Heroic Doses: An interview with Dr. Jeffrey Kamlet about ibogaine for opioid addiction-copy

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HEROIC DOSES

An interview with Dr. Jeffrey Kamlet about ego-dissolving entheogenic experiences, the ibogaine flood-dose for addiction recovery, micro-dosing trends and who benefits, and awake.net’s FEAT pilot program.

by Lakshmi Narayan

 

Hi, Dr. Kamlet.

I really appreciate you taking time out of your busy schedule to do this interview. Please tell us who you are and a little bit about your background.

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Kamlet:

Well, thank you for having me here. It’s a beautiful Sunday in Miami Beach, and I hope you’re all comfortable wherever you are. My name is Jeffrey Kamlet and I’m a medical physician, initially trained in internal medicine and cardiology.

Before I became a physician, I had a profound experience with psychedelic drugs and it became my hope in the early 1980’s to consider the use of psychedelic drugs in medicine because I saw the therapeutic value of these experiences helping other people. I coined a  term back then “Neuro Psychiatric Immunology,” the power of psychedelics to heal one’s brain and to teach ethics. So much so, I thought that possibly, if everybody would just have the same experience that I had, the world would be  in order and at peace. I was that naive at that time. But life went on, and I went on to train in different fields. I spent about a decade or more as a Director of an ER doing Emergency Medicine and teaching. In the mid-90s, I became board certified in Addiction Medicine and several fields of Forensics including Forensic Psychology.

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Currently I’m the Medical Director of a clinic in Miami Beach called TriStar Wellness, where we do general medicine, addiction medicine, pain management, and intravenous IV Ketamine treatments for major refractory depressive disorder, PTSD, and drug addiction.

Somewhere in the mid to late 90’s, I met a PhD from the University of Miami who was about to begin an Ibogaine for addictions study that lasted for the next five years in St. Kitts. At our first meeting we talked for hours. She said,  “Jeff, you have experience with psychedelic drugs, you’re board certified in Addiction Medicine, and you’re an experienced ER doctor. I have a drug from Africa that stops opiate withdrawal in one day — would you help me with this project?”

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Well, I was very skeptical but I went to see an ibogaine treatment in action. I saw patients with very bad opiate addictions who in  24 to 36 hours post-ibogaine flood dose treatment, were telling me they felt 100% fine, showing no signs or symptoms of withdrawal, relating no cravings and stating that they had a  profound spiritual experience like a waking dream and a life review, gaining  insights into their addictive behavior and life itself.

I  witnessed nothing short of a miracle.

I’m not here to say that ibogaine by itself can end addiction, but it is absolutely the closest thing we have to a way to interrupt opiate dependence as well as other addictive disorders without withdrawal symptoms.

ibogaine appears to work very well for the spectrum of other drugs including alcohol, cocaine and methamphetamines, but not very effective for sedative hypnotic dependence, i.e., benzodiazepines.

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I recently took a position with a company called Ehave, like ‘behave’ without the ‘B,’  a Canadian company doing ethical, cutting-edge research into psychedelic medicines, specifically cannabis, psilocybin, Ibogaine,  and ketamine.

We will be brain-mapping to see if we can get  objective data, to prove neuroplasticity, the ability of the brain to create permanent curative changes. We’re hearing it from patients, but we don’t have real objective data to prove that we’re actually turning on and off brain receptor sites that were not functioning properly.

People will ask me, “if ibogaine is such a miracle drug, and we have thousands and thousands of people saying this drug saved their lives, and many more thousands dying from opiate overdose, why is it not legal here in the United States?”

 

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Ibogaine goes against the typical big pharma corporate model of, no drug is a good drug unless you have to keep taking it. Somewhere between “we’re here to help” and “we’re here to make profits for our shareholders,” there’s a problem.

If a cure cuts into our profits, we’re going to make its availability as difficult as possible. This is why ibogaine is not available in the United States and is illegal for anybody to possess or use, but it is available in clinics in other countries.

Narayan:

This is the  handle that has been used for decades to block Ibogaine research and investments;  that it’s unsafe because there are cardiac risks, and yet more dangerous medicines are regularly dispensed and used inside the health care system safely under correct medical protocols and supervision everyday.  So, couldn’t Ibogaine also be administered with perfect safety in the U.S. if we had protocols in place that were followed by physicians trained in the safe use of ibogaine ?

Kamlet:

I absolutely agree. Ibogaine, unlike most psychedelics, does have some physiologic risks, especially at the high dose treatments needed to break an opiate dependence in 24 hours. Yet, in general, it’s still a remarkably safe substance. I’ve studied deaths associated with ibogaine for the last 20 years, and I believe every one of those deaths was avoidable had the providers been medical professionals who followed pre-, during-, and post-treatment protocols similar to most treatments done in the USA .

It requires a certain level of expertise and many years of medical training to administer ibogaine safely. Scores of deaths have been reported by some well-intentioned but medically unqualified people  trying to free addicts from their addiction. When something went wrong, when the patient’s blood pressure dropped or the patient’s pulse dropped, or the patient had an arrhythmia, they didn’t know what to do. Big pharma and investors use these deaths as additional justification to not make ibogaine the most important psychedelic to be legalized before any other psychedelic given that we face a global opiate pandemic.

In my opinion, It’s more important than MDMA for PTSD. It’s more important than psilocybin for depression, and it’s more important than ketamine.

The reason is that we have a worldwide pandemic of opiate dependence. We set a record for overdose deaths in the US in 2020, 93,000, driven by opioids.

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The heroin is no longer heroin, it’s fentanyl, which can be 100 times more potent than heroin. The number of people dying from overdose is hundreds of times higher than  it was 20 to 25 years ago, when we first discovered that  ibogaine cures opiate dependence. This is not to say those other psychedelics are not important and  will not ease suffering, but Ibogaine has the greatest possibility of saving lives. My clinic does several IV ketamine treatments legally in Miami every week with perfect safety and tremendous efficacy. I  hope someday soon I can say the same about Ibogaine.

In 2021 I wrote an article  published  in the Spring Edition of MAPS  Journal where I compared the vigilance used for a screening colonoscopy in the United States, with the level of safety we would need to do  ibogaine treatment with zero mortality. Now, no drug, not even aspirin or Tylenol, can assure absolute safety, but the real question should be, do the benefits greatly outweigh the risks? Real science is predictable and reproducible.

Many ibogaine clinics are not adequately funded and they do not  have properly trained physicians who could treat any adverse events.

So every once in a blue moon, there are complications, and these clinics rationalize the deaths by saying that “these patients are drug addicts and addicts die anyhow, so we’re actually saving more lives than without ibogaine.”

Although that might be statistically true, there would be nobody dying with the proper medical experience and treatment protocols in place and the price of treatment would be far less expensive than the standard US model of painful pharmaceutical substitution detox followed by 30-90 days residential rehab with its dismal success rate for sustainable recovery.

I think with the right therapeutic model of treatment and aftercare, ibogaine is above 95% effective for sustainable recovery for opiates and alcohol.

This is not a cavalier statement that I’m making either.  It’s 24 years of administering ibogaine and I still stay in touch with many of these patients  and see what happens to their lives, as compared to people who just get some ibogaine online, or go to an ibogaine clinic that fails to give them the proper flood dose required to break their addiction and doesn’t educate them about the importance of aftercare or incorporating certain spiritual principles into their lives on a daily basis, post Ibogaine.

When I say “ego dissolving dose” or “flood dose” or “heroic dose,” I’m talking about the same thing, I’m talking about a  large quantity of Ibogaine HCl , at a level that is safe if done with an IV in place and constant cardiac monitoring , but it’s a single experience and nothing in that person’s life after having this experience, will ever be the same. Every decision made for the rest of their life hopefully will be affected by this experience.

It’s transformative. Ibogaine is a”plant teacher.”

There are other plant teachers but only Ibogaine ameliorates the hell of opiate withdrawal, making it  one of the most important chemicals on  the planet right now. People are dying every day because they can’t get through the protracted physical and mental anguish of acute and post acute opiate withdrawal syndrome (PAWS). If there is a hell on earth, it’s the 90  days of opiate withdrawal.

Narayan:

I’m not a doctor but in my personal experience with entheogens, a heroic dose experience has to be integrated to cause lasting change in your life. Sometimes that integration can take weeks, months, years.

Kamlet:

Exactly, or perhaps even a lifetime to integrate. “The Joy is in the journey,” be it a flood dose or a lifetime of “one day at a time.” Entheogens show one the righteous path.

Ibogaine can interrupt or break the addiction cycle, ameliorate withdrawals, but the healing process is just beginning. People have to integrate the insights they gained into their lives. Post-ibogaine patients need to remain grateful and understand we all get a daily reprieve. It is said, a grateful addict will never use again. Addiction is a cunning and sneaky disease. It has genetic roots and it can be arrested one day at a time by incorporating  certain spiritual practices into one’s life.

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Breaking the physiological addiction and changing our habitual behavior are very different concepts, and this is why aftercare and integration is so important.

I see it as two disease processes:

How do I get off the drugs and not be incredibly  ill  comes first.

How I do not relapse and stay clean on a daily basis for the rest of my life is another.

 

Dr. Kamlet's account of his first ego-dissolving entheogenic experience (full version)

Narayan:  In 2018, you spoke at a psychiatric conference in London and mentioned your first LSD experience, and you said that you could remember that experience like it was yesterday. Could you describe it?

So we’re talking about something that happened probably 40 years ago. I was 25 or so, and I was literally on my way to start medical school, and I decided to go visit my best friend since kindergarten in San Diego, California. We had plans  that night to go see Frank Zappa because I ran into him at the airport earlier that day. Now, I already was smoking pot and I’d read all the standard beat author spiritual books–Kerouac, Ginsburg, et al. -but I never knew about the true nature of the psychedelic experience.

I’m sitting in a bed in the dorm room at San Diego University, just sitting on the bed talking to people. I didn’t know that my best friend Richard, (May he rest in peace) had dosed me with liquid LSD on my scalp.

By being dosed without my knowledge I  just floated into this experience with no resistance at all. Had I known that somebody had  given me LSD. I might have been a bit scared and not had the same experience.

I was sitting on the edge of the bed with my feet on the floor, and the music was playing on some stereo. The next thing I remember is, all of a sudden, I’m sitting in a tantric position and floating in the cosmos, darkness and  stars, but  yet I’m inside a room. And I’m outside the room at the same time.

I remember this right now as if it happened a second ago, the inside of the walls of this room had no ceiling and had no floor, but the walls were tiled, like an Arabic mosque with  beautiful psychedelic art. Being of Jewish ethnicity, it was interesting that my  first vision would be one that comes from Muslim temples. Whoever made those ancient  Muslim temples must have had a psychedelic experience because that’s the sacred geometry right there.

Now in this room, I’m sitting floating in this tantric bliss and there’s a square fountain dead center in the middle of the room. And there’s water coming up through the fountain like you’d see at any kind of botanical garden. If I look at the ceiling, I’m seeing just infinite space but the upper corners of the room are fluted like a pitcher. Although the room wasn’t filling up with water, the water was  coming up from the fountain pouring off the four upper corners of this room and in some kind of sixth sense, I knew this water was going out the pitcher, going underneath, and coming back through the fountain.

I thought, “Oh, my God, I was taught in college science that energy is never created or destroyed. It’s just transformed. Now I had a profound proof of that.

After a long while, it went on to show me what I like to call The Sacred Geometry. I started to see kaleidoscopic visions, for me, it was very Vedic and Tantric.

I was at times seeing thousands of images a second in this beautiful, symmetrical, Fibonacci pattern of sacred art, that is not switching from picture to picture but just molding one into the other in millions of colors that don’t exist in languages that I don’t understand. But I understood.

It’s like seeing the massive universe and subatomic structure at the same time and knowing it is all the same, universes in universes in universes all flowing back into itself.

Six hours later somebody tapped me on the shoulder and said  we had to leave. Six hours had gone by with me sitting on the edge of the bed, not knowing that I had been dosed with liquid LSD, while I had this profound, intimate, timeless experience with a God of my understanding.

Now, interestingly enough, a couple of months later, I went to a museum on Staten Island called the Jacques Marchais Museum of Tibetan Art. It’s a New York treasure that most people don’t know exists. They brought over an actual temple from Nepal or Tibet. It’s got a lot of sacred objects like thunderbolts, bells and singing bowls. They had books that are  hundreds of years old with titles like The Sacred Snake Powers. On the walls were Tanka paintings, the Vedic Wheel of Life and birth and recycling. And I looked at one of these paintings. It was a kind of a peach, purple color painting, and when I looked at it I said, “Oh, my God, I saw that, that night on LSD, I saw this exact image.” Now this painting was made a  couple of hundred years ago, painted by some meditating holy man on a mountain in Tibet before anybody knew of LSD.

And I said, How is this possible? How could some guy have painted what I saw in my mind’s eye, something of incredible beauty and symmetry? I concluded I must have been tapping into genetic memory and tapping into something that is timeless, that is eternal.

Narayan:

I had an almost exact experience of this, of seeing a Tanka, a Buddhist Wheel of Life once when I did a psilocybin journey. It was a sacred geometric structure, a fantastic multi-dimensional experience loaded with meaning for me to this day. What do you think is happening here?

Kamlet:

I have this little talk with every person I give a psychedelic to, whether it’s ketamine or ibogaine, I say: “You and I are right now having a conversation in a paradigm that I’m going to call “Womb to Tomb,” We are born and we die. And no matter how many psychedelics we take, we may not get an answer and  for every answer we get, a hundred new questions may arise. Psychedelics give us a picture of what death may be about, and that I will be responsible and  accountable for my behavior when I die. A lot of scientists are saying that when people take hallucinogenic drugs, the visions are delusions, and it’s just random stuff that’s individual to each person’s mind and childhood trauma etc.

Now it’s been proven that there’s universality and commonality  to the  visions, that people see the same things and travel to the same places. So there’s something in common with all psychedelics, whether it’s mescaline, peyote, ibogaine, LSD and even ketamine, and I can go on and on. And yet each one has something a little bit different about it.

They have something in common because they’re all tapping into a universal consciousness in which time does not exist and is always right in front of us and yet we cannot see it without  the medicines. Just like we can’t see magnetism, sonar, or infrared, it’s right in front of us at all times and other species in the Womb to Tomb paradigm can see these energies, like birds navigating by magnetic field perception.

The big illusion is that we can control the exterior world and the people around us. Buddha called it the Veils of lllusion. in fact, the only thing we control is our own emotions and actions. The committee of thousands in our heads needs to be quieted. We are always having an internal dialogue and most of the time we are “time tripping” in our heads. Thinking about the past is guilt and worrying  about the future is anxiety. nothing is real but the “now.”

In womb to tomb lectures, I ask my audience, “What is the most potent hallucinogenic substance on the planet?” and they all start throwing out names of complex chemicals. “It’s 5-Meo, it’s DMT, it’s harmaline,” and so on. And I say “No you are wrong. They look perplexed and I answer,  “It’s oxygen. If I take away your oxygen, this hallucination disappears”

So there is a universal energy which is timeless, it has always existed and will always exist. You may want to call that God or Quantum Physics or whatever else you choose but you can access that energy with a heroic dose, an “ego-dissolving” entheogenic experience. But you have to prepare for such a journey, you have to know how to navigate it safely and successfully, and make room for post-journey integration. The unbelievable aspect to this—and this is after 40 years of experience—is that anybody can have a less than pleasant  trip at any time. I still approach these substances with respect and reverence.  If you’re going to do one of these heroic dose treatments, it has to be the right time, right frame of mind, right drug, right intentions  and right sitters . All those things should be  in order, if you take it under pressure, or let’s say take a dose of psychedelics and go to a disco and drink alcohol and snort cocaine you  will bump up against reality and  it may become very unpleasant. The more you try to stay in control and want to control the trip, the more difficult it becomes.

ON MICRODOSING

Narayan:

Microdosing is very popular these days. What’s your position on it?

Kamlet:

When we microdose, we might get a little bump in serotonin the same way we might get a little bump if we took an antidepressant, but I don’t think it’s curing anybody of anything. We’re taking a psychedelic, but we’re not having a psychedelic experience. Micro-dosing is managed care. I see an oxymoron in the term ‘microdosing psychedelics’. There is nothing psychedelic about it. It’s a way these drugs may find their  way in capitalist big pharma’s model of medications and it worries me that so many companies and venture capitalists have sprung up and are trying to own the rights to these sacraments and I’ve seen some publications that use pure bullshit to manipulate their stock prices to rise.

Several months ago, JAMA, or the New England Journal of Medicine, the gold standard of medical journals, published a study where they gave patients micro-doses of psilocybin. This was  a double-blind placebo-controlled study, so the patients didn’t  know what they’re getting and neither did the doctors who were administering the drug and gathering the results. The findings were interesting. Microdosing psilocybin worked as well as an antidepressant called Lexapro, but it was no better. This is part of what I’m saying.

If you can take Lexapro and manage your depression, what benefit is it to take a lower-than-effective dose of a psychedelic?

Many patients  tell me they microdosed and got better and I have also seen others become schizo-affective after months of low dose usage only to return to baseline after weeks of non usage.

As far as micro-dosing relates to ibogaine, specifically for opiate addiction, a patient must be administered an effective dose, a “flood dose,” to reach the threshold to break the physiological addiction while gaining insight into the cause of their addiction.

Narayan:

Could you talk a little bit about why you joined awake.net and what you hope to accomplish here?

Kamlet:

I think I got licensed to practice medicine in 1986 or 1987, and it was probably seven or eight  years prior to that when I had my first psychedelic experience. From that very first experience I wished that there was some way I would be able to use psychedelics in a therapeutic model  to access our own consciousness, heal ourselves, and live more joyful lives.

Now it’s some 30  years later, and ibogaine is no closer to being approved for the treatment of addiction in the United States than it was back then.

I’ve detoxed literally thousands of patients in the US model in what we call pharmaceutical substitution therapy. If you need to get off heroin, fentanyl or oxycodone, we lock you up in a comfortable setting, hopefully it’s comfortable, and we give you other opiates and slowly taper them off, day by day by day and this can take seven to 14 horrific days if you’re lucky enough to afford it or have great insurance.

That is typically followed by 30-90 days of rehab to babysit you through the post-acute withdrawal syndrome. The only other option is to get prescribed a legal addictive substance like Methadone (only obtainable at scarce DEA federally regulated methadone clinics where you have to go five times a week to drink your juice) or be put on Suboxone by a medical professional who may know little about addiction.

You are now legal but still dependent, and these long-acting drugs make detox even more painful and protracted.

So, instead of waiting for legislation to change in the US for ibogaine, Awake.net’s FEAT is a non-profit that intends to raise funds to send people to parts of the world where ibogaine is legal or decriminalized and provided by medical professionals who follow the Kamlet Protocols* for Ibogaine safety.

I’m hoping one day, Awake’s FEAT program will be sponsoring hundreds of patients  for ibogaine treatment.

Narayan:

That would indeed be a pretty amazing feat.

Kamlet:

I hope and pray in my lifetime, I get to see this. I really do. 

END

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