Safety First
Is Ibogaine safe? Learn about Nekawa, the safest Ibogaine medical structure available.
Through our program, ibogaine is administered by an independent licensed Brazilian physician inside a fully licensed hospital, with 24-hour ICU monitoring, qualified clinical staff, and emergency cardiac protocols on standby. Profound healing, without compromise.
What makes Ibogaine unsafe?
Ibogaine offers significant benefits whilst posing real risks if not administered properly. Unregulated countries, such as Mexico and Costa Rica, operate more as wellness spas than medical facilities, facing three critical safety limitations:
No pre-treatment prep
The weeks before treatment are vital to prepare the body for the ibogaine experience. It’s important to enter Ibogaine as healthy as possible. Some detox is required ahead of time.
No hospital or ICU
Cardiac events happen! Most clinics are far from hospital emergency care and rely on ambulances, so if a patient has a cardiac event, it can take too long to receive proper intervention.
Not enough time
What many don’t realize is that after ibogaine is the most critical window. Our in-person integration period is 15 days, that’s longer than other ibogaine clinics’ full programs. More days means better results.
Where the risk actually lives
The number long quoted against ibogaine, a death rate of roughly 1 in 427, comes from data gathered between 1989 and 2006, before modern cardiac screening existed. In June 2026, researchers checked that number against clinics operating under modern safety guidelines.⁸⁵ The risk was never evenly spread. It is cardiac, and it concentrates in one identifiable group: people detoxing from opioids.
Patients analyzed
Treatment records from 11 international clinics operating under the 2016 safety guidelines, the largest ibogaine safety dataset ever assembled.
Deaths within 72 hours
A rate of 0.03%, and every one was an opioid detox patient. The authors call this a lower bound, not the true rate, because clinics reported their own outcomes.
Deaths outside addiction treatment
Among the 8,689 people treated for PTSD, trauma, and other non-addiction indications, no one died.
This is not proof that ibogaine is safe. The study is a preprint that has not completed peer review, and one of its authors holds equity in ibogaine companies (he was kept out of the data analysis).⁸⁵ What it shows is where the danger sits: opioid detox, and the heart. A known, concentrated risk is a manageable one, and managing it is the whole design here: cardiac screening before any treatment decision, treatment in a hospital, ICU monitoring throughout.
We built Nekawa in Brazil because Ibogaine is a prescribed medicine
Nekawa was built in Brazil specifically because Brazil allows a physician-prescribed medical pathway for ibogaine. Through our program, students access ibogaine treatment that is delivered by an independent licensed physician in a real hospital setting, not in a private home or wellness center, as is common in unregulated jurisdictions.
Prescription Access In Brazil
Ibogaine is physician-prescribed in Brazil, allowing us to operate transparently and professionally.
24-Hour Hospital Admission (under the physician’s care)
Patients are placed on continuous telemetry in a hospital suite with ICU staff monitoring.
Emergency Protocols for Arrhythmias
The physician’s clinical team is trained in advanced cardiac protocols, from magnesium sulfate to synchronized cardioversion and external pacing.
Pharmaceutical-grade Ibogaine, prescribed for you specifically
The quality of the medicine matters as much as the medical setting. The ibogaine prescribed by the physician is not a grey-market compound. It is a precision pharmaceutical, manufactured under international standards and dispensed as an individual prescription by a licensed pharmacist.
Medical and program screening before treatment
Every prospective student undergoes a multi-stage screening before ibogaine treatment is cleared for prescription access and treatment. Each screening is independent.
Nekawa Program-Fit Screening
Our team conducts a separate conversation about whether the program structure and community are a fit for you. This screening is independent of the medical and psychological assessments.
Physician Consultation (independent)
A licensed Brazilian physician reviews your full medical history, current medications, and cardiovascular status. A 12-lead EKG, QTc interval measurement, and comprehensive bloodwork are ordered to assess cardiac and metabolic risk before any treatment decision is made by the physician.
Psychological Consultation (independent)
A licensed psychologist conducts a structured intake to assess your mental health history, trauma background, current psychiatric status, and readiness for treatment. This shapes your preparation protocol and ensures ibogaine is the right intervention at the right time.
The clinical and program team
The professionals you’ll work with through the program are credentialed and experienced. The independent clinical professionals operate under their own medical licenses and are not employed by Nekawa. The Nekawa program team supports your stay, integration, and community experience.
Independent Medical Team
- Licensed and experienced physicians
- Registered nurses
- Psychedelic-experienced psychologists
Nekawa Wellness Team
- Indigenous teachers and ceremony facilitators
- Peer mentors with lived experience recovery
- Integration specialists and certified coaches
Frequently Asked Questions
Ready to experience Ibogaine the safe way?
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Citations (2)
[85] Arns M, Shinozuka K, Barsuglia J (2026). 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 preprint (posted 17 June 2026; not yet peer reviewed). Read the source →
The largest ibogaine safety analysis to date: 19,071 patients treated under the 2016 safety guidelines at 11 international clinics. Six deaths occurred within 72 hours of dosing (0.03%), all among the 10,382 opioid use disorder patients; there were none among 8,689 non-SUD patients. An updated systematic review found 41 of 44 fatalities with a known indication involved substance use disorder, predominantly opioid detox. The authors describe the 0.03% as a lower bound rather than the true rate, since clinic participation was voluntary and deaths were not independently adjudicated. A preprint that has not completed peer review; one author holds equity in ibogaine companies and was firewalled from the data analysis.
[85] Daly N, Jacobs A (2026). Americans Encounter Risks at Psychedelic Clinics Abroad. The New York Times, 26 August 2026. Read the source →
Investigation into overseas psychedelic clinics. The Times counted at least 40 clinics and wellness centers in Mexico offering ibogaine, up from almost none a decade ago, and found no official tally anywhere of injuries or deaths. Patients described absent medical screening, prescription drugs given without regard to medical history, pressure to stop psychiatric medications abruptly, upselling during treatment, and sexual assault with little legal recourse. Also reports a JAMA survey of 49 retreats and clinics in which fewer than half employed a medical professional and roughly 10% employed a staff member with emergency medical training.
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