Last Updated on June 25, 2016 by Dr. Alberto Solà

Ibogaine Treatment for Dual Diagnosis

by Jun 22, 2016

Ibogaine Treatment & Dual Diagnosis

Dual diagnosis is a term for patients who are both drug dependent and dealing with a co-occurring mental disorder. Dual diagnosis is a very broad category that encompasses a wide spectrum of comorbid conditions spanning the range from relatively mild depression, to severe bipolar disorder or PTSD.

Research shows that more than half of all drug-dependent individuals fall under the category of dual diagnosis. Co-occurring disorders significantly complicate treatment plans, and it can be difficult to diagnose which came first. Is someone who binge drinks self-medicating their depression, or are they depressed because they binge-drink? Substance abuse or mental illness can develop first.

Persons with mental health conditions quite often turn to drugs or alcohol as a form of self-medicating their underlying disorders, which the substance abuse is masking. For instance, if a patient suffers from bipolar disorder, then perhaps they self-medicate using opioids because it takes the edge off their manic phase, or lifts them out of severe depression when they’re in the depressive phase. Drugs can have an immediate effect which staves off the more severe symptoms of the mental disorder patients are self-medicating.

The longer term effects, as expected, can be, and usually are, severely detrimental to the individual who suffers from dual diagnosis. The effects of drugs and alcohol wear off, leaving the patient’s original symptoms worse than ever, while expanding their original diagnosis into two or more distinct disorders, each of which requires treatment.

Drug and alcohol dependence disorders often co-occur with:

  • Bipolar disorder
  • Depression
  • PTSD
  • Anxiety disorders
  • Schizophrenia
  • and a wide spectrum of personality disorders (DSM V, Axis II disorders).


Common symptoms of mood disorders include:

  • Loss of interest in formerly pleasurable activities which once brought joy to a person’s life.
  • Severe irritability or anger management issues.
  • Unexplained aches and pains which defy clinical diagnosis and never seem to go away.
  • Recurring thoughts of suicide or a preoccupation with death.
  • Aggressive behavior
  • a Decreased need for sleep, while not feeling tired.
  • Racing thoughts and speech.
  • Feeling sad and crying, or angry and lashing out, for no reason.
  • Feelings of worthlessness, guilt and hopelessness.
  • The inability to concentrate or make meaningful decisions.
  • Extreme irritability and/or energy, lasting for days (or weeks).
  • Delusions and Hallucinations, wherein people think thoughts which have no basis whatsoever in reality, or experience visual or auditory hallucinations without the benefit of being on psychedelics.
  • Poor judgement and impulsive or reckless behavior, such as making questionable business decisions, engaging in reckless spending, sexual promiscuity, gambling, or any number of ill-advised, high-risk behaviors.
  • Pessimism, loss of energy, constant exhaustion, the overall feeling that things will never go right.
  • Isolation and lack of desire to socialize with anyone.
  • Experiencing overwhelming anxiety or worry.
  • Extreme self-confidence and optimism, not grounded in reality, giving way to grandiose thoughts and ideation.

If you experience 5 or more of the above symptoms on a regular basis, it’s quite likely that you suffer from a mood disorder and may be experiencing clinical depression or bipolar disorder, which you are self-medicating with your drug(s) of choice.

Having some basic level of self-awareness is extremely helpful and can provide motivation to seek help. However, only a qualified health care professional with experience in treating mood disorders can make a diagnosis. Patients who attempt self-diagnosis are usually setting themselves up for failure, or connecting-the-dots in a manner which doesn’t bear any actual relation to what is happening.

It is important to remember that a person who has a dual diagnosis, has two separate and distinct, medical conditions, which are interconnected, but need to be addressed on their own terms, with individualized treatment plans for both. Neither drug dependence nor co-occurring disorders are moral failings or character flaws, they are medical conditions which require treatment and do not discriminate based upon race, religion, sexual orientation, age, or socioeconomic background.

Common Dual Diagnoses include:

  • Self-medicating PTSD with opiates or opioids.
  • Attention-deficit and hyperactivity disorders, combined with cocaine, amphetamines and alcohol.
  • Bipolar disorder and opioids and/or alcohol.
  • Self-medicating schizophrenia with opiates and opioids.
  • Depression and opioids or stimulants.

Successful Treatment

In order for a patient with dual-diagnosis to move forward, for the treatment to be effective, medical professionals generally agree that it’s critical to first address the individual’s drug-dependence issues.

Ibogaine treatment is remarkably effective for addressing a patient’s drug dependence issues, and provides a painless, rapid detox from most drugs of abuse. However, it’s important to keep in mind that detoxification is only the first step. After a successful ibogaine detox has been completed, people often experience a change in their perspective and may have profound insights into their current psychological condition. In order for these insights to become actualized and transition to actual life-changes, therapy is almost always required.

Successful treatment for a patient’s condition often requires a combination of medication, behavioral therapy, and support groups, combined with holistic alternatives such as massage therapy, yoga, acupuncture, nutraceuticals, organic foods, enemas, juicing, or a wide assortment of different combinations and permutations of these methods.

Whatever treatment plan you pursue, it’s generally a good idea to stack the deck in your favor. Yes ibogaine works for drug detoxification and can provide that near-mythical window of opportunity, where anything seems possible, but it’s extremely important to make use of this time to the best of your ability to do so. With dual diagnosis this tends to mean individualized therapy. Cognitive behavioral therapy (CBT) in particular has proven to be extremely useful in our experience, in helping patients with dual diagnosis identify and modify destructive or harmful thinking and behaviors and learn enough about themselves to identify triggers that set off mood disorders and self-medicating through substance abuse.


Quite often individuals who choose to experience ibogaine treatment, have resonance with alternative healing paradigms and a profound distrust of the pharmaceutical industry as a whole. While many actions that big pharma takes may seem questionable and driven more by the desire to produce profits for their shareholders, than the desire to help people afflicted with diseases and medical conditions, it’s helpful if you are capable of processing that not everything is black and white and good or bad.

  • If you have high blood pressure, it’s probably a great idea to continue taking your blood pressure medication, until a clinician examines you and let’s you know that your low-sodium, watermelon, kale, yak butter and strawberries diet, combined with yoga and lots of enemas, has indeed, “cured” your medical condition.
  • If you’re an insulin-dependent diabetic, perhaps it’s not the world’s greatest idea to throw all your insulin in a trashcan and just think positive thoughts instead.
  • If you suffer from bipolar disorder, PTSD, are borderline schizophrenic, or experience any number of other mental disorders… then it might be a good idea to be kind to yourself, have a solid plan for continuing care after your ibogaine detox, and avail yourself of everything that’s available to help you at the present time. If you need medication to help you through your period of reintegration, this doesn’t make you a failure.

Your individual condition may, or may not, require medication and lifestyle changes. Give yourself time to learn to walk again. Talk with a therapist you trust and feel comfortable with on a regular basis. Get some kind of group support. Get a little bit of “clean time” and distance from the acute phase of drug dependence. Give yourself time. Then talk with your clinicians and formulate reality-based plans for moving forward. Whether or not these plans include conventional medications, or alternative possibilities, isn’t that critical to the stage you’re in immediately after being detoxed. What’s important in this stage, is whatever works to help provide you with a stable foundation, on which to build the rest of your new life.