Cocaine dependence · Mexico City
Ibogaine Treatment For Cocaine Addiction
There is no withdrawal to interrupt. That changes what the medicine is for, and what we check first.
Ibogaine’s reputation was built on opioids, where it stops withdrawal in hours. Cocaine has no withdrawal of that kind. What the published data measures instead is craving and the crash that follows a binge. And what decides whether you can be treated at all is your heart, because cocaine and ibogaine act on the same channel in it.
The short answer
What is ibogaine treatment for cocaine addiction?
Ibogaine treatment for cocaine addiction is 1 physician-supervised dose of ibogaine, given on day 3 of a 7-day inpatient stay under continuous cardiac monitoring, to reduce cocaine craving and the low mood that follows stopping. It does not treat withdrawal, because cocaine does not produce the kind of withdrawal ibogaine is known for interrupting.
That distinction matters more than anything else on this page. For opioids, the case for ibogaine rests on withdrawal scores falling within hours. For cocaine, the published data measures something quieter: craving scores, depression scores, and how long people stayed away from the drug afterward. Those results are real. They are also smaller and less certain than the opioid numbers, and we will not dress them up.
It is not a cure, it is not approved by the FDA, and it is not given to anyone whose heart fails the screen. Cocaine cases fail that screen more often than opioid cases do, for reasons the next 2 sections explain. If you read nothing else, read those.
Different drug, different job
What ibogaine does for cocaine, and what it does not.
Most of what you have read about ibogaine was written about opioids. Row by row, this is where cocaine matches that picture and where it does not. The dots are the plain version.
Supported in the published seriesPartly supported, small samplesNot what the drug does
The plain summary: for opioids, ibogaine changes the first 3 days. For cocaine, it changes the 3 months after, if it changes anything, and that is what the 90 days of follow-up exist to measure.
Why cocaine cases fail the screen more often
Cocaine and ibogaine act on the same part of the heart.
Ibogaine’s known risk is to the heart’s rhythm. Cocaine’s known damage is to the heart’s rhythm and its muscle. Put them on the same person in the wrong order and you have the 2 findings that recur in the reviews of ibogaine deaths: a heart that was already compromised, and another drug in the system.
What cocaine has already done
- The same potassium channelCocaine blocks the hERG channel that controls how heart cells reset between beats. Habitual users show a longer QT interval before any ibogaine is involved.
- Sodium channels tooIt also blocks sodium channels, which slows conduction and widens the QRS complex. On an EKG that can mimic a Brugada pattern, and we need to know whether it is cocaine or something structural.
- The hour after useHeart-attack risk is highest in the first hour after cocaine and falls quickly after that (Mittleman and colleagues, 1999). Heart attacks are documented in users in their 20s with clean coronary arteries.
- The years of useChronic use is linked to cardiomyopathy, a weakened heart muscle. A resting EKG can miss it. An echocardiogram does not, which is why the cardiologist asks for one when the history warrants it.
What ibogaine will do
- The same potassium channelIbogaine blocks hERG as well, and prolongs the QT interval for as long as its active metabolite is in the body. That is days, not hours.
- Rate and pressureIt slows the heart and can lower blood pressure through the session. On a heart already stressed by stimulant use, that is a bigger swing than on a heart that is not.
- ElectrolytesLow potassium and magnesium make the QT effect worse. Both are common after a binge with days of poor eating, which is why they are corrected before the dose, not after.
- The metabolite tailNoribogaine keeps the effect going well after the visible experience ends. Monitoring runs overnight and into day 4 for that reason, and it is not shortened for anyone.
Which is why
Two hERG blockers on one heart is a sequencing problem. The only safe order is: cocaine fully out, confirmed by a urine screen on arrival; the EKG read by a cardiologist against written thresholds; the echo done where it is asked for; potassium and magnesium in range. Then the dose. Never the other way round, and never on the same day as a positive screen.
In the forensic review of 19 ibogaine-associated deaths from 1990 to 2008, pre-existing heart disease and other drugs in the system explained or contributed to 12 of the 14 cases with usable post-mortem data (Alper and colleagues, 2012). In the 2026 update covering 48 deaths, cocaine was in the toxicology of 6. Every one of those is a reason the screen is slower for you than for someone whose heart has not been doing this.
Crack cocaine
Does ibogaine treatment work for crack cocaine?
Yes, on the same terms as powder cocaine, because crack is cocaine. It is the same molecule in its freebase form, smoked rather than snorted, which changes how fast it hits, how short it lasts and what the use pattern looks like. It does not change what ibogaine does or what the heart screen looks for. The one human series that included crack users, 75 patients in Brazil, reported a median of 5.5 months of abstinence after a single session and 8.4 months after repeat sessions, with 61% abstinent when interviewed. It was retrospective and self-reported, so it is a signal, not proof.
Same drug, faster route
Seconds to hit, minutes to fade
Smoked crack reaches the brain in seconds and wears off in minutes, which is why use runs in binges of repeated doses over hours or days. The binge is what produces the crash, and the crash is what the ibogaine data measures a change in.
What we ask about
The last binge, in detail
How long it ran, how many days ago it ended, whether you get chest pain during or after smoking, and what else was in the pipe or the room. Nobody is judged for the answers. They set the timing and the tests.
Checked for crack, not always for powder
Lungs, pressure, and the muscle
A lung and airway review, because smoked cocaine irritates both. Blood pressure at rest and on movement, because severe hypertension is where aortic and coronary tears have been reported in crack users. And an echocardiogram where the cardiologist asks, because years of binge use is where cardiomyopathy shows up.
What does not change
The dose, the days, the price, the honesty
1 dose on day 3, 7 days inpatient, $12,500, 90 days of calls. Same for crack as for powder. And nothing published says ibogaine works better or worse for crack than for powder cocaine, because nobody has run that comparison, so we do not claim it either way.
What you were using
The supply is purer than it was, and the deaths are not from contamination.
3 numbers from the 2 most recent US government reports, and what each one changes about your screening call. None of them is a reason to refuse you. All of them are reasons to answer the questions plainly.
84%
Average purity, seized cocaine, 2024
Purer than in 2020, so each line is a bigger dose than it used to be.
Average purity of powder and rock cocaine analysed at DEA laboratories reached 84% in 2024, continuing a rise since 2020. The same person taking “the same amount” as 4 years ago is taking more drug, and putting more load on the heart per use. It is why “I only use a little” does not reassure the screen, and why we ask about amount and frequency in plain numbers.
1%
Seized cocaine exhibits containing fentanyl
Fentanyl contamination is real and rare at the laboratory level.
Fentanyl or a fentanyl analogue was found in roughly 1% of exhibits where cocaine was the primary drug. Contamination happens, and it kills, but it is not the main way cocaine and fentanyl end up in the same body. If you use cocaine and also use an opioid, on purpose or to come down, say so on the first call. It moves you onto the opioid protocol and a longer washout, and the cardiac screen on this page still applies.
79%
Cocaine-involved overdose deaths that also involved an opioid
Set against the 1% above, the conclusion is co-use, not a poisoned supply.
From January 2021 to June 2024, 79.1% of US overdose deaths involving cocaine also involved an opioid, and only 6.3% involved cocaine alone. Drug-checking programs rarely find opioids in stimulant products. People die from combining, and the ones who die from a stimulant alone tend to be older, with a history of heart disease, which is the same finding as the section above, arrived at from the other direction.
2 more things the numbers do not show. Levamisole, the veterinary de-worming agent that was in 40% of seized cocaine in 2020, was down to 5.3% in 2024, so the old warnings about it are mostly out of date. And if you drink when you use, your liver makes cocaethylene, which lasts longer than cocaine and is harder on the heart than either drug alone. Whether you drink with it is a screening question, not a moral one.
Timing
Where the dose sits against the crash.
Stopping cocaine has a shape most people who use it already know. The bar is that shape. The 2 marks are where our part happens on it. There are no day counts, because the physician sets them for your case and puts them in writing before any deposit.
The crashHours to days
Exhaustion, sleep, appetite, a flat mood
Long sleep, big appetite, no drive, and craving that comes in waves. It does not endanger the heart the way opioid withdrawal endangers electrolytes, but it is where mood drops furthest, and how far it drops is the first thing the psychiatrist wants to know.
The weeks afterWeeks
Energy back unevenly, craving by cue
Sleep and energy return on their own schedule. Craving becomes cue-driven: payday, a Friday, a name on the phone. This is where the dose sits, once cocaine is out and the heart has been cleared, and it is the window the Mash series measured a change in at 1 month.
Living without itMonths
Where the result is decided
The Brazilian series measured a median of 5.5 months of abstinence after 1 session. Nobody stayed in a clinic for 5.5 months. The 90 days of calls exist because this stretch decides the outcome, not the session, and because the cues are at home rather than in Mexico City.
How long after your last use the dose can happen is set by the physician, confirmed by the urine screen when you arrive, and written down before you pay anything. If you use during the washout, tell us and the date moves. That is the whole penalty.
The 7 days
What is different about a cocaine stay.
The dose day and the monitoring are identical for every dependence we treat. The days around them are not. The tags mark where a cocaine case departs from the standard program.
Arrival, and the screen you already passed, run again
Private driver from MEX Terminal 1. Repeat 12-lead EKG and repeat labs, compared against the trace you were approved on. A urine drug screen. Full medication reconciliation. If cocaine is still showing, the dose moves inside the stay and nobody is charged for the wait.
No withdrawal to manage, so the day is the heart and the mood
For opioid cases this is the hardest day. For cocaine it is sleep, food, potassium and magnesium correction, blood pressure at rest and on movement, and the psychiatrist’s first full session on how far the crash has taken your mood. That session is not a formality. It decides how the dose is supported.
The dose
1 supervised oral dose of pharmaceutical-grade ibogaine. A cardiologist, an emergency physician and an ACLS-trained nurse in the room, 1 to 1. Continuous 12-lead ECG and pulse oximetry through the session and overnight. A crash cart on site and a written transfer agreement with a hospital 9 minutes away. The experience runs for the better part of a day and is usually described as dream-like rather than hallucinatory.
Telemetry through the metabolite tail
Overnight telemetry and a morning EKG. Noribogaine is still active well after the session ends, so monitoring runs past the point most people assume the treatment is over.
The psychiatrist, and the cues
Sleep and appetite settle. Psychiatrist sessions continue and for cocaine they run longer, because craving is cue-driven and the cues live at home: the people, the money, the day of the week. Family visiting hours are available, and family are told the same things you are.
Planning the first Friday night
Discharge planning with your home clinician, not after you land. The referral list of US clinicians is gone through with you. For a cocaine case the plan is specific about the first weekend, the first payday, and who you call before you call anyone else.
Discharge, in writing
A written clinical summary for your own physician, the referral list, and the call schedule. Weekly calls run through day 30, then psychiatrist calls at days 45, 60 and 90.
The evidence
Every study that touches cocaine, in 1 table.
The whole human literature on ibogaine and cocaine fits on one screen. That is not a criticism of the studies. It is a fact about how much anyone knows, us included, and it is why the last column exists.
| Year | Study | Who | What it measured | What it found | The limit |
|---|---|---|---|---|---|
| 2014 | Schenberg and colleagues, Brazil | 75 patients, crack and cocaine the main drugs, 72% using more than 1 substance | Months of abstinence after ibogaine plus psychotherapy | Median 5.5 months after 1 session, 8.4 after more than 1. 61% abstinent when interviewed. No serious adverse events reported. | Retrospective, self-reported, no control group, and an unregulated setting. |
| 2016 | Belgers and colleagues, meta-analysis of animal studies | Rats in 4 cocaine self-administration studies, out of 8 studies and 29 comparisons pooled | Cocaine intake after a dose of ibogaine | Intake fell sharply in the first 24 hours and the reduction was still measurable beyond 72 hours, after the drug itself had cleared. No study showed intake going up. | Animals only. A large animal literature that has mostly not been repeated in people. |
| 2018 | Mash and colleagues, St Kitts | 89 cocaine-dependent inpatients, alongside 102 opioid patients | Craving and depression scores, discharge and 1 month | Craving intensity 5.51 to 1.47. Depression score 14.3 to 4.2. Both held at 1 month. | Open label, no control group. Follow-up was hard to obtain once people went home. |
| 2026 | Arns, Shinozuka and Barsuglia, 11 clinics | 19,071 patients treated under modern screening protocols, 1996 to 2026 | Deaths per patient, by what they were treated for | 0.03% overall. All 6 deaths were opioid cases. Of 48 deaths recorded anywhere since 1990, cocaine was in the toxicology of 6. | Preprint, not yet peer reviewed. Clinic-reported data. Says nothing about whether treatment works. |
| None | Randomised controlled trial | Nobody | Nothing | No published randomised trial of ibogaine for cocaine or crack dependence exists. | Which is why nobody, including us, can quote you a success rate. |
The opioid studies, with their limits set out the same way, are on the opioid page, and the forensic review of ibogaine-associated deaths is on the what we treat page.
Who we turn away
The cocaine cases we say no to, the ones we say not yet, and the ones people wrongly assume are a no.
Every answer arrives in writing with the reason. Any deposit is refunded in full, and where we can we hand you a referral to a clinician near you. Nobody is passed to another clinic for a fee.
A heart attack, cardiomyopathy on echo, heart failure, or a prior cardiac arrest
Cocaine has already done what ibogaine would add to. This is the most common permanent no in cocaine cases, and it is the reason the echo exists.
A QTc above threshold with no correctable cause, or conduction disease on the EKG
If the long QT is from cocaine and clears once you are off it, that is a not yet. If it does not clear, it is a no, and we will tell you which after the repeat trace.
Psychosis or paranoia that has not cleared after stopping
Binge cocaine can cause both. Ibogaine is not given into either. If they resolve with time off the drug, the case is reviewed again by the psychiatrist.
Cocaine in the urine screen on arrival, or use during the washout
The date moves. Say so before the screen says it for you, and there is no penalty and no lecture.
Potassium, magnesium or liver values out of range, or blood pressure not controlled at rest
Correct, recheck, proceed. Most of these are fixed inside the stay, some need your own doctor first.
Years of crack use, a relapse after another program, or drinking alongside cocaine
Each of these changes what we check. None of them is a reason to refuse you, and none of them has ever been.
The standing list for every dependence we treat, including pregnancy or breastfeeding, age under 18, and benzodiazepine dependence as the main problem, is on the what we treat page. Telling us the truth about what you have used is never a reason for a no.
Common questions
Cocaine, crack and ibogaine, answered plainly.
Most of what decides a cocaine case is an EKG, a urine screen and the answers to 4 questions about your last binge. The screening call exists for exactly that, and it costs nothing.
Does ibogaine stop cocaine withdrawal?
No, because cocaine does not produce the kind of withdrawal ibogaine stops. Opioid withdrawal is a physical syndrome and ibogaine interrupts it within hours. Stopping cocaine produces a crash: exhaustion, long sleep, flat mood and craving. What the published series measured in cocaine patients is a fall in craving and depression scores at discharge and at 1 month. That is the claim, and it is the only one we make.
Does ibogaine work for crack cocaine?
On the same terms as powder, because crack is the same molecule taken by a faster route. The only human series that included crack users, 75 patients in Brazil, reported a median of 5.5 months of abstinence after 1 session. It was retrospective and self-reported. Nothing published compares crack against powder outcomes, so we do not claim a difference either way. What does differ is the screen: lungs, blood pressure, and an echocardiogram where the cardiologist asks.
How long do I need to be off cocaine before the dose?
The physician sets the washout for your case, in writing, before any deposit, and a urine drug screen on arrival confirms it. We do not publish a number of days because your EKG decides it, not a calendar. If you use during the washout, tell us and the date moves. If the screen on arrival is positive, the dose moves inside the stay and you are not charged for the wait.
I drink when I use cocaine. Does that matter?
Yes, for 2 reasons. When cocaine and alcohol are in the body together the liver makes cocaethylene, which lasts longer than cocaine and is harder on the heart than either alone, so the cardiac history is read with that in mind. And if the drinking is daily, alcohol withdrawal has to be managed under supervision before any dose, which is the sequence on the alcohol page. Neither is a reason to refuse you. Both are reasons to say so on the call.
I use cocaine and opioids. Which protocol am I on?
Both. The opioid decides the washout and the withdrawal management on days 1 and 2, so you are planned as an opioid case for timing. The cocaine decides the cardiac screen, so the echo and blood pressure work on this page still apply. The 2 most recent US reports found fentanyl in about 1% of seized cocaine but an opioid in 79% of cocaine-involved deaths, which means the combination is usually deliberate, and it is the combination that kills. Tell us about both.
What are the odds it works for me?
Nobody can say, us included. There are 2 human series worth the name, neither had a control group, both relied on what patients reported, and no randomised trial exists. Any clinic quoting you a success rate for cocaine has invented it. What we can tell you is what those 2 series measured and where they fall short, which is the table above.
Is the experience different for cocaine users?
The medicine and the monitoring are the same. Most people describe a dream-like state rather than hallucinations, often with a long autobiographical review that runs for hours, followed by a reflective stretch with little sleep. What differs is the days around it: no withdrawal to manage on days 1 and 2, and more time with the psychiatrist, because the crash and the cues at home are what a cocaine case has to plan for. A nurse is with you 1 to 1 throughout.
What does it cost, and what is not included?
$12,500 for the 7 days and the 90 days of follow-up, the same for cocaine, crack and every other dependence we treat. Not included: flights, the EKG, echo and labs your own doctor orders before screening, extra nights beyond 7, medications prescribed after discharge, and family accommodation outside the facility. All of it is itemised on the pricing page.
Screening costs nothing
Find out what cocaine has already done to your heart, before anything is added to it.
3 questions on the contact page. A physician or nurse calls you back within 1 business day and tells you which tests to order at home. The answer comes in writing, whether it is yes, not yet, or no.