Just Say Go

[January 31st, 2007] Rocky Caravelli worked as a flooring contractor for 23 years installing hardwoods, linoleum and carpeting in Portland and the San Francisco Bay Area. But three years ago, he became something else: an evangelist. Not for God, but for ibogaine, an illegal substance that is finding popularity in Portland.

Ibogaine is used to treat drug addiction, and Caravelli has plenty of experience with that. For 15 years, he abused methamphetamines, heroin and even methadone.

After visiting four different rehab clinics and spending time in and out of Narcotics Anonymous, Caravelli went to Mexico to learn about ibogaine, an alkaloid from the root bark of the iboga plant, which grows in West Central Africa. In 2003, Caravelli visited a Mexican ibogaine clinic, where he could legally buy the drug. He spent $3,000 to take two doses in three days. On the third day, he awoke in Tijuana and realized his teeth had stopped hurting and that all he wanted to do was lie naked in the sun.

"It was like I was returned to my natural state overnight," says Caravelli, 42.

Since then, Caravelli says, he's been clean. He returned to Portland, sought out other drug addicts and preached to them the gospel of ibogaine.

And he created a business.

On Jan. 1, he opened up an ibogaine clinic—near Puerto Vallarta, Mexico—called the Awakening in the Dream House. Caravelli has a staff of six people and an on-site Mexican physician. "It's not a casual treatment; it's serious work," Caravelli says. "We're all doing this because this is what we love to do."

He has an office in Southeast Portland and a P.O. box at the Hawthorne post office, all of which he says is legal.

"We are involved with a lot of things that are happening [in Portland]—referrals, consultations," says Caravelli. "We needed to have a facility [in Mexico] where people could stay for a few days. It's emotionally hitting the core of your addiction, and to let it sink in takes at least a week."

Caravelli says his hunch about the demand for a legal, above-ground treatment center was right. The Awakening in the Dream House has already had close to a dozen patients, and Caravelli anticipates they will see 12 to 15 people coming in every month.

So what is ibogaine, exactly? Practitioners of the Bwiti religion (which incorporates animism and ancestor worship, as well as aspects of Christianity) have used ibogaine for thousands of years. Ibogaine only reached the U.S. in the early 1960s, when 19-year-old Howard Lotsof discovered its use as an opiate-addiction interrupter as well as a powerful hallucinogen. Lotsof dropped his own heroin habit and passed the drug on to others who wanted to do the same; eventually he patented ibogaine's use in the treatment of chemical dependency.

For the first few hours after ingestion, ibogaine acts as an oneiric drug, creating a kind of waking dream. It also severely limits motor function, and in many cases induces vomiting. In other words, there's a reason it never caught on as a party drug. Once this initial phase is over, the ibogaine breaks down into its metabolite form, known as noribogaine, which stays in the body for up to two months and relieves most of the withdrawal symptoms usually associated with a heroin detox.

There's just one little catch: Ibogaine is a Schedule 1 drug and has been since 1966. This means the U.S. government sees it as a substance with no medical use and a high potential for abuse.

So, to use ibogaine, people must travel to clinics in Mexico, Canada, Europe or South Africa. If they can't afford to travel, they can seek it out in the underground ibogaine networks that are active in many U.S. cities, including Portland.

WW spoke to a Portland herbalist who says he has illegally administered the drug to about 30 people in their homes. Some of those people are recovering from methadone, heroin or methamphetamine addictions, while others are seeking help with psychological trauma. He gets his ibogaine shipped from Europe, where the substance falls into a legal gray area in many countries. He is currently the only underground ibogaine provider in Portland, replacing someone else who had been doing it for years. The herbalist estimates that hundreds of people have been treated in Portland.

He says he treats an average of one person every two weeks for a fee ranging from $1,600 to $2,500, depending on the dosage (compared with clinics like Awakening in the Dream, which charges between $2,500 and $3,300).

Dr. Nathen Gabriel, director of operations at the Ibogaine Association in Tijuana, where Caravelli had his treatment, says much of the underground treatment is flawed. He says underground therapists too often treat ibogaine as an instant cure when it requires aftercare to change an addict's behavior.

"You don't just give someone the drug and walk away," says Gabriel. "We're aiming for the ideal, and most underground therapists are not."

Caravelli has a different view. "Whether they're above-ground clinics or any other treatment options available, I'm supportive for ibogaine treatment in any kind of safe setting," he says.

Dr. James Thayer, medical director at Portland's Hooper Detoxification Center, is not yet convinced. "It's a little off the beaten track, but there's so much about addiction that we don't understand," he says. "Until somebody...proves that it's really effective, I don't think it's going to reach very many people, and I don't think it should reach too many people until we know more about it."

Dr. Deborah Mash, professor of neurology at the University of Miami School of Medicine, is the only person in the U.S. who has conducted a clinical study of the effects of ibogaine. From 1996 to 2004, Mash operated a clinic on the small Caribbean island nation of St. Kitts and treated more than 400 people with ibogaine. She recently presented her findings about ibogaine's effectiveness as an addiction interrupter to the U.S. Food and Drug Administration, and she's hoping to develop a pharmaceutical form of noribogaine, which does not act as a hallucinogenic.

She believes the feds are wrong to classify ibogaine as a Schedule 1 drug. "Ibogaine has, in my estimation, no abuse liability," she says. She explains that ibogaine was classified around the same time 40 years ago as other psychedelic substances such as LSD and psilocybin (magic mushrooms), and has never been re-examined with strong, scientific data.

Mash says ibogaine is basically safe, but can cause serious complications when mixed with other drugs or taken by someone with a preexisting heart or liver condition. She couldn't offer any specifics about how many deaths have resulted from ibogaine treatments.

Dr. Mash has harsh words for the underground, and she's skeptical of offshore ibogaine clinics.

"Ibogaine is a complex drug with a complex pharmacology," she says. "There's never been a report of an ibogaine death when people were medically screened, but in unskilled hands, complications have been reported—some lethal."

Offshore clinics and the ibogaine underground may someday be rendered obsolete, however.

"It's an uphill battle as for any pharmaceutical development, but I'm optimistic," says Dr. Mash. "It's not a magic bullet. There is none, but for some it's a powerful addiction interrupter and a powerful first step on the road to addiction recovery. If it didn't work, there would be no demand."