Presley Gerber, son of supermodel Cindy Crawford, died on 20 September, aged 27, at a rehabilitation centre in California. Police are investigating the case as a possible overdose and cardiac arrest, and the final toxicology results are still pending. Months earlier, he had said publicly that he had tried ibogaine - an experimental psychedelic substance - in his fight against addiction.

It's easy to connect two dots that shouldn't be connected. Psychopharmacologist Antón Gómez-Escolar, a psychedelics expert at the Inawe foundation, is clear: "His death cannot be linked to ibogaine. He took that treatment several months ago." But the case has raised a question worth asking without sensationalism: what exactly is ibogaine, and why is it being researched at all?

What ibogaine is

Ibogaine is a psychoactive substance from the root of the Tabernanthe iboga plant, which grows in Central Africa, particularly in Gabon. Scientific interest is growing because of its possible effect on addiction to opioids, cocaine and alcohol. It isn't taken like an ordinary daily medication: it's given as part of a treatment in which an intense psychedelic experience goes hand in hand with psychotherapy. The aim is for the patient to see their addiction differently and use that experience in the sessions that follow. In the US, where Gerber lived, it is not approved as a medical treatment.

What sets it apart is that, according to research so far, it may act both on psychological dependence and on some of the physical mechanisms - easing withdrawal and cravings for the substance. That matters for people who have spent years trying to quit, going through treatment after treatment and relapsing again. But preliminary results are not proof: broader studies are needed to know how long the effect lasts and who it really helps.

Gómez-Escolar links the effect to neuroplasticity - the brain's ability to rewire its connections. Psychedelics appear to stimulate it, creating a state in which deeply rooted patterns of thinking and behaviour can change more easily. The experience doesn't replace psychotherapy, but creates better conditions for it. In this approach, he says, the psychedelic "makes it possible to tackle the root of the disorder and speed up recovery, so that no medication is needed in the future".

The risk that can't be skipped

Ibogaine is usually taken orally, in a capsule, and the experience lasts several hours and requires specialised medical supervision. Unlike other psychedelics, it carries a serious cardiovascular risk: it can prolong the QT interval, meaning the heart takes longer than normal to recover electrically after each beat. That can disrupt the rhythm and trigger dangerous arrhythmias. That's why the heart is checked before treatment, blood tests are done and possible interactions with other medications are screened for, while heart activity is monitored continuously during treatment.

Other psychedelics are further along. Since 2023, Australia has allowed authorised psychiatrists to prescribe psilocybin for treatment-resistant depression and MDMA for post-traumatic stress disorder. Germany has opened compassionate-use access to psilocybin, and Canada, Switzerland and New Zealand have exemptions. In Spain, the Sant Joan de Reus hospital, together with the organisation ICEERS, ran a clinical study with 20 methadone-dependent patients. Psilocybin for severe depression already has positive results from two phase-three studies. Ibogaine is much further behind.

The question science still can't answer remains: who will respond, how long the effect lasts, and how to guarantee safety. And for the Balkans - are we ready for that conversation, or does the word "psychedelic" still shut it down before it even starts?