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  • Writer's pictureDr. Harold Pierre

Ayahuasca in Addiction Treatment: A Miracle Cure or Just Hype?

Updated: Dec 7, 2023

Introduction


Ayahuasca has become an increasingly popular topic in recent years. Many scientist and patients are questioning if this ancient plant medicine could be an effective treatment option for drug addictions and other disorders. But is ayahuasca in addiction treatment for real? In this blog post, we'll look into the science behind ayahuasca, its reported benefits, and potential risks to determine if it lives up to the hype as a miracle addiction cure.


What is Ayahuasca?


Ayahuasca is a psychoactive brew or tea made from the ayahuasca vine (Banisteriopsis caapi) and the chacruna leaf (Psychotria viridis). The ayahuasca vine contains harmala alkaloids that act as monoamine oxidase inhibitors (MAOIs), while the chacruna leaf contains dimethyltryptamine (DMT), a powerful psychedelic compound.


Here's the intriguing part: normally, our digestive system breaks down DMT, preventing it from influencing our brain. Yet, the presence of MAOIs from the ayahuasca vine changes this dynamic. It allows DMT to bypass the usual barriers, leading to profound hallucinations and spiritual journeys that can span anywhere from 4 to 8 hours.


A Brief History of Ayahuasca


Ayahuasca brew in bowl with bark and a stem cut and leaves on a brown wooden table copy

The use of ayahuasca originated in the Amazon basin among indigenous tribes such as the Shipibo, Shuar, and Urarina. These groups brewed ayahuasca for divinatory and healing purposes, with shamans or healers guiding ceremonial use of the tea.


Around the 1930s, mestizo spiritual leader Pablo Amaringo brought ayahuasca rituals to more urban areas in Peru, leading to the development of new religious movements like Santo Daime, Barquinha, and União do Vegetal that incorporated Christian elements.


In recent decades, ayahuasca retreateds and tourism have become increasingly popular worldwide. Thousands of people now travel to countries like Peru and Brazil annually to experience traditional ayahuasca ceremonies guided by local shamans. Some also seek treatment for mental health disorders, addictions, and other conditions.


How Does Ayahuasca Work?


Ayahuasca is a hallucinogen. Once ingested, the DMT in ayahuasca tea binds to serotonin receptors (particularly 5-HT2A) throughout the central nervous system. This leads to altered levels of neurotransmitters like serotonin, dopamine, and glutamate.


The psychedelic effects from DMT binding are enhanced by the MAOIs from the vine, which prevent breakdown of DMT and other neurotransmitters.

Subjective effects include:

  • Vivid visual and auditory hallucinations

  • Intense emotional experiences and euphoria

  • Sense of spiritual insight

  • Nausea, vomiting, diarrhea

  • Increased blood pressure, heart rate, body temperature

  • Tremors, impaired motor control

These effects are attributed to the impact of ayahuasca on areas like the default mode network, salience network, and fronto-parietal control network in the brain.


What are the Reported Benefits of Ayahuasca?


Many ayahuasca supporters believe ayahuasca has significant therapeutic potential for treating mental health disorders and substance abuse Some main areas of benefit include:

Depression and Anxiety

Studies indicate ayahuasca may help depressive symptoms, sometimes after just one dose. It's been hypothesized that ayahuasca activates areas involved in memory and emotion processing to "reset" negative thought patterns. There's also evidence it can reduce anxiety.


Post Traumatic Stress Disorder (PTSD)

Early research suggests ayahuasca retreats may help reduce PTSD symptoms and improve quality of life in sufferers. Experts believe by catalyzing a mystical-type experience, ayahuasca allows people to emotionally process trauma in a safe setting.


Addictions

Some observational studies report users reducing or quitting alcohol, tobacco, cocaine, and other drugs after participating in ayahuasca ceremonies. This may be partly explained by DMT's effects on dopamine pathways involved in addiction. But long term sobriety studies have not been done.


Personal Growth

Many users report powerful spiritual insights, increased mindfulness and life satisfaction, and a renewed sense of purpose from their ayahuasca experiences. However, more studies are needed on long-term personality changes.


While these benefits appear promising, most current evidence is anecdotal or based on small studies with design limitations. More rigorous research is still needed.


What are the Risks of Ayahuasca Addiction?


Despite its therapeutic potential, there are also risks associated with ayahuasca use:

  • Although rare, deaths have occurred from mixing ayahuasca with medications like SSRIs that affect serotonin

  • Negative psychological effects like fear, paranoia, and anxiety are possible, especially in beginners

  • Cardiovascular effects can be dangerous for those with underlying heart conditions

  • Long term effects on mental health remain unknown

  • Nausea and vomiting during ceremonies may lead to dehydration

  • There are no formal safety guidelines for ayahuasca retreats

But one of the most common questions is whether you can get addicted to ayahuasca itself?


Overall, ayahuasca is not considered an addictive substance in the traditional sense. Most research indicates the dangers of ayahuasca addiction is low.


For example, one study gave rats ayahuasca for 20 days then tracked any withdrawal effects - no changes were observed that would indicate physical dependence.

While a psychological or behavioral addiction to the transcendent experience could theoretically develop, current evidence suggests this is rare. Most long-term users do not show problematic dependence or addiction to ayahuasca use patterns or life dysfunction.

However, some experts argue more studies are needed to definitively understand ayahuasca's addiction potential, especially with its rising popularity.


Is Ayahuasca Effective for Treating Drug Addiction?


Amazonian Shaman portrait preparation for ayahuasca ritual copy

Given its reported benefits, one major area of research has been ayahuasca's efficacy in treating drug addictions like alcoholism, cocaine dependence, and tobacco use.

Unfortunately, current evidence is limited:

  • There are no placebo-controlled trials showing a direct therapeutic effect of ayahuasca on addiction disorders.

  • Most data is anecdotal from people who used ayahuasca ceremonies recreationally then subjectively felt it helped their addiction.

  • For substances like cocaine, rat studies show extracts like harmine reduce self-administration - but human clinical data is lacking.

  • Differences in ceremonial use, brew potency, and participant expectations make findings hard to generalize.

That said, some observational studies have found promising results:

  • A study of Brazilian church members found prior alcoholics and drug abusers reported ayahuasca helping their recovery process.

  • Interviews with North American users cite ayahuasca providing insights into their addictive behaviors that helped quit drugs.

  • An analysis of Amazonian indigenous groups showed no evidence of problematic substance use, possibly due to ceremonial ayahuasca use.

So while ayahuasca shows some potential for treating addictions, controlled clinical trials are still needed to truly determine efficacy and safety. It should not replace conventional rehab treatment at this time.


What Happens During an Ayahuasca Ceremony?


In a traditional setting, ayahuasca ceremonies take place over 4-8 hours through the night and into the early morning. They're led by an experienced shaman who prepares the brew and guides the ritual.


Typically, participants fast and abstain from certain medications/drugs beforehand. The shaman may open the ceremony by blowing tobacco smoke to purify the space and setting intentions.


After drinking the bitter tea, participants lay down in darkness and silence as they wait for the effects to begin. The shaman may sing healing songs called icaros, play instruments, or come around offering more ayahuasca.


Vomiting often occurs which is called "la purga" - this is seen as cleansing the body and mind. As the trip intensifies, shamanic visions and teachings may be received.

In the morning, the ceremony ends once the ayahuasca wears off. Shamans discuss participants' experiences to help integrate any lessons and insights gained.


Ayahuasca Retreats: Tourist Trap or Effective Treatment?


The rising popularity of ayahuasca has led to hundreds of retreat centers worldwide offering ceremonies for recreation, mental health treatment, and spiritual development.


Some see these as predatory tourist traps that commercialize and corrupt the brew's traditional use. Safety standards vary wildly, and deaths have occurred at poor clinics.

However, others believe the integration of ayahuasca into modern medicine is warranted given rising addiction rates and treatment limitations. Retreat experiences may provide healing unavailable in daily life.


Overall, great care must be taken when considering an ayahuasca retreat - extensive research on the center and staff is a must to avoid dangerous situations. Medical screening is also advised to reduce health risks if you have certain conditions.


Key Takeaways: Miracle or Hype?


Real Shamanic Ceremony using Ayahuasca copy

In summary, is ayahuasca worthy of its sensational reputation as a miracle addiction cure? A few key takeaways:

  • Ayahuasca is a potent psychedelic that may provide therapeutic benefits for some. But it is not a panacea.

  • Addiction treatment should still rely on conventional rehab programs; ayahuasca is not a replacement.

  • More rigorous research is needed to truly determine its efficacy as addiction medicine.

  • Physiological and psychological risks exist, especially when safety guidelines are not followed.

  • Overall, ayahuasca has promising medicinal potentials that warrant further investigation - but the hype should be tempered with caution.

  • Anyone considering ayahuasca should carefully weigh potential benefits vs risks under medical guidance.

So in summary - ayahuasca is not a miracle cure-all, deaths have occurred, and we need more future research to determine if this really work. But with proper precautions and expectations, it may complement recovery for some people struggling with addiction. I believe when a patient has a high risk addiction, all options should be considered to save their life.


Nichols DE. Psychedelics. Pharmacol Rev. 2016;68(2):264-355. doi:10.1124/pr.115.011478


Zafar, R., Siegel, M., Harding, R., Barba, T., Agnorelli, C., Suseelan, S., Roseman, L., Wall, M., Nutt, D.J. and Erritzoe, D. (2023) Psychedelic therapy in the treatment of addiction: the past, present and future. Frontiers in Psychiatry, 14, 1183740. https://doi.org/10.3389/fpsyt.2023.1183740 About the author: Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is certified by the American Board of Anesthesiology and the American Board of Addiction Medicine. Dr. Pierre relentlessly pursues cutting-edge advances in addiction and pain medicine to bring the latest breakthrough treatments to his patients.


Frequently Asked Questions


Here are some common questions about ayahuasca and addiction treatment:


What are the active ingredients in ayahuasca?

The main active compounds are DMT from the chacruna plant and harmala alkaloids like harmine and tetrahydroharmine from the ayahuasca vine.


Is ayahuasca legal?

Ayahuasca's legality depends on the country. DMT is illegal in the US and many places, but exemptions exist for religious use. It's legal or decriminalized in parts of South America.


Can you get addicted to DMT or ayahuasca?

DMT does not appear addictive, and ayahuasca has low potential for dependence or abuse. But more research is still needed.


What type of addiction treatment programs use ayahuasca?

No accredited rehab programs currently offer ayahuasca. Some alternative retreats and ceremonies incorporate it, but effectiveness claims are unproven.


Is ayahuasca helpful for opioid addiction treatment?

There is no clinical evidence showing ayahuasca treats opioid addiction. Conventional medications and therapy remain most effective for recovery.


Can you mix antidepressants like SSRIs with ayahuasca?

No - combining ayahuasca with SSRIs, MAOIs, or many other medications can lead to dangerous serotonin syndrome effects.


What are common side effects of ayahuasca?

Short-term side effects include vomiting, diarrhea, anxiety, frightening visions, and increased heart rate and blood pressure. Long-term effects of ayahuasca require more research.


Can you microdose ayahuasca? Does microdosing help addiction?

Some people microdose ayahuasca components like DMT, but there is no evidence this helps addiction. Effects and risks of microdosing remain unknown.


How long do ayahuasca trips last?

Ayahuasca visions and hallucinogenic effects typically last 4-8 hours depending on dose. But some subjective effects may persist beyond the main trip.


What is an ayahuasca retreat or ceremony like?

Led by a shaman, ceremonies involve chanting, introspection, and spiritual rituals to induce a psychedelic experience where users "purge" physical and emotional toxins.


Where can I find more information?

Gonçalves, J., Luís, Â., Gallardo, E., & Duarte, A. P. (May 2023). A Systematic Review on the Therapeutic Effects of Ayahuasca. Plants (Basel), 12(13), 2573. https://doi.org/10.3390/plants12132573


About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.


This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.




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