STORIES

The Dawn of Medical Ayahuasca

By David Jenison on September 8, 2017

"Do you want to smoke a joint?" I hear a French man ask behind me. 

The year is 2010, and I'm returning from the beach at Sancho Bay on Fernando de Noronha, a gorgeous volcanic archipelago off the coast of Brazil. I turned to see a French traveler I met the previous day, and I naturally accepted his invitation. 

Sitting at his rustic bungalow passing the joint back and forth, he told me about an Amazonian ritual he planned to partake in the following month. "I'm going to try ayahuasca," he said. 

Hearing about the psychedelic tea for the first time, I replied, "I don't know what that is." The Frenchman then explained the experience in the most simplistic terms, wrongly suggesting it's not illegal, but emphasizing the need to find a legitimate shaman who, per the legend, can see what you're seeing during the hallucination.  

I spent much of the next two years in South America hearing about ayahuasca—or yagé as it's called in Colombia—with increasing frequency. Most people talked about ayahuasca as a spiritual experience that helped them face their inner-demons, but in more recent years, individuals who partake in the experience regularly refer to the psychedelic as medicine. Just as many naysayers question the medical value of cannabis, it might be easy to question the therapeutic use of a hallucinogen, but modern clinical studies continue to find potential therapeutic applications, particularly for mental health. 

Roughly translated from the Quechua language as "vine of the soul," ayahuasca is a ritualistic brew made from psychotropic plants. Westerners first encountered it among the indigenous Amazonian tribes during colonization, and William Burroughs and Allen Ginsberg's The Yage Letters (1963) and the True Hallucinations book (1994) and documentary (2016) helped popularize it in North America. (To see Wellness host Heather Hoffman's take on ayahuasca, click here.)

The most common iteration combines the vine Banisteriopsis caapi and the shrub Psychotria viridis, which are typically boiled in water in a large pot over an open flame. Ayahuasca contains a MAO inhibitor and N,N-dimethyltryptamine (DMT), and it induces an introspective dream-like state with visions, flashbacks, spiritual insights and emotional spikes. Though westerners have expanded the nature of its use, ayahuasca has its roots in shamanistic tradition as a healing sacrament. 

Modern researchers are now exploring the "healing" aspect of the psychedelic, and early findings suggest it might play a viable role in treating anxiety, depression, post-traumatic stress disorder, substance abuse and possibly even Parkinson's disease. As with cannabis, the Schedule I status of ayahuasca limits the scope of clinical studies that can take place, but many researchers in different countries continue to learn whatever they can using different forms of analysis. 

To highlight the emerging evidence, PRØHBTD combined findings from several clinical studies, which are as following:

"Ayahuasca intake increases certain mindfulness facets related to acceptance and to the ability to take a detached view of one's own thoughts and emotions. Based on the available evidence, we conclude that ayahuasca shows promise as a therapeutic tool by enhancing self-acceptance and allowing safe exposure to emotional events. We postulate that ayahuasca could be of use in the treatment of impulse-related, personality and substance use disorders and also in the handling of trauma." - Ayahuasca: Pharmacology, neuroscience and therapeutic potential in Brain Research Bulletin (2016).  

"Studies of long-term users have suggested its therapeutic potential, reporting that its use has helped individuals abandon the consumption of addictive drugs. Furthermore, recent open-label studies in patients with treatment-resistant depression found that a single ayahuasca dose induced a rapid antidepressant effect that was maintained weeks after administration." - Exploring the therapeutic potential of Ayahuasca: acute intake increases mindfulness-related capacities in Germany's Psychopharmacology (2016).

"Increasing evidence... indicates that ayahuasca may have therapeutic effects in treatment of substance use disorders and depression. A recent study on the psychological effects of ayahuasca found that the tea reduces judgmental processing and inner reactivity, classic goals of mindfulness psychotherapy. Another psychological facet that could potentially be targeted by ayahuasca is creative divergent thinking. This mode of thinking can enhance and strengthen psychological flexibility by allowing individuals to generate new and effective cognitive, emotional, and behavioral strategies…. The present data indicate that ayahuasca enhances creative divergent thinking. They suggest that ayahuasca increases psychological flexibility, which may facilitate psychotherapeutic interventions." - Ayahuasca enhances creative divergent thinking while decreasing conventional convergent thinking in Psychopharmacology (2016). 

"A growing number of studies indicate that the psychotherapeutic potential of ayahuasca is based mostly on the strong serotonergic effects…. In the right therapeutic or ritual setting with proper preparation and mindset of the user, followed by subsequent integration of the experience, ayahuasca has proven effective in the treatment of substance dependence…. On the biological level ayahuasca may act against chronic low grade inflammation and oxidative stress... which can explain its widespread therapeutic indications." - The Therapeutic Potentials of Ayahuasca: Possible Effects against Various Diseases of Civilization in Frontiers in Pharmacology (2016) 

"Increasing evidence suggests that endogenous DMT plays important roles for a number of processes in the periphery and central nervous system, and may act as a neurotransmitter…. DMT appears to have limited neurotoxicity and other adverse effects except for intense cardiovascular effects when administered intravenously in large doses. Because of its role in nervous system signaling, DMT may be a useful experimental tool in exploring how the brain works, and may also be a useful clinical tool for treatment of anxiety and psychosis." - Neuropharmacology of N,N-dimethyltryptamine in Brain Research Bulletin (2016) 

"Preliminary findings of our study show that the introspective state induced by ayahuasca promotes reflection on personal issues. The experience usually consists of thoughts, memories, emotions and bodily sensations that can enable the users to relive and integrate this experience on all levels. The participants usually describe that during the ayahuasca experience, they can simultaneously be an observer and relive the traumatic experience. That is exactly the perspective necessary for the therapeutic process to take place and to integrate the traumatic experience in the here and now." - Comparison of Healing Potential of Ayahuasca with the Process of Psychotherapy: Presentation of Findings of First Research in Slovenia on the Healing Potential of Ayahuasca in New Approaches, New Possibilities: Psychedelics in Psychotherapy (2017).  

"Inhibition of MAO-B activity by β-carbolines harmine and harmaline, in addition to potent MAO-A inhibition responsible for antidepressant activity, provide protection against neurodegeneration, and has a potential therapeutic value for the treatment of Parkinson's diseases…. The presence of two potent antioxidants… have significant added value for the protection of neuronal cells damage by oxidative free radicals…. Collectively, these results give additional basis to the existing claim of B. caapi stem extract for the treatment of Parkinsonism, including other neurodegenerative disorders." - Banisteriopsis caapi, a unique combination of MAO inhibitory and antioxidative constituents for the activities relevant to neurodegenerative disorders and Parkinson’s disease in Journal of Ethnopharmacology (2010). 

"Our findings also point out a new biological role for dimethyltryptamines, which may act as systemic endogenous regulators of inflammation and immune homeostasis through the sigma-1 receptor." - Psychedelic N,N-Dimethyltryptamine and 5-Methoxy-N,N-Dimethyltryptamine Modulate Innate and Adaptive Inflammatory Responses through the Sigma-1 Receptor of Human Monocyte-Derived Dendritic Cells in PLOS One (2014). Note: DMT is an endogenous agonist for the sigma-1 receptor in the central nervous system.

"The therapeutic properties of ayahuasca are related to its effects on the brain—it activates cerebral areas associated with memories of personal events (called episodic memory) and with the conscious experience of emotions and internal sensations. From a psychological perspective, a recent study showed that the therapeutic potentials of ayahuasca might be related to its ability to increase what is called in clinical psychology 'decentering,' or the capacity to observe thoughts and emotions as transitory events of the mind without being trapped by them.... A recent study reported anti-depressant effects of ayahuasca in patients with major depression, effects that were sustained for 21 days after the administration of a single dose. This therapeutic effect was associated with brain changes measured with neuroimaging techniques, thus providing an objective demonstration of therapeutic change.... Other recent studies showed preliminary evidence of efficacy in the treatment of drug dependence.... Several authors propose that ayahuasca could also be used to treat post traumatic stress disorder or antisocial behavior, among other disorders." - Ayahuasca Technical Report 2017 by the International Center for Ethnobotanical Education. 

"Statistically significant reductions of up to 82% in depressive scores were observed between baseline and 1, 7, and 21 days after AYA [i.e., ayahuasca] administration…. These results suggest that AYA has fast-acting anxiolytic and antidepressant effects in patients with a depressive disorder." - Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report in Brazilian Journal of Psychiatry (2015).

These are just a few of many studies currently out there, though it is important to note that ayahuasca experiences involve risks, which can include excessive serotonin stimulation and improperly prepared teas by money-hungry fake shamans. Individuals with psychotic disorders in particular should take care when engaging in such experiences. Nevertheless, clinical studies suggest the plant-based brew can have medical benefits that should be further explored, which also reiterates the need for the U.S. government to allow more research on fully prohibited Schedule I drugs like ayahuasca. 

To sum up the rise of ayahuasca and its potential medical use, the aforementioned Frontiers in Pharmacology said it best: "Masses of people from all parts of the world travel to the Amazon to participate in ayahuasca rituals. This unique phenomenon characterized by some as 'drug tourism' is not as frivolous pursuit as it sounds, since a significant number of travelers search for spiritual and therapeutic opportunities. The principal motivations can be characterized as: seeking improved insight, personal growth; emotional healing; and contact with a sacred nature, deities, spirits and natural energies produced by the ayahuasca."

Or to quote Canadian anthropologist Jeremy Narby, "Ayahuasca is the television of the forest," and who doesn't like getting stoned and watching nature programs on TV. 

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