An Ibogaine Patient Bill of Rights (and Obligations)

Before any treatment begins, you have a right to your cardiac screening results in full: not "your ECG looks fine," not "you passed." Your QTc value, your bloodwork, your electrolytes. These are your numbers. A clinic that won't share them with you is a clinic that doesn't think you need to understand your own risk profile. You do.

If you have a condition other than addiction or trauma (Parkinson's, MS, TBI, chronic pain), ask the clinic directly how many people with your condition they've treated and what the outcomes looked like across that group. One impressive case is not a dataset. A clinic that uses a single recovery story as its primary evidence for treating your condition should be pressed on what the full picture looks like. If they can't answer, that's the answer.

If a clinic requires cardiac screening, that screening should happen before you book a flight, not the morning you arrive. A patient who flies from Chicago to Tijuana and learns on Day 1 that they can't be treated has been failed by the clinic's process, not by their own biology. If a clinic screens on arrival (some do, for legitimate reasons), you have a right to a complete, no-questions-asked refund of program fees if you're screened out, and a right to know in advance, in writing, that you're traveling at your own financial risk for non-program costs.

One reasonable exception: if you've successfully completed ibogaine treatment before, were cleared by ECG and bloodwork at that time, and have had no change in health since your last treatment, on-site screening at the start of a return visit is defensible. Cardiac status can change, so screening still happens; it just doesn't have to happen before you commit.

If you have a movement disorder, reduced mobility, or fall risk, this question deserves its own conversation before you book. Ask specifically: Are there grab rails in the showers? Can you get in and out of the beds independently? Is the outdoor space safe for someone who falls? A clinic built around addiction and trauma patients may never have thought through what a Parkinson's patient actually needs on the ground. That's not always malice. It's a gap. But it's your gap to close before you're there, not after you've arrived and can't leave.

You have a right to a written, itemized breakdown of what the program costs and what's included before any financial commitment is made. Not a range on a website: the actual figure, with what's covered and what's extra. A family in crisis isn't in a position to negotiate. A clinic that keeps its pricing opaque until after you've emotionally committed is exploiting that.

The conversations you have with a clinic before treatment — what was agreed, what was promised, what the protocol includes — should exist in writing. If your primary intake channel is informal messaging at odd hours with no documentation, you have no record of what was committed to, and neither does the clinic. A clinic serious enough to administer ibogaine is serious enough to run a structured intake. Chaos before treatment is a signal about how care will be managed during it.

Not on call. Not a 20-minute drive away. A doctor in the same building, monitoring your vitals for the duration of your session, whether that's in the room with you or in an adjacent room watching a camera feed while you're hooked up to an ECG. Both are fine. What isn't fine is a physician who can be paged. Ibogaine's peak cardiac effects can occur hours after dosing. The response window if something goes wrong is minutes.

Ask the clinic directly: what is the emergency protocol if something goes wrong during my session? The answer should be specific: a named hospital with an established relationship, a documented handoff procedure, and a physician who knows the route. A clinic that answers in generalities ("we have everything we need on-site" / "we're very experienced") has not thought through the worst case. The clinics that have thought through it can tell you exactly what happens, in what order, and who makes the call.

Continuous means continuous: not a baseline ECG at the start and then a check-in when the experience winds down. Cardiac telemetry throughout the acute phase. Someone watching you the whole time.

Medical clearance tells a clinic your heart can handle ibogaine. It doesn't tell them whether you're ready for what comes up during it, or after. A serious intake also assesses your motivation, your expectations, your psychological stability, and the support systems you'll return to. If the program includes additional medicines — ayahuasca, kambo, Bufo — each carries its own psychological demands that deserve their own evaluation. Being medically cleared isn't the same as being ready. A clinic that only screens for the former is skipping half the intake.

If you're coming off opioids, the days before the flood dose are the most medically complicated part of your treatment. You have a right to a specific, individualized plan for that period: what it involves, why, and how your doctor will know you're ready. "We'll figure it out when you get here" is not a protocol.

Before ibogaine is administered, you have a right to know the dose you're receiving and the clinical reasoning behind it. Some clinics calculate dose primarily by body weight, expressed in milligrams per kilogram; others factor in presenting condition, prior ibogaine experience, and individual clinical judgment alongside weight. Both approaches exist among serious practitioners. Whatever the method, it needs to be explained to you specifically. A clinic that can't or won't explain how your dose was determined is asking you to trust a black box at the most consequential moment of your treatment. Ask the question. The answer should be specific.

You have a right to know that the people in that building with you have been vetted. Background-checked staff, a documented process for reporting misconduct, and no exceptions on sexual contact with patients during treatment and for a defined period after. These aren't elevated expectations: they're the minimum conditions for a setting where patients are in acute psychological states, away from home, and in the care of people who become authority figures fast. Ask the clinic directly: what are your staff conduct standards, and how do I report a concern?

A session with a therapist, not a pamphlet from a coordinator. A named human being at the clinic to contact in the first 30 days. And a specific referral to an integration coach or therapist you can actually reach when you get home — not a generic list of resources, but a name. They don't have to be in your city; remote integration work is common and effective. What isn't acceptable is sending a patient home from one of the most intense experiences of their life with no one lined up on the other end. Most patients who struggle post-treatment don't know where to turn. A referral doesn't guarantee they'll follow through, but without one, the odds are worse.

You also have a right to be told, before treatment, that the days immediately following a flood dose can be emotionally difficult. For some patients, the transition out of the ibogaine experience brings a significant crash — hopelessness, flatness, occasionally suicidal thoughts. This isn't universal, but it's real enough that it belongs in informed consent the same way cardiac risk does. A clinic that prepares you only for the medical risks and not the psychological ones has left part of the picture out. Routine check-ins in the days after your session — specifically including an assessment for suicidal ideation — aren't optional aftercare. They're part of the treatment.

Integration support is more than a therapist referral and a check-in call. What a clinic owes you before you leave is an honest picture of what the real work looks like: that it extends into sleep, nutrition, movement, relationships, purpose, routine, and how you handle pressure when the medicine has worn off and ordinary life comes back. No clinic delivers all of that, and none should be expected to. But they should be naming it, so you know what's coming. That's the floor. The programs that distinguish themselves go further: structured integration protocols, longer follow-up windows, referrals to practitioners who specialize in the hard months after treatment.

If you're screened out, you have a right to know exactly why, including your specific cardiac finding, so you can bring that information to your own doctor. A rejection is more useful as medical information than as a verdict. And if the reason you're screened out is something a different clinic or clinical approach might be equipped to handle — a longer pre-treatment stabilization window, a program built for patients on your medication, a specialist in your presenting condition — you have a right to a referral, not just a no. Declining to treat you and leaving you with no next step isn't caution. It's a missed responsibility.

Any clinic that tells you it has never had a serious adverse event hasn't treated enough patients, or isn't tracking. Among practitioners who have administered ibogaine at any real scale, a zero-incident record is a red flag, not a credential. You won't get a full incident report. No clinic is going to walk you through its worst cases. The legal and reputational incentives all point the other way, and that's true even of the clinics that have genuinely learned from them. What you can get is evidence of that learning, if you ask the right questions. How has your protocol changed in the last few years, and what drove those changes? What's the most medically complex case you've had to manage, and how did you handle it? What would you do differently now from when you started? A clinic that answers these specifically — that can point to something concrete it changed, and why — has a learning culture. A clinic that responds with reassurances about experience and safety, without specifics, is telling you something too.

Every substance, every medication, every supplement. Your full kratom history, including what form you're using. Your methadone dose. The SSRI you've been on for four years. The antihistamine you've been taking for allergies that you don't think counts. It counts. The documented deaths in the ibogaine record include people who didn't tell their clinic what they were taking. The clinic can't protect you from what it doesn't know.

How much, how long, what else you tried. Minimizing your use to seem like an easier case is the kind of thing that gets people hurt. The intake process only works if you're honest in it.

If you are a parent, a spouse, or a sibling reading this because someone you love is destroying themselves and you are out of options: this is the hardest thing to hear, and it is the most important thing in this document. Ibogaine is not something you can want for someone else. The patient has to want it. Not just agree to it to get you to stop asking, not just show up because the ticket is already bought. They have to want to go.

This isn't a judgment of your loved one. It's a clinical reality that the best practitioners in the field will tell you plainly: a patient who arrives under family pressure, without their own genuine intention to change, is not a good candidate, and no clinic worth its reputation should admit one. If the person you love isn't there yet, ibogaine will wait. The treatment works best when the patient meets it.

If the clinic asks you to taper an SSRI before you arrive, that taper takes weeks. It can't happen the week before your flight. If you're asked to get labs done in advance, get them done. These requirements aren't bureaucratic friction. They're the part of your safety protocol that happens at home.

Ibogaine can open a door. What you do on the other side of it is on you. Showing up for integration sessions, doing the therapy, making the lifestyle changes the treatment opens up; none of it is optional. The patients who get the most from ibogaine treat the flood dose as a beginning, not a finish line.