Episode #49

Episode 49 Full Transcript:  Narcissistic Guides, Reframing Addiction & Ibogaine Treatment For Opioid Dependence with Juliana Mulligan 

Laura Dawn: Welcome Juliana. It’s such a pleasure to be able to spend some time with you today and drop in with you. It was so nice to see you in real time in person at Horizons back in December. So, thank you so much for taking the time to drop in with me here today. 

Juliana Mulligan: Yeah, thank you so much for having me. I’m excited to have this conversation with you and be a part of a long line of amazing people you’ve had on the podcast.

Laura Dawn: Thank you so much. I would really love to start by giving you the space to share your truly remarkable story and the journey you’ve been on that has led you to do the very important work that you’re doing today. So, I really just want to give you as much space as you need to really share that journey and that story with my audience.

Juliana Mulligan: Sure. Yeah, I’m happy to tell that story. It’s a big part of my work and why I do the work that I do. So, I’m a former opioid dependent person and formerly incarcerated. I spent the first seven years of my twenties going through all of the kind of typical things that people go through as someone who’s dependent on opioids in this country. So, going to rehab, going to jail. Being homeless, being beaten up, being on Suboxone, being on methadone, 12 step programs, kind of like that whole rigamarole. The treatment system in the U.S was really traumatizing for me. Because of the disease concept and the one size fits all mentality of mainstream drug treatment which tells you that you’re sick for life. You have a brain disease and there’s nothing you can do about it. That never sat right with me, but I didn’t know that there were other ways to think about these concepts. Because it was always pushed onto me that if you have a problem with drugs, this is the only way to work on it. This is the only way to view this issue and so I just felt really uninspired and discouraged by this way of looking at substance dependence. So, I tried kind of all the typical things, went to multiple rehabs. 

Finally after seven years I was living in Bogota, Colombia, and I was teaching English. I had discovered that I could get whatever drugs I wanted from the pharmacy. So, I was like having a heyday with that and actually that’s kind of what helped me realize that I wanted to be done with opioids. Because I finally had as much as I wanted which usually for most people that aren’t super wealthy in this country. It’s always like you can’t get enough. It’s always, if I can only have more. So, I finally had that in Columbia because I had this pharmacy access and I got to have as many opiods as I wanted and I realized that it sucked and then I was really lonely and miserable and I wanted to get off. So, I had heard about Ibogaine a few years before that from a friend who was super nerdy about psychedelics. When I first found out about, Ibogaine, I wanted to do it, but just didn’t have the resources at the time. So, when I really was at the end of my rope in Bogota, I decided like, I think that this is it. I think I need to do Ibogaine. I was at first going to order it and do it myself, which thank God a friend who knew nothing about Ibogaine, talked me out of doing that. I was really reluctant to tell my family what was going on. Because I had already put them through so much, but I did. I told my mom and she was to my surprise, a hundred percent on board with Ibogaine. I found a clinic in like a couple of days in Guatemala and I was on a plane to Guatemala in less than a week. So, I left my life in Columbia and I never went back and I went to Guatemala. So, the guys that treated me, we have kind of a phenomenon in the Ibogaine community of these like mad scientists, cowboy type personalities. Who think that they’ve been given special gifts to administer Ibogaine and are not necessarily safe and aren’t necessarily receptive to feedback. But maybe their heart’s in the right place and so I ended up with a couple of these type of guys and I didn’t know this too much later, but they were not following safety protocols whatsoever. I was coming to them on a really high dose of fentanyl. They told me I had the highest tolerance they’d ever treated. I was also like 110 pounds. So, that was saying a lot. Usually with, Ibogaine, you have to stabilize someone, especially somebody with a high tolerance, for a number of days. You don’t treat someone who’s done fentanyl in the last 10 days. Because of the way it sticks around in your system. These guys, though, they started giving me, Ibogaine 24 hours after I arrived. So, no stabilization period whatsoever. They were giving me Ibogaine, my withdrawal wasn’t going away, which is what usually happens with Ibogaine. So, they kept giving me more and come to find out later they did not measure the doses. Because the guy that treated me thought that he had a magical, intuitive sense of how much to give me. This is not something you can play around with. Ibogaine, now we can get into this more later, but there’s cardiac side effects. 

You have to be very exact and precise about what you’re doing and very, very careful. So, they ended up giving me about double the amount of Ibogaine that’s safe to give anyone. What happened was I started to have a really scary looking EKG, which is what often happens when you mis-administer Ibogaine or you don’t follow the protocols. So, they rushed me to a hospital. It was like a state Guatemalan hospital. That hospital turned me away because they had never heard of Ibogaine. I was like this 27 year old woman who, you know, seemed healthy otherwise, what are they talking about? I have an arrhythmia or something on with my EKG. So, they sent us away. We went to a second hospital that sent us away. Mind you, these hospitals were like packed. It was like a war zone in there. So, they just kind of didn’t have time for us. So, we got to the third hospital. They kept me for a few hours until the EKG kind of looked better and sent us home. We got back to the clinic, EKG got much worse. I was going into a deadly rhythm called torsades. That pretty much always ends in cardiac arrest unless you have an intervention. So, we rushed to a fourth hospital, which also was about to send us away until I hit the floor in the emergency room. That was my first of six cardiac arrests that I had to be defibrillated and resuscitated out of. So, they finally took us seriously of course, and after the sixth cardiac arrest, I think it was in a 24 hour period. They put me on an external pacemaker. Because what Ibogaine does is it, it blocks something called the potassium channel and doesn’t allow your heart to conduct electricity properly. Which is temporary, once Ibogaine enters your system, there’s no damage long-term damage to my heart. It was just that I began interfering with its functioning. So, I got put on this external pacemaker for a couple of weeks and I was in the ICU in Guatemala. This all sounds really crazy. But when I came out of bed. I kind of didn’t care what had happened. I was really fixated on the fact that I wasn’t in opiod withdrawal. As an opioid user who had been through countless cold turkey detoxes, and just basically living my life for seven years, running from withdrawal all the time and being half in withdrawal half of the time to come off of the biggest habit I’ve ever had in my life and to not be sick, I couldn’t believe it. It was astounding. 

My mom told me that I kept telling her on the phone, I’m not in withdrawal, I’m not in withdrawal. Yeah, that was amazing to me and the other thing was that I felt that a huge weight had been lifted off of me. I didn’t feel any of the shame or guilt that I had felt before for all the years that I had been fucked up. I felt excited about life and the biggest thing was that I knew in that moment that it was my duty to do whatever I could to change the mainstream addiction treatment system. To change the way people view people who use drugs and the misunderstanding of what you know, so-called addiction really is. The other thing that I felt was Ibogaine was the future for opioid treatment. I want to work with this. So, I was kind of like off on my mission. I was fired up and it was the first time in my life that I felt like I had a purpose. What was great about this purpose is that it means that all those years that I thought I was wasting and screwing up were actually my training to do the work I was supposed to do. So, suddenly I just felt liberated from all of these chains that society had put on me around my drug use and it made complete sense. So, the fact that I had had this medical emergency was like, well, you know that’s okay because I feel great now. Well come to find out a year later when I went to my first Ibogaine conference, I realized that they weren’t following the safety protocols whatsoever and that it was a completely avoidable situation. So, the good part about this is that it’s made me really fixated on safety protocols and ethics in Ibogaine treatment. People tend to listen up when I talk about it because of what happened to me. So, that’s the pro of that but that’s basically what happened to me, that was in 2011. Ever since I’ve been doing various things related to Ibogaine treatments. That’s that segment of my story. At least the beginning. 

Laura Dawn: Okay. That’s such a remarkable story and I think this is a good place to pause. Because you’ve mentioned really feeling passionate about rewriting the narrative around addiction and opioid dependency. So, can we just unpack that a little bit for people who are listening and they’re thinking, what is she actually talking about? What is the old or current narrative and what paradigm and new narrative are you trying to help introduce into our mainstream culture now? 

Juliana Mulligan: Yes. So, the mainstream narrative is that addiction is a brain disease and there’s no cure and you have it for the rest of your life and there’s nothing you can do about it. Most people also think that the only treatment is going to 12 step programs and admitting you’re powerless and going through those steps and you have to keep going to these meetings or else you’re gonna die, end up in jail or end up in an institution. So, that is not what I’m into anymore. The issue with this, well, let me just start by saying, I work in a harm reduction psychotherapy center here in New York City called The Center For Optimal Living. We approach things very different. First of all, the brain disease concepts doesn’t even make sense. It doesn’t qualify as a disease whatsoever. Actually the guy that came up with that theory was proven to be a charlatan later on in life. There was no scientific backing. I think it was just society just needed something. Needed an explanation because the original notion was that drug use is a moral failing. We realized that wasn’t right. So, at the time, actually addiction as a disease was like a progressive step forward. But now we’re realizing that that doesn’t make sense either. That actually, when you tell someone that they have a disease that can’t do anything about it, it eliminates the possibility of exploration, of the very complex reasons that people do substances. Because it’s actually quite meaningful. 

People are using substances for really big, important reasons and experiences and things that they’ve survived in their life. So, harm reduction really allows for an exploration of all those unique factors. The other thing about the mainstream disease concepts is that it holds people hostage in one place. It doesn’t allow for the fact that we are all constantly evolving and changing beings. Once we address certain aspects of ourselves, we might not reach for substances in the same way. I don’t reach for substances in the same way at all anymore. Because I don’t feel that urgency to escape out of my body. I used to be desperate to turn off how I felt. I don’t want to do that at all anymore. I actually really like being here and that’s because I’ve done therapeutic work. So, this isn’t to say that like, oh, eventually I’m going to use heroin recreationly, it would be fine. Like, no, I don’t want anything to do with that drug because it’s like super sedating and doesn’t, I have just no connection to it anymore. But it does mean that I can have a glass of wine and nothing happens, and maybe that’s not going to be the case for everybody. But for me, I don’t use substances to numb myself out anymore and I can leave them or take them. This is like a revolutionary concept for people that have been super indoctrinated into 12 step that tells you, you can never touch anything again, it’s going to be a disaster. So, I think that there is an infinite amount of possibilities for each person and the traditional concepts of addiction don’t really allow for that. The other thing that I want to emphasize is that there has been this imaginary line drawn between people who struggle with drugs and everybody else, and it doesn’t make any sense. Because every single person on this planet has a destructive behavior at some point in their life that they use as a coping mechanism. Whether that’d be shopping, whether that’d be sex, relationships, gambling, workaholism, and some of these are glorified within capitalism. So, what it comes down to is which destructive habit actually works within capitalism in which doesn’t okay. So, being a heroin user, most of the time does not benefit capitalism, but if you’re a workaholic, it does. 

So, why are we adhering to this line from a toxic system telling us that these disruptive behaviors are okay because it makes you productive. But these destructive behaviors are a problem because it takes away from your productivity. I am not participating in the drawing of that line anymore. I would argue that every single person on this planet could qualify as having an addiction at some point in their life. What I think it is, is it’s really one, the underlying mental health issues that people have. Like, when people say, oh, does this clinic do addiction treatment? Or does it focus on like, psychospiritual, there’s not really a difference between these issues. It’s just the differences in how society treats them. It’s to me, the reason that people use drugs suffer more than everybody else is because of the stigmatization of societies, because of the criminalization. It’s because we’ve made it incredibly unsafe to be a drug user. But we’ve made it really safe to be an alcohol user. We’ve made it very safe to be a chronic shopper and a workaholic. So, for me, I really want to work towards erasing this line and designating people who use drugs as especially sick because it’s a society created problem.

Laura Dawn: I really, really appreciate that perspective. It also makes me think of Gabor Monty’s work, who I’m curious if his work has had a meaningful inspiration in your life. When you look at the core, as someone who has also struggled with debilitating addiction in my own life, a lot of times I can see the core was rooted in unworthiness or not good enough or disconnection and isolation. What would you say are some of those core aspects that really drive people to reach for substances? 

Juliana Mulligan: So, I think that the original wound for many of us and especially most people who struggle with addictive tendencies is that we’ve been told since we were young, that what we think and feel is wrong. Our parents do this to us. Society does this to us. You know, we say, suck it up and keep working. That’s the whole ethos of capitalism and modern capitalism. So, we learned to shove our feelings down. We learn to turn off. We learn not to listen to our intuition because we have to do our homework, because we have to keep going to school. Or for whatever reason people are telling us, like, no, no stop crying. Just, you know, you need to go and sit with your grandmother, even if you don’t want to, you need to. You need to get to school at seven in the morning, even if you’re feeling terrible, it’s like, there’s no true exploration of how children feel in many family systems. So, this original wound of what you think and feel is wrong gets perpetuated when people go for treatment for addiction. Because you get told what you think and feel is wrong and you’re powerless, and you need to listen to us and submit to this program. It’s like you know, it’s reinforcing that original wound. It’s perpetuating, it’s retraumatizing it. Actually in harm reduction, what we do is we prioritize the goals of the person. 

We value what their goals are. We value what feels right for them and so it’s a re empowering. I really think that this is what people need, but I do think that this original wound of what you think and deal is wrong. This wound of like you know, I think being told from when you’re a kid, that your value is how you do in school. I think that’s awful that children are really made to feel that their entire value is based on their performance in a school system. That was modeled after Nazi Germany to make soldiers, it’s really, not a system that welcomes creative, unique children whatsoever. So, if you don’t do well in that system, something’s wrong with you. I mean, for me, that was a big thing. I felt like the most horrible person in the world because I couldn’t do well in school. Then when you grow up your value is based on your career. So, these are like really toxic things and it makes you feel bad, it affects your self esteem. If you can’t function these systems, if you don’t feel like you fit in with the other children, it affects your self esteem. So, I think isolation, loneliness, not feeling like you fit in. Being told that what you feel is wrong are all what precipitates these kinds of issues. 

Laura Dawn: I really appreciate the way that you’re setting the context of all of this within the societal structure of capitalism. Its really extending our understanding of set and setting and the environment that we find ourselves in is also extended to our culture and the systems that actually create that structure. So, this kind of links back to that second part of the story is like back in 2011, when you came through that journey out the other side and correct me if I’m wrong. But my understanding is that a big portion of relapse after people go through Ibogaine treatments is because they put themselves back in old environments and surround themselves with the same people where they used to use. I’m curious, what was that like for you to come out of that back in 2011, which was a very different psychedelically informed time than it is even right now. We still have a really long way to go, but that was a decade ago. So, what was that like and what do you wish that you had then that now people do have access to that has informed your work in the center that you work at now? 

Juliana Mulligan: Well, one thing that benefited me is that I didn’t go back to where I was living in Columbia. I came back to the U.S. So, changing environments gave me a big edge, and I also didn’t have any using friends because I used opiates. Opioids are more of a lonely drug in my opinion. So, I didn’t have to worry about like friends that I had to cut off. Thank God. So, that was helpful, but I do wish that I would have had therapy which I didn’t get around to finding for a few years after that. I didn’t find out, I didn’t even really learn what harm reduction was until like a year after. So, even though I was often running and, you know, I never used opioids again. So, I’m considered like a success, even though there are many different versions of success and relapsing after everything doesn’t mean you weren’t successful. Also, I just want to say that and I do wish that I would have had a better mental health support and harm reduction, oriented mental health support. As well, the place that I work now, it’s like the center of my dreams. All of the clinicians are amazing and it’s just such a beautiful thing to work with clients who are so used to the abstinence only model. Then they come to us and they’re like, wait a minute. You want me to set my goals? You care what I want to do? Like what I feel is valuable? Like I am an empowered person? Like I don’t have the disease for life? Like it’s so wonderful to watch people when they hear this. I had a guy the other day, break down in tears because he was like, so relieved that there was this other way because the abstinence only 12 step model never felt right for him. 

Laura Dawn: So, what was some of the next steps that you took and when did you know that you really wanted to step into providing this care for people? 

Juliana Mulligan: Well, you know, even though my Ibogaine fighter almost killed me. One of the great things that he did for me was I wanted to stay and work in the clinic. I didn’t want to leave and that is a common thing that happens. Most people who work in clinics, providing Ibogaine, did a treatment themselves, and then immediately opened a clinic or went to work in the clinic. This actually causes some issues. My provider said, go back home, learn how to live your life for a year and then come and work in a clinic. I’m so glad he told me that because it was the first time that I was like living as a responsible adult, essentially. Learning how to like make money and manage my life and all of that. A lot of people who go immediately from their own treatment to working. They think they can’t do anything else, but provide Ibogaine. This contributes to a lot of issues that we can dive into later of people that don’t take breaks and don’t leave providing treatments when they should. It ends up endangering clients. But that’s a whole other issue. So, I went home, I ended up moving to the Bay Area. I knew that I wanted to prepare for working in clinics. So, I got an EMT certification. Because of what happened to me. I was like more at that point, more interested in the medical side of things. So, I got an EMT certification. Went to my first Ibogaine conference in Vancouver in 2012, met everybody. Kind of started to set up where I was going to go train. So, I ended up taking longer than I had expected and started working in clinics in 2014 in South Africa. That was the first clinic I worked at. I worked at a clinic in Costa Rica after that, and then one in Mexico after that. After my time providing treatments, I realized that there was something about being an Ibogaine provider that didn’t feel completely fulfilling to me. I felt like I had skills and talents that could do something else, but I wasn’t sure what it was. I was very resistant to going to school. Because I had had such a hard time as a child with ADD and, you know, I thought, well, if I have a good provider, I don’t ever have to go to school again. 

This is great. But then when I realized that that wasn’t the right thing for me, I was like, shit, I’m going to have to go to school. So, I realized that working more from the psychotherapeutic angle was really where my skills were at. So, I embarked on the long journey of getting a bachelor’s degree and now I’m working on my master’s. But throughout that process, I’ve always been informally helping families and people seeking treatment, to find the right treatment. Because it’s actually not easy to know where the good clinics are and what to look for. So, I kind of solidified that into a business about three and a half years ago working with people and their families around treatment. Now I’m also advising clinics on safety protocols and mental health protocols and just kind of helping people doing consultations with people, for whatever they need. But I’m really interested in like safety ethics, how clinics are set up. I also work with, Ibogaine providers supporting them through crisis situations. That’s like one of my favorite things. So, there’s a couple of clinics that call me when they have emergencies. They have a really tough decision to make about a treatment. So, that’s kind of like where I’m at now, but it’s been an evolution and it took a lot of trial and error to figure out like where my place was in the community.

Laura Dawn: Wonderful, and the person that administered that first dose, or that significant journey where you almost died, is he still providing? 

Juliana Mulligan: No, he actually passed away, I think it was the end of 2017, which is really sad. This guy, you know, He was a pretty reckless guy, but he wasn’t like an evil dude. We kind of have this phenomenon in the community of people who come into it with the right intentions. They have really big hearts, but they’re not taking care of themselves. Ibogaine attracts the people with the biggest trauma, because it’s the hardest psychedelic in the world. It’s not recreational. It is not fun. So, people come to Ibogaine, who’s tried everything else generally, and who will have really big, heavy issues. Once you do Ibogaine, you feel so invigorated and excited about life. You feel like all of your problems are solved. A lot of us are like, I’m going to, my calling is to be an Ibogaine provider. So, people dive into it without getting proper mental health support. They do it in a kind of a workaholic destructive way where they don’t take enough breaks and they’re not taking care of themselves. We probably have one Ibogaine provider a year die for various reasons because they’re not taking care of themselves, in a car accident. Even like murders in Mexico have happened. So, it’s a big issue. We have a lot of talented, loving people working, but who aren’t really safe to work with vulnerable people because they haven’t worked on their own issues. This is the case with my provider who just wasn’t taking care of himself. He got progressively worse and after me, there was a handful of deaths over the years in Costa Rica because of his negligence and he just kind of got more delusional with time. Which I’ve seen happen with a number of people in the community. Eventually he got in a car accident and passed away. So, this is why I’m really excited about supporting providers. I’d love to be in a community where there was funding for every single person working in a clinic to be in therapy, where there was supervision for every single person working in a clinic. This medicine is so amazing, but it’s also so dangerous and it’s an art form to administer it carefully. We really need more support for the people providing it, or it’s just not going to be safe. 

Laura Dawn: I so appreciate that. I also really appreciate the way that you’re actually bringing a lot of compassion talking about this man who supported you on a journey who put you almost on your death bed. But yet you’re able to sit here and say, you know, he had a really good heart and really good intentions. I think that that’s an important balanced view because I think there’s also a lot of demonization happening in this space right now. A lot of judgment and people throwing shit around. I think that we can actually do better as a community to hold space for these conversations that really come down to safety and harm reduction. Let’s just get more informed and your idea to have funding, to support healing the healers. Let’s support the healers, let’s support the practitioners. Even right now, we’re seeing burnout at such high rates in the psychedelic space. On a whole, it’s really, really a major issue that’s happening right now. So, I really love that you’re speaking to this. So, poignantly, and I’m curious to ask you if we could just shift gears a little bit for people listening. When they hear you say that you went through this journey and that you didn’t have any withdrawal symptoms on the other side. That’s very different than other programs and going to rehab. What is the mechanism in Ibogaine that facilitate something like that? That seems actually quite miraculous. 

Juliana Mulligan: Yeah. Well, I want to clarify and say that I did have 15 to 20% withdrawal, which is nothing in comparison to the full blown thing. You know, like I definitely felt kind of uncomfortable and antsy for like a week or so afterwards and like trouble sleeping. So, there’s a little bit less, it doesn’t take everything away, but it takes away the majority. I also want to clarify that, it doesn’t do that for all opioids, suboxone, and methadone. It doesn’t really work on it in that way. A lot of people who are coming off fentanyl do have more withdrawal symptoms than someone coming off oxycodone. So, it kind of depends on the opioid and the way it works. But the way that it works. So, one of the most important researchers in Ibogaine Dr. Ken Albert. He says that we understand like 1% of how Ibogaine works because it’s so complicated. It acts on every receptor site in your brain. Other psychedelics are much less, it’s like a couple of receptor sites. But Ibogaine hits everything, which is why it’s so amazing and also a little bit dangerous. But the opioid system, there’s a bit of a disagreement between researchers on how it works. But essentially it’s sitting on your receptor without activating the part that gets you an opioid high, like it adheres to the opioid receptors, but it’s not activating it. So, it’s kind of like holding the place of where the opioids would have been and its slowly wearing off. So it’s like, yeah, it’s basically holding the place and not leaving your system quickly. So, that’s why you’re able to essentially like skip the withdrawal process. It’s also doing something to the serotonin and dopamine receptors that feels to me like a resetting mechanism and that’s how it’s described. But they also don’t fully understand how it works. Unfortunately, there hasn’t been enough funding for Ibogaine research, although that’s been improving. So, I think there’s going to be a lot of really interesting things that we learn in the future about Ibogaine. It’s being used to treat Parkinson’s as well in very small daily doses, not the big psychedelic dose. So, there’s a lot of implications for how this works, but the opioid thing is amazing. It feels like a miracle after going through so many withdrawals from different opioids myself. 

Laura Dawn: I can just imagine, you know, a parent listening to this right now, who is watching their child go through opioid addiction. Who doesn’t know that this even exists and might have questions and concerns and it’s amazing that your mother was on board to support you in this journey. 

Juliana Mulligan: My mom’s an angel, basically. I think that’s