Although early in its developmental process, Colorado has stated plans to move forward with legalising ibogaine services as soon as 2026. Although Colorado’s plans are early, such initiatives should not progress without gathering relevant biocultural information and conducting research in advance, in order to understand safety risks, set-up extensive safety protocols, ensure ethical and regulated supply, and create expert-informed therapeutic frameworks. Failure to address such critical issues early on could result in unintended consequences, which may include safety risks, or overharvesting and exploitation of iboga. Colorado has already had one prosecution for an ibogaine-related death.
One major oversight has yet to be addressed regarding the potential safe use of iboga or ibogaine in Colorado. The average altitude elevation in Colorado is 6,800 feet above sea level. Working with ibogaine or iboga in high elevations increases medical risk, with severe risks at around 8-9,000 feet. At 5,000 feet, the risk of altitude sickness is amplified, which includes common symptoms of headache, nausea, trouble sleeping, and lethargy. Research from Swacon International Hospital in Nepal has found that exposure to altitudes of 5,400 feet (roughly that of Denver) could lead to an increase of 14 mmHg in systolic blood pressure and 10 mmHg in diastolic blood pressure within a 24-hour period. Moderate to high altitudes are also associated with increased risk of arrhythmia. Ibogaine causes QT prolongation, which means that it increases the time between QT intervals, which can lead to fatal arrythmias. Elevation decreases the oxygenation in the blood which can amplify this effect. These factors would theoretically increase the risk of medical complications of administering ibogaine in many regions of Colorado.
To our knowledge, there is no research on individuals ingesting iboga at high altitudes. According to David Nassim, Co-Director from Blessings of the Forest, the iboga plant grows best at sea level and currently it is not known if it can even grow far above that elevation. In decriminalizing or promoting ibogaine, a central element of responsibility and stewardship with this powerful medicine is informing the public of the added risks that high elevation may create, although medical supervision can help reduce some of these risks. High altitudes are not the historic location for administration of iboga.
We are confident that the Colorado Natural Medicine Advisory Board will address such topics once they have built a trusted board of diverse advisors who understand the complexities, origins, and best practices surrounding this powerful medicine. Although we are supportive of Colorado and its desire to help increase access to ibogaine, there are added safety concerns based upon elevations in this particular jurisdiction. Ultimately, we need to be looking at such considerations and a myriad of other contextual factors well in advance, before creating policy, not as an afterthought.