Therapeutic Effects of Ritual Ayahuasca Use in the Treatment of Substance Dependence—Qualitative Results

Abstract

This qualitative empirical study explores the ritual use of ayahuasca in the treatment of addictions. Ayahuasca is an Amazonian psychedelic plant compound created from an admixture of the vine Banisteriopsis caapi and the bush Psychotria viridis. The study included interviews with 13 therapists who apply ayahuasca professionally in the treatment of addictions (four indigenous healers and nine Western mental health professionals with university degrees), two expert researchers, and 14 individuals who had undergone ayahuasca-assisted therapy for addictions in diverse contexts in South America. The study provides empirically based hypotheses on therapeutic mechanisms of ayahuasca in substance dependence treatment. Findings indicate that ayahuasca can serve as a valuable therapeutic tool that, in carefully structured settings, can catalyze neurobiological and psychological processes that support recovery from substance dependencies and the prevention of relapse. Treatment outcomes, however, can be influenced by a number of variables that are explained in this study. In addition, issues related to ritual transfer and strategies for minimizing undesired side-effects are discussed.

• addiction
• ayahuasca
• cross-cultural psychotherapy
• ethno-medicine
• ethno-psychotherapy
• safety
• substance dependence
• therapeutic mechanism
• treatment
• variables influencing treatment outcome

The authors wish to thank Dr. Henrik Jungaberle for his guidance for the design and evaluation of this study, and Dr. Brian Anderson and Dr. Mitch Liester for their insightful comments on a preliminary version of this article. The authors also wish to thank interviewed patients and therapists for their valuable contributions to this study.

Notes

1. 1.Contraindicated drugs include irreversible or non-selective MAO inhibitors (e.g., phenelzine, tranylcypromine); selective-serotonin-reuptake-inhibitors (SSRIs, such as fluoxetine [Prozac]); tricyclic antidepressants; some kinds of opiates; barbiturates; analgesics; MDMA; cocaine; amphetamines; and dietary supplements such as gingko biloba, ginseng, and kava.

2. 2.Due to the DMT content of the ayahuasca beverage, the legality of ayahuasca is quite complex and ambiguous and is dependent on the particular laws of different countries (Labate & Feeney 2012; Tupper 2012). In Peru, the use of ayahuasca is recognized as a therapeutic element of traditional medicine and is considered a National Cultural Patrimony (Instituto Nacional de Cultura 2008). In Ecuador and Colombia, the therapeutic use of ayahuasca is politically tolerated. In Brazil, the religious use of ayahuasca has been legally permitted since 1986; the therapeutic use of ayahuasca is not allowed, but is tolerated when therapeutic effects occur secondary to religious ceremonies. In other Latin American countries, such as Argentina, Mexico, or Chile, the legal situation of the therapeutic use of ayahuasca remains undefined.

3. 3.Such treatments are provided by practitioners of traditional medicine, therapists working in private practices, NGOs, or religious groups. Usually, patients contribute a varying amount of money to their treatment; in some humanitarian or religious groups, treatment is delivered free of charge.

4. 4.It should be noted, however, that persons who did not have a positive response to ayahuasca-assisted treatment were not included in this study.

5. 5.All names are pseudonyms.

6. 6.It is an observed fact throughout addiction science that substances such as nicotine, cocaine, and heroin, which can function as mood regulators in an immediate and predictable way, have a higher potential for psychological dependence.