Ibogaine is a psychoactive alkaloid naturally occurring in the root bark of the West African shrub iboga. While ibogaine is a mild stimulant in small doses, in larger doses it induces a profound psychedelic state. Historically, it has been used in healing ceremonies and initiations by members of the Bwiti religion in various parts of West Africa. People with problem substance use have found that larger doses of ibogaine can significantly reduce withdrawal from opiates and temporarily eliminate substance-related cravings.

Although first-hand accounts of ibogaine treatment indicate that ibogaine is unlikely to be popular as a recreational drug, ibogaine remains classified as a Schedule 1 drug in the United States (it is also scheduled in Belgium and Switzerland). Yet despite its classification as a drug with a high potential for abuse and no currently accepted medical use, people who struggle with substance abuse continue to go to international clinics or underground providers to undergo ibogaine therapy.

By some estimates, ibogaine use has a mortality rate of about 1 in 427. Deaths from ibogaine have been attributed to bradycardia (slowing of the heart), lethal combinations with other substances, liver problems, and other conditions. That is why it is essential to take ibogaine under medical supervision. Since untreated drug addiction can also involve serious health risks (including death), some people decide that ibogaine treatment is worth the risk while others do not. Anyone interested in using ibogaine to treat substance abuse should carefully weigh the risks and benefits of such treatment, and in particular should make sure that medical assistance is available during the session.
The outcome of ibogaine treatment will depend on proper aftercare and patient motivation.

Here is how Rabbi Nobick describes the psychological effects of treatment at an ibogaine program.

People describe the visionary and auditory elements of the Iboga
experience as a state of dreaming wide awake. Each thought becomes a
picture, each picture a movie, each movie a complete reality. For many
this phase is very overwhelming. In addition to the ataxia and intense
visual dream state; people report feeling an enormous amount of energy
flowing through their entire body. Many report visualizing a rapid
run-through of their lives and/or the lives of family members, even of
those who have already past away. The visions may appear to be actual
memories running, rather as though a film of one’s life was being
shown inside the head, or may take the form of characters acting out
roles, rather as though a play was taking place inside the head.
Significant life events are re-experienced. The original core issues
or traumas are often dealt, complete with a new perspective. The
emotional content of that experience is relived, along with the
visual, pictorial gestalt of the experience itself. In most cases, the
experience is complete with 3-D effects and the sensation of actually
being there. Yet, there is also the presence of the witnessing self,
who watches and finds understanding. It is this understanding that
seems to allow the former addict to begin again, making new, healthy
choices.

In the second stage, that can last approximately 20 to 40 hours,
several things can happen. Some people still experience a dream-like
period, although it is supposedly less intense. The person usually
stays awake most of the time. There is time to evaluate the visionary
experiences, which can bring about profound insight into life and
death and the reasons behind compulsive or addictive behavior. Many
find these hours uncomfortable. While the first stage is more an
overwhelming observation, this stage is more interactive. One meets
and gets to know one’s real self – beyond all of the illusions and
delusions. Most people will start to drink, and some might even begin
to eat.

During the third stage most people fall asleep for a couple of hours,
after which they generally awake feeling rested, very hungry and in
need to wash up. In the course of this day most people are able to
resume normal activities. People usually stay free of cravings for
several months

The possible amount and intensity of released material can be so
overwhelming, that people have said that they simply could not
remember everything they had seen, or that it took months to remember
certain visions. Therefore, the processing of released material and
the ability to verbalize these matters and learn to interpret their
often symbolic content can take extended amounts of time and continue
over years. Subjects have reported experiencing a mental or spiritual
transformation due to the Iboga which they compare to ten years of
therapy in 2 days, or taking a truth-serum. Whatever people report
on their experiences, they have been observed returning from their
Iboga experiences with a greater understanding of previously made
choices.”