At first blush, psychedelics may seem to be the antithesis to substance use disorder (SUD) treatment, conjuring outdated images of 1960s counterculture.
But their increasing acceptance, especially among many of the same institutions that historically denounced them, holds great promise for those with SUD, mental health issues, including post-traumatic stress disorder (PTSD), and traumatic brain injuries. Proponents, including those who have undergone ibogaine treatment for SUD, tout elimination of withdrawal symptoms, loss of cravings to use drugs and an introspection unlike they had been able to achieve prior to the treatment.
With the recent significant attention in the media, medical and research communities, and even some legislative bodies, psychedelics are having their day. On April 18, 2026, President Trump issued an executive order,
“Accelerating Medical Treatments for Serious Mental Illness,” that directs federal agencies to expedite access to psychedelic-assisted therapies for Americans suffering from serious mental illnesses, including SUD. Fifty-five years ago in 1971, another Republican president, Richard M. Nixon, declared his war on drugs, with an especially strong aversion toward the psychedelic LSD, citing it as the root cause of the anti-Vietnam War movement, youth rebellion, and social disorder. The juxtaposition of the two eras underscores just how significant today’s environment is.
Part of the reason for the vastly different philosophy on psychedelics today versus conservative ideologies of the past,
according to the New York Times, is the immense promise they hold for treating veterans suffering from PTSD.
Although several psychedelics are being discussed as options for treatment of mental health and SUD, only ibogaine was specifically mentioned in the president’s executive order. Ibogaine is a naturally occurring psychoactive compound found in the roots of the African shrub iboga. Ibogaine has been designated as a Schedule I drug since 1970, preventing its use within the United States, but clinics in Canada and Mexico offer legal ibogaine treatments.
Ibogaine Treatment
Ibogaine induces vivid hallucinations, which some patients describe as psychologically insightful,
according to the University of Virginia School of Medicine. It is generally administered orally, and repeat doses over several days are common. How it actually works on the brain is complex, likely through multiple pathways. Its administration is associated with potential risks, including cardiotoxicity.
Most people describe
two phases: the visionary phase (first four to eight hours), with vivid dream-like imagery, memories, and emotions, which some people describe like watching a movie of their life; and the reflective phase (next 12–24+ hours), where the visuals fade but deep insight, emotional release, evaluation, and a sense of clarity remain.
Physically, people may feel dizzy, experience nausea and vomiting, and many stay awake for 24 hours or more. Afterwards, a “gray day” of fatigue is common before energy and mood lift again.
With the cardiac risks associated with ibogaine treatment, advocates stress reputable, medical clinics for the treatment. Advocates also acknowledge the need for ongoing therapy and support well beyond the actual ibogaine treatment episode(s). Although many testimonials include overnight transformations, proponents talk about ibogaine as a transformative experience that simply opens the way to a greater ability to make and sustain change over longer periods of time.
Research
Researchers,
in a review of 24 studies, concluded that the published data suggest that ibogaine is an effective therapeutic intervention within the context of SUDs, reducing withdrawal symptoms and cravings. Data also point toward a beneficial impact on depressive and trauma-related psychological symptoms. However, studies have reported severe medical complications and deaths, which seem to be associated with neuro- and cardiotoxic effects of ibogaine.
Another
study analyzed 88 patients who received ibogaine treatment in Mexico between 2012 and 2015. Most participants (72 percent) had used opioids for at least four years and 69 percent reported daily use. Most (80 percent) indicated that ibogaine eliminated or drastically reduced withdrawal symptoms; 50 percent reported that ibogaine reduced opioid cravings, while 25 percent reported a reduction in cravings lasting at least three months; 30 percent reported never using opioids again following ibogaine treatment, and more than one half (54 percent) of those individuals had been abstinent for at least one year, with 31 percent abstinent for at least two years. Although 70 percent of the total sample reported a relapse following treatment, 48 percent reported decreased use from pretreatment levels and an additional 11 percent eventually achieved abstinence.
State-specific Legislation
Perhaps one of the strongest indicators of its growing acceptance and credibility can be found in Texas.
In June 2025,
Governor Greg Abbott signed Senate Bill 2308 into law to grant $50 million in state matching funds for research of ibogaine.
"Texas is home to more veterans than any other state," said Abbott. "Many of those veterans suffer from injuries both seen and unseen. A therapy that has shown great promise in treating those conditions is ibogaine. This law authorizes a Food and Drug Administration approved clinical drug trial that will seek approval of ibogaine as a medication for the treatment of opioid use disorder and other behavioral health conditions, especially those suffered by our veterans."
Three other states – Arizona, Indiana, and Ohio – have passed ibogaine-related legislation, and nine other states have introduced bills. Advocates for ibogaine have included Pennsylvania as one of their target states for legislation. RCPA will continue to work with stakeholders as the country moves into this next frontier.
