Kenneth Tupper is a collaborating scientist with the Canadian Institute for Substance Use Research and an adjunct assistant professor at the University of Victoria.
Next week, the new documentary film In Waves and War makes its streaming debut on Netflix in both Canada and the United States. Although focused on the remarkable healing journeys of three U.S. special-operation-forces veterans battling combat-related post-traumatic stress disorder (PTSD) at a clinic in Mexico, the story has a compelling Canadian connection behind the scenes.
Dismissed and mostly ignored as “shell shock” following the First World War, PTSD among military personnel and veterans is now recognized as a major health concern. For many soldiers, it can be compounded by traumatic brain injury (TBI) from exposure to ballistic strikes or improvised explosive devices, and is often accompanied by depression, anxiety, sleep disorders and substance-use disorders.
Sadly, the best currently available psychiatric treatments for PTSD and TBI have modest outcomes at best, often leaving affected individuals and families struggling through a revolving door of emotional pain, existential distress and continuing suffering. Yet the experimental treatment featured in In Waves and War offers new hope, so much so that in June, the state government of Texas earmarked US$50-million to accelerate clinical scientific research into it. What has gotten the U.S. veteran community so excited, and in the current fractious American political climate, galvanized bipartisan representative support? It is psychedelic medicine – specifically, two compounds: ibogaine and 5-methoxydimethyltryptamine (or 5-MeO-DMT).
One compound, ibogaine, is an alkaloid found in the root of the West African shrub Tabernanthe iboga, which has long been used by Indigenous peoples of Gabon in Bwiti spiritual ceremonies. The other compound, 5-MeO-DMT, is an analogue of dimethyltryptamine (one of the primary components of the traditional Amazonian medicine ayahuasca) and is also known as “toad medicine,” as it is found in the venom secreted in skin glands of the Sonoran Desert toad. Both compounds are among the most powerful of psychedelic substances, and their consumption is not for the faint of heart – quite literally with respect to ibogaine, for which potential cardiac issues are a known risk factor, with several associated fatalities documented in medical literature.
The pioneering clinic Ambio Life Sciences in Tijuana has established and refined a careful, medically supervised screening and administration protocol for ibogaine that mitigates these risks. Ambio was founded in 2021 by a Mexican paramedic, José Inzunza, and two ex-pat Canadians, Jonathan Dickinson and Trevor Millar. Mr. Millar had previously sought to offer ibogaine in Canada as a potential treatment for opioid-use disorder. With a challenging Canadian drug-policy environment, the Ambio founders instead established their innovative clinic in Mexico. Mr. Dickinson also secured a licence from the government of Gabon to export iboga root, enabling Ambio to source their ibogaine in full compliance with the United Nations Nagoya Protocol for sustainable development and reciprocity.
Over the past four years, Ambio has increasingly attracted the unlikely patient population of some of the toughest and most battle-hardened U.S. military veterans, who spread by word-of-mouth and social media powerful personal stories of not only profound healing, but full-blown psychospiritual transformations. The clinic also came to the attention of neuroscience researchers from Stanford University, who in July published the results of an observational study involving 30 veterans who received ibogaine at Ambio.
Comparing fMRI brain scans of these subjects before, a few days after and then a month following a single administration of ibogaine, the Stanford team found highly significant results. Notably, large reductions in disability, PTSD, depression and anxiety were measured post-treatment across the cohort, and these were sustained for the overwhelming majority of subjects at the one-month follow-up. Although 5-MeO DMT was not administered to participants in this Stanford study, it is routinely offered as a capstone experience for Ambio patients two days following ibogaine, and perhaps for good reason – an intranasal formulation of this substance was just independently designated a “breakthrough therapy” for treatment-resistant depression by the U.S. Food and Drug Administration earlier this month.
While it is too soon to say whether further clinical studies will corroborate the promising preliminary findings on ibogaine and 5-MeO-DMT, the In Waves and War documentary may help to spark public interest in supporting such research. Given the leadership of the Canadians who developed the program, as well as the clear need for new options to treat recalcitrant mental health issues like PTSD, TBI and substance-use disorder, it would be exciting to see philanthropic or government research grants proffered to advance such science here in Canada. Or, to put it more patriotically, it would be a shame for Canada to allow the lone-star state of Texas to become the de facto north star for this expanding frontier of psychedelic research.