technically quite good, some of them, but the storylines were poor," he says.

Throughout this period Scott was using methadone. His addiction waxed and waned; his life, tethered to it, stabilised, deteriorated, stabilised, never truly improving. During 1999, Scott made Little Criminals, for which he was nominated for a Bafta new talent award. The film is a voyage round a loosely associated group of drug-users who fund their habit through shoplifting. As with the subsequent Wireburners – a film about the men and women in Glasgow, often homeless or drug-addicted, who rummage through the city's debris looking for scrap metal they can sell on – Scott taps into hidden seams of society, lives normally squeezed from the frame. His junkies live in tiny, neglected rooms. They shoot up, come down, trawl shops and malls, sell, buy and shoot up again. They are locked into a behavioural cycle, menaced on the one hand by predatory dealers and on the other by those glimpses, now and then, of how horrible it all is.

While making Little Criminals, Scott succumbed to temptation and started using heroin again. "It was naive of me to think I wouldn't," he says. Then he heard about ibogaine. His brother Ian, a successful artist, returned from a visit to New York with a book about American experiments with the drug. Using this as his starting point, Scott soon found out about Dr Deborah Mash, a professor of neurology at the University of Miami School of Medicine. Hers is the only laboratory to have conducted official ibogaine tests on human subjects, making her the foremost scientific authority on ibogaine in the world. "We know Ibogaine works," she has said, "that it's very effective for opiates in terms of detoxification and maintaining sobriety thereafter. It's like a miracle." Her convictions were startling; her prices even more so. Because she cannot get a licence to treat in the US, she offers the programme only in a clinic in St Kitts in the Caribbean – at a cost of $10,000 a time.

Closer to home in the UK, where ibogaine is an unlicensed drug – not illegal but not available through established medical channels either – Scott got in touch with a campaign group called the Ibogaine Project, working out of London. As far as he knows, no one in Scotland is offering ibogaine treatment. He was directed to a man called Edward Conn, who has never been a drug addict but has tried ibogaine personally and has been administering treatments out of his London flat for several years now. Conn says he was attracted to Ibogaine because it seemed to inspire a "spiritual awakening" in people; as such, it chimed with his aspirations in life, which are geared towards self-awareness and understanding and very manifestly away from the fakery of opiates.

It took Scott a long time to persuade Conn that he was a suitable candidate. Conn takes a professional pride in what he does. He wants his patients living and breathing at the end of the treatment, and insists they have proper, clinical tests done on their heart and liver. He will not begin the process until he is sure they are physically – and psychologically – up to it. "I don't recommend anyone taking ibogaine by themselves," he says in his soft, lilting voice. "Alone, you can get sucked up into your own internal world – without any idea of what it is."

There is also the small matter of mortality. Sceptical reports in the press have linked ibogaine with several deaths – although, says Dr Kenneth Alper, an associate professor of neurology and psychiatry at the New York University School of Medicine, there have only been three incidents in the US or Europe of a death having occurred straight after the use of ibogaine. In none of these cases, he adds, did the coroner conclude that ibogaine was to blame. Nonetheless, Conn is not given to complacency. "David and I talked about this for two years," he says. "At first he was very, very anxious. I had to be sure he wasn't just doing this as material for a film, that it was actually about him." For his part, Scott recalls that Conn was "very hesitant" about the idea of the treatment being filmed. "But he let himself be persuaded and, in the end, was actually talking directly to camera about what was going on during the treatment."

And so we come to Friday, 22 August 2003. The curious garb, the white robe and death-mask face-paint Scott has chosen to wear is part tribute to the Bwiti, part personal ritual. He is dressed, he says, as a "methadone ghost". By the time the treatment is finished, the make-up will have worn off; as, he hopes, will his addiction to this most life-sapping of drugs. "There's a way that opiates affect the eyes," says Scott, explaining how drugs such as heroin and methadone leave users with feelings of detachment and isolation. "They contract the pupil, so there's less light. Everything appears very white and ghostly. Taking methadone, I have felt like a ghost.

"It doesn't make you euphoric; it's more like a glow. It causes huge fluctuations in your body temperature and mood, gives you headaches, makes you sleepless, has you sitting staring at an object for hours, like you're hypnotised." Yet opiate withdrawal is horrific, he says. "For weeks you can't sleep and your waking dreams are hell. Over the months, other symptoms emerge. The physical pain is terrible but the psychological pain is worse. The world is bleak. When I tried [to withdraw], I felt there was something lacking in my brain, like a miss-ing piece of a jigsaw puzzle." He reverted to methadone again and again, each time noticing how the world lost a little more of its colour.

Safe in Conn's flat, Scott takes four capsules of ibogaine hydrochloride. The dose is carefully measured, in accordance with his body weight. He will take a fifth capsule later, bringing his total dose up to a one and a half grammes. Forty minutes in, he is saying that his fear of dying has gone off the scale. Conn sits beside him and tells him it's all right. The wall opposite, painted a spring yellow, begins to glow, building to a crackling intensity. The low rumble of underground trains becomes a drone, like waves of warplanes in a dark sky. His apprehension rises further. Conn takes his hand.

"Your mindset, who you're with, how you're thinking, is important when you take ibogaine," explains Conn. He says the drug brings people home to themselves – "and they should do that with another human being present. They've been on the periphery for a long time."

When he shuts his eyes, Scott sees yellow grids stretching into the empty darkness of space. Soon he will see himself as a little boy; then as a 17-year-old. A cold, dark landscape drifts through his head. These aren't hallucinations of the LSD, hands-reaching-out-of-the-walls variety, though: he is only dreaming. When he opens his eyes, they are gone.

This dream-stage is the ibogaine at work. In the past, dreams were thought to be the vessels of prophecy, but modern research has prompted a more enlightened view. REM-sleep, the dreaming stage that comes before the slow-wave deep sleep, is essential for forming memories. If you stay up all night cramming for an exam, you won't fail because you're tired but because your brain has leaked its short-term memory like a colander. All day, you are taking in information; your subsequent sleepiness is your brain's signal to shut down for the day, so it can back up the information and reset some of its systems for the following morning.

An ibogaine treatment follows the same principle, just more intensely. Addiction is a habit, an established custom lodged deeply in the memory part of the brain – as deeply as the memory of how to walk. You do it without thinking. Trying to interrupt that process with rational thought is as difficult as forgetting how to walk. Such deep-vein memories are stored in the cerebellum, the lower rear part of the brain, which is stimulated in sleep. In dreams our bodies are always moving, as are our eyes.

During ibogaine treatment this stimulation is more intense – according to ibogaine practitioners it is like ten years of psychotherapy, or six months of REM sleep, collapsed into 36 hours. Ibogaine allows your brain to completely reset the systems so that, when you come through, you are no longer addicted. Indeed, it's as if you never were addicted. Deborah Mash explains that it "blocks the signs of opiate withdrawal" – by which she means the screaming aches and pains and the endless, bleak depression that comes in its wake.

The concentration of ibogaine in the blood reaches a sharp peak two to eight hours after ingestion. It then falls off as the liver metabolises it into a substance called noribogaine, which causes another peak – although a more shallow one – at around the 12-hour mark.

Nothing happens, yet everything happens. A figure that has haunted Scott for years, that of a Chinese torture victim, floats into his mind. It is a photograph from the philosopher Georges Bataille's book The Tears of Eros, a study of sex and death, showing a young man being systematically sliced to pieces. In this vision, the figure is radiant, as if transcending its own horror. This connects with Scott. Taking opiates, he sees now, was a form of self-torture.

As the hours pass, Scott feels himself disintegrating. He can see himself as something composed of molecules. Life is a cycle of death and rebirth. There is a humming sound, a deep, resonant noise; it sounds as ancient as time.

The last hours are quiet. He feels a little sick and the face-paint has vanished. Slowly, as the night recedes, the sounds of Sunday morning London return. Over the next few days he will find his legs buckling beneath him. Over the next few weeks he will be enormously tired and his legs will ache. "But 85 per cent of the rattling's gone," he will note to his camera. So is his addiction to methadone.

Deborah Mash has two suggestions as to why the medical establishment is so reluctant to engage with Ibogaine. "It didn't come out of an established medical centre," she says. "It comes from these ancient tribes in Africa. But some of the best discoveries, like aspirin, come serendipitously. Sometimes you have to look beyond the obvious." Second, she says, there's the money. Since gaining permission from the US Food and Drugs Administration to conduct ibogaine tests on human subjects, Mash says her laboratory has been "unable to attract a single dollar, either from federal or private sources, to further the research." She adds: "The profits aren't there for the big pharmaceutical companies because they don't own the patent. With anti-depressants they can make a billion dollars; with ibogaine, maybe $50m. There's no incentive for them."

The issue is a complex one, and Scott's experience is by no means proof that ibogaine is the right treatment for everyone. He is different from the majority of drug addicts in that he no longer lives in an environment which reinforces his usage. Yet there are voices among the medical fraternity that would like to see more research into such alternative therapies.

"We do know how to get people off heroin and methadone, but we don't know how to keep them off it when they go back to their housing schemes," says Professor Neil McKeganey. "That's when the problem reasserts itself. I'd say addiction is 25 per cent chemical: the other 75 per cent is about lifestyle, about finding a way forward."

Methadone, he says, is only a partial solution. One-third of opiate addicts in Glasgow are believed to be on the methadone programme; when it was begun, ten years ago, it was suggested it should lead to a reduction in drug-related crime of up to 75 per cent. "If these figures were anywhere near accurate," says McKeganey, "we would have seen a massive reduction – a sea change. But we haven't."

He believes society needs to get away from the notion of a one-size-fits-all programme. "We need to be more open about people getting off methadone and heroin; more systematic in trying out small-scale evaluations, rather than being so dependent on methadone. There may be a range of drugs – ibogaine may be one – that are more useful in breaking addiction."

McKeganey says he would like to see more abstinence programmes tailored to those who genuinely want to walk away from drugs, "for those who have that aspiration. The majority want rid of all of them [drugs]. We should build on that very worthy aspiration and do nothing that undermines it." He warns against the complacency that could eventually go hand-in-hand with long-term drugs programmes. "There is an ever-increasing number of people using powerful narcotic drugs for years," he says. "It's not a good situation, not something we should be comfortable with."

Since those intense two days last August, David Scott has been coping well. The 500ml of methadone he keeps on a shelf in his flat sits there still, untouched, and he sleeps at nights. He is working on the film about his experience with ibogaine and on animations to illustrate the extraordinary visions he had. Five months on, he keeps finding old "works" – needles and other apparatus of his addiction – stashed in the wall and under floorboards.

"I'm not there yet," he says. "I've just started what is a long-term process. Ibogaine helped me to see my place in the world, how to act, how to be within relationships. It gives you great insight into what it is to be a human being."

Edward Conn, however, sees a huge change in Scott. "There's a lightness, as if something's been lifted from him," he says. "They talk about there being a monkey on your back, and it's as if he's shaken it off. He's a much easier person to be with." He nods. "I think he's done and dusted. I think he's sorted."

But what of the others? Last year Scotland issued 360,326 methadone prescriptions, at a total cost of 4m. Opiate addiction is a curse, a living nightmare. Perhaps Scott was remarkable in his response to ibogaine, his circumstances particularly conducive; then again, perhaps many others would be as lucky too. At the moment, few doctors seem to want to find out. And addicts are remaining stalled on methadone with little hope of coming off any time soon.

David Scott's film of his ibogaine experience, made in association with Hopscotch Films, will be broadcast on television later this year.

Copyright 2004 Newsquest (Herald & Times) Limited. All Rights Reserved.

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