When my mother walked into my bedroom and sat on the edge of the bed, I’d been drifting in and out of opioid withdrawal, ducking out at night to score, letting days blur past under the covers. After years of struggle, she simply asked: “You haven’t left this bed in three days. What can we do?”
That question broke something open in me. I finally said what I’d been afraid to admit: I needed help, and I wanted to try a medicine I’d read about called ibogaine.
Ibogaine — derived from the iboga shrub indigenous to west-central Africa — may be added to Colorado’s Natural Medicine program. While federally illegal, medically supported access is only available overseas. My ibogaine treatment in 2011 didn’t fix my life overnight, but after years of failed treatments, it allowed me to finally engage in recovery. (Ibogaine helps people with a variety of addictions, and it is the only plant-derived medicine with psychedelic effects that reduces or eliminates severe opiate withdrawal symptoms and cravings within 24 to 48 hours.)
I later became a licensed addiction counselor here in Colorado. Three years ago, I wrote an op-ed supporting the Natural Medicine Health Act because ibogaine had been included, and I wanted others to have a safer, legal path to the kind of intervention that helped save me.
That’s why I’ve been watching the Natural Medicine Advisory Board’s ibogaine discussions with admiration — and with hope that the spirit of this work can be expanded.
The recently developed “Ibogaine Sourcing & Nagoya Protocol” fact sheet acknowledges iboga’s cultural, ecological and spiritual significance to the Bwiti people in Gabon. In 2019, Gabon halted exports, designating iboga a “national treasure,” and began implementing the Nagoya Protocol, a framework for equitable access and benefit sharing. The board’s attempt to approach ibogaine with reciprocity is genuinely commendable.
And as I read that fact sheet, something else struck me: Nothing in it speaks to the people who may seek ibogaine here — people experiencing addiction in Colorado.
The document outlines how international stakeholders should be engaged, how prior consent and benefit sharing should work when utilizing a natural resource indigenous to another country, and how to protect vulnerable communities abroad.
But nothing speaks to the people I work with: the person using fentanyl because it quiets panic long enough to function; the person whose “treatment history” is a carousel of court orders, coercion, shame and inadequate care; the person who wants help but can’t find stable housing long enough for any medicine — psychedelic or otherwise — to take root.
Reading the Nagoya fact sheet, I realized it models an ethical way of relating to a community long overlooked. If the Nagoya Protocol is rooted in an ecosystem view — one in which the well-being of the whole depends on the well-being of every part — then Colorado’s Natural Medicine program needs something parallel at home. There needs to be a similar application of these principles to people in Colorado living with addiction.
If we took the spirit of the Nagoya Protocol seriously, we would ask:
What does prior informed consent look like for someone who has been coerced or court-ordered into treatment? It might mean instead offering truly trauma-informed, noncoercive care where the first question sounds more like my mother’s, “What can we do?”
What does benefit-sharing look like in a state where treatment access, housing and harm reduction remain deeply unequal? It might mean reinvesting any economic benefits from ibogaine into overdose prevention, peer support and services in communities most impacted.
What does protecting vulnerable communities mean in a place where people who use drugs are still routinely criminalized? It might mean rejecting policies and practices that increase fear and isolation.
These questions are not add-ons. You cannot import an ethical framework from abroad while ignoring inequities in the soil where the medicine is planted. If we reach outward to work responsibly with Gabon but plant ibogaine into an unstable, undernourished system here at home, the effort will not bear fruit.
I’m not asking the Natural Medicine Advisory Board to care less about Gabon. I’m asking it to recognize that ethical commitments travel in both directions. With the thoughtful deliberations to protect the people who have stewarded iboga for generations, there should also be serious discussion outlining how we will protect the people here who might one day seek ibogaine: people navigating homelessness, trauma, poverty, stigma and a treatment system that has not always treated them with dignity.
An ethical framework for ibogaine in Colorado would do both. It would honor international reciprocity and build a compassionate response here — rooted in trauma-informed care, housing, harm reduction, peer support and long-term integration.
My own recovery didn’t begin in a courtroom or rehab intake. It began in a bedroom, with someone sitting beside me, and lovingly asking, “What can we do?”
That is the posture Colorado’s Natural Medicine program should adopt as it considers ibogaine: humility, reciprocity and a willingness to support the whole ecosystem — including the people who need healing most.
Kevin Franciotti, of Littleton, is an addiction counselor and advocate for compassionate care of people with substance use disorder.
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