Martin Polanco, MD (TW: @MARTIN_POLANCO7, CROSSROADSIBOGAINE.COM), is the founder and program director of Crossroads Treatment Center, based in Rosarito, Mexico. Crossroads specializes in helping patients conquer powerful addictions (such as heroin or cocaine) using the African hallucinogen ibogaine and 5-MeO-DMT, also referred to as “the God molecule.”
Dan Engle, MD (TW: @DRDANENGLE, DRDANENGLE.COM), is board-certified in psychiatry and neurology. He combines functional medicine with integrative psychiatry to enhance regenerative health and peak performance. His prior experience includes traumatic brain injury research and working in the Peruvian jungle with plant medicines such as ayahuasca.
In this profile, we discuss several psychedelics, including one legal option: flotation therapy. Ibogaine and 5-MeO-DMT are detailed at some length, as they’re both used at Martin’s clinic. Ibogaine is the only compound I’ve seen that can eliminate 90%+ of the physical withdrawal symptoms of heroin addiction in one fell swoop. It’s also one of the few psychedelics that can kill you, so I cover it at the end.
Spirit animal: Martin = Gummy bear
• What would you put on a billboard?
DAN: “Be curious.”
DAN: “I’m just about as excited about flotation therapy as I am about psychedelics, because not everybody is going to do a psychedelic. Maybe it’s not in everybody’s best interests to do it … but everybody can float. When prepped well and done consistently over time, it can still be an extraordinary ‘psychedelic’ arena. By this, I essentially mean coming back to a deeper connection with one’s self.”
TF: “Flotation therapy,” in simple terms, is floating in a roughly 98.6°F hot tub with a lid over it. It’s completely dark, there is no sound, and there are 800 to 1,200 pounds of Epsom salt in the water to make you float on the surface, feeling weightless. It can be thought of as a sensory-deprivation tank.
If you can’t handle at least 60 minutes in a flotation tank, you aren’t ready to have an unstoppable psychedelic experience. As one guide for the latter put it to me: “I can start the music, but I can’t make it stop.” In contrast, if you get twitchy during a float, you can step out. Use this environment as training. Lab-verified lucid dreaming (Google “Lucid Dreaming 101 Ferriss”) is also useful for developing navigational skills for psychedelics, but lying in salt water requires less work.
When possible, I now try to float twice per week—Monday and Friday. After 2 weeks, I feel like I normally would after a month of daily meditating, even if I’m not meditating.
DAN: “[Floating in an isolation tank] is the first time that we’ve been without sensory experience, sensory environmental stimuli, since we were conceived. There is no sound, no sight, no temperature gradient, and no gravity. So all of the brain’s searching and gating information from the environment is relaxed. Everything that was in the background—kind of ‘behind the curtain’—can now be exposed. When done consistently over time, it’s essentially like meditation on steroids. It starts to recalibrate the entire neuroendocrine system. People who are running in stress mode or sympathetic overdrive start to relax that over time, and you get this bleed-over effect into everyday life. It’s not just what happens in the tank. It continues outside of the tank. You see heart rate normalize, hypertension normalize, cortisol normalize. Pain starts to resolve. Metabolic issues start to resolve.
“Anxiety, insomnia, and mental chattering can be significantly improved in [2 to 3 times per week for a total of] anywhere between 3 and 7 sessions. For pain, it’s normally 7 to 10 sessions. I recommend doing a 2-hour float if people are able.”
TF: According to Dan, most people get exponentially more benefit from a single 2-hour session than 2 separate 1-hour sessions. Nonetheless, 2-hour floats still make me fidgety, so I routinely do 1-hour sessions.
Keeping it simple, Dan suggests you start with 2 to 3 floats inside of 1 month. “I’ve never had anybody come back and say ‘Yeah, that didn’t work.’”
This Amazonian brew is one of Dan’s specialties. The experience generally lasts 4 to 7 hours.
If you think of psilocybin, LSD, or peyote as different types of alcohol—say vodka, red wine, and Scotch—ayahuasca is more like a cocktail. This makes it hard to standardize. Just as in an Old Fashioned, there are core ingredients. In this case, they are the DMT-containing chacruna leaf and the ayahuasca vine itself, which contains an MAO inhibitor that makes the chacruna DMT orally bioavailable. Different ayahuasqueros (ayahuasca shamans) will then add their own ingredients to the brew, sometimes including powerful or even dangerous plants like toé (similar to the North American Datura plant, containing scopolamine). No session is quite the same as any other.
For me, ayahuasca has been unique among psychedelics for many reasons.
In my second-ever session, for example, I had the scariest experience of my life. It involved uncontrolled grand mal seizures on a floor for 2 hours, among other things. I awoke to rug burns all over my face and hands, and I was untethered from reality for the next 48 hours. Thankfully I had hired someone to watch me 24/7 during and after the weekend. He was able to baby-sit and prevent insane ideas from becoming life-destroying actions. His repeated advice was “If it’s really true today, it will still be true tomorrow.”
I haven’t had this extreme a reaction since, but it happened.
And such a response, while not typical, is also not that uncommon. You might wonder: Why would I ever use ayahuasca again after that? Here’s why: Over subsequent weeks, I realized that some of most critical relationships in my life had been completely repaired. I saw things differently, reacted differently, and interacted differently, as if I had been reprogrammed. Those changes all persist to this day. So, there’s a huge potential upside but equally huge potential downside if taken lightly or done with the wrong people.
I mention this cautionary tale because ayahuasca has become terribly trendy. It’s THE thing to talk about at cocktail parties, and I shudder every time I hear something along the lines of “I’m going to my friend’s place in Manhattan for an aya ceremony this Sunday night. She mail-ordered some brew from Hawaii, and we’re doing it together. It’s going to be amazing.” There are now hundreds of new-age folks—out-there yoga instructors, didgeridoo players, whatever—who decide to “play shaman” based on reading a few books, watching a few YouTube videos, or having experienced a few ceremonies themselves. I consider this all psychological Russian roulette.
My suggestion is that you treat ayahuasca as if you are planning to have a brain tumor removed by a brain surgeon. Spiritually, this is effectively what you’re attempting.
In such a case, you would spend months, if possible, researching all of the best doctors. You would treat it like a life-and-death decision because of what could go wrong if it were done incorrectly. From my direct experiences, I feel like ayahuasca warrants this level of caution, respect, preparation, and due diligence. Martin elaborates:
“That’s why it’s so critical to have preparation before the experience and then a period of integration afterward, because you are in this opened-up and receptive state and more suggestible. Whatever habits you incorporate in the weeks afterward can stick, and these can be good or bad.”
DAN: “Ayahuasca is traditionally done in a group ceremony setting, but it’s a very solo, inward journey. Typically, it’s done in the dark, in the jungle. You go through deep, psychological healing, oftentimes pre-verbal healing around traumatic issues that [occurred] between birth and age 4. From a developmental psychological perspective, this is when most of the long-term personality traits are formed. You gain a witness perspective, the fear centers relax, the trauma is brought back up onto the screen of the mind … you oftentimes get this replay of very early things and can have a corrective experience….
“Through that, I can [personally] see the network of interrelated factors and potentials. My mind starts to understand how things have affected me, how things are affecting the world, [and] potentially the next step for me to take in my journey.”
TF: Ayahuasca is sometimes called la purga (“the purge”), because participants often experience uncontrolled vomiting or defecating. I’ve never experienced either, but all of my companions have at least vomited. I was concerned at one point that I wasn’t “doing it right” or getting maximum benefit, and the shaman assured me that purging is not a good measure of how valuable the experience is. He had only purged twice in 10 years.
DAN: “It is very successful in helping people transition from chronic depression into what would be called euthymia, or normal mood. Many people don’t even know what having a normal mood feels like; but optimism, faith, courage, strength, [and] personal empowerment are some of its qualities.”
TF: Ayahuasca is classically described as very “visionary,” or rich in visual hallucinations, though some people have more mental or kinesthetic experiences. I tend to go through it in three stages: visual (often overwhelming), mental (intellectually able to engage and see solutions or answers), then physical. More often than not, I will cycle through these three phases during each long icaro, or song, that is sung. For the best approximation, search for Jan Kounen’s “Ayahuasca Visions” on YouTube.
Martin uses 5-MeO-DMT with his patients after treating them with ibogaine and iboga. DMT is sometimes referred to as the “spirit molecule,” and its variant 5-MeO-DMT is called the “God molecule.” 5-MeO-DMT is found in the venom of a desert toad and is vaporized and inhaled (not taken orally; it’s toxic if ingested). It is a short 5- to 15-minute experience.
To put it in context, here is what the schedule might look like for a heroin addict at Martin’s clinic:
Pre-care for several weeks: Improving diet and exercise, weaning off psychiatric meds, etc.
Monday of treatment week: Comprehensive medical tests in Mexico; heroin addicts are switched to morphine.
Wednesday night: IV of saline and electrolytes, then encapsulated ibogaine, dosed at 10 to 12 mg per kg of body weight. Patients are hooked up to continuous cardiac monitoring throughout. The IV catheter is kept in with a hep-lock, in case atropine needs to be administered for an abnormally slow heartbeat (bradycardia).
Thursday: Patients typically haven’t slept, and this is nicknamed the “gray day.” Addicts sometimes have residual withdrawal symptoms and feel as though they’re not benefitting.
Friday: Patients begin to feel better and regain their feet. If any residual withdrawal symptoms persist, iboga (300 mg capsule, then more if needed), which contains ibogaine and other alkaloids, is used.
Saturday: 5-MeO-DMT administered.
Post-care: 2 to 3 weeks in San Diego (recommended but optional).
MARTIN: “DMT is found in ayahuasca, whereas the 5-MeO-DMT is naturally found in certain plants and in the venom of the Sonoran Desert toad (also known as the Colorado River toad), which lives in northern Mexico and southern Arizona. Its venom is thought to have been used ceremonially for hundreds, if not thousands, of years by Mexican indigenous cultures to induce states of mystical consciousness.
“What we like about this medicine, and what is particularly useful for drug addiction, is that it reliably occasions mystical experiences. In our patients, about 75% report experiencing an intense and profound sense of awe, divine presence, peace, joy, and bliss that transcends time and space. People often describe their 5-MeO experience as one of the peak transformational and spiritual moments of their entire lives.
“In the body, 5-MeO-DMT acts on the serotonin 1A and 2A receptor sites, which have been linked to mystical experiences in other psychedelics such as LSD and psilocybin. However, compared to classic psychedelics, 5-MeO appears to induce these experiences more consistently, and with greater potency and shorter duration. Interestingly, 5-MeO is also shown to have anti-inflammatory, immune-regulating, and pain-reducing effects because of its action at the sigma-1 receptor. Our patients often report a reduction or elimination of pain as a result of their experience. Frequently people will stretch or move their bodies during sessions to work out physical and emotional tension that they may not have been aware of.
“By incorporating 5-MeO-DMT into the treatment program, we can help patients who have had the ibogaine experience to feel a certain sense of release from the material that came up, as well as motivation and inspiration to move on with their life. Ibogaine can bring up a lot from the subconscious and people are overwhelmed after the experience. In a recent overview article of the research on using psychedelics to treat addiction, the depth of one’s mystical experience was the greatest predictor of long-term success. When we added the 5-MeO-DMT to our ibogaine protocol, we saw better outcomes in our patients versus ibogaine alone.”
TF: 5-MeO-DMT was not classified as a Schedule 1 substance in the U.S. until 2011, and its use is legal in Mexico.
DAN: “It’s extraordinarily strong in its flavor and acts as a rocket ship back to God…. It does take you back to source consciousness.”
MARTIN: “[Addicts] realize that they are divine beings, and when you have this realization that you’re indestructible and infinite and divine, it’s very hard to put a needle in your arm and continue using.”
TF: I have used 5-MeO-DMT but prefer edible, longer-acting psychedelics. I don’t worry much about 5-MeO addiction, but the rapid onset and short duration is closer in profile to substances I want to avoid (such as crack). I feel it’s too user-friendly for my convenience-seeking personality. I like the fact that most edible whole-plant options make one slightly nauseous, have a 4- to 8-hour or longer effect, and if you consume too much, you will almost certainly vomit. I view these characteristics as built-in safety mechanisms. Different strokes for different folks.
Okay, now we’ll cover the big gun.
MARTIN: “Iboga is an obscure psychedelic that doesn’t have a long history of recreational use, because it is not a recreational experience. It is probably the least recreational psychedelic…. It’s an African psychedelic that has been used for decades to treat opiate addiction and other types of substance-abuse disorders.”
TF: “Iboga” refers to the plant, specifically a root bark, that has been taken as a rite of passage by the Bwiti followers in Gabon for centuries. Ibogaine is the primary alkaloid found in iboga. Both act as dissociatives. The effects are similar but not identical. The difference is akin to using white willow bark for inflammation versus its refined version, aspirin. Martin’s clinic uses ibogaine to detox patients and iboga as a “booster,” or supplementary medication, after the treatment.
NOTE: Traditional ceremonial doses of ibogaine/iboga, while incredibly promising for eliminating opiate (e.g., heroin) addiction in record time, can also produce fatal cardiac effects in roughly 1 out of every 300 people. Even certain antibiotics interact with ibogaine/iboga and can cause arrhythmias.
For this reason, both Dan and Martin generally reserve its use for dire-straits addicts, who are likely—without a successful intervention—to die prematurely from drug use or related violence. Based on notes from non-addict friends who’ve done “full-ride” iboga and microdosing, microdosing twice weekly appears to provide at least 50% of the anxiolytic (anxiety-reducing) benefits with a tiny fraction of the risk.
Interestingly, ibogaine appears to cause hallucinations that are mediated via muscarinic cholinergic pathways involved in dreaming and memory, as well as through the kappa-opioid receptors (activated also by the plant Salvia divinorum), rather than via serotonin receptors.
MARTIN: “Who is a good candidate for ibogaine and who isn’t? I get requests from people who just want to explore their psyche, or they have depression, or they want to deal with some childhood trauma. I often direct them toward ayahuasca, because I do think that ibogaine is the big gun and it is generally best used for [treatment of] addictions. That’s not to say that people who don’t have addictions don’t derive benefit from it, but I do think that there are other modalities that they should explore first that are less risky.”
DAN: “Just because something is effective doesn’t mean somebody is ready for it…. Iboga is like Everest. It’s climbing a huge mountain. Never going hiking and then starting with Everest is a bad idea.
“[It] is such an ego-focused medicine. It will ride the psyche relentlessly until a person has no choice but to essentially give up and give in to the experience. They can then surrender to the greater experience of becoming who they thought they could be, or who they were maybe scared to be, freed from the limitation of something like addiction….
“Iboga is four to five orders of magnitude [superior to] anything in the general psychiatric rehab arena [for treating opiate addicts]. You have the same level of success with using MDMA-assisted therapy to treat chronic post-traumatic stress disorder (PTSD). That’s why MDMA is going into Phase III trials. Psilocybin is similarly going into Phase III trials because you have such a high success rate with people going through [cancer-related] end-of-life transitions being relieved of anxiety, and really being able to walk through death with dignity and strength.”
TF: Phase III trials are critically important for rescheduling psychedelics, which would make them prescribable by qualified physicians. As noted earlier, nearly all psychedelics are currently Schedule I drugs, defined by “high potential for abuse” and “no currently accepted medical treatment use in the U.S.” These substances are largely non-addictive, so the abuse claim is unfounded, but this is difficult to prove in long-term human studies given current legal constraints. Therefore, the more efficient path to “prescription-legal” is demonstrating a clear medical application for conditions such as treatment-resistant depression or end-of-life anxiety in terminal cancer patients. Since quitting the investment game (see here), I’ve redirected much of my financial focus to this area.
Funny aside: During the 1972 presidential race, Hunter S. Thompson claimed that Democratic primary candidate Edmund Muskie was addicted to ibogaine. Hunter made the whole thing up but used it to spin the media into a tizzy.
The typical ibogaine experience is long-lasting—up to 36 hours total—and has three major phases. It tends to keep patients awake for several days. Martin explains:
“The first [phase] is a visionary component, which can last anywhere from 3 to 12 hours, and these hallucinations are perceived almost like watching a movie of your life.
“It’s a life review, and people report that in the back of their eyelids they have gigantic screens where they see images from their childhood. They see opportunities they missed, people they’ve hurt, and unfinished business that they need to resolve. I think being confronted with who they really are, and not being able to look away, can be difficult. Patients who are using opiates are generally trying to numb themselves. They don’t want to think; they don’t want to feel. Ibogaine really forces them to have that discussion. Look what you’ve done, look where you will end up if you continue using. So it is not a fun experience.
“Many cases of addiction are linked to post-traumatic stress disorder. This can also be resolved with ibogaine because it allows a person to go back to that traumatic event and experience it without any emotional pain. One is able to go back and let go of the experience, come to terms with the experience, or just re-contextualize the experience.
“Like Dr. Engle was saying, a lot of trauma that happens is pre-verbal…. The brain stores this as an emotional charge because there are no words associated with the experience. Ibogaine allows them to go back and see what happened, almost as if they were floating in the room as an observer. Because they’re seeing this experience through the eyes of an adult, it allows them to put it in a different context.
“Other imagery that comes up during the ibogaine experience is related to the sentience or intelligence of plant life, the creation and the fate of the universe, and our own mortality. There are certain images that can be disturbing to patients. You do see spirits and images of dead people. In Africa, they say ibogaine is a ‘controlled-death experience.’ So you go into the land of the dead, and you’re given information by your ancestors, which you can then take back into this world and apply to your life.”
“The second phase is a phase of introspection and this can last up to 24 hours. Opiate withdrawal is pretty much gone [at this point], as well as the craving. Ibogaine has a very potent antidepressant effect, so people who take it feel an elevated mood for a period of time afterward.
“In terms of the differences between ibogaine and ayahuasca, I think that introspective life review is more pronounced with ibogaine, although only 70% of people have it. So a full 30% experience no visions at all. I don’t know the statistics with ayahuasca, but it might be more reliably psychedelic in that regard than ibogaine.”
“The third phase, which takes place after the clinical experience, is referred to as the ‘temporary freedom’ or the ‘window of opportunity,’ as noribogaine, a metabolite of ibogaine, continues to do its work for up to 3 months, making it easier for new patterns and habits to take effect. This is referred to as the ‘integration phase,’ where a person takes action to fuel the necessary positive changes that were revealed through the experience. It is important to take advantage of the learning and growth opportunities in this phase, and to develop habits that will help sustain self-control once noribogaine flushes out.”
“[Ibogaine isn’t] just masking the withdrawal like a substitution drug would. For example, if somebody on heroin takes methadone, they won’t have withdrawal for a period of time, but as soon as the methadone leaves the system, the withdrawal comes back. This is not something that happens on ibogaine. You take ibogaine, and the withdrawal is gone—90% of the withdrawal is completely gone. That’s telling us that the ibogaine is actually changing the receptor to the way it was before the person started using. It’s actually restructuring and healing it. Ibogaine appears to affect almost every major class of neurotransmitter, primarily via opioid, NMDA, serotonin, sigma, and nicotinic receptors. A prominent ibogaine researcher, Dr. Kenneth Alper [of New York University School of Medicine], has stated in presentations that certain aspects of ibogaine defy traditional paradigms in pharmacology.”
TF: I have noticed that microdosing seemed to increase my happiness “set point” by 5 to 10%, to peg a number on my subjective experience. This persists for several days after consumption. Preliminarily, the effect appears to relate to upregulation of mu-opioid receptors. From one study: “… in vivo evidence has been provided for the possible interaction of ibogaine with μ-opioid receptor following its metabolism to noribogaine.”fn1
MARTIN: “[In treating chemical dependency] it’s opiate-specific. We have seen some benefits for certain psychiatric medications, but not for benzodiazepine or alcohol withdrawal. These two withdrawals are actually dangerous. When somebody gets the shakes, it’s DT (delirium tremens) and that can be deadly. So, it’s a very delicate process and somebody who’s physically addicted to alcohol should not take ibogaine. They need to detox first, and then they can take ibogaine for the psychological and the anti-addictive benefits.”
Following powerful healing experiences with psychedelics, Dan’s strong recommendation is “Hold the gold.” He explains:
“Keep that experience really close and private. When it feels right to share, share it with people who are very sensitive to the fact that you just went on a strong life-altering journey, and who are going to be supportive of that.
“[Pick people who are] not going to ridicule it or judge it or persecute it, because all of that flavors your primary experience. So many people, when they have a big experience, want to go share it, and sometimes the response they get isn’t always supportive. That alters the healing that they just received.”
Heffter Research Institute (heffter.org): I’ve interacted most with this organization. Founded and run primarily by PhDs and MDs, Heffter facilitates cutting-edge research at universities like Johns Hopkins, NYU, University of Zurich, and others.
MAPS (maps.org): Founded in 1986, the Multidisciplinary Association for Psychedelic Studies (MAPS) is a 501(c)(3) non-profit research and educational organization that develops medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana.
ICEERS (iceers.org): Based in Spain, the International Center for Ethnobotanical Education, Research, and Service has the primary goal of bridging the ethnobotanical knowledge of indigenous cultures (primarily iboga and ayahuasca) with Western science and therapeutic practice.
GITA (ibogainealliance.org): The Global Ibogaine Therapy Alliance is an international group of ibogaine providers, researchers, and advocates. They recently published the first established standard of care guidelines for ibogaine treatment.
Singing to the Plants: A Guide to Mestizo Shamanism in the Upper Amazon by Stephan V. Beyer. This book did not come up in the podcast, but it is the most comprehensive book related to ayahuasca that I’ve found.
The Cosmic Serpent by Jeremy Narby
Autobiography of a Yogi by Paramahansa Yogananda. This was one of the more impactful books that Dan read while living in the jungle. Steve Jobs had this book passed out to attendees at his funeral.
The Journey Home: Autobiography of an American Swami by Radhanath Swami
Ibogaine Explained by Peter Frank
Tryptamine Palace: 5-MeO-DMT and the Sonoran Desert Toad by James Oroc. Martin considers this a fantastic read because it looks at the 5-MeO-DMT experience from a Buddhist and Hindu perspective.
The Toad and the Jaguar by Ralph Metzner. A quick read on 5-MeO-DMT from a pioneer in psychedelic therapy and research.