A bill approved by lawmakers might see Colorado become the first state in the nation to open an ibogaine clinic, treating conditions including substance use disorder. Before its doors could open, regulators would need to consider legal and regulatory issues, safety concerns with the drug and ways to foster equitable access.
In November 2022, Colorado voters dramatically changed the state’s approach to psychedelics by approving Proposition 122. That measure decriminalized possession, growing and sharing of naturally occurring psychedelics. It also called for the creation of a regulated, licensed psychedelic therapy system in the state. Initially, this would just cover psilocybin services. But Prop 122 gave Colorado the option to ultimately go further, by authorizing ibogaine, DMT and mescaline services after June 2026.
Now, however, state lawmakers have advanced legislation with amendments that change some of the provisions of Prop 122. Senate Bill 23-290 would apply certain restrictions to the psychedelic therapy model. It would also allow the state to regulate and allow ibogaine services at any time—without having to wait a few years, as with the other psychedelics on the list. Such a move would first have to be approved by the Natural Medicine Advisory Board, which Prop 122 created, and the state licensing authority. This bill has now passed both chambers of the legislature and headed Governor Jared Polis (D).
Neither Colorado Senate President Steve Fenberg (D) nor Representative Judith Amabile (D), who sponsored the legislation, responded to Filter‘s requests for comment by publication time.
“We’re going to start an ibogaine clinic in Colorado.”
Ibogaine is a powerful hallucinogen derived from certain plants, most notably Tabernanthe iboga, a shrub native to the central African countries of Gabon, Republic of the Congo and Democratic Republic of the Congo. Iboga consumption plays a role in the Bwiti spiritual practice of Indigenous African peoples.
In recent decades, ibogaine has drawn increasing international attention for its therapeutic potential for conditions including depression and opioid use disorder. Reportedly, ibogaine temporarily disrupts opioid cravings and withdrawal symptoms, allowing the person to rapidly detox. According to an observational study published in the American Journal of Drug and Alcohol Abuse, “A single ibogaine treatment reduced opioid withdrawal symptoms and achieved opioid cessation or sustained reduced use in dependent individuals as measured over 12 months.” One clinical trial in Spain has been testing an ibogaine treatment protocol for patients who want to taper off methadone.
As anticipation grew about ibogaine treatment becoming a reality in Colorado, Dana Beal, a veteran advocate for cannabis legalization and ibogaine treatment, posted a photograph on Facebook on April 24. “Kevin Matthews is on my right,” said the caption, referring to the Colorado advocate who directed the 2019 Decriminalize Denver campaign and was chief sponsor of Prop 122. “We’re going to start an ibogaine clinic in Colorado.”
Beal told Filter that his relationship with Matthews dates back over a year, to when Prop 122 was being drafted. “I got him to put ibogaine in the bill,” he said. “It was a chorus of people saying let’s do psilocybin first because it’s not threatening to people, [and] they wanted a gradual approach.” Matthews was not able to provide comment to Filter by publication time.
Details about the potential clinic are currently light—unsurpisingly so, when various regulatory issues remain to be resolved, even if Gov. Polis signs the bill. For one thing, the legislation prohibits any synthetic version or analog of a naturally occurring psychedelic. So where would a clinic source its ibogaine, which is a Schedule I controlled substance under federal law? And would the restriction to natural sources put additional strain on overburdened wild plant populations?
Beal, who said that he is working with an FDA-licensed lab in India to develop ibogaine suitable for clinical use, believes such challenges can be overcome.
Ibogaine is not without some significant risks. The drug prolongs the heart’s “QT” interval, disruption which may lead to tachycardia. In rarer cases, the drug may also cause adverse effects including ataxia or seizures. It also has some serious contraindications with other medications, including pharmaceutical antidepressants like SSRIs or MAOIs, and benzodiazepines.
“You need a nurse that’s really experienced giving ibogaine, who’s seen just about everything,” Beal said. “Having a heart doctor would be nice, but they’re expensive and you don’t need them 99 percent of the time.”
“It seems odd to premise this bill on the supposed safety concerns of psilocybin and then also fast-track ibogaine, which clearly has the greatest safety concerns.”
The extra safety considerations with ibogaine compared with some other psychedelics are in part why Mason Marks, a law professor at Florida State University specializing in psychedelic law and publisher of Psychedelic Week, questions the bill’s plan to speed up ibogaine rollout.
Legislators are “blowing up the safety concerns about psilocybin,” he told Filter, “in some cases exaggerating them (not that there aren’t risks)—it seems odd to premise this bill on the supposed safety concerns of psilocybin and then also fast-track ibogaine, which clearly has the greatest safety concerns.”
Marks also noted the involvement of Matthews, as Prop 122’s chief sponsor, in the proposed ibogaine clinic. “I think there already has been some exclusivity granted in terms of access to the lawmakers,” he said, calling the idea of a business being developed after exclusive access, if that were the case, “concerning.”
“There were other groups that reached out to [Senator Fenberg’s] office and were not allowed to meet with him,” Marks said, adding that despite Fenberg inviting advocates to meet with him about the Senate bill, no meetings seem to have been granted—including to Marks, who himself requested one.
Noah Potter, a longtime ibogaine advocate and consultant, and author of the New Amsterdam Psychedelic Law blog, said that Matthews’ involvement wouldn’t be “in and of itself” a conflict. “I think it depends on the degree to which there’s open competition available,” he told Filter. “If you have some kind of exclusive deal, that’s something that should be subject to consideration. [Just] create open access.”
“You have a body of knowledge as to how to administer. There shouldn’t be a delay.”
Noah Potter also believes that Colorado can and should authorize and regulate ibogaine services as quickly as possible.
“People have been giving underground treatments since the late 1980’s in Europe and the US,” he said. “You have a body of knowledge as to how to administer. There shouldn’t be a delay. The task at hand should be to understand the practices already in use and regulate no more than [to ensure] those systems work safely—and immediately.”
Asked how Colorado might approach this, he said, “Allow the local governments to regulate ibogaine treatments themselves. You have the local health department. Give them the authority to facilitate access to ibogaine. In terms of the unlicensed market, allow safe consumption sites with medical personnel on hand.”
If it does so, Colorado will face the question of how to balance safety concerns with the potential to create inequalities in ibogaine access. In Oregon, voter-approved psilocybin therapy services are expected to launch later this year. But the complex system of regulations, licensing and trainings mandated by the state means that these services are projected to cost clients several thousand dollars. As the state has acknowledged, this will restrict access based on income. Similarly, licensing costs and other expenses like real estate and equipment mean that becoming a psilocybin business owner is far more difficult for small and independent entrepreneurs.
The author participated with Dana Beal in organizing cannabis legalization protests during the 2016 elections, and also helped Noah Potter co-organize the 2017 New York City Cannabis Parade.
Photograph of Tabernanthe iboga by Ji-Elle via WikiMedia/Creative Commons 4.0
