Washington Just Put $4.9 Million Behind Ibogaine. The People Flying to Tijuana to Quit Opioids Are Still Waiting Their Turn.

Marc Dervaes lost his right arm to a rocket-propelled grenade near Jalalabad in September 2009. The surgeries that followed left him with a prescription opioid problem, and years later, alcohol nearly finished the job: two months before he called an ibogaine clinic in Tijuana, he was in the hospital with alcohol poisoning. The earliest open slot was nine months out. He waited. In August he took the drug, came out the other side, and told a reporter, eyelashes wet, “I feel reborn.” Less than a month later a friend died by suicide, and Dervaes started drinking again. “I was angry for even going there and wasting my time and money,” he told The War Horse.

His story is the most honest thing anyone has published about ibogaine this year, because it holds both halves at once. The thing worked on him, and then life happened anyway.

On Thursday, the federal government put money behind half of that story.

The government funded the veterans’ story. It did not fund the overdose story, and those were always the same people.

The money is real, small, and pointed at PTSD first

Health Secretary Robert F. Kennedy Jr. announced on November 12 that HHS is committing up to $4.9 million, through its advanced research agency ARPA-H, to prepare ibogaine for study as a treatment for post-traumatic stress disorder. It is worth being precise about what that buys, because the headlines will not be. The money does not pay for anyone to be treated. Kennedy said so himself: it covers the unglamorous groundwork of manufacturing a consistent drug, figuring out dosing, and designing studies that the FDA will accept. Two teams were named, one led by Mark Cuban’s Cost Plus Drug Company and one by Beond, a Texas company that, per the Associated Press, has treated more than 3,000 people with ibogaine in Mexico, where it is not prohibited. Kennedy said the government will get Beond’s data and treatment guidance, and that this will “dramatically accelerate the clinical trial process.”

VA Secretary Doug Collins framed it around veterans: “For veterans living with PTSD, we owe them both urgency and the best science we can produce.” That sentence is right. It is also where the announcement’s priorities show. Addiction appeared in Kennedy’s remarks as a possibility, with “additional awards” that “may” explore ibogaine for addiction later.

Here is why that ordering matters to anyone reading this from inside recovery. Ibogaine did not become famous as a PTSD drug. It became famous because people with opioid use disorder reported that it shut off withdrawal, and the underground clinics in Mexico and the Caribbean were built on that reputation. The Carlat Addiction Treatment Report, in a July clinical update by Noah Capurso, summed up what the evidence actually supports: ibogaine appears to reduce acute opioid withdrawal and cravings within 24 to 48 hours, some patients report their depression lifts, and nobody knows whether any of it lasts. Translation: it may get you through the worst two days. Whether it keeps you out is unproven. The claim that it “resets” the brain in one session, Capurso wrote, “is not supported.” Dervaes, notably, came to ibogaine with both trauma and a substance problem. Most people who board that flight do. Splitting them into a PTSD population and an addiction population is a convenience for grant officers, not a description of who shows up in Tijuana.

None of this makes the PTSD-first approach wrong. A rigorous trial in one condition is how a drug earns the right to be tested in a harder one. But the announcement arrived with a sitting president quoted, via Joe Rogan, as texting “Sounds great. Do you want FDA approval? Let’s do it,” and with Kennedy predicting “a record drug approval process.” When officials talk like that, people who are dope sick on a Tuesday hear that the cure is coming. It is not coming this year, and when it arrives it will be for something else first.

But the announcement arrived with a sitting president quoted, via Joe Rogan, as texting “Sounds great.

If you have read about ibogaine in a recovery group chat and felt the pull of a single weekend that ends the whole thing, that pull makes sense. Years of daily dosing, clinic lines, and pharmacy fights wear a person down, and a one-time fix sounds like freedom. The pull is exactly why the next part matters.

The heart is the whole story, and the money doesn’t change the heart

Ibogaine’s problem is not that it is a psychedelic. It is that it interferes with how the heart resets itself between beats. In plain terms, the drug blocks one of the electrical channels the heart muscle uses to recharge, which stretches out a part of the heartbeat that cardiologists measure as the QT interval; stretch it far enough and the heart can fall into a chaotic rhythm that kills in minutes. Capurso’s review cites one observational study where average QT prolongation was 95 milliseconds and half of participants crossed 500, a threshold that makes cardiologists nervous. For comparison, methadone, the opioid medication with a well-known QT warning, prolongs it by roughly 10 to 15 milliseconds on average. Capurso also notes fatal arrhythmias “at therapeutic doses and in individuals without preexisting cardiac conditions.” His suggested script for clinicians is blunt: “My main concern is your heart.”

This is not new information. Xaver Koenig and Karlheinz Hilber laid out the cardiac record in a 2015 review in the journal Molecules, cataloguing case reports of long QT, arrhythmias, and sudden death. The War Horse, citing a 2022 literature review, reported 38 deaths and 20 medical emergencies associated with ibogaine, most during treatment for opioid addiction. That last detail is the one to sit with. The people who have died on ibogaine were, disproportionately, people trying to get off opioids. They often arrive with other heart-rhythm risks already in play, including methadone, which carries its own QT warning, and the Koenig and Hilber review notes that people break the drug down at very different speeds depending on their genes, so the same dose can hit two bodies very differently.

The best recent evidence comes from a population with a different profile. Stanford’s Nolan Williams and colleagues published a 2024 study in Nature Medicine following 30 male special operations veterans with traumatic brain injuries who received ibogaine with magnesium, given specifically to protect the heart, at a clinic in Mexico. The veterans reported large drops in PTSD, depression, and anxiety symptoms, and the study reported no serious cardiac events. Calibrated honestly: thirty men, no control group, outcomes largely self-reported, a carefully screened population, and the authors themselves called for controlled trials. It is a reason to fund research. It is not a reason to assume the same safety margin applies to a 45-year-old coming off fentanyl with no cardiac workup.

Beond’s 3,000 patients will be valuable data. They are also data from a private clinic that charges, per the AP, $10,000 to $20,000 a course, in a country with lighter regulation. A government that hands a company’s outcomes to the FDA as a shortcut has to be careful that “accelerate” does not quietly become “skip.”

We have watched this drug get close and then disappear before

Ibogaine has been here, almost exactly here, before. In 1962 a 19-year-old in New York named Howard Lotsof, using heroin and looking for a new high, swallowed a bitter powder from a West African shrub and came out the other side no longer craving heroin. He spent the rest of his life, until his death in 2010, trying to make the medical system take that seriously. By the early 1990s he nearly had. NIDA held review meetings and seemed ready to move. Then a woman died suddenly after taking it, and, as Koenig and Hilber recount, NIDA, “critically advised by pharmaceutical industry consultants”, declined to fund further human studies in 1995. The research went underground and offshore for thirty years. The clinics in Mexico are what filled the vacuum a federal agency left. Every person who has since flown south and paid cash for an unmonitored dose is part of the bill for that decision.

The clinics in Mexico are what filled the vacuum a federal agency left.

The more recent history rhymes. In 2023, Kentucky’s opioid settlement commission, under chair Bryan Hubbard, proposed spending $42 million of settlement money on ibogaine research; the incoming attorney general replaced Hubbard and the plan died. Texas then passed a $50 million ibogaine research law in 2025, but by this March no drug company had met the state’s terms, and Texas announced it would run the research itself through UTHealth Houston. Rice University’s Katharine Neill Harris told the Texas Tribune that a drug development effort like this “will likely require much more than $100 million overall.”

Put those numbers side by side. Texas: $50 million and a two-year trial that has not reported. Kentucky: $42 million proposed and pulled. Washington: $4.9 million for groundwork. The federal number is the smallest of the three, and it is the one with the loudest press conference. The pattern from 1995 holds: ibogaine gets proximity to legitimacy, a political moment, and then the hard, slow, expensive part, the cardiac-monitored controlled trial in people with opioid use disorder, is left for later.

What to do with this while the science catches up

For people in recovery, the most important fact in this whole story does not appear in the HHS announcement. The medicines that already work for opioid use disorder are still here, still legal, and still yours. The National Academies concluded in 2019 that methadone and buprenorphine are safe, effective, and save lives, and Capurso’s advice to clinicians is the same advice we would give a friend: for someone stable on an effective medication, giving it up for an unproven alternative is not a worthwhile trade. If you are not on one and want to be, the SAMHSA National Helpline at 1-800-662-4357 is free, confidential, and answers around the clock, and you can search for treatment near you on Rize.

If you are going to Mexico anyway, and some of you are, go with your eyes open. Ask whether the clinic does a full cardiac workup before dosing and monitors your heart continuously during it, whether a physician is on site, and what happens if your rhythm goes wrong at 3 a.m. Tell them every medication you take, especially methadone. And understand that if the treatment works and you go days or weeks without opioids, your tolerance drops fast. A return to your old amount after that is how people overdose. Carry naloxone home with you.

For providers, the move this week is concrete. Add one question to your intake and your medication-management visits: “Have you looked into ibogaine or any treatment abroad?” Patients are hearing about it from the President of the United States now, and they will not always volunteer it. If the answer is yes, get a baseline ECG, review QT-prolonging medications on the chart, and talk through the elicit-educate-elicit approach Carlat recommends: ask what they’ve heard, tell them what’s known, ask what they think now. Then document a plan for the window after they return, when tolerance is lowest and a prescription for naloxone matters most.

The broader psychedelic pipeline is moving fast. We covered how the first psilocybin application landing at FDA is already reshaping conversations in recovery rooms, and our psychedelics and empathogens hub tracks the rest. For more on the medicines that work right now, see our opioids hub, and follow the money on our policy and funding desk.

Marc Dervaes went back to Tijuana in early December, with a nonprofit covering the cost, took ibogaine a second time, and vowed never to drink again. Maybe it holds. We hope it does. But his year is the actual shape of this drug: a real opening, a real risk, and no guarantee that a single night changes what comes after. Howard Lotsof spent 48 years waiting for his country to study the thing that saved him. People coming off fentanyl do not have 48 years, and they should not have to wait behind a press conference to be told the truth about their own hearts.

But his year is the actual shape of this drug: a real opening, a real risk, and no guarantee that a single night changes what comes after.