Ibogaine in Costa Rica

An absence, and how far we can prove it

Costa Rica does not appear to have scheduled ibogaine, and the practical evidence points that way, but we should be precise about what we checked.

Law 8204 defines controlled drugs by reference to the 1961, 1971 and 1988 UN conventions, with the operative lists published in La Gaceta. We have not obtained that list. What we do have is negative evidence from the state itself: in its January 2025 warning the health ministry expressly identifies DMT, the active compound in ayahuasca, as a substance on the national and international control lists, and makes no equivalent statement about ibogaine. It treats ibogaine purely as a product lacking sanitary registration.

That is the clearest indication available that ibogaine is not scheduled here. It is an inference, and we flag it as one.

It is worth saying plainly what that means, because the sector’s marketing depends on the ambiguity. Nobody in Costa Rica has decided that ibogaine is safe, or that these facilities are competent, or that this treatment works. No decision was made at all. A gap in a schedule is being read as an endorsement.

The government has actually spoken

Unlike most unscheduled jurisdictions, Costa Rica has not been silent.

On 27 January 2025 the Ministry of Health’s Directorate for the Regulation of Products of Health Interest published an Advertencia Sanitaria covering ayahuasca and ibogaine together. It recommends that the public not consume, use, apply or promote either for therapeutic purposes, nor take part in rituals including them, and asks people to report establishments or individuals promoting them.

The warning has no enforcement teeth attached to the substance itself, which is the difficulty with warning about something you have not scheduled. It remains the clearest official statement available, and it is the opposite of what the sector’s presence in the country implies.

Deaths, and what is actually known

On 5 August 2024 an American woman died at an establishment offering iboga ceremonies in Paquera, Puntarenas, and the Judicial Investigation Agency in Nicoya opened a file. Its report went to the prosecutor in March 2025. The agency concluded that, medically and legally, the death was from natural causes: the autopsy found advanced cardiac and pulmonary disease, and toxicology found no ibogaine. Her family disputes that reading, pointing out that the centre’s own pre-session ECG already showed abnormalities and cleared her anyway. The criminal file remains open against persons unknown.

The older cases are better documented as to cause, and there were two of them rather than one disputed date. An American died at the Iboga House Center in Cañas Dulces de Liberia in early 2013, and a Norwegian woman of 41 died at the same facility in April 2014. Forensic officials attributed her death to a cardiac complication caused by ibogaine, confirming it publicly almost a year later. In the 2013 case the toxicology was never asked to look for the substance. The facility closed.

Enforcement has been thinner than the warnings. In March 2015 the health ministry issued a national alert instructing its regional directorates to check for the substance during inspections, and opened an investigation into a Guanacaste resort; IAFA said it would order that resort closed for lacking accreditation. Eight months later the ministry granted the same resort a sanitary operating permit as an addiction treatment centre.

That is the pattern everywhere ibogaine is administered without cardiac screening. Ibogaine prolongs the QT interval, which can degenerate into a fatal arrhythmia, and the risk is manageable with an ECG beforehand and monitoring throughout. Where nothing requires those, whether they happen depends on the facility.

What to establish before booking

Because nothing local will do it for you:

• Does the programme hold IAFA authorisation, and under what name?
• Is a physician present throughout the session, and what are they registered in?
• Is an ECG performed before administration, and by whom is it read?
• Is cardiac rhythm monitored continuously during the session?
• What is the protocol for an arrhythmia, and what equipment is on site?
• How far is the nearest hospital with a cardiac unit, and how long is the transfer?
• What is the substance: pharmaceutical-grade hydrochloride, or root bark?

A provider who answers those precisely may still be poor. A provider who does not answer them has told you what you needed to know.

The full list, and the signals that should end the conversation, are in the treatment section.

Costa Rica in context

Costa Rica sits with Mexico in the unscheduled group, and the two account for most ibogaine treatment tourism. The difference is that Costa Rica’s health ministry has put its position on the record.

See the status by country table for the full picture, and Mexico for the larger of the two destinations.