Doctors have been prescribing drugs to treat substance addictions for decades. Most commonly known is the use of buprenorphine and naloxone (Suboxone) in opioid addiction which provides some opioid activation, helping with withdrawal and cravings, without the same “high” and many of the associated psychosocial effects of illicit drug use. But Suboxone isn’t the only one — methadone, modafinil, naltrexone, ketamine, and many more examples exist in which the use of a chemical has been prescribed to help those who struggle with addiction and its co-occurring conditions.
So, what about using ancient plant medicines to treat addiction? It may seem completely contradictory to treat someone who has a substance use disorder with a psychedelic drug that may induce hallucinations, but there's emerging evidence to support this approach.
The use of ayahuasca, a psychotropic plant medicine blend that originates in the Amazon, is one of those substances that might break the mold of how we view addiction treatment.
What is ayahuasca?
You may never have heard of ayahuasca before, but it has been used by native Amazonian tribes for centuries for a range of medicinal and spiritual purposes. Ayahuasca is a psychotropic drug, which means it affects your central nervous system and changes how your brain processes information by altering your mood, thoughts, emotions, behavior and/ or perceptions.
Ayahuasca is not really a “drug” but a blend of two plants: the ayahuasca vine (Banisteriopsis caapi) and a shrub called chacruna (Psychotria viridis). The mixture is brewed into a tea made from these plants, which contain dimethyltryptamine (DMT) and harmala alkaloids that can induce a hallucinogenic state when orally ingested. Some users report auditory and visual hallucinations and most report intense emotional and spiritual effects that lead to an overall positive shift in mental state.
And the preparation has been studied academically for over a decade. In fact, there is growing scientific evidence to support ayahuasca’s therapeutic value and use as a holistic treatment to addiction, with research suggesting that it can help alleviate a range of mental health issues.
You’re might be thinking that introducing a new drug for people with an addiction is just substituting one problem for another. But, you're wrong! As mentioned above, using chemicals to help with addiction struggles has a long history. And early studies show that Ayahuasca is not addictive and has actually been linked to a reduction in substance use disorders and related psychosocial problems. Indeed, hallucinogens, in general, are not considered addictive despite their use for centuries.
What exactly is the appeal of ayahuasca in addiction treatment? Well, it has little risk of abuse and it helps people find their own personally valid spiritual understanding and create breakthroughs. It helps people open up and heal past wounds and roadblocks to growth and recovery. Many people who have used it say that it’s like a shortcut to talk therapy.
Ayahuasca isn’t the first hallucinogenic drug proposed to treat drug addiction in Western countries. In the 1950s, LSD was introduced to treat alcohol and drug use disorders with promising results, however, due to the legality issues surrounding the treatment, it was quickly phased out.
Unfortunately, ayahuasca faces similar legal issues with the sale and use of the chemical DMT found in ayahuasca illegal in most countries, except for Peru, where it is legally used as an addiction treatment medication. In the U.S., ayahuasca is legal for use in specific religious groups, namely the UDV and Santo Daime that use ayahuasca as part of their healing ceremonies.
The origins of ayahuasca in addiction treatment
Ayahuasca has been used for treatment for decades, but only recently did it gain public recognition. Michael Pollan’s 2015 New Yorker article, "The Trip Treatment" highlighted the emotional and psychological impact of a psychedelic substance called Psilocybin (magic mushrooms) on the experience of cancer patients. The participants reported the spiritual experience induced by the substance reduced or completely eliminated their fear of death. Pollan’s book, How To Change Your Mind, explores the science behind psychedelics such as LSD, psilocybin, and ayahuasca in the treatment of drug addiction and mental health issues.
While ayahuasca has been used as a healing agent in traditional rituals for thousands of years, it wasn’t until Western science studied the substance that addiction treatment trials were initiated. Dr. Jacques Mabit spent years in Peru in the early 1980s studying plant medicines as an apprentice shaman and it was then that the outside world really became aware of ayahuasca’s potential.
Renowned addiction expert Gabor Mate believes that addiction is a direct result of the coping mechanisms developed in early childhood to deal with stress, abuse, or trauma (Mate is a member of the Psychotherapist/Trauma camp defined in my book, The Abstinence Myth). He believes in the power of ayahuasca as a treatment to the underlying psychological distress experienced by people facing addiction.
"No matter what a person is addicted to—whether it’s eating, shopping, sex, drugs—each addicted person harbors a deep pain, which they may or may not be in touch with. The plant removes the self-created barriers to get in touch with the source of that pain, so you realize what you’ve been running from all of your life.” —Gabor Maté
This is a view shared by experts worldwide, including myself, because addiction does not exist in a vacuum. It is a complex problem that has many contributing factors and may be as a result of trauma and mental health problems.
Psychological distress as an explanation for addiction is not a new one. In 1982, the Rat Park Experiment heralded by psychologist Bruce Alexander (read his summary here) showed that we become addicted, at least in part, when we are trying to fill an emotional void. He calls this the "poverty of spirit." When we can't fill it with the community, a sense of purpose or love, then we find a substitute.
Does ayahuasca really work in addiction treatment?
Emerging evidence supports the effectiveness of ayahuasca in addiction treatment.
A Canadian study published in the Current Drug Abuse Reviews Journal (2013) reported on a four-day addiction treatment retreat that involved group therapy and two ayahuasca “ceremonies” led by a professional. The following findings were reported:
- Improved wellbeing
- A decline in alcohol, tobacco, and cocaine use
- No change in cannabis and opiate use
- No evidence of any harm caused by the ingestion of ayahuasca
In a qualitative study published in The Journal of Psychoactive Drugs, the therapeutic effects of ritual ayahuasca use in substance addictions were examined using ten participants, who had undergone ayahuasca treatment for substance addiction at least two years prior. These individuals reported ongoing positive effects of the treatment, including:
- At least two years abstinence or less harmful drug use
- Improved understanding of the underlying causes of their addiction
- Improved problem-solving around addictive behavior
- More than 50 percent of participants reported reduced cravings after Ayahuasca
However, it is important to note that the study participants were primarily of Latin origin who may already have a spiritual belief system around ayahuasca rituals, which may have had an impact on the results. The sample size was also very small and participants were selected because of their self-reported ongoing abstinence success.
In a scientific literature review of classic hallucinogens in the treatment of addiction, the “mystical or other meaningful experiences” such as that associated with ayahuasca has strong evidence of its therapeutic effects.
This initial body of literature suggests that larger-scale research is greatly needed to further examine the workings of psychedelic drugs such as ayahuasca and the role it can play in the treatment of addiction and mental health issues.
5 ways ayahuasca might help treat addiction
Ayahuasca has many potential benefits for addiction treatment and associated mental health struggles. Since I don't believe that addiction is primarily an issue related to the drugs themselves (but is instead a complex interaction of biological, psychological, environmental and spiritual factors), ayahuasca seems to play a role in at least three of these factors—biology, psychology, and spirituality. Here are some specific reasons why it may work to help relieve addiction issues:
1. It doesn’t require "talking."
For people who don’t like “talk therapy” or who aren’t strong in expressing their thoughts and feelings verbally, then ayahuasca offers a non-verbal experience that draws on your other senses to facilitate psychological and spiritual.
2. It can improve mental health.
Not only has ayahuasca therapy been linked to a reduction in symptoms related to depression and anxiety, but it may also induce a biological effect on specific brain areas that impact these conditions (like the insula and amygdala).
3. It has healing powers.
People who have participated in ayahuasca ceremonies sometimes report psychological healing from childhood trauma and unconscious psychological distress, through increased insight and reflective capacity on past experiences. It can open people up to engage in traditional psychotherapies with greater success.
4. It can help to provide a different mindset.
A commonly reported side-effect of ayahuasca treatment (and hallucinogenic experiences broadly) is a change in mindset. It can induce a sense of hope, confidence, and feelings of empowerment. It can also make you more mindful and connected to self, other people and the environment.
5. It can help regulate biology.
Ayahuasca therapy can improve serotonin activity, which regulates mood and is a critical player in the pleasure-seeking urges related to substance addictions.
In particular, alcohol and cocaine addictions have been treated with Ayahuasca, while in the case of opiate addictions, people are advised to first use Ibogaine under close expert supervision.
The future of ayahuasca treatment
Ayahuasca is not a one-size fit all approach to addiction and requires careful consideration and weighing up of the benefits vs. the risks. There is some support for its effectiveness in treating addiction but further research on a larger scale is required. Hallucinogens are serious chemicals and their use needs to be considered seriously and deliberately.
Certainly, more controlled evidence of ayahuasca's benefits need to be explored, and the idea that ayahuasca is a cure for addiction is certainly preliminary and exaggerated. There is a lack of clear scientific evidence and follow up is needed.
What is exciting about the use of ayahuasca in addiction treatment, is that it reinforces the need for individualized treatment based on your individual circumstances. Holistic and alternative treatment options offer competitive results compared with traditional treatment methods. I aim to support people with addiction at any stage on their journey toward recovery and I believe a non-judgmental and holistic approach is both necessary and beneficial for recovery success. That's the whole point of the IGNTD Recovery approach – addressing underlying needs while helping people find their own unique experience to recovery.
Thomas, G., Lucas, P., Capler, R.N., Tupper, K.W., & Martin, G. (2013). Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada. Current Drug Abuse Review, 6 (1). Retrieved from: http://www.maps.org/research-archive/ayahuasca/Thomas_et_al_CDAR.pdf
Bogenschutz, M.P., & Johnson, M.W. (2016). Classic hallucinogens in the treatment of addictions. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 64(4), pp 250-258. Retrieved from: https://doi.org/10.1016/j.pnpbp.2015.03.002
Kuypers, K.P.C., Riba, J., de la Fuente Revenga, M., Barker, S., Theunissen, E.L., & Ramaekers, J.G. (2016). Ayahuasca enhances creative divergent thinking while decreasing conventional convergent thinking. Psychopharmacology (Berl), 233, pp 3395-3403. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989012/
Brierley, D.I., & Davidson, C. (2012). Developments in harmine pharmacology — Implications for ayahuasca use and drug-dependence treatment. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 39, pp 263-272. Retrieved from: doi:10.1016/j.pnpbp.2012.06.001
Loizaga-Velder, A., & Verres, R. (2014). Therapeutic Effects of Ritual Ayahuasca Use in the Treatment of Substance Dependence—Qualitative Results. Journal of Psychoactive Drugs, 46 (1), pp 63-72. Retrieved from: http://www.tandfonline.com/loi/ujpd20