Polisubstance Risks & Protocol Update

As the field of ibogaine treatment continues to evolve, so too does the responsibility to speak honestly about both its promise and its risks. At IbogaQuest, we believe that careful transparency, shared with respect, context, and discernment, is essential for the long-term safety and integrity of this work. The reflections below are offered as part of an ongoing commitment to learning, accountability, and collective responsibility within the ibogaine community.

IbogaQuest, Tepoztlán - reflecting on safety and responsibility in ibogaine work

At IbogaQuest, we have worked with ibogaine for 17 years as a small-scale clinic, offering 1 treatment week per month to a maximum of 7 participants. Over those 17 years, we had no fatalities. This year, sadly, we experienced our first and only fatality.  Out of respect for the family, we are limited in what we can share publicly, but we feel it is important to be as transparent as possible within those boundaries.

The individual who passed had a history of opioid and polysubstance use. He completed our standard medical screening prior to treatment, including EKG and assessments of liver, heart, and kidney health, medication review, and tapering off contraindicated substances. During treatment, our doctor, nurse, and paramedic team were on site at all times. Based on the information available, his passing appeared to involve underlying physiological vulnerabilities that had compromised his body in ways not detectable through even thorough medical screening.

The family asked for privacy and space and did not pursue legal action. In the period following his passing, they also expressed gratitude for the sensitivity with which we handled the situation, including the care taken around communication and the ritual offering made in his honor. We share this not as justification, but to acknowledge the importance of respect, dignity and human care in moments like these.

This case has led us to further refine and strengthen our medical pre-screening process as the drug landscape continues to evolve. With the rise of potent synthetic substances and new compounds entering the market, potential risks have become more complex and difficult to anticipate. This makes thorough screening and careful medical assessment more essential than ever.

Following his passing, we shared details of the case transparently within professional networks, including GITA and fellow experienced providers in our network. We see this kind of peer-level transparency and knowledge sharing as good practice and essential for collective learning and safety improvement.

Unlike larger organizations, we do not have the backing of PR teams, political organizations, or institutional infrastructure. Our work comes from a different lineage, part of an older, smaller community of underground providers, with roots going back to figures such as Howard Lotsof (a personal friend of Barry). 

For many years, any adverse event in this space risked being immediately weaponized, without distinction between negligence and inherent risk, and without regard for context. 

This has historically made small providers particularly cautious about public disclosure. 

At the same time, we recognize that the field is changing. There is growing support for ibogaine research and more open public conversation, and this is relatively new territory for all of us. We welcome this shift and believe that increased transparency, when done carefully and responsibly, will lead to better understanding, better standards, and ultimately greater safety.

We believe it is essential to distinguish between fatalities that result from medical or ethical negligence and those that arise from the inherent and sometimes unforeseeable risks of working with medically compromised individuals in recovery, particularly in a landscape where new synthetic and unknown substances continue to emerge.

These distinctions have not always been clear to the broader public, and ibogaine providers have often been grouped together regardless of experience, standards, or the specific circumstances involved. We are encouraged to see that this understanding is beginning to evolve.

Our intention in sharing this is to help foster a more informed and responsible public conversation, grounded in the realities, responsibilities, and complexities of this work.

As part of a broader community of practitioners and researchers, we remain committed to open dialogue, shared learning, and ongoing refinement of safety practices, recognizing the challenges posed by evolving substances and the limits of what can be known or predicted.