Stimulant Use Disorder
Compulsive use of methamphetamine, amphetamine, methylphenidate or cocaine that continues despite harm. All four drive dopamine far beyond anything ordinary life produces. The brain answers by pulling dopamine receptors from the synapse, and what is left behind is anhedonia: the flat, colorless state in which only the drug still registers as reward.
- There is no approved medication for stimulant use disorder, so conventional care is behavioral only
- Stopping carries no dangerous physical withdrawal, but the crash brings days of exhaustion, low mood and intense craving
- Prescription stimulants (Adderall, Vyvanse, Ritalin, Concerta) can produce the same dependence as street methamphetamine, usually starting from a legitimate script
- Ibogaine acts directly on the dopamine system the stimulant exhausted, which is why it anchors this program
Who it is for
One structure, four stimulant profiles
Methamphetamine
Smoked, injected or oral. Broadened cardiac screening, sleep and nutrition rebuilt before the main session, and any history of paranoia or psychosis assessed at intake.
Adderall, Vyvanse, Dexedrine
Prescription amphetamines, whether the script escalated or the use was never prescribed. Paused before arrival on the physician's instruction, with a plan for ADHD afterwards.
Ritalin, Concerta, Focalin
Methylphenidate clears fast, so the pre-arrival window is the shortest of the four. The sleep and appetite disruption that drove the dose up is the first thing the program repairs.
Cocaine and crack
The strict 72-hour window and an ECG that looks for the conduction changes cocaine leaves behind. Binge and crash patterns are mapped in the first psychology session.
Functional and performance use
Work, study, weight or nightlife use that became daily. Often the least visible dependence and the one people wait longest to treat.
Which stimulant you used decides the medical detail
Methamphetamine
Substituted amphetamine, releaserEnters the neuron through the dopamine transporter and reverses it, forcing dopamine out of storage vesicles into the synapse. It also blocks reuptake and slows the enzyme that clears dopamine, so the surge is both larger and longer than any other common stimulant.
- Cardiac screening is broadened: an echocardiogram is usually requested, because chronic use can strain the heart muscle
- Sleep and nutrition are rebuilt during priming, since most people arrive after days without either
- Any history of stimulant-induced psychosis or paranoia is assessed at intake and shapes the session plan
Why stimulants are different
A dependence built on reward, not on withdrawal
Opioid and alcohol dependence are held in place partly by withdrawal: stopping hurts, so people keep going. Stimulant dependence works differently. Stopping is not physically dangerous, but the days that follow are flat, exhausted and joyless, because the dopamine system has been driven so hard that ordinary rewards no longer register. That flatness is anhedonia, and it is the reason behavioral treatment alone struggles: the person is asked to build a life they cannot yet feel.
This is the gap the program is designed around. Ibogaine and its long-acting metabolite noribogaine act on the dopamine and serotonin systems directly and raise glial cell line-derived neurotrophic factor (GDNF), the growth factor that supports the dopamine neurons stimulants exhaust. The weeks after a session are a neuroplastic window in which new routines take hold more easily than they otherwise would. The ten-day structure exists to enter that window safely and to use it deliberately rather than leave it to chance.
Ten days is the standard length because the physiology needs it. A full baseline day and four days of low-dose priming let the medical team read your response before committing to a main-session dose, and a crash that started at home has time to settle. After the session, the day of rest, two days of structured integration and a clinician-led 5-MeO-DMT session on the second-to-last day give the insights somewhere to land before you go home. Twelve days is used when a medication transition, such as coming off a prescribed stimulant or an antidepressant, needs more room before the main session.
Mechanism
How the program works on the reward system
Booster priming reads you before it doses you
Days two to five deliver sub-psychoactive ibogaine TA boosters, a full dose each morning and a half dose each afternoon. Each one yields an observed QTc, heart rate, sleep and mood response. The main-session dose is set from that response, not from a weight chart.
One purified HCl session, fully monitored
Day six is the main session: ibogaine HCl under continuous cardiac telemetry, pulse oximetry and blood pressure, with IV access, a physician and a dedicated nurse present, in a protected low-stimulation room, followed by overnight observation.
Reward-system retraining, not just abstinence
From day three the psychology team maps the high-dopamine coping pattern (work stress, boredom, late nights, sex, weight) and builds replacement behaviors, urge-intensity tracking and a craving-response plan. Ordinary-life satisfaction is an explicit goal, not a hoped-for side effect.
The ten days, one at a time
Arrival and medical baseline
Private transfer from Cozumel airport, then a full day of measurement before any dosing decision is made. Nobody is dosed on the day they arrive.
- 12-lead ECG with QTc, repeated later in the day
- Bloodwork: CBC, metabolic panel, magnesium, potassium, phosphorus
- Urine toxicology documents what is still on board at arrival
- Orthostatic vitals and cardiac history, including any strain left by stimulant use
- Medication reconciliation with every dose verified
- Monitoring plan set: daily ECG through priming, continuous telemetry for the main session
- Psychologist orientation, plus baseline craving, sleep and wellbeing scores
- Nutritionist consult: most people arrive depleted and under-slept
- Sleep and hydration rhythm set for the whole stay
Booster priming begins
With the baseline reviewed, low sub-psychoactive ibogaine TA boosters start: a full dose in the morning and a half dose in the afternoon, so sleep stays protected.
- First TA booster, split-dose, under observation
- QTc read against the morning baseline
- Daily vitals, orthostatics and sleep tracking
- Craving score and stimulant severity scale recorded daily from here
- First 1:1 psychology session: the story of use, the triggers, and what the stimulant was doing for you
- Movement, breathwork and sound therapy paired with each booster
Priming continues
Each booster tells the team how your heart rhythm, sleep and autonomic tone respond. That response, not body weight alone, is what sets the main-session dose.
- Second booster day, same split-dose pattern
- Booster response logged: QTc, heart rate, sleep quality, emotional tone
- Electrolytes repleted where needed
- Reward-system retraining begins: mapping the high-dopamine coping triggers, such as work stress, boredom and late nights
- Physical therapy intake and a light exercise program
Sleep and nutrition restored
By the fourth day most people are sleeping properly for the first time in months. The medical team wants that in place before the main session, not after it.
- Third booster day
- Sleep reviewed in detail: stimulant users arrive with the deepest deficit
- Any prescribed medications adjusted on the physician's sequence
- Craving-response planning with urge-intensity tracking
- Group processing session
- Restorative yoga and massage
Readiness conference
The Clinical Director leads an interdisciplinary readiness review. Nobody goes into the main session on a schedule. They go in when the numbers say yes.
- Final booster, the last priming dose before the main session
- Repeat ECG and electrolyte panel
- Readiness conference: medicine, psychology and nursing in one room
- Low-stimulation preparation and an early night
- Intention-setting session with your psychologist
- Family or care-partner call if you want one
Ibogaine HCl main session
A purified ibogaine HCl session, dosed from your own booster response, under continuous cardiac telemetry with a physician and nurse present throughout.
- Continuous cardiac telemetry, pulse oximetry and blood pressure throughout
- IV access and dedicated nursing observation
- Protected low-stimulation environment
- Overnight observation with the physician team on site
- The introspective phase: many hours of vivid, waking review of the patterns behind use
- Nothing is interpreted during the session. The processing comes in the days after.
Post-session recovery
The day after is quiet by design. Ibogaine's long-acting metabolite, noribogaine, is still working, and the body needs rest, fluids and food.
- Post-session ECG and labs as ordered
- Hydration and electrolyte support
- NAD+ therapy when ordered by the physician
- Grounding-focused 1:1 integration psychology
- Restorative yoga and light physical therapy
- The first return of ordinary appetite and sleep is noted and scored
Integration begins
With the acute window closed, the structured psychological work starts: what came up, what it means, and what changes on the first morning at home.
- Daily vitals continue; craving and severity scales scored
- Home medication plan reviewed with the physician
- Professor Vazquez writing session: identity and self-narrative
- Reward-system retraining: replacement behaviors, and ordinary-life satisfaction as an explicit goal
- Group skills: distress tolerance and non-avoidant coping
Integration intensive and the 5-MeO-DMT session
The second-to-last day carries a clinician-led 5-MeO-DMT session, cleared that morning by a review of your recovery, sleep and rhythm, followed by relapse-prevention planning.
- Morning clearance review: post-ibogaine recovery, stable vitals, sleep, orientation
- Clinician-led 5-MeO-DMT session with the medical team present
- If clearance is not given, the day continues on the restorative integration pathway
- Writing session: meaning, accountability and future behaviors
- Support-system or partner session
- Written relapse-prevention plan drafted with your psychologist
Consolidation and discharge
Discharge is a clinical decision, never a scheduling decision. You leave with a printed plan, a confirmed follow-up schedule and your first month of aftercare microdoses.
- Final physician exam and ECG
- Medication reconciliation with a printed schedule
- One-month aftercare microdose supply dispensed at discharge
- Care-partner training for the first weeks at home
- 90-day integration program launched, weekly coaching to begin
- Follow-up assessments booked at one and three months
What keeps working after day ten
Schematic of the program design on a 100-day axis. The neuroplastic window is drawn from the pharmacology and the clinic's integration structure, not measured per person.
The scales your recovery is scored on
Cocaine Selective Severity Assessment
Eighteen items, each scored 0 to 7, covering craving frequency and intensity, depressed mood, anhedonia, sleep, appetite, energy and agitation over the past 24 hours.
It is the standard instrument for the stimulant crash. Because it scores anhedonia and craving separately, the team can see whether the reward system is recovering even while craving still spikes.
- 1Pre-treatment
- 2Daily on site
- 3Discharge
- 41-month follow-up
- 53-month follow-up
* Added when indicated: the ASSA extension for methamphetamine and prescription-amphetamine guests, the PHQ-9 and GAD-7 when the intake assessment points to depression or anxiety. The rest are scored for every stimulant guest.
Why it works for stimulants
Why this structure fits stimulant dependence
Stimulant dependence is one of the conditions where ibogaine's effect is most visible, because the drug acts on the exact system stimulants exhaust. Guests typically describe craving falling away during the stay and ordinary pleasure returning: food tastes like something, sleep comes on its own, and a conversation can hold their attention. That is the anhedonia lifting, and it is the change the whole program is built to protect once you are home.
The structure does the rest. The crash is managed on site rather than endured alone. Sleep and nutrition are rebuilt before the main session, not after it. The neuroplastic window is used for reward-system retraining, writing work and a relapse-prevention plan while it is open, and the 90-day integration program keeps the new routines supported past the point where most people would drift back.
We measure rather than promise. The validated scales above are scored through the stay and repeated after discharge, and aggregate results are published on the outcomes page once a consented cohort is large enough to report. The success rates page sets out how the clinic reports outcomes across every program. For a worked example of what the stimulant trajectory looks like, read the stimulant recovery case study, and for the evidence base behind ibogaine and stimulants see how ibogaine works.
Compared
The 10-day program against behavioral-only rehab
| Ibogaine | Behavioral-only rehab | |
|---|---|---|
| What it acts on | The dopamine system itself, through ibogaine, noribogaine and GDNF, then behavior on top | Behavior and environment; no approved medication exists for the neurochemistry |
| The crash | Managed on site with medical support, sleep and nutrition rebuilt before the main session | Endured, often as the first weeks of a 30 to 90 day stay |
| Anhedonia | Addressed directly; the return of ordinary reward is the program's central goal | Waited out, which is when most people leave |
| Dose decisions | Individualized from four days of observed booster response and QTc | Not applicable |
| Measurement | CSSA (the ASSA extension for amphetamine-class guests), craving, sleep and wellbeing scored daily, at discharge, and at one and three months | Varies; often attendance and self-report only |
| Time away from life | 10 to 12 days on site, then a 90-day integration program from home | 30 to 90 days residential, sometimes longer |
| Cardiac safety work | Required: ECG, QTc, electrolytes, continuous telemetry during the session, and usually an echocardiogram for methamphetamine | Not required, because nothing is dosed |
What is included
Everything in the stimulant program
All-inclusive 10 to 12 day program. No hidden fees. See the cost guide for every program price and what is and is not included, and contact us for an honest assessment of whether this program fits your situation.
Before you arrive
From pre-screen to your first morning in Cozumel
Confidential pre-screen
Register in the patient portal and complete the pre-screen: substance history including every prescription, cardiac and psychiatric history, and what you want from treatment. It takes about fifteen minutes and nothing is shared outside the medical team.
Medical review
A physician reviews your pre-screen and asks for what is missing, usually a recent ECG and bloodwork, and for methamphetamine usually an echocardiogram. If something rules you out, you hear it now, not after you have booked flights.
Treatment plan in your portal
The Clinical Director writes your treatment plan and it appears in your portal: program length, the stimulant-free window before arrival, what happens to any prescriptions, and the arrival date.
Medication and washout plan
Prescribed stimulants are paused on the physician's schedule (24 hours for methylphenidate, 48 for amphetamines, 72 for methamphetamine or cocaine). Any other medication that interacts with ibogaine gets its own written plan.
Travel and arrival
Fly into Cozumel. A private transfer meets you at the airport and the medical baseline begins the same afternoon. Nobody is dosed on the day they arrive.
Stimulant program FAQ
Frequently asked questions
Related Treatments
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Looking for stimulant addiction treatment accessible from your state? MindScape Retreat treats patients from across the US with direct flights to Cozumel. Find ibogaine treatment near you.
Precision dosing
Your main dose is measured, not estimated
Before the main session, we give a short series of low, sub-psychoactive ibogaine TA boosters. Each one is a measurement. Ibogaine and its long-lived metabolite noribogaine both affect the heart's hERG potassium channel, and that effect is dose-dependent, so instead of predicting how you will respond we observe it directly at doses far below a full session. Your main dose is then chosen from your own cardiac response and the margin you have left.
No ibogaine given. 12-lead ECG, electrolytes and liver panel establish the starting point. A baseline outside safe limits stops the programme here.
These are the measurements the protocol is built around. The trace above is a schematic used to explain the method; it is not a recording of a patient, and the values shown are illustrative rather than results.
How the booster protocol works for stimulant dependency →Find Out if You're a Candidate
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