Can a pill derived from a little-known plant get an addict off heroin in just a single dose? One woman thinks so, and she’s risking her life trying to make it available to those who need it most
“My experience was just so profound and it had such an impact on me that I never could shake it. I was fascinated by ibogaine.”
It’s December 9, 2013, and 27-year-old Shea Prueger is speaking to me over Skype from a friend’s house on the Thai island of Koh Samui, a place of beautiful beaches, tropical fruits, and sea breezes. Also: meth, heroin, and a massive sex-tourism industry. It’s almost 4 a.m. there, and she is quiet so as not to disturb the other occupants of the house, which, like many in the area, is perched in a tree. Over the course of a few hours, she will tell me how she went from being a misfit teen in Iowa; to a globetrotting, drug-addicted model; to one of the world’s only female providers of ibogaine therapy, a controversial “cure” for drug addiction.
For the eight months leading up to this first interview, Prueger has been running the only medically monitored facility in Asia where people can go to be treated with ibogaine, a powerful psychedelic derived from the root bark of the Tabernanthe iboga shrub. Considered a sacrament in the Bwiti belief system of Gabon and Cameroon, the drug produces an intense, dreamlike trip that some say is conducive to introspection and spiritual exploration. Sometime around the turn of the century, the drug made its way to the Western world, but remained obscure to all but the most adventurous psychedelic explorers, even while the 1960s counterculture elevated drugs like LSD to mainstream infamy.
In 1962, a 19-year-old American heroin addict named Howard Lotsof discovered that powdered iboga extract had therapeutic applications for opiate addiction, as a result of his finding his heroin cravings completely gone after taking ibogaine recreationally. This set off a flurry of interest on the part of medical researchers. But clinical trials were, and remain, difficult to fund due to ibogaine’s low potential for profitability; as a naturally occurring substance, it cannot be patented, and most opiate addicts are treated with it just once. In addition to treating every kind of addiction (from nicotine to heroin), ibogaine can be used for psychotherapeutic purposes.
American experimentation with ibogaine was driven underground in the late 1960s, when government agencies, frightened by the psychedelics movement, added the little-known substance to its list of Schedule I drugs, a classification reserved for those with “high potential for abuse” and no accepted medical use. This list also includes cannabis, LSD, cocaine, and heroin. But while the drug remains illegal in the U.S., Australia, and parts of the European Union, it’s largely “unscheduled” elsewhere. So, over the past few decades, ibogaine treatment centers have popped up all over the world—most densely in Central America, but also in South America and parts of Africa—for the primary purpose of treating addiction. Meanwhile, in places where the drug is illegal, like America, underground networks provide it to those undeterred by the risk involved.
Prueger first sought out ibogaine therapy for herself at age 24 for the same reasons many do. She’d been trying to get off heroin for several years and found herself caught in a cycle of addiction, even when ostensibly “clean” on maintenance drugs like methadone. “I kicked opiates on my own loads of times,” she explains. “But I always returned to them.”
Born to Mormon parents in Utah and raised in Iowa, Prueger tells me that she never felt like she belonged. She chafed at her religious upbringing and rebelled in all the limited ways a small-town teen could (drinking, drugs, boys). Still antsy after a year at Iowa State University, she packed up and moved to New York at age 18 with $150 in her pocket. Armed with a fake ID, she quickly became a fixture on the nightlife scenes of the Lower East Side and Williamsburg, which provided her not only with odd jobs and crash pads, but also with cocaine and prescription painkillers such as Oxycontin that helped her get through long days of beauty school and long nights as a coat-check girl.
Her introduction to heroin happened when she started dating an addict. “I got a really bad migraine one day, and he kinda came out with the news that he had heroin,” she says.
“I don’t want to throw him under the bus, but he really did say, ‘It’s the same thing as Oxycontin.’ It was cheaper and it felt better.”
As with many addicts, her usage increased gradually until one weekend when she traveled to Philadelphia and fell ill with flu-like symptoms.
“I thought I was sick,” she relates.
“Then I did heroin, and I wasn’t sick anymore. The realization that I was addicted was awful, because it was so unintentional. That was a bad feeling; it’s a really terrible train to get on. But it didn’t stop me.”
Around the same time that Prueger was getting addicted to heroin, she was embarking on a serious modeling career. She’d already spurned several scouting attempts over the course of her first two years in N.Y.C. when an IMG agent approached her at a bar where she was working. “I was tired of having three jobs and working late,” she says. She also liked the idea of getting to travel, so she called the number on the agent’s card and got signed the next day.
Despite (or perhaps because of ) her drug problem, Prueger did well as a model, booking jobs all over the world. In addition to having the right look, she was able to broadcast that “edgy” attitude so many lifestyle brands crave, while simultaneously being docile to work with. “I was an insanely functional addict,” she says. “My senses were just so numbed by the heroin. All the sketchy stuff that would happen with photographers or on a shoot—being naked in front of people and being objectified…the exploitation of really young girls—it never bothered me ‘cause I was high all the time. As long as I had drugs, I didn’t care.”
Prueger tried to kick heroin about eight times over the course of the next three years. At age 22, an outpatient facility in London put her on methadone, but she “still used on top of the methadone all the time,” seeing it mainly as a way to avoid getting sick on days she couldn’t score, and cheated on her weekly drug tests. “I still had an addict’s brain,” Prueger explains. “I would become unbelievably depressed. The issues opiates were covering up were still lingering and only got exacerbated off the opiates. I could get clean, but I was miserable, and would always end up going back.”
In the absence of other options she tried Suboxone, a controversial maintenance opioid prescribed by her psychiatrist. “He said I only had to be on Suboxone for a short time and it would be easy to get off of,” she says. “But every time I wanted to get off, he said I wasn’t ready. And whenever I’d get stressed out or have cravings, he would double my dose. So I was on a lot of Suboxone.” Eager to free herself, Prueger tried to quit on her own, only to find Suboxone withdrawal was far worse than with heroin. “It was the worst withdrawal I’ve ever had,” she says, “a sickness I can’t even describe. The jump from just being on a crumb of Suboxone is really difficult, because it stays in your system for so long.”
It was at this point that Prueger began seriously looking into ibogaine. She was intrigued by the stories she’d read online, and the idea that it might help her turn back the clock to before she took her first Oxy. She’d met Eric Taub—an ibogaine therapy pioneer in the West since the early 1990s—through an ex-boyfriend who’d done ibogaine on Taub’s advice. So she called him and received an invite to go see his business partner Lex Kogan at his I Begin Again center in Guatemala. To prepare, she replaced her daily regimen of Suboxone with Oxycodone, a short-acting opiate, since Suboxone is known to interfere with ibogaine’s anti-addictive results. (Ibogaine is only administered once a person starts to go into withdrawal, since having opiates in one’s body at the same time as ibogaine can be deadly.) She then traveled to the Guatemalan center in the jungle, where she swallowed a capsule full of ibogaine powder and went into a dreamlike state.
"I woke up one morning and I was super happy. It was like I had gone through 30 years of therapy. It was incredible."
“I saw my whole life in front of me,” she says. “The harder memories to watch were in cartoon form, and other memories were so real looking, there was no difference between seeing them and looking at my hand. At the same time, I saw demons trying to steal these memories, and I saw myself doing things I wasn’t proud of. I wasn’t emotionally attached to anything I saw, which made it possible for me to really work through what I was seeing. I saw an apparition of myself come in the room, pull out a gun, and shoot me. I also had auditory hallucinations where I listened to past conversations I’d had. It was really intense. Some moments seemed insignificant, but later on I realized how important they were, and that I really had no problems except for the drugs. That without the drugs, my life was really beautiful.” The full-on dream state phase of treatment can last anywhere from 9 to 48 hours; Prueger estimates she felt the effects of the ibogaine for 36.
Prueger came out of this experi-ence with no physical addiction to narcotics, no withdrawal symptoms, and no cravings. But she still had substantial psychological work to do. In the weeks following her treatment—ibogaine can stay in the system for months—Prueger says she could feel herself “shedding layers and changing.” “I’d get these crazy flashes of things I’d blocked out in my past, and they’d be as clear as day and just come out of the blue,” she says. “It’s like a symptom of PTSD, but it was more like when I was seeing them, I was releasing them.” She also went through periods of social withdrawal and periods of intense anger during which she believes she released years of bottled up emotions. And then it was over. “I woke up one morning and I was super happy,” she marvels. “It was like I had gone through 30 years of therapy in eight months. It was incredible.”
Her acupuncturist was also amazed to find that some of the health problems Prueger had dealt with for years were suddenly gone. “He’d never seen anything like it before, and his only conclusion was that ibogaine had completely reset my body,” she says. “I haven’t had one migraine since I did ibogaine, and other health issues I’ve dealt with, like irregular menstrual cycles, severe dysmenorrhea, and some old running injuries, were just completely fixed.” (There is actually some science behind this claim; in West Africa, the iboga plant has long been prescribed for fertility issues. It also causes lymphatic drain, which can account for the healing of old sports injuries.)
Since her first ibogaine experience—she has done it about once a year since then for its continued therapeutic benefits—Prueger has never again fallen back into the cycle of addiction, and has benefitted in other ways as well. “Cocaine was a big vice of mine and I haven’t touched it, or any other amphetamine since ibogaine,” she says. “I drink way, way less and not regularly, and I was a near daily drinker before.” She remains interested in psychedelics, which she believes belong in a different class from other drugs.
When I ask Prueger if there are any statistics related to ibogaine’s effectiveness, she says it’s hard to get data on what is still an underground phenomenon, but that, anecdotally, about 70 percent of the people who come to her center stay clean after their first treatment. Of the other 30 percent, “Those who relapse often use less when they do go back,” she says. “Or they use and then come back to us and stay clean after the second time. Or they admit they never wanted to get clean in the first place.” As for scien-tific evidence, relatively little exists; NIH, the National Institute of Health, did laboratory studies with ibogaine in the mid-1990s, but stopped due in part to concerns about potentially fatal heart arrhythmias and neurotoxicity.
"I could feel my heart rate drop, and that’s when it hit me that I needed to dedicate some time to really learning the medical side of this before I kept working with it."
Indeed, ibogaine is not for amateurs; at least 19 people have died during ibogaine therapy since 1990, including one in a controlled, clinical setting. Prueger says most complications can be avoided with proper screenings and safety protocols before, during, and after a session, and that most deaths have occurred in people who never should have been given ibogaine in the first place. Still, she admits that “patients need to be educated on the dangers of doing something like this.”
Prueger learned that the hard way. Upon returning to America renewed and centered after her first visit to the I Begin Again center, she briefly joined an underground network of people in the U.S. who administer ibogaine illegally. She had observed enough treatments during her stay in Guatemala to feel she knew how to help others the way she had been helped. It wasn’t until she administered it to herself, however, that she realized it might not have been the best idea. “I did it completely by myself and there was no one around me whatsoever,” she says. “I could feel my heart rate drop, and that’s when it hit me that I needed to dedicate some time to really learning the medical side of this before I kept working with it.”
Wanting to know more, she called up Kogan, whom she’d gotten to know during her two-month-long stay at his center, and asked him to train her in administering ibogaine. He declined at first, saying he’d tried to train others and it hadn’t worked out, but she was persistent. A few weeks later, he told her he’d changed his mind.
Prueger studied at Kogan’s center in Costa Rica with two of his doctors and two of his nurses for six months, learning how to read EKGs, how to take people’s vital signs, how to screen patients beforehand, and how to tell when something was going wrong. She also learned about electrolyte therapy and how to safely and properly give an IV. She worked nights, checking in on people every 20 minutes during their trips. She learned when to give someone more ibogaine and when to stop. And she saw many people come through the center and interact with ibogaine in all kinds of ways. “It was one of the most interesting experiences I’d ever had in my life,” she says.
Once Kogan felt Prueger was ready, she flew to Thailand and set up an outpost of I Begin Again on the island of Koh Samui. It was to be the first medically monitored ibogaine facility in Asia. Despite not yet knowing a word of Thai, she had one week to find a house, a medical staff, and the proper equipment before her first scheduled appointment.
A few months in, things were going well for Prueger. She had a beautiful house with a pool surrounded by palm trees, and she was meeting and treating people from all over the world. Several members of her family came to visit her and were supportive. She was also able to offer treatment on a sliding-scale basis, enabling locals to get help they otherwise wouldn’t have been able to afford.
But there was trouble in paradise. Almost as soon as she got there, Prueger began receiving emails from an anonymous address telling her she needed to leave the island or something bad would happen to her. A few months later, her house was broken into and all her medical equipment was stolen. She didn’t feel safe staying in the house after that, so she moved. But she started getting threatening emails again, so she moved again, to the location where I reached her. (In between, she fled to Burma to make it look like she’d left for good.) She also received numerous threatening phone calls, which she assumed were coming from a rival ibogaine provider.
At first glance, ibogaine can seem like a lucrative business; most legitimate centers start addiction treatments at around $5,000. But the overhead is substantial. In addition to real estate, centers must have all of the necessary medical equipment, a staff of registered nurses, at least one certified MD, and reliable sources of ibogaine (which, while not illegal in much of the world, is hardly available in wholesale quantities). Centers also perform numerous pre-screening tests, and patients receive around-the-clock care and monitoring for the majority of their stay. Done properly, it’s almost impossible to make a substantial profit. But Prueger believes a handful of charlatan ibogaine practitioners threatened by her competition for patients could be to blame for her harassment.
As our first interview draws to a close, Prueger tells me she doesn’t plan to leave Thailand any time soon. “I definitely feel stressed out,” she says. “But I’m happy to be here, I’m happy to be working with ibogaine. There isn’t anything else that I want to do. The things that I’ve had to go through over the last few months, they’re temporary.”
Unfortunately, Prueger’s troubles didn’t go away. When I contact her for a follow-up interview nine months later, she’s living and working in Costa Rica, after having left Thailand a year into her stay there. “I had problems with local organized crime,” she says carefully. “I’m not sure how much of it I can discuss.” Shortly after we last spoke, Prueger says she began receiving threats of an entirely different nature. “[Representatives of the local mafia] came to my house wanting a portion of the money I was making off the treatment, as well as an insane amount of money to keep operating there without any [corrupt] police intervention or trouble,” she says. “These people saw a young, female American running a business alone and they assumed I had money that simply didn’t exist.” One week later, Prueger woke to find a man holding a knife to her throat. He screamed at her, demanding the money that had been requested a week prior, ransacked her house looking for cash, demanded 50 percent of all her future sessions, and threatened her life if she didn’t comply. It was then she realized she needed to get out of the country.
As soon as she felt her two remaining patients were ready to be released, Prueger fled Thailand and escaped back to Iowa, where she took some time to process what had happened. “I think the issues I experienced were more about money being made in a certain territory,” she posits. “It’s possible that I would have had the same problems if I was doing something else on that island.” However, due to territory, unscrupulous competitors, or the threat effective rehab programs pose to local drug trades, similar stories follow ibogaine therapists all over the world, and she wasn’t sure if the job was worth the heartbreak anymore. Kogan himself had to flee his first center in Mexico, and dealt with various forms of harassment in his earlier days as a provider.
A month after she returned to America, Kogan called and asked Prueger to come to Costa Rica and help him with his practice. “I was pretty done with ibogaine at that point,” Prueger says, “but I owe Lex my life and I would do anything for him.” She soon remembered everything she’d loved about the job, one month became five, and now she’s preparing to take over many of the day-to-day duties as Kogan prepares to spend more time with his family. She estimates that she’s helped with over 300 sessions so far.
Prueger says she prefers the culture of Thailand to that of Costa Rica, but that it’s much easier to live and work in her new home. “It’s more of a functional society here,” she observes. “Thailand is so corrupt. Since I left, there’s been a coup, and the place is under martial law.” In contrast, she says Costa Rica is “one of the most peaceful places on the planet—there’s no military, and the most feared police are the environmental police.” And it’s not like it’s hard on the eyes; Prueger lives on the side of a mountain with panoramic views of the ocean and rainforest.
After everything she’s been through, and everything that still could happen, does Prueger still feel as committed to the work as she did at the end of 2013? “Yes, totally,” she says without hesitation. “There isn’t anything else in the world that I want to do. So I feel like some of the difficulties and chaos that come with this sort of job, psychologically, I’m able to handle them. I just don’t know of anything that interests me more than ibogaine, so that really keeps me going. I believe in ibogaine so much that I think it’s worth everything that comes with it.”
By Jamie Peck
Top photo via Wikimedia Commons
This article originally appeared in the December/January 2015 print edition of BUST Magazine. Subscribe today!
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