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Cuerva K, Spirou D, Cuerva A, Delaquis C, Raman J. Perspectives and preliminary experiences of psychedelics for the treatment of eating disorders: A systematic scoping review. EUROPEAN EATING DISORDERS REVIEW 2024; 32:980-1001. [PMID: 38783636 DOI: 10.1002/erv.3101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/10/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Research regarding the therapeutic application of psychedelics and psychedelic-assisted psychotherapy in the treatment of eating disorders (EDs) has begun to emerge. This systematic scoping review aimed to map and synthesise the existing evidence regarding the participant reported efficacy and perspectives concerning psychedelics in the treatment of EDs, and to identify significant research gaps. METHOD A systematic search was undertaken across several databases in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. RESULTS 1290 publications were identified, 1135 after duplicates removed, with 17 meeting full-eligibility criteria. Overall, findings suggested that most participants reported experiencing a meaningful reduction in their ED symptoms and having positive experiences or an openness to explore psychedelics as a treatment for ED symptoms, although some noted concerns of adverse effects and the importance of having psychological support to increase safety and efficacy. CONCLUSIONS While preliminary research suggests psychedelics and psychedelic-assisted psychotherapy may be a viable treatment option for ED symptoms, further research with more robust research designs is required to increase confidence in its efficacy, generalisability, and safety as a therapeutic medium.
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Affiliation(s)
- Karolina Cuerva
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Adrian Cuerva
- Clinical Psychology Unit, The University of Sydney, Sydney, NSW, Australia
| | | | - Jayanthi Raman
- School of Psychological Sciences, University of Newcastle, Callaghan, NSW, Australia
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Arenson A, Campbell CI, Remler I. Psychoactive plant derivatives (ayahuasca, ibogaine, kratom) and their application in opioid withdrawal and use disorder - a narrative review. J Addict Dis 2024; 42:253-263. [PMID: 37199191 DOI: 10.1080/10550887.2023.2195777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The opioid epidemic and limited access to treatment for opioid withdrawal (OW) and opioid use disorder (OUD) has led individuals to seek alternative treatments. This narrative review aims to educate clinicians on the mechanisms of action, toxicity, and applications of psychoactive plant-based substances patients may be using to self-treat OUD and OW. We specifically discuss ayahuasca, ibogaine, and kratom as they have the most evidence for applications in OUD and OW from the last decade (2012-2022). Evidence suggests these substances may have efficacy in treating OW and OUD through several therapeutic mechanisms including their unique pharmacodynamic effects, rituals performed around ingestion, and increased neuroplasticity. The current evidence for their therapeutic application in OUD and OW is primarily based on small observational studies or animal studies. High-quality, longitudinal studies are needed to clarify safety and efficacy of these substances in treatment of OW and OUD.
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Affiliation(s)
- Alexandra Arenson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Cynthia I Campbell
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ilan Remler
- Addiction Medicine and Recovery Services, Kaiser Permanente San Leandro Medical Center, San Leandro, CA, USA
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3
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Williams M, Kingston Miller A, Lafrance A. Ayahuasca ceremony leaders' perspectives on special considerations for eating disorders. Eat Disord 2024; 32:120-139. [PMID: 37943076 DOI: 10.1080/10640266.2023.2271201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Eating disorders (EDs) are difficult conditions to resolve, necessitating novel treatments. Ayahuasca, a psychedelic plant medicine originating in Indigenous Amazonian communities, is being investigated. Aspects of ceremonial ayahuasca use (purging, dietary restrictions) appear similar to ED behaviors, raising questions about ayahuasca's suitability as an intervention for individuals with EDs. This study explored the perspectives of ayahuasca ceremony leaders on these and other considerations for ceremonial ayahuasca drinking among individuals with EDs. A qualitative content analysis of interviews was undertaken with 15 ayahuasca ceremony leaders, the majority of whom were from the West/Global North. Screening for EDs, purging and dietary restrictions, potential risks and dangers, and complementarity with conventional ED treatment emerged as categories. The findings offer ideas, including careful screening and extra support, to promote safe and beneficial ceremony experiences for ceremony participants with EDs. More research is needed to clarify the impacts of ceremony-related purging and preparatory diets. To evolve conventional models of treatment, the ED field could consider Indigenous approaches to mental health whereby ayahuasca ceremony leaders and ED researchers and clinicians collaborate in a decolonizing, bidirectional bridging process between Western and Indigenous paradigms of healing.
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Affiliation(s)
- Meris Williams
- Independent Researcher, Vancouver, British Columbia, Canada
| | - Annie Kingston Miller
- School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada
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Vargas-Perez H, Minauro-Sanmiguel F, Ting-A-Kee R, Grieder TE, Méndez-Díaz M, Prospéro-García O, van der Kooy D. Rewarding Effects of the Hallucinogen 4-AcO-DMT Administration and Withdrawal in Rats: A Challenge to the Opponent-Process Theory. Neurosci Lett 2024; 820:137597. [PMID: 38110146 DOI: 10.1016/j.neulet.2023.137597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023]
Abstract
According to the opponent-process theory of drug addiction, the intake of an addictive substance initiates two processes: a rapid primary process that results in the drug's rewarding effects, and a slower opponent process that leads to the aversive motivational state of drug aftereffects. This aversive state is integral in the desire, pursuit, and maintenance of drug use, potentially leading to dependence and addiction. However, current observational and experimental evidence suggests that the administration of a 5-hydroxytryptamine receptors-type 2A (5-HT2A) agonist, while capable of inducing a positive mental state in humans, may not generate the behavioral patterns typically associated with drugs of abuse. In this study, we found that administering the 5-HT2A agonist 4-Acetoxy-N,N-dimethyltryptamine fumarate (4-AcO-DMT) did not result in place preference in male rats compared to control saline administration 24 h later, after the drug has been cleared from the organism. However, in a modified place preference test where only the acute motivational effects of the drug were evaluated (excluding withdrawal), 4-AcO-DMT was found to be rewarding. Furthermore, in another modified place preference test where only the motivational effects of drug withdrawal were evaluated (excluding the acute effects of drug administration), the 24-hour aftereffect of 5-HT2A agonist administration also resulted in a robust place preference. Therefore, while 4-AcO-DMT administration was able to induce place preference, its 24-hour aftereffect also produced a strong reward. In the counterbalanced test, this reward from the aftereffect effectively overshadowed its acute rewarding properties, which could potentially create a false impression that 4-AcO-DMT lacks motivational properties. This suggests that 5-HT2A agonist administration follows a different dynamic than that proposed by the opponent-process theory of motivation and implies that the administration of 5-HT2A agonists may lead to behavioral patterns less typical of drugs associated with addiction.
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Affiliation(s)
- Hector Vargas-Perez
- The Nierika Intercultural Medicine Institute, Ocuilan, Estado de México, 52483, Mexico; Institute of Medical Science and Department of Molecular Genetics, University of Toronto, Toronto, Ontario M5S 3E1, Canada; Postgrado En Ciencias Cognitivas, Universidad Autonoma Del Estado de Morelos, Cuernavaca, Mexico.
| | - Fernando Minauro-Sanmiguel
- Unidad de Investigación Médica en Genética Humana, Hospital de Pediatría, Centro Médico Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Ryan Ting-A-Kee
- Institute of Medical Science and Department of Molecular Genetics, University of Toronto, Toronto, Ontario M5S 3E1, Canada
| | - Taryn Elizabeth Grieder
- Department of Molecular Genetics, the Donnelly Centre, University of Toronto, Toronto, Ontario M5S 3E1, Canada
| | - Mónica Méndez-Díaz
- Laboratorio de Cannabinoides, Departamento de Fisiología, Facultad de Medicina, UNAM, Mexico
| | - Oscar Prospéro-García
- Laboratorio de Cannabinoides, Departamento de Fisiología, Facultad de Medicina, UNAM, Mexico
| | - Derek van der Kooy
- Institute of Medical Science and Department of Molecular Genetics, University of Toronto, Toronto, Ontario M5S 3E1, Canada; Department of Molecular Genetics, the Donnelly Centre, University of Toronto, Toronto, Ontario M5S 3E1, Canada
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5
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James E, Erritzoe D, Benway T, Joel Z, Timmermann C, Good M, Agnorelli C, Weiss BM, Barba T, Campbell G, Baker Jones M, Hughes C, Topping H, Boyce M, Routledge C. Safety, tolerability, pharmacodynamic and wellbeing effects of SPL026 (dimethyltryptamine fumarate) in healthy participants: a randomized, placebo-controlled phase 1 trial. Front Psychiatry 2024; 14:1305796. [PMID: 38274414 PMCID: PMC10810248 DOI: 10.3389/fpsyt.2023.1305796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
Background Due to their potential impact on mood and wellbeing there has been increasing interest in the potential of serotonergic psychedelics such as N,N-dimethyltryptamine (DMT) in the treatment of major depressive disorder (MDD). Aim The aim of Part A of this study was to evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamic (PD) profile of escalating doses of SPL026 (DMT fumarate) in psychedelic-naïve healthy participants to determine a dose for administration to patients with MDD in the subsequent Phase 2a part of the trial (Part B: not presented in this manuscript). Methods In the Phase 1, randomized, double-blind, placebo-controlled, parallel-group, single dose-escalation trial, psychedelic-naïve participants were randomized to placebo (n = 8) or four different escalating doses [9, 12, 17 and 21.5 mg intravenously (IV)] of SPL026 (n = 6 for each dose) together with psychological support from 2 therapy team members. PK and acute (immediately following dosing experience) psychometric measures [including mystical experience questionnaire (MEQ), ego dissolution inventory (EDI), and intensity rating visual analogue scale (IRVAS)] were determined. Additional endpoints were measured as longer-term change from baseline to days 8, 15, 30 and 90. These measures included the Warwick and Edinburgh mental wellbeing scale and Spielberger's state-trait anxiety inventory. Results SPL026 was well tolerated, with an acceptable safety profile, with no serious adverse events. There was some evidence of a correlation between maximum plasma concentration and increased IRVAS, MEQ, and EDI scores. These trends are likely to require confirmation in a larger sample size. Using the analysis of the safety, tolerability, PD, PK results, doses of 21.5 mg SPL026 were the most likely to provide an intense, tolerated experience. Conclusion Based on the data obtained from this part of the trial, a dose of 21.5 mg SPL026 given as a 2-phase IV infusion over 10 min (6 mg/5 min and 15.5 mg/5 min) was selected as the dose to be taken into patients in Part B (to be presented in a future manuscript).Clinical trial registration:www.clinicaltrials.gov, identifier NCT04673383; https://www.clinicaltrialsregister.eu, identifier 2020-000251-13; https://www.isrctn.com/, identifier ISRCTN63465876.
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Affiliation(s)
| | - David Erritzoe
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Zelah Joel
- Small Pharma Ltd., London, United Kingdom
| | - Christopher Timmermann
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Claudio Agnorelli
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Brandon M. Weiss
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Tommaso Barba
- The Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | | | | | - Helen Topping
- Hammersmith Medicines Research, London, United Kingdom
| | - Malcolm Boyce
- Hammersmith Medicines Research, London, United Kingdom
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Madrid-Gambin F, Fabregat-Safont D, Gomez-Gomez A, Olesti E, Mason NL, Ramaekers JG, Pozo OJ. Present and future of metabolic and metabolomics studies focused on classical psychedelics in humans. Biomed Pharmacother 2023; 169:115775. [PMID: 37944438 DOI: 10.1016/j.biopha.2023.115775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023] Open
Abstract
Psychedelics are classical hallucinogen drugs that induce a marked altered state of consciousness. In recent years, there has been renewed attention to the possible use of classical psychedelics for the treatment of certain mental health disorders. However, further investigation to better understand their biological effects in humans, their mechanism of action, and their metabolism in humans is needed when considering the development of future novel therapeutic approaches. Both metabolic and metabolomics studies may help for these purposes. On one hand, metabolic studies aim to determine the main metabolites of the drug. On the other hand, the application of metabolomics in human psychedelics studies can help to further understand the biological processes underlying the psychedelic state and the mechanisms of action underlying their therapeutic potential. This review presents the state of the art of metabolic and metabolomic studies after lysergic acid diethylamide (LSD), mescaline, N,N-dimethyltryptamine (DMT) and β-carboline alkaloids (ayahuasca brew), 5-methoxy-DMT and psilocybin administrations in humans. We first describe the characteristics of the published research. Afterward, we reviewed the main results obtained by both metabolic and metabolomics (if available) studies in classical psychedelics and we found out that metabolic and metabolomics studies in psychedelics progress at two different speeds. Thus, whereas the main metabolites for classical psychedelics have been robustly established, the main metabolic alterations induced by psychedelics need to be explored. The integration of metabolomics and pharmacokinetics for investigating the molecular interaction between psychedelics and multiple targets may open new avenues in understanding the therapeutic role of psychedelics.
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Affiliation(s)
- Francisco Madrid-Gambin
- Applied Metabolomics Research Group, Hospital del Mar Research Institute, 08003 Barcelona, Spain.
| | - David Fabregat-Safont
- Applied Metabolomics Research Group, Hospital del Mar Research Institute, 08003 Barcelona, Spain; Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, 12071 Castelló, Spain
| | - Alex Gomez-Gomez
- Applied Metabolomics Research Group, Hospital del Mar Research Institute, 08003 Barcelona, Spain; CERBA Internacional, Chromatography Department, 08203 Sabadell, Spain
| | - Eulàlia Olesti
- Department of Clinical Pharmacology, Area Medicament, Hospital Clinic of Barcelona, 08036 Barcelona, Spain; Clinical Pharmacology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Natasha L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, 6200 MD Maastricht, the Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, 6200 MD Maastricht, the Netherlands
| | - Oscar J Pozo
- Applied Metabolomics Research Group, Hospital del Mar Research Institute, 08003 Barcelona, Spain.
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Ruffell SGD, Crosland‐Wood M, Palmer R, Netzband N, Tsang W, Weiss B, Gandy S, Cowley‐Court T, Halman A, McHerron D, Jong A, Kennedy T, White E, Perkins D, Terhune DB, Sarris J. Ayahuasca: A review of historical, pharmacological, and therapeutic aspects. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e146. [PMID: 38868739 PMCID: PMC11114307 DOI: 10.1002/pcn5.146] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/13/2023] [Accepted: 08/30/2023] [Indexed: 06/14/2024]
Abstract
Ayahuasca is a psychedelic plant brew originating from the Amazon rainforest. It is formed from two basic components, the Banisteriopsis caapi vine and a plant containing the potent psychedelic dimethyltryptamine (DMT), usually Psychotria viridis. Here we review the history of ayahuasca and describe recent work on its pharmacology, phenomenological responses, and clinical applications. There has been a significant increase in interest in ayahuasca since the turn of the millennium. Anecdotal evidence varies significantly, ranging from evangelical accounts to horror stories involving physical and psychological harm. The effects of the brew on personality and mental health outcomes are discussed in this review. Furthermore, phenomenological analyses of the ayahuasca experience are explored. Ayahuasca is a promising psychedelic agent that warrants greater empirical attention regarding its basic neurochemical mechanisms of action and potential therapeutic application.
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Affiliation(s)
- Simon G. D. Ruffell
- Onaya ScienceIquitosPeru
- Psychae InstituteMelbourneVictoriaAustralia
- School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | - Max Crosland‐Wood
- Onaya ScienceIquitosPeru
- Psychology and Psychotherapy departmentCentral and North West London NHS TrustLondonUK
| | - Rob Palmer
- Onaya ScienceIquitosPeru
- School of MedicineUniversity of YaleNew HavenConnecticutUSA
- Department of PsychologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | | | - WaiFung Tsang
- Onaya ScienceIquitosPeru
- Institute of Psychology, Psychiatry and NeuroscienceSouth London and The Maudsley NHS TrustLondonUK
- Department of Psychology, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Brandon Weiss
- Onaya ScienceIquitosPeru
- Division of PsychiatryImperial College LondonLondonUK
| | | | - Tessa Cowley‐Court
- Psychae InstituteMelbourneVictoriaAustralia
- School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | - Andreas Halman
- School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | | | - Angelina Jong
- Institute of Psychology, Psychiatry and NeuroscienceSouth London and The Maudsley NHS TrustLondonUK
- Department of Psychology, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | | | - Daniel Perkins
- Psychae InstituteMelbourneVictoriaAustralia
- School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
- Centre for Mental HealthSwinburne UniversityMelbourneAustralia
| | - Devin B. Terhune
- Psychology and Psychotherapy departmentCentral and North West London NHS TrustLondonUK
| | - Jerome Sarris
- Psychae InstituteMelbourneVictoriaAustralia
- NICM Health Research InstituteWestern Sydney UniversitySydneyAustralia
- Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneAustralia
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8
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Cruz L, Bienemann B, Palhano-Fontes F, Tófoli LF, Araújo DB, Mograbi DC. A quantitative textual analysis of the subjective effects of ayahuasca in naïve users with and without depression. Sci Rep 2023; 13:19635. [PMID: 37949934 PMCID: PMC10638373 DOI: 10.1038/s41598-023-44193-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/04/2023] [Indexed: 11/12/2023] Open
Abstract
Ayahuasca is a brew with psychoactive properties that has been used as an entheogen for centuries, with more recent studies suggesting it is a promising treatment for some clinical disorders. Although there is an emerging scientific literature on its effects, to the best of our knowledge no study has explored the self-reported experiences of first-time ayahuasca users with quantitative textual analysis tools. Accordingly, the current study aimed to analyze the subjective experience of naive individuals with depression and healthy controls after consuming ayahuasca. For this purpose, responses from a subsample of participants from a previous clinical trial to open-ended questions regarding their experience with ayahuasca underwent textual analysis. Data from nine patients with treatment-resistant depression and 20 healthy individuals were included, and quantitative textual analysis was performed using IRaMuTeQ 0.7 alpha 2 and R 3.1.2. The analysis identified five clusters: alterations in the state of consciousness, cognitive changes, somatic alterations, auditory experiences, and visual perceptual content. Additionally, findings suggest specific features of the experience of people with depression with ayahuasca, such as increased aversive bodily reactions. The results are consistent with previous findings indicating central axes of the psychedelic experience, and may inform therapeutic approaches using ayahuasca.
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Affiliation(s)
- Lucas Cruz
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - Bheatrix Bienemann
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | | | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Dráulio B Araújo
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - Daniel C Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil.
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, PO Box 078, London, UK.
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Mendive F, Giovannetti C, García Arce S. Ancient medicine for a modern disease: traditional Amazonian medicine to treat substance use disorders. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:691-704. [PMID: 37948338 DOI: 10.1080/00952990.2023.2264466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 09/24/2023] [Indexed: 11/12/2023]
Abstract
Background: There exists an underexploited opportunity to develop innovative therapeutic approaches to SUDs based upon the complementarity between modern and traditional health systems.Objectives: Illustrate the feasibility and potentiality of such an approach through the comprehensive description of Takiwasi Center's treatment model and program, where health concepts and practices from traditional Amazonian medicine work synergistically with modern psychotherapy and medicine in an intercultural dialog to assist in the rehabilitation of people suffering from SUDs.Methods: The description was built from a review of the literature, institutional data, participatory observation and unstructured interviews with staff, researchers and patients during treatment.Results: Since the foundation of the Takiwasi Center in 1992 in the peruvian Amazon, more than a thousand patients with different socio-cultural, ethnic and religious backgrounds have received residential treatment. We present how traditional Amazonian medicine techniques and health concepts cooperate to complement modern psychology in a therapeutic community setting and propose some hypotheses about the neurobiological, psycho-emotional and spiritual healing mechanisms triggered by the program to help people identify and heal the roots of their substance misuse and addictive behavior. We also summarize quantitative outcomes during treatment showing significant improvements in a wide variety of mental health indicators.Conclusion: Takiwasi Center's program is an option for people seeking non-conventional treatment who are sensitive to traditional Amazonian medicine practices and ready to explore the roots of their addiction. From this intercultural approach, some lessons could emerge toward a broader understanding of SUDs that may result in better patient care.
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Affiliation(s)
| | - Cecile Giovannetti
- Institute of Tropical Medicine and International Health, Charite Universitat Medizin Berlin, Berlin, Germany
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10
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Loizaga-Velder A, Giovannetti C, Campoy Gomez R, Castillo Valenzuela TE, Ochoa Jaime GR, Agin-Liebes G, Marcus O, Rush B. Therapeutic Effects of Ceremonial Ayahuasca Use for Methamphetamine Use Disorders and Other Mental Health Challenges: Case Studies in an Indigenous Community in Sonora, Mexico. J Psychoactive Drugs 2023; 55:549-557. [PMID: 37675972 DOI: 10.1080/02791072.2023.2255182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 08/20/2023] [Accepted: 08/20/2023] [Indexed: 09/08/2023]
Abstract
This paper describes three case studies from an outpatient intercultural therapeutic program founded and run by Yaqui health professionals and traditional healers to serve members of the Yaqui tribe residing in Sonora, Mexico. This pilot therapeutic program has been designed specifically for Indigenous individuals, incorporating the ceremonial use of naturally derived psychedelics in addressing substance use disorders and other mental health issues. The program employs a community-based approach, integrating various traditional Indigenous healing practices like the sweatlodge (temazcal), medicinal plant preparations, and the ritualistic use of selected psychedelics from natural sources (such as ayahuasca, peyote, and secretions from Incilius alvarius). These approaches are complemented by culturally attuned group and individual psychotherapy sessions, as well as group sports, community meals, collaborative construction efforts for a permanent clinical infrastructure, and cultural engagements such as art, crafts, and collective music. To evaluate the program's efficacy, safety, and cultural implications, an ongoing observational study is being conducted by an international team of researchers. The preliminary results demonstrate therapeutic progress and improved psychometric outcomes observed in the three case studies presented, indicating promise for this intercultural therapeutic intervention.
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Affiliation(s)
- Anja Loizaga-Velder
- Department of Research, Nierika Institute for Intercultural Medicine A.C, Ocuilan, Mexico
| | | | | | | | | | | | - Olivia Marcus
- Rory Meyers College of Nursing, New York University, New York, USA
| | - Brian Rush
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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11
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Williams M, Kingston Miller A, Loizaga-Velder A, Files N, Lafrance A. "Getting to the Root": Ayahuasca Ceremony Leaders' Perspectives on Eating Disorders. J Psychoactive Drugs 2023; 55:425-433. [PMID: 36171638 DOI: 10.1080/02791072.2022.2113484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 10/14/2022]
Abstract
Given the mortality, chronicity, and treatment drop-out rates observed among individuals with eating disorders (EDs), innovative approaches are needed. Ayahuasca, a psychedelic plant medicine from the Amazon, is currently being investigated. This study expands on prior exploratory research by describing the perspectives of ayahuasca ceremony leaders regarding their conceptualizations of EDs and the potential therapeutic mechanisms of action of ayahuasca for individuals with EDs. Qualitative content analysis of interviews with 15 ayahuasca ceremony leaders produced two main categories, with relevant subcategories. The first category encompassed the leaders' theories of EDs from a shamanic perspective, including that EDs are symptomatic of an underlying concern, serve a function and affect health in multiple domains. The second category described leaders' perspectives on the potential mechanisms of action of ayahuasca for EDs, including that ayahuasca facilitates "energetic healing"; helps identify, process, and integrate the "root" of the ED; promotes holistic healing; and enhances and/or reorganizes relationships. From the perspectives of ceremony leaders and consistent with previous exploratory research, ceremonial ayahuasca use may offer a potentially useful, novel and complementary intervention for EDs.
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12
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Gonçalves J, Luís Â, Gallardo E, Duarte AP. A Systematic Review on the Therapeutic Effects of Ayahuasca. PLANTS (BASEL, SWITZERLAND) 2023; 12:2573. [PMID: 37447135 DOI: 10.3390/plants12132573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023]
Abstract
Traditional therapies, resorting to the use of plants, have acquired a great demand over the years, both for economic reasons and the preference for natural treatments. Some studies suggest that ayahuasca may have beneficial properties in treating some physical and psychological imbalances. Thus, we carried out a systematic review of studies published up to December 2022, where these themes were addressed. The search was carried out in the PubMed database, and only studies written in English and published in peer-reviewed journals were included. Thus, 228 publications were identified, of which 66 were included in the present study. The reviewed studies suggest that ayahuasca may have beneficial effects on various physical and psychological conditions, namely in the treatment of depression, anxiety and various diseases of the neurobiological system, as well as anti-inflammatory and antimicrobial properties, demonstrating its therapeutic potential. The number of studies that address this issue has also been growing, demonstrating interest in the search for alternative treatments. However, to the best of our knowledge, this is the first systematic review where all the findings of therapeutic effects associated with the consumption of ayahuasca are reviewed.
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Affiliation(s)
- Joana Gonçalves
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
| | - Ângelo Luís
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
| | - Eugenia Gallardo
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
| | - Ana Paula Duarte
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, Estrada Municipal 506, 6200-284 Covilhã, Portugal
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13
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Apud I, Scuro J, Carrera I, Oliveri A. Ayahuasca Ritual, Personality and Sociality: Observational Research Conducted in a Substance Use Disorder Rehabilitation Center in Uruguay. J Psychoactive Drugs 2023; 55:141-150. [PMID: 35506737 DOI: 10.1080/02791072.2022.2053004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/13/2021] [Accepted: 01/10/2022] [Indexed: 10/18/2022]
Abstract
The current article presents a mixed qualitative-quantitative observational study of the effect of ayahuasca ritual on subjective experiences and personality traits on participants of a center specialized in the treatment of substance use disorder in Uruguay. When comparing the psychological traits of ayahuasca participants to a control group, quantitative results using the Zuckerman-Kuhlman-Aluja Personality Questionnaire showed statistically significant higher scores in Impulsive Sensation Seeking, Boredom Susceptibility, and Social Warmth scales. Qualitative analysis of ayahuasca experiences resulted in five main categories: emotional experiences (including social emotions such as love and empathy), corporal experiences, spiritual/transcendental experiences, personal experiences, and visions. Last, qualitative descriptions provide support for the importance of social interactions in the phenomenological manifestations of the psychedelic experience. Both quantitative and qualitative results suggest that the combination of social interactions and the pharmacological action of ayahuasca could facilitate the manifestation of social emotions during the ritual, and may contribute to the long-term increase of empathic and social aspects of personality.
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Affiliation(s)
- Ismael Apud
- Institute of Foundations and Methods in Psychology, Faculty of Psychology, Universidad de la República, Montevideo, Uruguay
| | - Juan Scuro
- Department of Social Anthropology, Faculty of Humanities and Educational Sciences, Universidad de la República, Montevideo, Uruguay
| | - Ignacio Carrera
- Department of Organic Chemistry, Faculty of Chemistry, Universidad de la República, Montevideo, Uruguay
| | - Andrés Oliveri
- Institute of Foundations and Methods in Psychology, Faculty of Psychology, Universidad de la República, Montevideo, Uruguay
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14
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Soares CM, Leite Â, Pinto M. Self-Care Practices with Psychedelics - A Qualitative Study of Users' Perspectives. J Psychoactive Drugs 2023; 55:159-169. [PMID: 35574941 DOI: 10.1080/02791072.2022.2071134] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 02/09/2022] [Accepted: 02/25/2022] [Indexed: 10/18/2022]
Abstract
This article explores the psychedelic experience from the users' point of view and through the lens of self-care, a concept within the domain of health and well-being. In a time of renewed interest in psychedelic-assisted psychotherapy, we aim to contribute to a better understanding of these substances by exploring their role in different settings. A phenomenological approach was used in this study. We conducted semi-structured interviews with 19 psychedelic users and inquired about the relationship between their experiences and self-care. Analysis of the interview data was based on inductive content analysis. Most participants reported using psychedelics with self-care intentions in ceremonial, recreational, or private settings. Self-perception and existential meaningfulness were identified as the main mechanisms of self-care. Participants also mentioned difficult experiences and adversities that impair self-care. The results suggest that for some people, the use of psychedelics may be experienced as part of a self-care process and may improve self-care abilities in naturalistic settings.
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Affiliation(s)
- Carla Mendes Soares
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Ângela Leite
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Marta Pinto
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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15
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Kawakami A, Suzuki M. Ayahuasca in Western society and the metacognitive counselling approach. COUNSELLING & PSYCHOTHERAPY RESEARCH 2023. [DOI: 10.1002/capr.12628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- Atsuko Kawakami
- Division of Sociology, School of Behavioral Sciences Tarleton State University Stephenville Texas USA
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16
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Perkins D, Ruffell SGD, Day K, Pinzon Rubiano D, Sarris J. Psychotherapeutic and neurobiological processes associated with ayahuasca: A proposed model and implications for therapeutic use. Front Neurosci 2023; 16:879221. [PMID: 36798604 PMCID: PMC9928213 DOI: 10.3389/fnins.2022.879221] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 12/12/2022] [Indexed: 02/01/2023] Open
Abstract
Ayahuasca is a psychoactive Amazonian plant brew. It is usually made from the Banisteriopsis caapi vine (Spruce ex Griseb. Morton, Malpighiaceae), which contains three primary harmala alkaloids, along with the leaves of Psychotria viridis (Ruiz et Pavon, Rubiaceae) in which the potent psychedelic dimethyltryptamine (DMT) is found. DMT-harmaloid concoctions have gained popularity in recent years, due to growing anecdotal and scientific reports of therapeutic benefits associated with their consumption. Ayahuasca is now ingested in a variety of different settings across the globe, from traditional ethnobotanical to so called "neo-shamanic" ceremonies. Furthermore, related preparations involving alternative sources of DMT and harmala alkaloids are becoming increasingly common as knowledge of ayahuasca continues to spread internationally. This article reviews the existing literature and draws on original qualitative data from a large cross-sectional study of ayahuasca drinkers, to propose a model of psychotherapeutic processes associated with the consumption of ayahuasca. We assert that it is these processes, facilitated by a range of neurobiological effects, that lead to beneficial mental health and wellbeing outcomes. Our proposed model identifies five key psychotherapeutic processes or effects inherent to the ayahuasca experience; somatic effects; introspection and emotional processing; increased Self-connection; increased spiritual connection, and finally the gaining of insights and new perspectives. We note some important differences in these processes compared with other classic psychedelics as well as the implications of the model for the therapeutic use of ayahuasca. Improved understanding of the psychotherapeutic processes involved with the ayahuasca experience will better equip practitioners to work with this potentially transformative concoction and enable the optimization of therapeutic treatment models for potential clinical use.
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Affiliation(s)
- Daniel Perkins
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia,School of Social and Political Science, University of Melbourne, Melbourne, VIC, Australia,Psychae Institute, Melbourne, VIC, Australia,Centre for Mental Health, Swinburne University, Melbourne, VIC, Australia,*Correspondence: Daniel Perkins,
| | - Simon G. D. Ruffell
- School of Social and Political Science, University of Melbourne, Melbourne, VIC, Australia,Psychae Institute, Melbourne, VIC, Australia,Centre for Mental Health, Swinburne University, Melbourne, VIC, Australia,Onaya Science, Iquitos, Peru
| | | | | | - Jerome Sarris
- Psychae Institute, Melbourne, VIC, Australia,NICM Health Research Institute, Western Sydney University, Sydney, NSW, Australia,Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
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Politi M, Tresca G, Menghini L, Ferrante C. Beyond the Psychoactive Effects of Ayahuasca: Cultural and Pharmacological Relevance of Its Emetic and Purging Properties. PLANTA MEDICA 2022; 88:1275-1286. [PMID: 34794194 DOI: 10.1055/a-1675-3840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The herbal preparation ayahuasca has been an important part of ritual and healing practices, deployed to access invisible worlds in several indigenous groups in the Amazon basin and among mestizo populations of South America. The preparation is usually known to be composed of two main plants, Banisteriopsis caapi and Psychotria viridis, which produce both hallucinogenic and potent purging and emetic effects; currently, these are considered its major pharmacological activities. In recent decades, the psychoactive and visionary effect of ayahuasca has been highly sought after by the shamanic tourism community, which led to the popularization of ayahuasca use globally and to a cultural distancing from its traditional cosmological meanings, including that of purging and emesis. Further, the field of ethnobotany and ethnopharmacology has also produced relatively limited data linking the phytochemical diversity of ayahuasca with the different degrees of its purging and emetic versus psychoactive effects. Similarly, scientific interest has also principally addressed the psychological and mental health effects of ayahuasca, overlooking the cultural and pharmacological importance of the purging and emetic activity. The aim of this review is therefore to shed light on the understudied purging and emetic effect of ayahuasca herbal preparation. It firstly focuses on reviewing the cultural relevance of emesis and purging in the context of Amazonian traditions. Secondly, on the basis of the main known phytochemicals described in the ayahuasca formula, a comprehensive pharmacological evaluation of their emetic and purging properties is presented.
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Affiliation(s)
- Matteo Politi
- Department of Pharmacy, Botanic Garden "Giardino dei Semplici", Università degli Studi "Gabriele d'Annunzio", Chieti, Italy
- Research Department, Center for Drug Addiction Treatment and Research on Traditional Medicines - Takiwasi, Tarapoto, Peru
| | - Giorgia Tresca
- Department of Pharmacy, Botanic Garden "Giardino dei Semplici", Università degli Studi "Gabriele d'Annunzio", Chieti, Italy
| | - Luigi Menghini
- Department of Pharmacy, Botanic Garden "Giardino dei Semplici", Università degli Studi "Gabriele d'Annunzio", Chieti, Italy
| | - Claudio Ferrante
- Department of Pharmacy, Botanic Garden "Giardino dei Semplici", Università degli Studi "Gabriele d'Annunzio", Chieti, Italy
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18
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Apud I, Scuro J, Carrera I, Oliveri A. Psychological effects and subjective experiences of ayahuasca rituals in participants of two neoshamanic centers of Uruguay. JOURNAL OF PSYCHEDELIC STUDIES 2022. [DOI: 10.1556/2054.2022.00202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Background
Ayahuasca's psychological and subjective effects were compared in rituals of two neoshamanic groups in Uruguay.
Aims
Compare, describe and analyze psychological effects and subjective experiences of ayahuasca ceremonies in two different groups: a psychospiritual holistic center, and a center specialized in substance use disorder's treatment.
Methods
A mixed qualitative-quantitative study was conducted, using the Hallucinogen Rating Scale for measuring psychological effects, and in-depth interviews for the description of ayahuasca subjective experiences. Data from both techniques were compared, analyzing convergences and differences.
Results
When comparing the two neoshamanic groups, significant differences with a medium-size effect were found in the psychological variables Affect (r = 0.47), Cognition (r = 0.36) and Perception (r = 0.36). The qualitative descriptions of ayahuasca experiences in the group with higher scores in those variables showed more frequent and complex experiences of emotional, cognitive, and perceptive content. Dissimilar results were found when comparing Intensity and Somaesthetic domains, with no significant results in the quantitative part, while in the qualitative part intensity was reported as “soft” in one group, and corporal experiences (e.g., purging effects) were especially manifested.
Conclusions
Stronger subjective experiences and higher psychological effects may be related to differences in the dosage and the setting of the centers. Emotional, cognitive, and perceptive psychological effects of ayahuasca rituals measured by the Hallucinogen Rating Scale, seem to be associated with more frequent and complex subjective experiences in the mentioned domains. Qualitative group differences in corporal alterations and the overall intensity of the experience differed from non-significant results of the quantitative part of the study.
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Affiliation(s)
- Ismael Apud
- Faculty of Psychology, Universidad de la República Montevideo, Uruguay
| | - Juan Scuro
- Faculty of Humanities and Educational Sciences, Universidad de la República Montevideo, Uruguay
| | - Ignacio Carrera
- Faculty of Chemistry, Universidad de la República, Montevideo, Uruguay
| | - Andres Oliveri
- Faculty of Psychology, Universidad de la República Montevideo, Uruguay
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McCartney AM, McGovern HT, De Foe A. Psychedelic assisted therapy for major depressive disorder: Recent work and clinical directions. JOURNAL OF PSYCHEDELIC STUDIES 2022. [DOI: 10.1556/2054.2022.00211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Psychedelic substances such as psilocybin and ketamine may represent the future of antidepressant treatment, due to their rapid and prolonged effects on mood and cognition. The current body of psychedelic research has focused on administration and treatment within a psychiatric context. Here, instead, we put to the test the contention that it is necessary to evaluate the current state of this literature from a broader biopsychosocial perspective. Examining these arguably neglected social and psychological aspects of psychedelic treatment can provide a more holistic understanding of the interplay between the interconnected domains. This review of six major clinical trials applies a biopsychosocial model to evaluate the antidepressant effects of psilocybin and ketamine assisted therapy. We conclude that combination psychedelic treatment and psychotherapy facilitate more enduring and profound antidepressant effects than produced by ketamine or psilocybin alone. Emphasising the advantages of therapeutic intervention will encourage those who may attempt to self-medicate with psychedelics to instead seek a framework of psychological support, minimising associated risks of unregulated use.
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Affiliation(s)
| | | | - Alexander De Foe
- The Royal Melbourne Institute of Technology, Melbourne, Australia
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20
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Marcus O. 'Everybody's creating it along the way': ethical tensions among globalized ayahuasca shamanisms and therapeutic integration practices. INTERDISCIPLINARY SCIENCE REVIEWS : ISR 2022; 48:712-731. [PMID: 38164518 PMCID: PMC10753198 DOI: 10.1080/03080188.2022.2075201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/23/2022] [Indexed: 01/03/2024]
Abstract
Ayahuasca has a variety of traditional uses, yet there is a growing global interest in its potential therapeutic benefits for mental health conditions. Novel approaches to psychotherapy are emerging to address the needs of ayahuasca users to prepare as well as to guide them in 'integrating' their powerful psychedelic experiences, yet there is little discussion on the ethical frameworks that may structure these therapeutic processes or the social and cultural assumptions that influence the assignment of ayahuasca as a medicine. Based on ethnographic fieldwork in San Martín and Loreto, Peru, I examine the varied social meanings and uses of ayahuasca in the Peruvian vegetalista tradition and the potential ethical tensions among curanderos, mental health practitioners, and ayahuasca retreat centers. Practitioners and ayahuasca centers are left with navigating globalized concepts of mental health and ethics while attempting to remain authentic to local ontologies of healing, care, and safety.
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21
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Rodrigues LS, Rossi GN, Rocha JM, L Osório F, Bouso JC, Hallak JEC, Dos Santos RG. Effects of ayahuasca and its alkaloids on substance use disorders: an updated (2016-2020) systematic review of preclinical and human studies. Eur Arch Psychiatry Clin Neurosci 2022; 272:541-556. [PMID: 33914164 DOI: 10.1007/s00406-021-01267-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/22/2021] [Indexed: 12/09/2022]
Abstract
Ayahuasca is a hallucinogenic/psychedelic traditionally used for ritual and therapeutic purposes. One such therapeutic use is related to Substance Use Disorders (SUDs). A previous systematic review of preclinical and human studies published until 2016 suggested that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. To conduct an update of this previous review. A systematic review of quantitative studies which analyzed the effects of ayahuasca and its alkaloids on drug use (primary outcome) and other measures (secondary outcomes) related to SUDs was conducted, including articles from 2016 to 2020. Nine studies (four preclinical, five observational) were included in the review. Preclinical studies in rodents reported reductions in amphetamine self-administration and anxiety, and in alcohol- and methylphenidate-induced conditioned place preference. Observational studies among healthy ritual ayahuasca users and patients with SUDs reported reductions in drug use, anxiety, and depression, and increases in quality of life and well-being. We replicated the findings of the previous review suggesting that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. However, translation of preclinical data to humans is limited, observational studies do not allow us to infer causality, and there is a lack of standardization on ayahuasca doses. Although promising, randomized, controlled trials are needed to better elucidate these results. The PROSPERO ID for this study is CRD42020192046.
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Affiliation(s)
- Lucas Silva Rodrigues
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Giordano Novak Rossi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Juliana Mendes Rocha
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Flávia L Osório
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil
| | - José Carlos Bouso
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- ICEERS Foundation, International Center for Ethnobotanical Education, Research and Services, Barcelona, Spain
- Medical Anthopology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | - Jaime E Cecílio Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil
| | - Rafael G Dos Santos
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
- National Institute of Science and Technology, Translational Medicine, Ribeirão Preto, Brazil.
- ICEERS Foundation, International Center for Ethnobotanical Education, Research and Services, Barcelona, Spain.
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22
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Daldegan-Bueno D, Maia LO, Massarentti CM, Tófoli LF. Ayahuasca and tobacco smoking cessation: results from an online survey in Brazil. Psychopharmacology (Berl) 2022; 239:1767-1782. [PMID: 35179623 DOI: 10.1007/s00213-022-06063-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022]
Abstract
RATIONALE Smoking-related disease is a major problem globally. Effective smoking cessation treatments are however limited. Increasing evidence suggests that psychedelics have potential as treatments for substance use disorders and may therefore prove an option in aiding smoking cessation. OBJECTIVES To establish which factors predict smoking cessation in people who reported quitting or reducing smoking following ayahuasca consumption. METHODS A retrospective cross-sectional mixed-method study (quantitative and qualitative design) was undertaken using data from an online survey evaluating peoples' experiences before and after drinking ayahuasca. Multivariate logistic regression was performed with smoking condition (cessation or reduction/relapse) as a dependent variable and demographics, smoking, ayahuasca-related variables and the mystical experience (MEQ30) as predicting factors. RESULTS A total of 441 responses were grouped according to self-reported smoking status: cessation (n = 305) or reduction/relapse (n = 136) smoking. Logistic regression showed that mystical experience (OR: 1.03; 95% CI [1.00-1.05]) and frequency of ayahuasca intake (OR: 2.16[1.00-4.70]) were protective factors, while positive mood (measured by the MEQ30) during the ayahuasca experience was a risk factor (OR: 0.91[0.85-0.97]). Qualitative thematic analysis identified eight themes (e.g. acquired awareness, spiritual experience, increased motivation) related to the ayahuasca experience and the process of smoking cessation/reduction. CONCLUSIONS Our results suggest that ayahuasca could be used as a potential tool for smoking cessation, and that effects may be mediated by mystical experience. Given the current burden of smoking-related disease and the limited treatment options, studies are needed to investigate the efficacy of psychedelics in smoking cessation.
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Affiliation(s)
- Dimitri Daldegan-Bueno
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil
- Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand
| | - Lucas Oliveira Maia
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil
| | - Carolina Marcolino Massarentti
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz Campinas, Rua Tessália Vieira de Camargo 126, Campinas, São Paulo, 13083-887, Brazil.
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23
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Serra YA, Barros-Santos T, Anjos-Santos A, Kisaki ND, Jovita-Farias C, Leite JPC, Santana MCE, Coimbra JPSA, de Jesus NMS, Sulima A, Barbosa PCR, Malpezzi-Marinho ELA, Rice KC, Oliveira-Lima AJ, Berro LF, Marinho EAV. Role of 5-HT 2A receptors in the effects of ayahuasca on ethanol self-administration using a two-bottle choice paradigm in male mice. Psychopharmacology (Berl) 2022; 239:1679-1687. [PMID: 35253069 PMCID: PMC10750423 DOI: 10.1007/s00213-022-06104-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/23/2022] [Indexed: 01/21/2023]
Abstract
RATIONALE Ayahuasca has been proposed as a potential treatment of alcohol (ethanol) use disorder (AUD). The serotonin 5-HT2A receptor agonist N,N-dimethyltryptamine (DMT) is the main psychoactive component of ayahuasca, suggesting that its therapeutic effects may be mediated by 5-HT2A receptors. OBJECTIVES The aim of the present study was to investigate the effects of ayahuasca on the expression of ethanol self-administration using a two-bottle choice procedure and the role of 5-HT2A receptors in those effects. METHODS Male mice had intermittent access to ethanol (10% v/v) in a two-bottle choice procedure for 30 days. Animals were then submitted to 3 treatment phases, each followed by ethanol re-exposure tests. During the treatment phase, every 3 days, animals received i.p. injections of either vehicle or the 5-HT2A receptor antagonist M100907 (M100, 1 mg/kg) followed by an i.g. (gavage) administration of vehicle or ayahuasca (100 mg/kg) and were exposed to the self-administration apparatus with no ethanol availability. During re-exposure tests, animals were submitted to the same conditions as during acquisition, with no treatments prior to those sessions. RESULTS Treatment with ayahuasca blocked the expression of ethanol self-administration, decreasing ethanol intake and preference during re-exposure tests. Pretreatment with M100 blocked the effects of ayahuasca on ethanol drinking without significantly attenuating ethanol self-administration. CONCLUSIONS Treatment with ayahuasca during alcohol abstinence blocked the expression of alcohol self-administration in mice, and 5-HT2A receptor activation is critical for those effects to emerge. Our findings support a potential for ayahuasca and other 5-HT2A receptor agonists as adjunctive pharmacotherapies for the treatment of AUD.
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Affiliation(s)
- Yasmim A Serra
- Department of Health Sciences, Universidade Estadual de Santa Cruz, Rod. Ilhéus/Itabuna, Km 16, Ilhéus, BA, 45662-0, Brazil
| | - Thaísa Barros-Santos
- Department of Biological Sciences, Universidade Estadual de Santa Cruz, Ilhéus, BA, Brazil
| | - Alexia Anjos-Santos
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute On Drug Abuse and the National Institute On Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Natali D Kisaki
- Department of Health Sciences, Universidade Estadual de Santa Cruz, Rod. Ilhéus/Itabuna, Km 16, Ilhéus, BA, 45662-0, Brazil
| | - Caio Jovita-Farias
- Department of Health Sciences, Universidade Estadual de Santa Cruz, Rod. Ilhéus/Itabuna, Km 16, Ilhéus, BA, 45662-0, Brazil
| | - João P C Leite
- Department of Biological Sciences, Universidade Estadual de Santa Cruz, Ilhéus, BA, Brazil
| | - Maria C E Santana
- Department of Biological Sciences, Universidade Estadual de Santa Cruz, Ilhéus, BA, Brazil
| | - João P S A Coimbra
- Department of Biological Sciences, Universidade Estadual de Santa Cruz, Ilhéus, BA, Brazil
| | - Nailton M S de Jesus
- Department of Biological Sciences, Universidade Estadual de Santa Cruz, Ilhéus, BA, Brazil
| | - Agnieszka Sulima
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute On Drug Abuse and the National Institute On Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Paulo C R Barbosa
- Department of Health Sciences, Universidade Estadual de Santa Cruz, Rod. Ilhéus/Itabuna, Km 16, Ilhéus, BA, 45662-0, Brazil
| | | | - Kenner C Rice
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, National Institute On Drug Abuse and the National Institute On Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Alexandre J Oliveira-Lima
- Department of Health Sciences, Universidade Estadual de Santa Cruz, Rod. Ilhéus/Itabuna, Km 16, Ilhéus, BA, 45662-0, Brazil
| | - Laís F Berro
- Department of Health Sciences, Universidade Estadual de Santa Cruz, Rod. Ilhéus/Itabuna, Km 16, Ilhéus, BA, 45662-0, Brazil.
- Department of Psychiatry and Human Behavior, Center for Innovation and Discovery in Addictions, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA.
| | - Eduardo A V Marinho
- Department of Health Sciences, Universidade Estadual de Santa Cruz, Rod. Ilhéus/Itabuna, Km 16, Ilhéus, BA, 45662-0, Brazil.
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Psychedelics: Alternative and Potential Therapeutic Options for Treating Mood and Anxiety Disorders. Molecules 2022; 27:molecules27082520. [PMID: 35458717 PMCID: PMC9025549 DOI: 10.3390/molecules27082520] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/07/2022] Open
Abstract
The word “psychedelic” (psyche (i.e., the mind or soul) and delos (i.e., to show)) has Greek origin and was first coined by psychiatrist Humphry Osmond in 1956, who had been conducting research on lysergic acid diethylamide (LSD) at the time. Psychedelic drugs such as N,N-DMT/DMT (N,N-dimethyltryptamine), 5-MeO-DMT (5-methoxy-N,N-dimethyltryptamine), LSD (lysergic acid diethylamide), MDMA (3,4-methylenedioxymethamphetamine) and psilocybin have had significant value as an entheogen in spiritual, religious (shamanic) and sociocultural rituals in Central and South American cultures for thousands of years. In the 1960s, the globalization of these drugs and their subsequent spread outside of their indigenous, old-world cultures, led to the subsequent implementation of strict drug control laws in many Western countries. Even today, psychedelics are still classified as Schedule I drugs, resulting in a still lingering negative stigmatization/perception, vilification, and ultimate criminalization of psychedelics. This controversy still lingers and still limits scientific research and full medical acceptance. For many years up until recently, the spiritual, religious and medicinal value of these drugs could not be explored in a scientific context. More recently, a second wave of psychedelic research is now focusing on psychedelics as neuropharmaceuticals to treat alcohol and tobacco addiction, general mood and anxiety disorders and cancer-related depression. There is now a vast array of promising evidence-based data to confirm the years of anecdotal evidence of the medicinal values of psychedelics. Natural therapeutic alternatives such as psychedelic drugs may provide a safe and efficacious alternate to conventional drugs used to treat mood and anxiety disorders. In a Western context in particular, psychedelic drugs as therapeutic agents for mood and anxiety disorders are becoming increasingly of interest amidst increasing rates of such disorders globally, changing social constructions, the implementation of government regulations and increasing investment opportunities, that ultimately allow for the scientific study to generate evidenced-based data. Alternative psychotherapeutic interventions are gaining interest also, because of their low physiological toxicity, relatively low abuse potential, safe psychological effects, and no associated persisting adverse physiological or psychological effects during and after use. On the other hand, conventional psychotic drugs and anti-depressants are becoming less favorable because of their adverse side effects. Psychedelic neuropharmaceutical interventions may with medical oversight be the solution to conventional psychiatric disorders such as depression and anxiety, and an alternative to conventional psychiatric treatment options. This paper will review the therapeutic potential of psychedelic drugs as alternative therapeutic options for mood and anxiety disorders in a controlled, clinical setting, where the chances of adverse psychological episodes occurring are mitigated.
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Watts R, Kettner H, Geerts D, Gandy S, Kartner L, Mertens L, Timmermann C, Nour MM, Kaelen M, Nutt D, Carhart-Harris R, Roseman L. The Watts Connectedness Scale: a new scale for measuring a sense of connectedness to self, others, and world. Psychopharmacology (Berl) 2022; 239:3461-3483. [PMID: 35939083 PMCID: PMC9358368 DOI: 10.1007/s00213-022-06187-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/27/2022] [Indexed: 11/10/2022]
Abstract
RATIONALE A general feeling of disconnection has been associated with mental and emotional suffering. Improvements to a sense of connectedness to self, others and the wider world have been reported by participants in clinical trials of psychedelic therapy. Such accounts have led us to a definition of the psychological construct of 'connectedness' as 'a state of feeling connected to self, others and the wider world'. Existing tools for measuring connectedness have focused on particular aspects of connectedness, such as 'social connectedness' or 'nature connectedness', which we hypothesise to be different expressions of a common factor of connectedness. Here, we sought to develop a new scale to measure connectedness as a construct with these multiple domains. We hypothesised that (1) our scale would measure three separable subscale factors pertaining to a felt connection to 'self', 'others' and 'world' and (2) improvements in total and subscale WCS scores would correlate with improved mental health outcomes post psychedelic use. OBJECTIVES To validate and test the 'Watts Connectedness Scale' (WCS). METHODS Psychometric validation of the WCS was carried out using data from three independent studies. Firstly, we pooled data from two prospective observational online survey studies. The WCS was completed before and after a planned psychedelic experience. The total sample of completers from the online surveys was N = 1226. Exploratory and confirmatory factor analysis were performed, and construct and criterion validity were tested. A third dataset was derived from a double-blind randomised controlled trial (RCT) comparing psilocybin-assisted therapy (n = 27) with 6 weeks of daily escitalopram (n = 25) for major depressive disorder (MDD), where the WCS was completed at baseline and at a 6-week primary endpoint. RESULTS As hypothesised, factor analysis of all WCS items revealed three main factors with good internal consistency. WCS showed good construct validity. Significant post-psychedelic increases were observed for total connectedness scores (η2 = 0.339, p < 0.0001), as well as on each of its subscales (p < 0.0001). Acute measures of 'mystical experience', 'emotional breakthrough', and 'communitas' correlated positively with post-psychedelic changes in connectedness (r = 0.42, r = 0.38, r = 0.42, respectively, p < 0.0001). In the RCT, psilocybin therapy was associated with greater increases in WCS scores compared with the escitalopram arm (ηp2 = 0.133, p = 0.009). CONCLUSIONS The WCS is a new 3-dimensional index of felt connectedness that may sensitively measure therapeutically relevant psychological changes post-psychedelic use. We believe that the operational definition of connectedness captured by the WCS may have broad relevance in mental health research.
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Affiliation(s)
- Rosalind Watts
- Centre for Psychedelic Research, Imperial College London, London, UK. .,Acer Integration, London, UK. .,Synthesis Institute, Amsterdam, Netherlands.
| | - Hannes Kettner
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK
| | - Dana Geerts
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK ,grid.5012.60000 0001 0481 6099Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Sam Gandy
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK
| | - Laura Kartner
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK
| | - Lea Mertens
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK
| | - Christopher Timmermann
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK
| | - Matthew M. Nour
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK
| | - Mendel Kaelen
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK
| | - David Nutt
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK
| | - Robin Carhart-Harris
- grid.7445.20000 0001 2113 8111Centre for Psychedelic Research, Imperial College London, London, UK ,grid.266102.10000 0001 2297 6811Psychedelics Division, Department of Neurology, University of California San Francisco, Neuroscape, USA
| | - Leor Roseman
- Centre for Psychedelic Research, Imperial College London, London, UK.
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Daldegan-Bueno D, Révész D, Morais PR, Barbosa PCR, Maia LO. Psychosocial and Drug Use Assessment of Regular vs. Non-Regular Ayahuasca Users in a Brazilian Sample: a Web-Based Survey. Subst Use Misuse 2022; 57:1072-1081. [PMID: 35466853 DOI: 10.1080/10826084.2022.2063896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Preliminary evidence suggests that long-term ayahuasca use is associated with better psychosocial outcomes and less drug use; however, available data on the association between ayahuasca intake frequency and psychosocial outcomes is limited. Objectives: We sought to characterize and investigate the association of regular ayahuasca use, as compared to non-regular use, on licit (alcohol and tobacco) and illicit (cannabis, psychostimulants, psychedelics, and non-medical opioids) drug use and psychosocial outcomes. Methods: An online-based cross-sectional survey was taken among people who use ayahuasca in Brazil assessing sociodemographic, drug and ayahuasca use, anxiety and depression (HAD-S), intrinsic religiosity (IRI), negative and positive affects (PANAS), satisfaction with life (SWLS), and five quality of life domains (WHOQOL-Brief). Multivariate regressions for each psychosocial outcome and drug use were performed comparing regular to non-regular ayahuasca users while correcting for sociodemographic variables. Results: A total of 286 valid answers were retrieved, divided into people with regular (n = 101) and non-regular (n = 185) ayahuasca use. Groups had similar sociodemographic profiles and lifetime use of drugs. In the multivariate analysis, regular use of ayahuasca was associated with lower anxiety (B: -0.97), negative affect (B: -2.62), general (B: 0.22) and physical (B: 0.17) quality of life, higher intrinsic religiosity scores (B: 4.16), and less past-month licit (OR = 0.30) and illicit (OR = 0.49) use of substances. Conclusions: Our results show that ceremonial regular ayahuasca compared to non-regular use is associated with better psychosocial and mental health outcomes and less drug use. Studies with repeated ayahuasca administration and extended follow-ups are essential to clarify the nature of ayahuasca's therapeutic effects and to guide future clinical research.
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Affiliation(s)
- Dimitri Daldegan-Bueno
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil.,Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | | | - Paulo Rogério Morais
- Department of Psychology, Federal University of Rondônia, Porto Velho, Brazil.,Observatory of Violence, Health and Work (OBSAT), Federal University of Rondônia, Porto Velho, Brazil
| | | | - Lucas Oliveira Maia
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil
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Michael P, Luke D, Robinson O. An Encounter With the Other: A Thematic and Content Analysis of DMT Experiences From a Naturalistic Field Study. Front Psychol 2021; 12:720717. [PMID: 34975614 PMCID: PMC8716686 DOI: 10.3389/fpsyg.2021.720717] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/15/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction: N,N-dimethyltryptamine (DMT) is an endogenous serotonergic psychedelic capable of producing radical shifts in conscious experience. Increasing trends in its use, as well as new trials administering DMT to patients, indicate the growing importance of a thorough elucidation of the qualitative content, over and above structure, which the drug occasions. This is particularly in light of the hyper-real, otherworldly, and often ontologically challenging yet potentially transformative, nature of the experience, not least encounters with apparently non-self social agents. Laboratory studies have been limited by clinical setting and lacking qualitative analyses of experiential content, while online surveys' limitations lie in retrospective design, uncontrolled use, and both of which not guaranteeing 'breakthrough' experiences, i.e., producing very strong psychoactive effects. Methods: We report on the first naturalistic field study of DMT use including its qualitative analysis. Screened, healthy, anonymised and experienced DMT users were observed during their non-clinical use of the drug at home (40-75 mg inhaled). In-depth semi-structured interviews (inspired by the micro-phenomenological technique) were employed immediately after their experience. This paper reports on the thematic analysis of one major domain of the breakthrough experiences elicited, the 'other'. Thirty-six post-DMT experience interviews with mostly Caucasian (83%) males (eight female) of average 37 years were predominantly inductively coded. Results: Invariably, profound and highly intense experiences occurred. The first overarching category comprised the encounter with other 'beings' (94% of reports), encompassing super-ordinate themes including the entities' role, appearance, demeanour, communication and interaction; while the second overarching category comprised experiences of emerging into other 'worlds' (100% of reports), encompassing super-ordinate themes of the scene, the contents and quality of the immersive spaces. Many further mid-level themes and subthemes also illuminate the rich content of the DMT experience. Discussion: The present study provides a systematic and in-depth analysis of the nuanced content of the otherworldly encounter within the breakthrough DMT experience, as well as elaborating on the resonances both with previous DMT studies focusing on entity encounters and other types of extraordinary experiences entailing such encounters. These include the alien abduction, folkloric, shamanic and near-death experience. Putative neural mechanisms of these features of the DMT experience and its promise as a psychotherapeutic agent are discussed in light of such findings.
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Affiliation(s)
- Pascal Michael
- School of Human Sciences, Old Royal Naval College, University of Greenwich, London, United Kingdom
| | - David Luke
- School of Human Sciences, Old Royal Naval College, University of Greenwich, London, United Kingdom
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Oliver Robinson
- School of Human Sciences, Old Royal Naval College, University of Greenwich, London, United Kingdom
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Lafrance A, Strahan E, Bird BM, St. Pierre M, Walsh Z. Classic Psychedelic Use and Mechanisms of Mental Health: Exploring the Mediating Roles of Spirituality and Emotion Processing on Symptoms of Anxiety, Depressed Mood, and Disordered Eating in a Community Sample. JOURNAL OF HUMANISTIC PSYCHOLOGY 2021. [DOI: 10.1177/00221678211048049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A resurgence of research has begun to systematically examine the relationship between psychedelic use and mental health and well-being. Although preliminary findings examining the therapeutic value of these substances show promise, the mechanisms through which psychedelic use may predict reduced mental distress remain poorly understood. To this end, we surveyed a community sample of individuals ( n = 159) who endorsed lifetime psychedelic use to examine relationships among psychedelic use and self-reported spirituality, difficulties in emotion regulation, and symptoms of mental health issues. Results revealed a pathway through which classic psychedelic use predicted greater spirituality, which in turn predicted better emotion regulation, ultimately predicting lower levels of anxiety, depressed mood, and disordered eating. These results contribute to our understanding of potential mechanisms of change with respect to psychedelics and mental health. They also add to the growing body of literature pointing to the healing effects of the cultivation of spirituality and emotion regulation as separate and related constructs.
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Affiliation(s)
| | - Erin Strahan
- Wilfrid Laurier University, Brantford, Ontario, Canada
| | - Brian M. Bird
- Simon Fraser University, Burnaby, British Columbia, Canada
| | | | - Zach Walsh
- The University of British Columbia, Kelowna, British Columbia, Canada
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29
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Kohek M, Sánchez Avilés C, Romaní O, Bouso JC. Ancient psychoactive plants in a global village: The ritual use of cannabis in a self-managed community in Catalonia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103390. [PMID: 34340169 DOI: 10.1016/j.drugpo.2021.103390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/23/2021] [Accepted: 07/12/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Cannabis is a plant with a rich history of medical, recreational, industrial and spiritual uses. This paper aims to explore drug use rituals as methods of community-controlled use that help maintain a self-regulated and healthy relation to the substance in questions. Furthermore, it explores how cannabis is used in developing spirituality and a sense of community. The ritual use of cannabis is discussed in the context of drug policy. METHODS Ethnographic research methods, such as fieldwork, participant observation, in-depth interviews, and qualitative analysis, were used to research a phenomenological community in rural Catalonia, where ancient psychoactive plants (APP), such as ayahuasca and cannabis, are regularly used in a ritual context. RESULTS Cannabis has a long history of ritual/spiritual uses and is still being used for such purposes in Catalonia. The rituals are effective harm reduction techniques and can even generate beneficial effects for the individual as well as the community by strengthening bonds between community members. The rituals associated with APP are seen as spiritual or religious practices, as well as forms of self-care and community-care, rather than involving drug dependence or addiction. CONCLUSION The contemporary use of APP in Western societies is gaining popularity. International drug policies and the schedule of controlled drugs claim to be based on scientific evidence, but this evidence is limited. The contemporary myopic focus on the risks and harms of drugs overlooks important realities, such as the benefits of non-problematic drug use. These omissions could in part be rectified through the consideration of scientific findings from the field of ethnography regarding the spiritual and community dimensions of drug use.
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Affiliation(s)
- Maja Kohek
- International Center for Ethnobotanical Education, Research & Service (ICEERS), Carrer de Sepúlveda, 65, Local 2, 08015 Barcelona, Spain; Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Catalunya Campus, Av. Catalunya 35, 43002 Tarragona, Spain
| | - Constanza Sánchez Avilés
- International Center for Ethnobotanical Education, Research & Service (ICEERS), Carrer de Sepúlveda, 65, Local 2, 08015 Barcelona, Spain
| | - Oriol Romaní
- Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Catalunya Campus, Av. Catalunya 35, 43002 Tarragona, Spain
| | - José Carlos Bouso
- International Center for Ethnobotanical Education, Research & Service (ICEERS), Carrer de Sepúlveda, 65, Local 2, 08015 Barcelona, Spain.
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30
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Perkins D, Opaleye ES, Simonova H, Bouso JC, Tófoli LF, GalvÃo-Coelho NL, Schubert V, Sarris J. Associations between ayahuasca consumption in naturalistic settings and current alcohol and drug use: Results of a large international cross-sectional survey. Drug Alcohol Rev 2021; 41:265-274. [PMID: 34308566 DOI: 10.1111/dar.13348] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Emerging evidence suggests that psychedelic compounds, including the Amazonian botanical decoction ayahuasca, may provide clinical benefit in the treatment of alcohol or other drug use disorders. This study investigates associations between ayahuasca consumption in naturalistic settings and current alcohol and other drug use. METHODS Online cross-sectional study of people who have consumed ayahuasca in religious, traditional and non-traditional settings in over 40 countries. A total of 8629 participants (53% male, average age 40 years) were included in the analysis. Logistic regressions were used to explore associations between ayahuasca drinking variables and the current use of alcohol and other drugs, as well as the influence of confounding factors, such as church or community membership. RESULTS The number of times ayahuasca had been consumed was strongly associated with increased odds of never or rarely drinking alcohol, never or rarely engaging in 'risky drinking' and having not consumed a range of drugs in the past month, with these effects greater for those with a prior substance use disorder compared to those without. The strength of ayahuasca drinkers subjective spiritual experience, number of personal self-insights obtained and drinking ayahuasca with an ayahuasca church were also associated with lower substance use in some models. DISCUSSION AND CONCLUSIONS Consumption of ayahuasca in naturalistic settings is associated with lower self-reported current consumption of alcohol and other drugs for those with and without prior substance use disorders, with such effects present after adjusting for religious or social group effects.
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Affiliation(s)
- Daniel Perkins
- School of Social and Political Science, University of Melbourne, Melbourne, Australia
| | - Emerita S Opaleye
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - José C Bouso
- International Center for Ethnobotanic Education, Research and Service, Barcelona, Spain.,Medical Anthropology Research Center, University of Rovira I Virgili, Tarragona, Spain.,Department of Neurosciences and Behavior, Ribeião Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Luís F Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Nicole L GalvÃo-Coelho
- Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Violeta Schubert
- School of Social and Political Science, University of Melbourne, Melbourne, Australia
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Sydney, Australia.,Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Melbourne, Australia
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Ruffell SGD, Netzband N, Tsang W, Davies M, Inserra A, Butler M, Rucker JJH, Tófoli LF, Dempster EL, Young AH, Morgan CJA. Ceremonial Ayahuasca in Amazonian Retreats-Mental Health and Epigenetic Outcomes From a Six-Month Naturalistic Study. Front Psychiatry 2021; 12:687615. [PMID: 34177670 PMCID: PMC8221532 DOI: 10.3389/fpsyt.2021.687615] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/14/2021] [Indexed: 12/29/2022] Open
Abstract
Ayahuasca is a natural psychoactive brew, used in traditional ceremonies in the Amazon basin. Recent research has indicated that ayahuasca is pharmacologically safe and its use may be positively associated with improvements in psychiatric symptoms. The mechanistic effects of ayahuasca are yet to be fully established. In this prospective naturalistic study, 63 self-selected participants took part in ayahuasca ceremonies at a retreat centre in the Peruvian Amazon. Participants undertook the Beck Depression Inventory (BDI-II), State-Trait Anxiety Inventory (STAI), Self-compassion Scale (SCS), Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), as well as secondary measures, pre- and post-retreat and at 6-months. Participants also provided saliva samples for pre/post epigenetic analysis. Overall, a statistically significant decrease in BDI-II (13.9 vs. 6.1, p < 0.001), STAI (44.4 vs. 34.3 p < 0.001) scores, and CORE-OM scores were observed (37.3 vs. 22.3 p < 0.001) at post-retreat, as well as a concurrent increase in SCS (3.1 vs. 3.6, p < 0.001). Psychometric improvements were sustained, and on some measures values further decreased at 6-month follow-up, suggesting a potential for lasting therapeutic effects. Changes in memory valence were linked to the observed psychometric improvements. Epigenetic findings were equivocal, but indicated that further research in candidate genes, such as sigma non-opioid intracellular receptor 1 (SIGMAR1), is warranted. This data adds to the literature supporting ayahuasca's possible positive impact on mental health when conducted in a ceremonial context. Further investigation into clinical samples, as well as greater analyses into the mechanistic action of ayahuasca is advised.
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Affiliation(s)
- Simon G. D. Ruffell
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Nige Netzband
- Department of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
| | - WaiFung Tsang
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Merlin Davies
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Antonio Inserra
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Matthew Butler
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - James J. H. Rucker
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), University of Campinas, São Paulo, Brazil
| | - Emma Louise Dempster
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
| | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, United Kingdom
| | - Celia J. A. Morgan
- College of Life and Environmental Sciences, Washington Singer Laboratories, University of Exeter, Exeter, United Kingdom
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Rush B, Marcus O, García S, Loizaga-Velder A, Loewinger G, Spitalier A, Mendive F. Protocol for Outcome Evaluation of Ayahuasca-Assisted Addiction Treatment: The Case of Takiwasi Center. Front Pharmacol 2021; 12:659644. [PMID: 34093190 PMCID: PMC8170098 DOI: 10.3389/fphar.2021.659644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/04/2021] [Indexed: 01/03/2023] Open
Abstract
The present study describes the protocol for the Ayahuasca Treatment Outcome Project (ATOP) with a special focus on the evaluation of addiction treatment services provided through Takiwasi Center, the first ATOP study site. The goal of the project is to assess treatment outcomes and understand the therapeutic mechanisms of an Ayahuasca-assisted, integrative treatment model for addiction rehabilitation in the Peruvian Amazon. The proposed intervention protocol highlights the significance of treatment setting in the design, delivery, and efficacy of an addiction rehabilitation program that involves the potent psychedelic tea known as Ayahuasca. After describing the context of the study, we put forth details about our mixed-methods approach to data collection and analysis, with which we seek to gain an understanding of why, how, and for whom this specific ayahuasca-assisted treatment program is effective across a range of outcomes. The ATOP protocol employs qualitative research methods as a means to determine which aspects of the setting are meaningful to clients and practitioners, and how this may correlate with outcome measures. This paper delineates the core principles, methods, and measures of the overall ATOP umbrella, then discusses the role of ATOP in the context of the literature on long-term residential programs. To conclude, we discuss the strengths and limitations of the protocol and the intended future of the project.
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Affiliation(s)
- Brian Rush
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Olivia Marcus
- Department of Anthropology, University of Connecticut, Storrs, CT, United States
| | - Sara García
- Takiwasi Center for Rehabilitation of Drug Addicts and Research on Traditional Medicine, Tarapoto, Peru
| | - Anja Loizaga-Velder
- Nierika Institute, National Autonomous University of Mexico, Mexico City, Mexico
| | - Gabriel Loewinger
- School of Public Health, Harvard University, Boston, MA, United States
| | | | - Fernando Mendive
- Takiwasi Center for Rehabilitation of Drug Addicts and Research on Traditional Medicine, Tarapoto, Peru
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Roseman L, Ron Y, Saca A, Ginsberg N, Luan L, Karkabi N, Doblin R, Carhart-Harris R. Relational Processes in Ayahuasca Groups of Palestinians and Israelis. Front Pharmacol 2021; 12:607529. [PMID: 34093170 PMCID: PMC8170481 DOI: 10.3389/fphar.2021.607529] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 02/03/2021] [Indexed: 12/20/2022] Open
Abstract
Psychedelics are used in many group contexts. However, most phenomenological research on psychedelics is focused on personal experiences. This paper presents a phenomenological investigation centered on intersubjective and intercultural relational processes, exploring how an intercultural context affects both the group and individual process. Through 31 in-depth interviews, ceremonies in which Palestinians and Israelis drink ayahuasca together have been investigated. The overarching question guiding this inquiry was how psychedelics might contribute to processes of peacebuilding, and in particular how an intercultural context, embedded in a protracted conflict, would affect the group's psychedelic process in a relational sense. Analysis of the interviews was based on grounded theory. Three relational themes about multilocal participatory events which occurred during ayahuasca rituals have emerged from the interviews: 1) Unity-Based Connection - collective events in which a feeling of unity and 'oneness' is experienced, whereby participants related to each other based upon a sense of shared humanity, and other social identities seemed to dissolve (such as national and religious identities). 2) Recognition and Difference-Based Connection - events where a strong connection was made to the other culture. These events occurred through the expression of the other culture or religion through music or prayers, which resulted in feelings of awe and reverence 3) Conflict-related revelations - events where participants revisited personal or historical traumatic elements related to the conflict, usually through visions. These events were triggered by the presence of 'the Other,' and there was a political undertone in those personal visions. This inquiry has revealed that psychedelic ceremonies have the potential to contribute to peacebuilding. This can happen not just by 'dissolution of identities,' but also by providing a space in which shared spiritual experiences can emerge from intercultural and interfaith exchanges. Furthermore, in many cases, personal revelations were related to the larger political reality and the history of the conflict. Such processes can elucidate the relationship between personal psychological mental states and the larger sociopolitical context.
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Affiliation(s)
- Leor Roseman
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Yiftach Ron
- Faculty of Social Sciences, Hebrew University, Jerusalem, Israel
- School of Creative Arts Therapies, Kibbutzim College, Tel Aviv, Israel
| | | | - Natalie Ginsberg
- Multidisciplinary Association for Psychedelic Studies (MAPS), Santa Cruz, CA, United States
| | - Lisa Luan
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Nadeem Karkabi
- Anthropology Department, University of Haifa, Haifa, Israel
| | - Rick Doblin
- Multidisciplinary Association for Psychedelic Studies (MAPS), Santa Cruz, CA, United States
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
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Kettner H, Rosas FE, Timmermann C, Kärtner L, Carhart-Harris RL, Roseman L. Psychedelic Communitas: Intersubjective Experience During Psychedelic Group Sessions Predicts Enduring Changes in Psychological Wellbeing and Social Connectedness. Front Pharmacol 2021; 12:623985. [PMID: 33995022 PMCID: PMC8114773 DOI: 10.3389/fphar.2021.623985] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/26/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Recent years have seen a resurgence of research on the potential of psychedelic substances to treat addictive and mood disorders. Historically and contemporarily, psychedelic studies have emphasized the importance of contextual elements ('set and setting') in modulating acute drug effects, and ultimately, influencing long-term outcomes. Nevertheless, current small-scale clinical and laboratory studies have tended to bypass a ubiquitous contextual feature of naturalistic psychedelic use: its social dimension. This study introduces and psychometrically validates an adapted Communitas Scale, assessing acute relational experiences of perceived togetherness and shared humanity, in order to investigate psychosocial mechanisms pertinent to psychedelic ceremonies and retreats. Methods: In this observational, web-based survey study, participants (N = 886) were measured across five successive time-points: 2 weeks before, hours before, and the day after a psychedelic ceremony; as well as the day after, and 4 weeks after leaving the ceremony location. Demographics, psychological traits and state variables were assessed pre-ceremony, in addition to changes in psychological wellbeing and social connectedness from before to after the retreat, as primary outcomes. Using correlational and multiple regression (path) analyses, predictive relationships between psychosocial 'set and setting' variables, communitas, and long-term outcomes were explored. Results: The adapted Communitas Scale demonstrated substantial internal consistency (Cronbach's alpha = 0.92) and construct validity in comparison with validated measures of intra-subjective (visual, mystical, challenging experiences questionnaires) and inter-subjective (perceived emotional synchrony, identity fusion) experiences. Furthermore, communitas during ceremony was significantly correlated with increases in psychological wellbeing (r = 0.22), social connectedness (r = 0.25), and other salient mental health outcomes. Path analyses revealed that the effect of ceremony-communitas on long-term outcomes was fully mediated by communitas experienced in reference to the retreat overall, and that the extent of personal sharing or 'self-disclosure' contributed to this process. A positive relationship between participants and facilitators, and the perceived impact of emotional support, facilitated the emergence of communitas. Conclusion: Highlighting the importance of intersubjective experience, rapport, and emotional support for long-term outcomes of psychedelic use, this first quantitative examination of psychosocial factors in guided psychedelic settings is a significant step toward evidence-based benefit-maximization guidelines for collective psychedelic use.
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Affiliation(s)
- H. Kettner
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - F. E. Rosas
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
- Data Science Institute, Imperial College London, London, United Kingdom
- Centre for Complexity Science, Imperial College London, London, United Kingdom
| | - C. Timmermann
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - L. Kärtner
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - R. L. Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - L. Roseman
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
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Vegetative value: promissory horizons of therapeutic innovation in the global circulation of ayahuasca. BIOSOCIETIES 2021. [DOI: 10.1057/s41292-020-00222-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Horák M, Somerlikova K, Kocarova R, Verter N, Aldama Gonzalez HS, Cruz de Souza Tronco M. Effective factors of addiction treatment communities in Peru, Nicaragua and Czechia. THERAPEUTIC COMMUNITIES 2021. [DOI: 10.1108/tc-06-2020-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to explore the effective factors that influence the treatment of drug addiction in therapeutic communities (TCs) and to determine its essential elements in the Peruvian, Nicaraguan and Czech context.
Design/methodology/approach
The qualitative data were collected during semi-structured interviews with inpatients/clients of seven TCs based in Peru (Takiwasi), Nicaragua (Centro de Especialiades en Adicciones, Centro de Rehabilitación del Alcohólico y Adicto a Otras Drogas and Albergue de Miembros Adictos en Recuperación) and the Czech Republic (Renarkon, Sejrek and Kladno-Dubi). All 90 interviews were manually transcribed, and content analysis was performed. Codes were created using the grounded theory method.
Findings
The effective factors of TC, treatment in Peru, Nicaragua and Czechia are identical in conditions such as the presence of a personal therapist, the use of psychotherapy and the importance of group cohesion. In Peru, the administration of medicinal plants and diet was perceived as a principal part of the treatment. Nicaraguan TCs were specific for practicing 12 steps. In Czechia, an emphasis is put on the therapeutic program, workshops and leisure activities. Spirituality and religion play a main role in the Peruvian and Nicaraguan TCs only.
Originality/value
The current study presents a unique insight into the factors considered effective by inpatients/clients of TCs in different socio-cultural contexts.
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Politi M, Friso F, Saucedo G, Torres J. Traditional Use of Banisteriopsis caapi Alone and Its Application in a Context of Drug Addiction Therapy. J Psychoactive Drugs 2020; 53:76-84. [PMID: 32985365 DOI: 10.1080/02791072.2020.1820641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Takiwasi is a therapeutic community for the treatment of Substance Use Disorders (SUDs) that combines traditional Amazonian medicine (TAM) with modern psychotherapy. One of the plant medicines from TAM used in this protocol is purgahuasca. It is a decoction of the vine Banisteriopsis caapi alone, whose use is traditional among the Awajún and other ethnic groups in Peru. The research began with a field trip to Awajún territory to explore the indigenous use of purgahuasca as an initiation rite. Then, analysis of its application was conducted in the clinical context of Takiwasi. Open-ended and semi-structured interviews with Awajún informants and Takiwasi's therapeutic staff were performed and analyzed following the narrative methodological approach. Further clinical data on the ingestion of purgahuasca by Takiwasi's SUD patients were obtained from the internal repository. These indicate that 359 (92.1%) patients reported having had the so-called mareación (dizziness), 299 (76.7%) experienced physical sensations, and 208 (53.3%) had visions. These effects can be related to the psychoactivity of β-Carbolines alkaloids from B. caapi, a medicinal plant that seems to have potential benefits also for SUD, especially giving a key contribution to the patients' therapeutic process of becoming aware of the personal reasons behind addictive behaviors.
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Affiliation(s)
- Matteo Politi
- Research Department, Center for Drug Addiction Treatment and Research on Traditional Medicines - Takiwasi, Tarapoto, Peru.,Department of Pharmacy, University of Chieti-Pescara, Chieti Scalo, Italy
| | - Fabio Friso
- Research Department, Center for Drug Addiction Treatment and Research on Traditional Medicines - Takiwasi, Tarapoto, Peru
| | - Gary Saucedo
- Research Department, Center for Drug Addiction Treatment and Research on Traditional Medicines - Takiwasi, Tarapoto, Peru
| | - Jaime Torres
- Research Department, Center for Drug Addiction Treatment and Research on Traditional Medicines - Takiwasi, Tarapoto, Peru
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Breeksema JJ, Niemeijer AR, Krediet E, Vermetten E, Schoevers RA. Psychedelic Treatments for Psychiatric Disorders: A Systematic Review and Thematic Synthesis of Patient Experiences in Qualitative Studies. CNS Drugs 2020; 34:925-946. [PMID: 32803732 PMCID: PMC7447679 DOI: 10.1007/s40263-020-00748-y] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Interest in the use of psychedelic substances for the treatment of mental disorders is increasing. Processes that may affect therapeutic change are not yet fully understood. Qualitative research methods are increasingly used to examine patient accounts; however, currently, no systematic review exists that synthesizes these findings in relation to the use of psychedelics for the treatment of mental disorders. OBJECTIVE To provide an overview of salient themes in patient experiences of psychedelic treatments for mental disorders, presenting both common and diverging elements in patients' accounts, and elucidating how these affect the treatment process. METHODS We systematically searched the PubMed, MEDLINE, PsycINFO, and Embase databases for English-language qualitative literature without time limitations. Inclusion criteria were qualitative research design; peer-reviewed studies; based on verbalized patient utterances; and a level of abstraction or analysis of the results. Thematic synthesis was used to analyze and synthesize results across studies. A critical appraisal of study quality and methodological rigor was conducted using the Critical Appraisal Skills Programme (CASP). RESULTS Fifteen research articles, comprising 178 patient experiences, were included. Studies exhibited a broad heterogeneity in terms of substance, mental disorder, treatment context, and qualitative methodology. Substances included psilocybin, lysergic acid diethylamide (LSD), ibogaine, ayahuasca, ketamine and 3,4-methylenedioxymethamphetamine (MDMA). Disorders included anxiety, depression, eating disorders, post-traumatic stress disorder, and substance use disorders. While the included compounds were heterogeneous in pharmacology and treatment contexts, patients reported largely comparable experiences across disorders, which included phenomenological analogous effects, perspectives on the intervention, therapeutic processes and treatment outcomes. Comparable therapeutic processes included insights, altered self-perception, increased connectedness, transcendental experiences, and an expanded emotional spectrum, which patients reported contributed to clinically and personally relevant responses. CONCLUSIONS This review demonstrates how qualitative research of psychedelic treatments can contribute to distinguishing specific features of specific substances, and carry otherwise undiscovered implications for the treatment of specific psychiatric disorders.
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Affiliation(s)
- Joost J Breeksema
- University Center of Psychiatry, University Medical Center Groningen, Postbus 30.001, 9700 RB, Groningen, The Netherlands.
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
| | | | - Erwin Krediet
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- ARQ National Psychotrauma Center, Diemen, The Netherlands
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Military Mental Health Care, Utrecht, The Netherlands
- ARQ National Psychotrauma Center, Diemen, The Netherlands
| | - Robert A Schoevers
- University Center of Psychiatry, University Medical Center Groningen, Postbus 30.001, 9700 RB, Groningen, The Netherlands
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O'Callaghan C, Hubik DJ, Dwyer J, Williams M, Ross M. Experience of Music Used With Psychedelic Therapy: A Rapid Review and Implications. J Music Ther 2020; 57:282-314. [PMID: 32227084 DOI: 10.1093/jmt/thaa006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Bonny Method of Guided Imagery and Music emerged following discontinuation of psychedelic therapy research in the early 1970s, but psychedelic therapy research has since revived. Music remains a vital component. This study examined participants' experiences of music in psychedelic therapy research. A rapid review of qualitative and quantitative journal articles in four major databases was conducted in February to April, 2019, using the terms hallucinogens, psychedelic, "lysergic acid diethylamide," psilocybin, ayahuasca, music, and/or "music therapy." Of 406 articles retrieved, 10 were included (n = 180; 18-69 years old). Participants had varied backgrounds. Music was widely considered integral for meaningful emotional and imagery experiences and self-exploration during psychedelic therapy. Music transformed through its elicitation of anthropomorphic, transportive, synesthetic, and material sensations. Music could convey love, carry listeners to other realms, be something to "hold," inspire, and elicit a deep sense of embodied transformation. Therapeutic influence was especially evident in music's dichotomous elicitations: Music could simultaneously anchor and propel. Participant openness to music and provision of participant-centered music were associated with optimal immediate and longer-term outcomes. Many studies reported scarce details about the music used and incidental findings of music experienced. Further understanding of participants' idiosyncratic and shared responses to music during drug therapy phases will inform optimal development of flexible music protocols which enhance psychedelic therapy. Music therapists could be involved in the psychedelic therapy research renaissance through assisting with research to optimize music-based protocols used. If psychedelics become approved medicines, music therapists may be involved in offering psychedelic therapy as part of therapeutic teams.
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Affiliation(s)
- Clare O'Callaghan
- Caritas Christi Hospice & Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, AustraliaDepartment of Medicine, St Vincent's Hospital, and Melbourne Conservatorium of Music, The University of Melbourne, Melbourne, Australia
| | - Daniel J Hubik
- Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, Australia
| | - Justin Dwyer
- Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, Australia
| | - Martin Williams
- Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, AustraliaPRISM Inc., Melbourne, Australia
| | - Margaret Ross
- Caritas Christi Hospice & Department of Psychosocial Cancer Care Research, St Vincent's Hospital, Melbourne, Australia
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Apud Peláez IE. Personality Traits in Former Spanish Substance Users Recovered with Ayahuasca. J Psychoactive Drugs 2020; 52:264-272. [PMID: 32362241 DOI: 10.1080/02791072.2020.1752960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Ayahuasca is a psychoactive brew that contains N,N-dimethyltryptamine and monoamine oxidase-inhibiting alkaloids. It is originally from the Amazon rainforest, but since the 1990s it has expanded worldwide. The compound is used in different religious, spiritual, and therapeutic settings. One of its common applications is for the treatment of addiction. The current study is an assessment of the impact of ayahuasca on personality traits in former substance users from Catalonia and surrounding areas. When compared with a control group, the ayahuasca group had statistically significantly higher scores in the dimensions Novelty Seeking and Self-Transcendence, and in the traits Attachment, Impulsivity, Compassion, and Spiritual Acceptance. Results suggest that recovery could be related less to a reduction of Impulsivity and Novelty Seeking, main features of substance use disorder (SUD), and more to an increase of Character dimensions and traits, especially Self-Transcendence and Cooperativeness. Those changes could be triggered by self-reflective, prosocial, and transcendental ayahuasca ritual experiences, which in the qualitative part of the research were described by the participants as being of great importance for their recovery, helping with the reconstruction of personal goals, gratifications, social bonds, and the general life's projection.
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Affiliation(s)
- Ismael Eduardo Apud Peláez
- Faculty of Psychology (UdelaR, Montevideo, Uruguay), National System of Researchers (ANII, Montevideo, Uruguay), Medical Anthropology Research Center (URV, Tarragona, Spain)
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Orsolini L, Chiappini S, Papanti D, Latini R, Volpe U, Fornaro M, Tomasetti C, Vellante F, De Berardis D. How does ayahuasca work from a psychiatric perspective? Pros and cons of the entheogenic therapy. Hum Psychopharmacol 2020; 35:e2728. [PMID: 32220028 DOI: 10.1002/hup.2728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/13/2020] [Accepted: 02/20/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Ayahuasca is a hallucinogenic plant preparation, traditionally consumed in sacred ceremonies by indigenous North-Westerner Amazonian countries like Colombia, Peru, Brazil, and Ecuador. It is fundamental to carefully balance benefits/risks related to the ayahuasca intake, both during ceremonies and experimental settings. The aim is at evaluating and comparing the potential therapeutic benefits versus health risks related to ayahuasca intake (both acutely and chronically), focusing on its application in psychedelic psychiatry. DESIGN A comprehensive mini overview focusing on psychiatric outcomes following ayahuasca intake both in healthy volunteers and in clinical samples. RESULTS Preclinical, observational, and experimental studies in healthy volunteers as well as in clinical samples suggest that ayahuasca may be beneficial as an antidepressant, emotional regulator, anxiolytic, and antiaddictive drug, by exerting fast-acting and enduring clinical effects. Ayahuasca appears to be safe and well tolerated, nausea and emesis being the most reported and transient side effects. Some findings suggest not to use ayahuasca in bipolar or psychotic patients because of an increased risk of manic switch and/or psychotic onset. CONCLUSIONS Further research should be carried out in randomized, double-blind, placebo-controlled trials, by implementing neuroimaging studies, in order to better evaluate therapeutic potential of ayahuasca in mental disorders.
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Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Department of Clinical Neurosciences/DIMSC, School of Medicine, Section of Psychiatry, Polytechnic University of Marche, Ancona, Italy.,Polyedra, Polyedra Research, Teramo, Italy
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Duccio Papanti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Roberto Latini
- Neomesia Mental Health, Villa Jolanda Hospital, Maiolati Spontini, Italy
| | - Umberto Volpe
- Department of Clinical Neurosciences/DIMSC, School of Medicine, Section of Psychiatry, Polytechnic University of Marche, Ancona, Italy
| | - Michele Fornaro
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy
| | - Carmine Tomasetti
- Polyedra, Polyedra Research, Teramo, Italy.,Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine "Federico II", Naples, Italy.,NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "SS. Annunziata", Giulianova, Italy
| | - Federica Vellante
- Department of Neuroscience, Imaging and Clinical Science, University of "G. D'Annunzio", Chieti, Italy
| | - Domenico De Berardis
- Polyedra, Polyedra Research, Teramo, Italy.,Department of Neuroscience, Imaging and Clinical Science, University of "G. D'Annunzio", Chieti, Italy.,NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
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Kaasik H, Kreegipuu K. Ayahuasca Users in Estonia: Ceremonial Practices, Subjective Long-Term Effects, Mental Health, and Quality of Life. J Psychoactive Drugs 2020; 52:255-263. [PMID: 32299306 DOI: 10.1080/02791072.2020.1748773] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The study aims to describe ayahuasca users in Estonia and compare their mental health and quality of life to those of nonusers. Ceremonial practices, motivation for ayahuasca use, use-related experiences, and subjective consequences of use are described. We conducted a cross-sectional case-controlled study of thirty ayahuasca users and thirty nonusers matched by gender, age, and education. The participants completed questionnaires, standardized psychometric tests, and neuropsychiatric interviews. Ayahuasca use in Estonia occurred mainly in (neo)shamanic group ceremonies. The main motives for ayahuasca use were spiritual development, self-knowledge, and spiritual experiences. The users reported mostly positive subjective consequences of ayahuasca use for their health and life. However, some difficult experiences and adverse effects were reported. No abuse of ayahuasca or addiction to it was found. Screening test indicators of depression and anxiety were lower in the ayahuasca-using group. No deterioration of the mental health of ayahuasca users in comparison to nonusers was found. The participants perceive their use of ayahuasca as a spiritual practice with mostly favorable outcomes for their health and life. They also perceive ayahuasca use in Estonia as a reasonably safe and self-limiting form of spiritual practice.
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Affiliation(s)
- Helle Kaasik
- School of Theology and Religious Studies, University of Tartu , Tartu, Estonia
| | - Kairi Kreegipuu
- Institute of Psychology, University of Tartu , Tartu, Estonia
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An exploratory study of experiences with conventional eating disorder treatment and ceremonial ayahuasca for the healing of eating disorders. Eat Weight Disord 2020; 25:437-444. [PMID: 30474794 DOI: 10.1007/s40519-018-0619-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 11/09/2018] [Indexed: 01/29/2023] Open
Abstract
PURPOSE Ayahuasca is a traditional Amazonian medicine that is currently being researched for its potential in treating a variety of mental disorders. This article reports on exploratory qualitative research relating to participant experiences with ceremonial ayahuasca drinking and conventional treatment for eating disorders (EDs). It also explores the potential for ayahuasca as an adjunctive ED treatment. METHODS Thirteen individuals previously diagnosed with an ED participated in a semi-structured interview contrasting their experiences with conventional ED treatment with experiences from ceremonial ayahuasca. The interviews were analyzed using thematic analysis. RESULTS Participant reports were organized with key themes including that ayahuasca: led to rapid reductions in ED thoughts and symptoms; allowed for the healing of the perceived root of the ED; helped to process painful feelings and memories; supported the internalization of greater self-love and self-acceptance; and catalyzed spiritual elements of healing. CONCLUSIONS The results suggest that ayahuasca may have potential as a valuable therapeutic tool, and further research-including carefully controlled clinical trials-is warranted. LEVEL OF EVIDENCE Level V, qualitative descriptive study.
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Sapoznikow A, Walsh Z, Tupper KW, Erowid E, Erowid F. The influence of context on ayahuasca experiences: An analysis of experience reports. JOURNAL OF PSYCHEDELIC STUDIES 2019. [DOI: 10.1556/2054.2019.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background and aims
Ayahuasca is a psychedelic decoction prepared from two (or more) plants containing monoamine oxidase inhibitors, N, N-dimethyltryptamine, and other chemicals. Ayahuasca has apparently been used for centuries in the Amazon basin of South America, and in recent years has increasingly been used internationally in diverse contexts. This study aims to elucidate differences between cross-cultural ceremonial and psychonautic contexts of ayahuasca use.
Methods
This study systematically examines subjective differences across contexts for contemporary ayahuasca-drinking practices. User reports of ayahuasca experiences were subjected to textual analysis to compare use in cross-culturalceremonial contexts that attempt to include elements of traditional Amazonian practices, with psychonautic use that does not formally integrate traditional ceremonial aspects. The experience reports were collected from an online database.
Results
The use of ayahuasca in a cross-cultural ceremonial context is associated with prominence of affective and motivational features, whereas psychonautic use was associated with an emphasis on cognitive processes.
Conclusions
The beneficial effects of ayahuasca may operate via affective processing and integration and as such, cross-cultural ceremonial use may have advantages relative to psychonautic use. Findings are considered in light of the importance of context on experiences with ayahuasca and other psychedelic substances.
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Affiliation(s)
- Avery Sapoznikow
- 1 Department of Psychology, University of British Columbia, Okanagan, Kelowna, Canada
| | - Zachary Walsh
- 1 Department of Psychology, University of British Columbia, Okanagan, Kelowna, Canada
| | - Kenneth W. Tupper
- 2 School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Argento E, Capler R, Thomas G, Lucas P, Tupper KW. Exploring ayahuasca‐assisted therapy for addiction: A qualitative analysis of preliminary findings among an Indigenous community in Canada. Drug Alcohol Rev 2019; 38:781-789. [DOI: 10.1111/dar.12985] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Elena Argento
- Centre for Gender and Sexual Health EquityUniversity of British Columbia Vancouver Canada
| | | | - Gerald Thomas
- Canadian Institute for Substance Use ResearchUniversity of Victoria Victoria Canada
| | - Philippe Lucas
- Global Patient Research and Access, Tilray and Social Dimensions of HealthUniversity of Victoria Victoria Canada
| | - Kenneth W. Tupper
- School of Population and Public HealthUniversity of British Columbia Vancouver Canada
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Abstract
The exploration of possible therapeutic benefits of hallucinogenic substances has undergone a revitalization in the past decade. This literature review investigated the published literature regarding the psychotherapeutic uses of hallucinogens in psychiatric disorders. The results showed that a variety of substances have been evaluated in the treatment of psychiatric disorders, including ayahuasca, ibogaine, ketamine, lysergic acid diethylamide, 3,4-methylenedioxymethamphetamine, and psilocybin. The conditions treated ranged from depression to autism, with the largest volume of research dedicated to substance use disorders. The majority of studies that were reviewed demonstrated significant associations with improvement in the conditions investigated. However, it was difficult to draw definitive conclusions as most studies suffered from small sample sizes, inconsistent measures, and poor study design. To properly assess the risks and potential benefits of hallucinogens in psychiatric treatment, there is a need for well designed, standardized studies that demonstrate the impact of hallucinogenic substances on psychiatric conditions.
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47
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Estrella-Parra EA, Almanza-Pérez JC, Alarcón-Aguilar FJ. Ayahuasca: Uses, Phytochemical and Biological Activities. NATURAL PRODUCTS AND BIOPROSPECTING 2019; 9:251-265. [PMID: 31134518 PMCID: PMC6646606 DOI: 10.1007/s13659-019-0210-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 05/12/2019] [Indexed: 05/14/2023]
Abstract
Ayahuasca (caapi, yajé), is a psychoactive brew from the Amazon Basin region of South America traditionally considered a "master plant." It is prepared as a decoction from Banisteriopsis caapi and Psychotria viridis, which it is thought that it stimulates creative thinking and visual creativity. Native healers of the Orinoco and Amazon basins have used traditionally ayahuasca as a healing tool for multiple purposes, particularly to treat psychological disorders in the patients, with some beneficial effects experimentally and clinically validated. Recently, several syncretic religions, as the "União de Vegetal" (UDV) group in Brazil, have been spread around the world. The use of ayahuasca has been popularized by internet and smart-shops, bringing the psychoactive substance to new highs, emerging new "ayahuasqueros." Ayahuasca has alkaloids as β-carbolines and dimethyltryptamines, which inhibit the monoamine oxidase and active the 5-HT2A (5-hydroxytryptamine) receptor, respectively, resulting in hallucinations in the users. Ayahuasca induces a psychedelic change in the anteroposterior coupling of the electrophysiological brain oscillations in humans. Traditional ayahuasca beverage is generating pharmacological, commercial and spiritual interest among the scientific community, government people, and different populations worldwide. The goal of this article is to report about the uses, chemistry and biological activities of ayahuasca.
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Affiliation(s)
- Edgar Antonio Estrella-Parra
- Laboratorio de Farmacología. Dpto. Ciencias de la Salud. Div. C.B.S. Universidad Autónoma Metropolitana, Unidad Iztapalapa. Av. San Rafael Atlixco No. 186, Col. Vicentina, 09340, Mexico CDMX, Mexico
- Laboratorio de Fitoquímica, Laboratorio de Farmacognosia, Laboratorio de Fisiología Vegetal, Unidad UBIPRO, FES-Iztacala, UNAM, Tlalnepantla de Baz, 54090, Mexico CDMX, Mexico
| | - Julio Cesar Almanza-Pérez
- Laboratorio de Farmacología. Dpto. Ciencias de la Salud. Div. C.B.S. Universidad Autónoma Metropolitana, Unidad Iztapalapa. Av. San Rafael Atlixco No. 186, Col. Vicentina, 09340, Mexico CDMX, Mexico
| | - Francisco Javier Alarcón-Aguilar
- Laboratorio de Farmacología. Dpto. Ciencias de la Salud. Div. C.B.S. Universidad Autónoma Metropolitana, Unidad Iztapalapa. Av. San Rafael Atlixco No. 186, Col. Vicentina, 09340, Mexico CDMX, Mexico.
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Hamill J, Hallak J, Dursun SM, Baker G. Ayahuasca: Psychological and Physiologic Effects, Pharmacology and Potential Uses in Addiction and Mental Illness. Curr Neuropharmacol 2019; 17:108-128. [PMID: 29366418 PMCID: PMC6343205 DOI: 10.2174/1570159x16666180125095902] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/07/2017] [Accepted: 01/24/2018] [Indexed: 01/07/2023] Open
Abstract
Background: Ayahuasca, a traditional Amazonian decoction with psychoactive properties, is made from bark of the Banisteriopsis caapi vine (containing beta-carboline alkaloids) and leaves of the Psychotria viridis bush (supplying the hallucinogen N,N-dimethyltryptamine, DMT). Originally used by indigenous shamans for the purposes of spirit communi-cation, magical experiences, healing, and religious rituals across several South American countries, ayahuasca has been in-corporated into folk medicine and spiritual healing, and several Brazilian churches use it routinely to foster a spiritual experi-ence. More recently, it is being used in Europe and North America, not only for religious or healing reasons, but also for rec-reation. Objective: To review ayahuasca’s behavioral effects, possible adverse effects, proposed mechanisms of action and potential clinical uses in mental illness. Method: We searched Medline, in English, using the terms ayahuasca, dimethyltryptamine, Banisteriopsis caapi, and Psy-chotria viridis and reviewed the relevant publications. Results: The following aspects of ayahuasca are summarized: Political and legal factors; acute and chronic psychological ef-fects; electrophysiological studies and imaging; physiological effects; safety and adverse effects; pharmacology; potential psychiatric uses. Conclusion: Many years of shamanic wisdom have indicated potential therapeutic uses for ayahuasca, and several present day studies suggest that it may be useful for treating various psychiatric disorders and addictions. The side effect profile ap-pears to be relatively mild, but more detailed studies need to be done. Several prominent researchers believe that government regulations with regard to ayahuasca should be relaxed so that it could be provided more readily to recognized, credible re-searchers to conduct comprehensive clinical trials.
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Affiliation(s)
- Jonathan Hamill
- Department of Psychiatry (Neurochemical Research Unit) and Neuroscience & Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Jaime Hallak
- Department of Psychiatry (Neurochemical Research Unit) and Neuroscience & Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada.,Department of Neurosciences and Behavior and National Institute of Science and Technology (Translational Medicine), Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Serdar M Dursun
- Department of Psychiatry (Neurochemical Research Unit) and Neuroscience & Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Glen Baker
- Department of Psychiatry (Neurochemical Research Unit) and Neuroscience & Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
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Mello SM, Soubhia PC, Silveira G, Corrêa-Neto NF, Lanaro R, Costa JL, Linardi A. Effect of Ritualistic Consumption of Ayahuasca on Hepatic Function in Chronic Users. J Psychoactive Drugs 2018; 51:3-11. [PMID: 30582439 DOI: 10.1080/02791072.2018.1557355] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Ayahuasca is a beverage obtained from decoctions of the liana Banisteriopsis caapi plus the shrub Psychotria viridis. This beverage contains a combination of monoamine oxidase inhibitors (harmine, harmaline, and tetrahydroharmine) and N,N-dimethyltryptamine, the main substance responsible for its visionary effect. The ritualistic use of ayahuasca is becoming a global phenomenon. Most members of ayahuasca churches consume this beverage throughout their life, and many reports have discussed the therapeutic potential of this beverage. Ayahuasca is consumed orally, and the liver, as the major organ for the metabolism and detoxification of xenobiotics absorbed from the alimentary tract, may be susceptible to injury by compounds present in the ayahuasca decoction. In this study, we evaluated biochemical parameters related to hepatic damage in the serum of 22 volunteers who consumed ayahuasca twice a month or more for at least one year. There was no significant alteration in the following parameters: alanine aminotransferase, aspartate aminotransferase, bilirubin, creatinine, urea, lactate dehydrogenase, alkaline phosphatase, and gamma glutamyl transferase. These findings indicate that chronic ayahuasca consumption in a religious context apparently does not affect hepatic function.
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Affiliation(s)
- Sueli Moreira Mello
- a Poison Control Center, Faculty of Medical Sciences , University of Campinas (UNICAMP) , Campinas , SP , Brazil
| | - Paula Christiane Soubhia
- a Poison Control Center, Faculty of Medical Sciences , University of Campinas (UNICAMP) , Campinas , SP , Brazil
| | - Gabriela Silveira
- a Poison Control Center, Faculty of Medical Sciences , University of Campinas (UNICAMP) , Campinas , SP , Brazil
| | - Nelson Francisco Corrêa-Neto
- b Department of Physiological Sciences , Santa Casa de São Paulo School of Medical Sciences , São Paulo , SP , Brazil
| | - Rafael Lanaro
- a Poison Control Center, Faculty of Medical Sciences , University of Campinas (UNICAMP) , Campinas , SP , Brazil
| | - José Luiz Costa
- c Faculty of Pharmaceutical Sciences , University of Campinas (UNICAMP) , Campinas , SP , Brazil
| | - Alessandra Linardi
- b Department of Physiological Sciences , Santa Casa de São Paulo School of Medical Sciences , São Paulo , SP , Brazil
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50
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Barsuglia JP, Polanco M, Palmer R, Malcolm BJ, Kelmendi B, Calvey T. A case report SPECT study and theoretical rationale for the sequential administration of ibogaine and 5-MeO-DMT in the treatment of alcohol use disorder. PROGRESS IN BRAIN RESEARCH 2018; 242:121-158. [PMID: 30471678 DOI: 10.1016/bs.pbr.2018.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ibogaine is a plant-derived alkaloid and dissociative psychedelic that demonstrates anti-addictive properties with several substances of abuse, including alcohol. 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring psychedelic known to occasion potent mystical-type experiences and also demonstrates anti-addictive properties. The potential therapeutic effects of both compounds in treating alcohol use disorder require further investigation and there are no published human neuroimaging findings of either treatment to date. We present the case of a 31-year-old male military veteran with moderate alcohol use disorder who sought treatment at an inpatient clinic in Mexico that utilized a sequential protocol with ibogaine hydrochloride (1550mg, 17.9mg/kg) on day 1, followed by vaporized 5-MeO-DMT (bufotoxin source 50mg, estimated 5-MeO-DMT content, 5-7mg) on day 3. The patient received SPECT neuroimaging that included a resting-state protocol before, and 3 days after completion of the program. During the patient's ibogaine treatment, he experienced dream-like visions that included content pertaining to his alcohol use and resolution of past developmental traumas. He described his treatment with 5-MeO-DMT as a peak transformational and spiritual breakthrough. On post-treatment SPECT neuroimaging, increases in brain perfusion were noted in bilateral caudate nuclei, left putamen, right insula, as well as temporal, occipital, and cerebellar regions compared to the patient's baseline scan. The patient reported improvement in mood, cessation of alcohol use, and reduced cravings at 5 days post-treatment, effects which were sustained at 1 month, with a partial return to mild alcohol use at 2 months. In this case, serial administration of ibogaine and 5-MeO-DMT resulted in increased perfusion in multiple brain regions broadly associated with alcohol use disorders and known pharmacology of both compounds, which coincided with a short-term therapeutic outcome. We present theoretical considerations regarding the potential of both psychedelic medicines in treating alcohol use disorders in the context of these isolated findings, and areas for future investigation.
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Affiliation(s)
- Joseph P Barsuglia
- Crossroads Treatment Center, Tijuana, Mexico; Mission Within, Oakland, CA, United States; New School Research, LLC, North Hollywood, CA, United States; Terra Incognita Project, NGO, Ben Lomond, CA, United States.
| | - Martin Polanco
- Crossroads Treatment Center, Tijuana, Mexico; Mission Within, Oakland, CA, United States
| | - Robert Palmer
- Yale School of Medicine, New Haven, CT, United States
| | - Benjamin J Malcolm
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Tanya Calvey
- Faculty of Health Sciences, University of the Witwatersrand Medical School, Johannesburg, South Africa
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