The heavy hallucinogen ibogaine is illegal in the US, but some addicts are flocking to Mexican clinics for it, hoping to be cured. A physician investigates.

I’m not sure I’ve ever met an opioid user who didn’t want to quit, and as an emergency room doctor, I’ve met a fair number of users. But the chemical need of the addiction can be indomitable. And the nature of that dependence is often misunderstood. It’s not only the high that keeps most users hooked—it’s also avoidance of the special hell of withdrawal.

This is why, when a heroin user who had just overdosed in his mother’s bathroom was brought to the ER where I work, he immediately shot up again in the hospital bathroom. Paramedics had given him naloxone, the antidote for opioid overdose. It saved his life, but the medication creates instant withdrawal. His brush with death had fazed him less than his roiling dope sickness.

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