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Psychedelics as Medicine Conference 2025: Day 1 Report
The "Psychedelics as Medicine" conference, held on February 27-28, 2025, brought together an impressive array of researchers, clinicians, advocates, and indigenous wisdom-keepers to explore the rapidly evolving landscape of psychedelic therapies. On the first day, participants gathered to share the novel research, clinical insights, and cultural perspectives that are shaping this emerging field.
The conference highlighted the growing recognition of psychedelics as transformative tools for mental and physical health, addiction treatment, and spiritual wellness. With the psychedelic renaissance gaining momentum globally, this gathering served as a vital nexus for cross-disciplinary exchange and collaboration.
Day one featured presentations spanning from traditional applications of plant medicines to cutting-edge neuroscience. The day's sessions revealed a field in dynamic evolution, and the speakers displayed an impressive capacity to balance scientific rigor with cultural respect, and medical applications with ethical considerations.
This report provides a thematic overview of key discussions from the first day, with particular focus on iboga-related content and its implications for addiction treatment, harm reduction, and ethical practice in psychedelic medicine.
Iboga & The Opioid Crisis: A Radical Path to Healing
One of the day's most significant sessions was the panel discussion "Iboga & The Opioid Crisis: A Radical Path to Healing," moderated by Simeon Schnapper and featuring W. Bryan Hubbard, Ethan Nadelmann, Dr. Kasia Malinowska, Juliana Mulligan, and Robert Rooks. The moderator opened by noting that 2025 seems to be emerging as "the year of iboga and ibogaine," setting the stage for a wide-ranging conversation about this powerful plant medicine's potential in addressing the ongoing opioid epidemic.
Policy Developments and Government Support
Bryan Hubbard, who has worked his way from private law through federal positions to running the Kentucky Opioid Abatement Advisory Commission (KOAAC), shared powerful personal insights about witnessing the birth and growth of the opioid crisis in his home state of Virginia and within his own family. His passionate advocacy has contributed to significant policy developments, with ibogaine research and treatment programs now receiving legal support and funding in Washington, New York, Arizona, and Kentucky, with Texas positioned to be next. This marks a remarkable shift in governmental approaches to addiction treatment and represents a potential watershed moment for iboga therapy.
Criminal Justice Reform and Harm Reduction
Robert Rooks, coming from a background in criminal justice reform, posed a compelling question: "Imagine if instead of a war on drugs, we had a system which focused on harm reduction." He shared that his work has contributed to reduced incarceration rates in the United States, with some prisons even closing—though he acknowledged that COVID-related crime increases temporarily slowed this progress. Rooks expressed strong confidence that iboga has a crucial role to play in the evolving approach to drug policy and addiction treatment.
Global Perspectives and Inclusive Solutions
Dr. Kasia Malinowska broadened the conversation to include international perspectives, urging American stakeholders to join global conversations rather than assuming that U.S. policy changes would transform the world. She challenged attendees to support diverse treatment approaches (including opioid-based treatments when appropriate), to reject psychedelic exceptionalism, and to engage with other advocacy communities such as those focused on pain management. Dr. Malinowska also highlighted how the harm reduction community successfully and vitally protected ketamine from criminalization, offering a model for iboga advocacy while protecting necessary access to ketamine for people in the developing world, where it is often the only available anesthetic.
Balanced Approaches to Drug Policy
Ethan Nadelmann, a long time drug legalisation advocate familiar with ibogaine's potential, pushed back against the criticism of "psychedelic exceptionalists"—arguing that, in many ways, psychedelics are inherently superior to other substances. However, he still advocated for a more comprehensive approach to drug policy along with full legalisation (even if the drugs cause us harm) based on the core principles of bodily autonomy, which, according to Nadelmann, should be paramount. He emphasized that all substances and treatment methods must be considered by policymakers, with multiple approaches championed in addressing the opioid crisis.
Safety, Ethics, and Indigenous Respect
Perhaps most directly relevant to practitioners was Juliana Mulligan's candid discussion of ibogaine safety. She began with the stark and shocking assertion that "anyone can die from iboga and ibogaine," emphasizing the critical need for practitioners to follow rigorous protocols, such as the published protocol guidelines from 2016. Mulligan advocated for centralized training, certification processes, and mandatory supervision for providers.
She shared her personal experience of the intense responsibility of monitoring heart activity during sessions and noted the concerning statistic that approximately one ibogaine provider ends up dead or homeless each year due to burnout and substance abuse. This underscores the need for provider support systems alongside client care protocols.
Mulligan also raised the crucial question of how to honor indigenous communities while working within medicalized treatment models—a tension that remains unresolved but essential to address as iboga treatment expands.
Together, this diverse panel illuminated the multifaceted challenges and opportunities surrounding iboga as a treatment for opioid addiction, showing that we stand at a promising intersection of policy change, clinical application, and cultural reconciliation, with iboga potentially playing a pivotal role in transforming addiction care while demanding careful attention to safety, ethics, and indigenous wisdom.
Safer Journeys: Navigating Harm Reduction in the Psychedelic Space
The morning panel on harm reduction, moderated by Ann Harrison, provided crucial insights relevant to all psychedelic practitioners, with particular applications for those working with iboga. The panel featured Juliana Mulligan, Dr. Kasia Malinowska, Allison Hoots, and Svala Jóhannesdóttir from the Matthildur Harm Reduction Initiative, each bringing unique expertise to this vital conversation.
Boundaries and Ethical Practice
Juliana Mulligan, drawing on her extensive experience with ibogaine, identified boundaries—both physical and emotional—as one of the most pressing ethical concerns in psychedelic-assisted therapies. She highlighted the concerning lack of clear boundaries in many treatment settings and how this can trigger attachment issues for clients.
Mulligan offered a nuanced perspective on how psychedelics can potentiate ego effects not only in clients but in guides as well, creating risks of inappropriate relationships or enmeshment. She emphasized that ethical practice must extend beyond safe medical protocols to encompass emotional safety, noting that clients with attachment trauma are particularly vulnerable to unhealthy dynamics with medicine providers.
She argued that being a part of capitalism means we constantly have our boundaries violated by the system, so we should be extra careful in medicine spaces, remembering always how broader social contexts can exacerbate vulnerability in therapeutic settings.
Client-Defined Success in Ibogaine Treatment
In a point particularly relevant to ibogaine providers, Mulligan stressed that any change in substance use patterns should be considered a success. She criticized providers who impose their own agendas and definitions of success on clients, arguing instead for an approach that empowers clients to define their own goals and metrics for improvement.
She advocated against automatically pushing the addiction disease model or 12-step frameworks, suggesting instead that providers be curious and spacious and empower clients to define their own success framework. This client-centered approach represents an important shift from more prescriptive treatment models.
Practical Harm Reduction Strategies
Svala Jóhannesdóttir shared concrete examples from her work implementing harm reduction at music festivals in Iceland. Beginning with a small team of five providing 24-hour support, their services included roving personnel, a dedicated phone number, and a safe space for those experiencing challenging psychedelic experiences.
Interestingly, she noted that approximately half of those seeking their services needed drug-specific advice, while the other half presented with mental health concerns—highlighting the interconnected nature of substance use and psychological well-being. The success of their "very low threshold service" (meaning that there were minimal requirements to be able to access the support) allowed people to rest, receive company during difficult experiences, and access reliable information without judgment.
Legal Challenges and Informed Consent
Attorney Allison Hoots addressed the significant challenges of providing harm reduction services in jurisdictions where substances remain illegal. These obstacles include limitations on education, care provision, and individuals' willingness to seek help when needed.
Hoots strongly advocated for thorough informed consent processes, ensuring that clients fully understand what they're taking and what to expect. She raised the critical question of how consent operates in altered states—a particularly relevant consideration with long-acting medicines like iboga, where the effects can last for 24 hours or more.
Global Harm Reduction Context
Dr. Kasia Malinowska, with three decades of harm reduction experience, placed psychedelic harm reduction within a broader historical context, reminding attendees: we're not discovering anything new, she said; we're standing on the shoulders of those who have come before. She also challenged the community of spiritually superior and judgmental psychonauts who dismiss other substance users while feeling superior due to their "better drugs."
Dr. Malinowska's observation that "if you treat people like responsible adults, they will take up [health services] with a lot of gratitude" encapsulates a core principle of effective harm reduction—treating clients with dignity and respect rather than judgment or paternalism.
Principles for Practice
The panel concluded with key principles for providers:
- Respect anonymity, support autonomy, and empower clients
- Include clients when developing policies and protocols
- Respect people's agency and avoid hierarchies among different substances
- Provide clear information about potential outcomes, both positive and negative
- Never guarantee specific results or claim clients will be ‘cured’
- Allow ideas of ‘success’ to be client-led and not determined by the provider’s expectations or desires
These principles offer valuable guidance for the iboga community as treatment options expand and evolve, ensuring that innovation remains grounded in ethics and client wellbeing.
Research Frontiers: Scientific Insights for Psychedelic Practice
Several presentations provided cutting-edge scientific insights into psychedelic mechanisms and therapeutic applications. While not directly focused on iboga, these research findings offer valuable context for understanding how different psychedelics affect consciousness and healing—knowledge that can inform iboga practitioners and researchers.
Deconstructing Consciousness: DMT Research
Christopher Timmerman from Imperial College London presented fascinating research on DMT and 5-MeO-DMT, compounds that share some properties with ibogaine despite their shorter duration. His presentation, "The Signal in the Noise: Deconstructing Consciousness with Psychedelics in Research and Therapy," explored how these substances disrupt core aspects of the sense of self.
Timmerman's brain scan studies revealed intriguing patterns during psychedelic experiences, including a comparison between 5-MeO-DMT and advanced meditation states. In one innovative experiment, an experienced Western Lama was administered DMT at both low and high doses. The Lama noticed that the experience of 5-MeO had many similarities with his deep meditation state, though interestingly, the meditator did not recognize the DMT state as equivalent to nondual meditation experiences.
A particularly relevant finding was that "entity encounters represent a momentary decreasing of entropy [in the brain]"—potentially offering insights into the visionary or entity encounters sometimes reported during iboga ceremonies. Timmerman emphasized that engaging the spiritual, emotional, and cognitive aspects of psychedelic experiences correlates with better mental health outcomes, supporting the holistic approach often employed in traditional iboga contexts.
He advocated for robust "scaffolds for meaning-making" around psychedelic experiences, including careful attention to music, setting, preparation, integration, and metacognitive processes—elements that iboga practitioners have long emphasized in their work. This idea, that the set and setting are vital to the experience, was something echoed by many researchers and providers throughout the weekend. Again and again, findings show that these sacred molecules don’t work in isolation. Intention, sacred space, and a connection to the greater meaning of the work seem to be crucial.
Imperial College Breakthroughs
Dr. David Erritzoe provided an overview of ongoing research at Imperial College's Centre for Psychedelic Research, outlining their methodological approaches to testing psychedelics. Their studies employ various trial designs, including two-arm studies (medicine vs. placebo), sequential studies (placebo followed by medicine), and studies without placebos. Part of the reason for this methodological diversity is the challenge inherent in blinding psychedelic trials—participants typically know whether they've received a psychedelic or placebo due to the unmistakable subjective effects, compromising the traditional double-blind gold standard of pharmaceutical research.
These investigations utilize multiple neuroimaging techniques: PET scans for molecular insights, MRI for structural and functional information, and EEG for electrophysiological data. This multimodal approach offers a comprehensive picture of how psychedelics affect the brain—methodologies that could be valuable for future ibogaine research.
An intriguing aspect of Erritzoe's presentation was the discussion of discrepancies between clinician and patient priorities in treatment outcomes. This raises important questions for iboga practitioners about how to balance traditional healing frameworks with contemporary patient expectations and clinical standards, harking back to what Juliana Mulligan spoke about earlier: the importance of allowing clients to define their own metrics of success, rather than practitioners inflicting their own expectations on their clients’ experiences.
Perhaps most provocatively, Erritzoe mentioned research comparing macrodosing, microdosing, and placebos, suggesting that the intense subjective experience normally considered essential for major change might not always be necessary for therapeutic benefits. While this remains controversial, it invites consideration of whether some of iboga's benefits might be accessible through protocols that don't require the full visionary journey. This echoes our perspective and experience here at iboga.org, that microdosing can be as powerful and transformative as full flood doses.
Therapeutic Models: The Roots to Thrive Approach
Dr. Pam Kryskow presented the Roots to Thrive model of psychedelic therapy, emphasizing that optimal outcomes result from the symbiotic integration of effective therapy with psychedelic medicines—neither component alone being sufficient.
Kryskow highlighted her involvement with two psilocybin clinical trials utilizing Acceptance and Commitment Therapy (ACT) and "psychedelic somatic interactional psychotherapy." She stressed three critical elements for therapeutic competence: medical and psychological safety protocols, skilled and supervised therapists, and utilizing the therapeutic model in which each practitioner excels rather than forcing a one-size-fits-all approach.
The Roots to Thrive program has reported impressive mental health outcomes, leading Kryskow to advocate for public funding of psychedelic-assisted therapy—a policy position that could benefit iboga treatment programs if extended to include this medicine.
Ketamine Research: A Model for Medical Integration
Dr. Lowan H. Stewart's presentation on ketamine offered valuable insights into how a once-controversial psychedelic substance has been successfully integrated into mainstream medicine. Dr. Stewart traced ketamine's development as a replacement for phencyclidine (commonly known as PCP or angel dust) as a dissociative anesthetic, before highlighting its remarkable effectiveness in treating depression.
According to Stewart, ketamine "reverses the effects of stress on the brain," placing it among what he termed "rapid-acting anti-depressants" (RADs)—a category that might conceptually include various psychedelics.
Most encouragingly, Stewart described his successful research and advocacy work in Norway, which is leading to ketamine treatment becoming accessible to all Norwegians through their national healthcare system. This breakthrough offers a potential roadmap for how ibogaine treatments might similarly achieve mainstream acceptance and accessibility in healthcare systems globally, especially in those countries (like Brazil and South Africa) where it is already legally available under prescription.
End-of-Life Applications: Psychedelics for Existential Distress
Dr. Anthony Bossis presented a beautiful and moving talk on psychedelics for psychological and existential distress in palliative and end-of-life care. His work focuses on facilitating an enlightened, aware, liberated death through psychedelic-assisted therapy.
Bossis highlighted the often-overlooked condition of "demoralization syndrome," which he described as medically neglected despite its prevalence in terminal illness. His research suggests that addressing spiritual meaning is a vital component in treating demoralization and depression, noting that when these conditions are effectively addressed, there's a drastically reduced desire for early death among patients.
He posed the profound question: "Why are we wired for meaning?"—a query that resonates with the deep meaning-making experiences often reported in traditional iboga ceremonies. While iboga may not typically be the medicine of choice for end-of-life care due to its intensity and cardiovascular considerations, the spiritual and meaning-oriented frameworks Bossis described align closely with traditional Bwiti approaches to iboga work.
Psilocybin's Global Presence and Evolutionary Significance
Paul Stamets delivered a compelling presentation on how "Psilocybin Mushrooms Bridge Cultures & Continents," tracing the worldwide distribution of these fungi alongside human migration patterns. Stamets said that networks—fungal, neural, and social—are foundational to life, noting that fungi gave birth to animals some 650 million years ago. His suggestion that psychedelics stimulate random acts of kindness points to their potential for fostering prosocial behavior across cultures.
Stamets documented the presence of 217 known psilocybin mushroom species globally, presenting evidence of their use throughout human history—from African cave paintings and Egyptian hieroglyphs to Indian temple surroundings and European artifacts. Challenging conventional scientific opinion, he proposed that psilocybin evolved as an anti-gastropod chemical rather than an insecticide. This evolutionary perspective invites consideration of iboga's own evolutionary history and ecological role in its native habitat, potentially informing how we understand its unique properties.
5-MeO-DMT: Powerful Insights from Another Profound Medicine
Joel Brierre's presentation on 5-MeO-DMT offered valuable comparative insights into another exceptionally potent psychedelic medicine. Describing it as "the most powerful psychedelic experience known to man," Brierre outlined how this fast-acting compound occurs both in nature and synthetic forms. He emphasized its potential not only for inducing mystical experiences but also for therapeutic applications ranging from mental health to chronic pain and neurodegenerative disorders.
Brierre shared fascinating neurological research showing that the brain under 5-MeO-DMT simultaneously resembles both deep anesthesia and an extreme epileptic state—paradoxical findings that may help explain its profound consciousness-altering effects. He candidly addressed the "dark side" of 5-MeO-DMT, including risks of myocardial infarction, asphyxiation, serotonin syndrome, psychological destabilization, psychosis, mania, and suicide—concerns that parallel many of the safety considerations in iboga work. His ethical approach to creating a legal, safe treatment center in Mexico after observing dangerous "cowboy" practices offers a potential model for responsible iboga service development.
Collectively, these research presentations offer valuable scientific context for the iboga community, suggesting both parallel mechanisms across different psychedelics and potential models for how iboga and ibogaine might be further integrated into clinical practice while honoring their traditional roots.
Cultural & Ethical Considerations: Honoring Roots While Moving Forward
Throughout the day, several presentations addressed the crucial cultural and ethical dimensions of psychedelic medicine—considerations that are particularly relevant for iboga, given its deep roots in Bwiti tradition and its complex journey into Western therapeutic contexts.
Indigenous Wisdom and Academic Collaboration
Dr. Jukka-Pekka Heikkilä and Cecilie Byholt Endresen presented on advancements in academia, particularly highlighting Nordic collaborations in psychedelic research. They advocated strongly for indigenous rights and the overwhelming value of indigenous wisdom, emphasizing that academic progress must occur alongside respect for traditional knowledge systems.
This theme of honoring indigenous contributions emerged repeatedly throughout the day, reflecting growing awareness that psychedelic medicines like iboga cannot be separated from their cultural contexts without significant ethical concerns and potential loss of wisdom.
Media Responsibility and Public Education
The panel on "Psychedelics in the Spotlight: Shaping Media, Shaping Minds" featuring Ann Harrison, Anne Philippi, and Dr. Julie Holland, moderated by Gina Vensel, explored how media representations influence public perception and policy around psychedelics.
Ann Harrison emphasized the importance of consulting with indigenous people when reporting on traditional plant medicines—a practice particularly relevant for iboga journalism. She advocated for accurate, balanced, and fair reporting which covers both the benefits and risks of psychedelics, noting the emergence of bipartisan political support for psychedelic therapy in the United States.
Harrison expressed concern about the “weaponization of language" in media and politics, calling for journalists and advocates to stand up for free speech to ensure that those who speak out about psychedelic benefits aren't subject to reprisal—crucial for iboga advocates navigating complex legal and social landscapes.
Anne Philippi proposed that "now's the time for a new media system" and called to "create a whole new content landscape around psychedelics." She suggested that psychedelic communities can define their own media narrative rather than relying on mainstream outlets, using intelligent social media channels to promote balanced information.
Dr. Julie Holland, drawing on her experience as a psychiatrist and media figure, advocated for utilizing both traditional and modern media platforms to promote harm reduction and drug safety. Her suggestion to advise TV writers on accurate portrayals of psychedelic use reflects the need to transform public narratives around psychedelics.
Gina Vensel ended by reminding us that we're all leaders in our communities and conduits for good, accurate, healthy, safe information into the world—a reminder of the responsibility carried by everyone in our sacred plant community to communicate thoughtfully about these powerful plant medicines.
Psychedelic Leadership and Personal Transformation
Dr. Stefan Frädrich's presentation on "Psychedelic Leadership" offered perspectives on how psychedelic experiences can transform individuals in leadership positions, potentially creating ripple effects throughout organizations and society.
Dr. Frädrich, a psychiatrist who observed that "the most depressed person in the hospital was the head clinician," shared his personal journey of healing through psychedelics after hitting a professional wall approximately four years ago. His experience led him to organize conferences focused on mental health and personal growth.
His observation that “having goals is a waste of time, you need to change yourself” reflects a transformative perspective often reported in iboga experiences—where participants describe fundamental shifts in identity and priorities rather than simply achieving predefined objectives.
Dr. Frädrich's encouragement for leaders to work with psychedelics suggests potential applications for iboga beyond addiction treatment—perhaps as a tool for transforming leadership consciousness in ways that could address systemic issues underlying many social problems.
Wisdom, Honesty, and Voice: The Healing Journey
Dr. Will Siu's opening presentation on "Wisdom, Honesty, and the Voice" provided a philosophical framework relevant to all psychedelic work. Siu discussed how modern psychotherapy has become "divorced from soul," etymologically connecting psychedelics to their role as "revealers of the soul."
Through his personal narrative of healing from depression, denial, and substance abuse (what he termed "soul silencers"), Siu illustrated how psychedelics can facilitate reconciliation with one's authentic self. His first psychedelic experience with DMT marked a turning point after years of struggling with these issues.
Siu's emphasis on honesty as "disruptive" yet necessary echoes the often-challenging clarity experienced reported in iboga experiences. As he noted, "honesty can mean loss"—of relationships, work, or perceived security—yet this disruption often precedes genuine healing and transformation.
His metaphor of voice as yarn that weaves our story, with words determining the quality of that yarn, offers a powerful frame for understanding integration work following intense psychedelic experiences. The sequence he proposed—"Wisdom (insight) catalysing honesty (endurance) leading to voice (action)"—maps well onto the process many describe after profound iboga experiences: gaining insight, facing difficult truths, and finally embodying new patterns in daily life.
Implications for the Iboga Community
The first day of the Psychedelics as Medicine Conference revealed a field in dynamic evolution, with iboga and ibogaine emerging as significant players in the changing landscape of psychedelic therapy. Several key implications stand out for the iboga community:
- Policy momentum is building. With states like Washington, New York, Arizona, and Kentucky moving to support ibogaine research and treatment, we appear to be at a turning point for iboga's legal status and accessibility in the United States, a country which is often a bellwether for other countries’ legal policies.
- Safety remains paramount. The candid discussions about cardiovascular risks and provider burnout underscore the importance of rigorous protocols, proper monitoring, and support systems for both clients and practitioners.
- Client-centered approaches are essential. The emphasis on empowering clients to define their own success metrics challenges traditional addiction treatment paradigms and aligns with more holistic views of healing.
- Indigenous wisdom must be honored. Throughout the conference, speakers highlighted the importance of respecting traditional knowledge and ensuring that medicalization doesn't erase cultural contexts.
- Integration with mainstream healthcare is possible. The ketamine model demonstrates how a once-controversial psychedelic can achieve medical acceptance and accessibility, potentially paving the way for iboga treatments.
- Media narratives are evolving. The growing bipartisan support and changing public discourse present opportunities for more nuanced, accurate representations of iboga and its potential.
- Applications may extend beyond addiction. Discussions of leadership transformation, meaning-making, and existential wellness suggest broader applications for iboga that align with traditional Bwiti perspectives.
A Sacred Conclusion: The Voices of Ancestors
The first day of the conference concluded with a transcendent musical performance by Snow Raven, a singer and vocal performer from the Indigenous Sakha people of Siberia. As the scientific discussions and policy debates gave way to her extraordinary vocal artistry, the room was transported to the wild expanses of the Arctic and beyond.
Snow Raven didn't merely perform music—she embodied the voices of the natural world. From the haunting hoot of an owl to the primal howl of a wolf, her voice became a living bridge between humanity and the wilderness. With each note, she seemed to dissolve the boundaries between performer and audience, between human and animal, between present and ancestral past.
"Listening is one of the powerful gifts the universe has given humans to connect with nature," she teaches, and her performance made this wisdom visceral. As her voice echoed through the conference hall, many attendees closed their eyes, perhaps finding in these ancient sound patterns a resonance with their own experiences in expanded states of consciousness.
In a day filled with data, policy discussions, and clinical protocols, Snow Raven's performance served as a profound reminder of why many are drawn to plant medicines like iboga in the first place—to reconnect with something ancient and wild within themselves, to hear again the voices of ancestors that modern life has muffled, and to remember that healing often comes through beauty that transcends rational understanding.
As attendees filed out afterward, the lingering vibrations of her voice seemed to ask a question that lies at the heart of the psychedelic renaissance: How might we integrate these medicines in ways that honor not just scientific evidence but also the mystery and magic that indigenous cultures have long recognized as essential to genuine healing?
