Photo: the sacred iboga medicine © E. Bast
Is it enough to bathe only once in a lifetime? Is it enough to practice yoga once? Meditate once? Go to the chiropractor once? Do an internal cleanse—only once? I suppose that all these, like the "booster dose," are ultimately subjective.
And what is a "booster dose?" This can be referred to a subsequent lighter dose of an entheogenic or psychedelic medicine, administered some time after an initial full ceremonial dose or "flood dose." The term "booster dose" is most often used in reference to iboga and ibogaine, the visionary sacred plant medicine from Africa and its pharmaceutical extract, respectively. Depending on the individual, a booster dose of iboga or ibogaine can be helpful or even critical to a person in recovery from severe drug or behavioral addiction.
My husband, artist Chor Boogie, and I first experienced the iboga medicine in a traditional Bwiti ceremony several years ago. We were initially drawn to the medicine by a terrifying healing crisis: Chor's opiate relapse. Once I started learning more about the medicine, it called to me to assist me with my own struggle with PTSD. Long story short, the medicine ceremony—as well as the highly skilled facilitation of our traditional shaman—rapidly helped to heal our primary issues along with much more than we ever anticipated. Six months after our first ceremony, we traveled to Central West Africa to immerse ourselves in the beautiful Bwiti culture, receive full initiation with the iboga medicine, and undergo a rite of passage. Six months after that visit to Africa, we were able to attend another Bwiti ceremony closer to home with the iboga medicine. Medical and therapeutic jargon might label these subsequent meetings with the medicine as "booster doses." Chor and I would simply call these being rerooted—to the iboga medicine as well as our Bwiti tradition. Though Chor did not need these booster doses in a critical sense after his first iboga healing ceremony to maintain his sobriety, they were extremely supportive for his continued well being—and mine.
Read the nutshell version of our process with the booster dose in this article in Rolling Stone magazine.
In Africa, the "booster dose" is what the tribe would regard as a regular part of village life, the medicine ceremony, held for a variety of purposes: healing, inspiration, divination, community relations, to celebrate special events, or to honor guests. These booster doses can be a healthy, occasional form of spiritual, mental, and physical cleansing and realignment. They may also serve as a deepening learning or initiatory process with the plant. They can reconnect our body and soul to the the ecosystem, that great web of life and Spirit.
In the same breath, we approach these "booster doses" with the medicine in a respectful way, as apprentices rather than entitled consumers. We inwardly ask the plant permission to partake of it, as our friends in Africa do, and then we listen intently for the silent answer. We wait for auspicious opportunities to commune. It's not just a matter of us humans deciding to take the medicine. It's the medicine calling to us as well. When we are fortunate enough to have medicine come into our lives, we infuse the sacrament with intentions, offer gratitude, and let go of our human ideas around how the medicine is doing it's work. Ultimately, we may become the full embodiment of our living prayer.
As our Bwiti teacher Moughenda says: We practice living without attachments, and we cannot even be attached to the medicine! If we are inwardly grasping at the medicine and choking it with the expectations of our limited minds, it can be disastrous rather than healing. Booster doses are a divinely timed gift of Grace.
Is a booster dose always necessary for people recovering from addiction? No. Some people have one flood dose of medicine, and that's all they need, for their healing and initiation, forever.
Yet, booster doses or seasonal ceremonies do have the potential to be good medicine for anyone, when the medicine calls, because we are all essentially "in recovery" from the human condition, every day. We are precisely wired with the receptor sites to receive the teachings of these sacred medicines. According to the Bwiti, sacred medicine is essential for most people to become fully realized human beings. Though sacred medicine might not be appropriate or necessary for every individual, they are right for humanity as a collective, and they work through some for the benefit of all.
Will a booster dose be needed or helpful? Again: We practice listening to our soul—and to the call of the medicine. And, hopefully, we are paying attention to the delicate issues of sustainability, ethical sourcing, and social impact on indigenous communities. We don't ever want to take more than we need or more than the earth can produce in a good way.
Sadly, the iboga medicine, along with all other psychoactive medicines, are currently highly illegal in the United States, even for qualified medical professionals and traditional practitioners, despite evidence of tremendous healing benefits and safety with good protocol. This is not only an issue of drug policy reform, but also one of of religious freedom. We pray to someday see the medicine made regularly available to all those who are called, in a way that is not only safe and responsible, but also culturally sensitive.
Cheers to the booster dose—and the rerooting of the soul.
Photo: Bwiti temple in Gabon © E. Bast
Dear Ones, I am excited to share this intimate conversation with the one & only Rak Razam on the In a Perfect World – Podcast about the medicine path, art, iboga, addiction recovery, my memoir, the Bwiti tradition, sacred union, and LOVE above all. We explore these questions, and more:
• What is iboga, the ancient African entheogen and ibogaine, the chemical that is extracted from it?
• How can iboga be used to treat addiction and trauma?
• How does iboga connect to the ancestor spirits, and what messages can we learn?
• How does iboga differ from other entheogens like ayahuasca?
• How can these medicines be integrated into the Western understanding?
• Why is integration a vital part of the medicine work?
• How can iboga and ibogaine be held safely?
• How can we come into right relationship with indigenous medicine communities?
I hope you find it useful. Please share as inspired!
I had the pleasure of meeting Jamie Mac at the Global Ibogaine Therapy Conference in 2016, and I was touched by her genuine passion for healing and helping. Not only is she a skilled medical professional, she also has incredible nutritional wisdom and spiritual awareness in relation to iboga & ibogaine, known in some circles as one of the world's most powerful psychedelic medicines for addiction recovery, psychotherapy, and spiritual healing.
Jamie Mac RN is co-founder of IbogaSafe, a medical training service for iboga & ibogaine medicine providers aimed at reducing the amount of adverse events during Ibogaine treatment through safety advocacy, empowering providers, and improving the client’s experience. Jamie graduated with honors and has 18 years experience in critical care nursing. In 2014, she began working with Iboga and researching Ibogaine safety and best practices. She also began volunteering with the Global Ibogaine Therapy Alliance (GITA) to co-author the Clinical Guidelines for Ibogaine-Assisted Detoxification, which led her to deepen her research into the medical considerations and risks related to Iboga/Ibogaine. In 2015 she completed training to become an American Heart Association BLS and ACLS (Advanced Cardiac Life Support) instructor and continued working with GITA to develop the first ACLS for Ibogaine, and Heartsaver CPR & AED pre-conference training courses offered at the 2016 Global Ibogaine Conference in Tepoztlan, Mexico. She also presented on the Ibogaine Therapy Ethics & Safety panel discussion at the conference.
CHECK OUT JAMIE'S IBOGA SAFETY WEBINAR
STARTING FEBRUARY 19TH
What inspired you to start IbogaSafe?
IbogaSafe was inspired organically through our many conversations over the last few years involving our various experiences in widely varying settings, and through our work on the Clinical Guidelines project with GITA. The common theme that kept resurfacing in our conversations was the provider community's need for safety advocacy, education and training in order to prevent and respond to potential adverse events during ibogaine treatment. We aim tackle that issue through an inclusive harm reduction approach.
What makes iboga different from other visionary medicines, in terms of safety?
The biggest safety issue surrounding Iboga is it's potential for cardiotoxicity. Iboga is the only visionary medicine that carries the risk of lethal cardiac arrhythmias and sudden cardiac arrest. My clinical background working with similar QT prolonging drugs, arrhythmias, responding to respiratory/cardiac arrests and witnessing hundreds of sudden cardiac deaths in a hospital setting has given me a profound awareness and respect for the heart that most people outside of emergency care settings cannot grasp. Lethal cardiac arrhythmias can cause a person to become unresponsive and completely lose their pulse and blood pressure within 5-10 seconds. A cardiac arrest needs to be recognized and responded to appropriately within 3-6 minutes in order to prevent permanent brain injury/death. Therefore I strongly feel that everyone working directly with this medicine should be CPR certified and have an appropriate AED onsite as a bare minimum standard of care. Heart health exists on a wide continuum that runs from total absence of symptoms to sudden death, in a matter of seconds and often without warning.
Why is qualified medical supervision necessary for iboga/ibogaine treatments?
Detoxing patients off various substances in a medical setting can be extremely complicated and unpredictable even without Ibogaine factored into the equation. The screening, preparation, and intake process for this medicine is not simple and requires keen assessment skills. Recognizing and responding to adverse events appropriately and in a timely manner is even more complicated and requires a certain amount of medical knowledge, experience, skill and training. ACLS certified medical professionals are preferred when dealing with this plant.
Do facilitators need medical training just for psychospiritual journeys (vs. addiction detox)?
There have been documented fatalities involving psychospiritual clients and at lower doses. One prime example of a preventable psychospiritual death in Dr. Alper's 2012 Ibogaine Fatality study was a 44 year old female who became unresponsive 4 hours after ingesting 300 mg of Ibogaine HCL. Toxicology negative, history of hypertension (change to high blood pressure), and her autopsy showed an old heart attack and significant 3 vessel coronary artery disease. An EKG 3 months prior to her death showed inverted T waves, which is an indication of heart damage/heart attack that should’ve been further investigated by a cardiologist who would've ordered more testing. A thorough screening process for Ibogaine could've detected her heart disease BEFORE an acute heart attack when it would've been treatable and survivable. Proper medical supervision during screening could've prevented her inevitable death. I think that ALL potential patients deserve the same screening and supervision regardless of intent. Heart disease accounts for 17 million deaths per year worldwide. It's the # 1 killer of men and women, killing twice as many people as all cancers combined. The odds are never in our favor when dealing with heart disease.
Why is it necessary for experienced traditional providers to take IbogaSafe courses?
I think of this webinar course as step one to truly understanding Ibogaine's effect on the heart. One needs to understand how the heart works normally to fully understand how Ibogaine can adversely affect even a healthy heart under certain circumstances. Ibogaine's effects work specifically on the electrical system of the heart, which is the( most complicated facet of learning the heart, but this course introduces all those concepts via learning to interpret ECG's. (remove because and separate the run on sentence) ECG's are essentially a live real time reading of the electrical system that drives the heart. My secondary hope for this course is that it encourages providers to start the process of improving their own safety measures as they are able, like getting CPR certified and getting basic equipment starting with an appropriate AED. Some models of AED's have displays and monitoring cables available so they could also be used to do continuous cardiac monitoring. One way to motivate more cardiac monitoring is to simply teach people what the squiggly lines on the monitor mean. It's our most valuable assessment tool, especially for a client who is lying down in a dark room. All of the above steps could drastically improve the survival rate for a potential cardiac arrest during treatment and as a cardiac nurse and ACLS/CPR instructor my goal is naturally to increase survival rates associated w/ ibogaine related cardiac events.
What is wrong with mail ordering medicine for underground treatments?
Due to demand outpacing supply currently, we are seeing a worldwide problem of counterfeit/tainted product available over the internet and there have already been deaths documented in medical journals due to this. One article involved 30 year old woman with a history of drug abuse and methadone treatment was found dead. A bag at the scene labeled "Top quality Tabernanthe Iboga 50 g Gabon, Africa" was analyzed and shown to contain no Iboga, but a similar looking root substance from a more common plant which has an alkaloid that produces "toxicity effects including hypotension, bradycardia, gastric hypersecretion, nausea, vomiting, diarrhea, skin flushes, nasal congestion, sedation, and coma. Another case study involved a 40 year old man w/ heroin addiction who ordered Ibogaine online for self-administration. He ingested 4 g of ibogaine and 2 g of an uncharacterized “booster.” He was found 8 hours later, unresponsive, covered in emesis, in an asystole (flatline) rhythm. He had suffered an acute cardiac arrest leading to cerebral edema and brain death, presentation consistent w/ ibogaine induced cardiotoxicity/cardiac arrest.” I suspect this is just the tip of the iceberg when it comes to deaths and near misses due to black market Iboga/Ibogaine and the dangerous practice of self administration or treatment with untrained underground providers.
Why would a nurse or a doctor need the IbogaSafe training in order to supervise iboga/ibogaine treatments?
Medical professionals are not on equal ground when it comes to attaining the knowledge and skills to safely screen and monitor Ibogaine clients or respond to emergencies. I personally did not learn ECG interpretation in nursing school and nursing/medical school generally only teaches students how to pass the licensing board testing. Like most medical professionals I learned on the job and via continuing education courses provided to me AFTER I graduated, passed (my boards, and specialized in working with cardiac patients right away. Hospitals spend a lot of time and money on staff education to make sure that they have qualified eyes on high risk patients. Also, while most medical professionals are certified in Basic Life Support, much fewer professionals are certified in Advanced Cardiac Life Support. Prerequisites required to pass an ACLS course are BLS certification and the ability to quickly interpret ECG rhythms on the heart monitor so they can be treated without delays. The minimum standard of care in the USA for professionals working directly with all cardiac monitored patients is that they obtain ACLS certification within the first year and I think that standard of care should also apply to medical professionals working with Ibogaine. Additionally, the medical community at large isn't educated on specific pharmacology and case studies involving Ibogaine ingestion and how ACLS protocols need to be altered when dealing with an Ibogaine emergency, which is why Jonathan Dickinson and I developed the ACLS for Ibogaine course for last year's Global Ibogaine Conference.
VISIT THE IBOGASAFE WEBSITE
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