Indication-stratified mortality risk of ibogaine treatment under contemporary safety protocols: a multisite analysis of 19,071 patients and updated systematic review of fatalities
Research Square June 17, 2026 Martijn Arns, Kenneth Shinozuka, Joseph Barsuglia
Ibogaine, a substance showing early promise for treating substance use disorders and PTSD in veterans, carries a risk of cardiac arrhythmia and death. A retrospective multisite study of 19,071 patients treated under safety guidelines at 11 international clinics found that all six deaths occurring within 72 hours were among patients treated for opioid use disorder (6 out of 10,382), with no deaths among 8,689 non-SUD patients. A systematic review of ibogaine-associated fatalities mirrored this pattern: 41 of 44 fatalities with known indication involved substance use disorder, predominantly opioid detoxification. The findings indicate that ibogaine-associated mortality is largely confined to opioid detoxification and rare in non-SUD indications.