Risk management in a global market of alternative addiction care: a case study of the ibogaine medical subculture

Ibogaine, a controlled substance, is reported to interrupt addiction. Because it is illegal, a network of addicts and harm reduction activists has explored its use for treating substance dependency in underground and off-shore clinics. Practitioners have developed strategies to mitigate harm from the drug's potential cardiotoxicity. This case study examines how a medical subculture can create global governance without public funding or state regulations. The authors argue that the global market in alternative addiction care foreshadows a future market-based healthcare system.

Study at a glance

Abstract

Abstract The controlled substance “ibogaine” is reported to have unique addiction-interrupting properties. Due to its illegal status, the drug's application for treating substance dependency has been explored by a network of addicts and harm reduction activists in underground and off-shore clinics. The article investigates the strategies that practitioners have adopted to mitigate harm from administrating this potentially cardiotoxic drug. The case study invites us to probe the affordances (or lack thereof) of a medical subculture to create a global governance structure in the absence of public funding and state regulations. The wider significance of the case study rests on our theoretical claim that the global market in alternative addiction care is indicative of the future of a market-based healthcare system at large.