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April 2003, Vol 93, No. 4 | American Journal of Public Health Winkelman | Peer Reviewed | Research and Practice | 647
RESEARCH AND PRACTICE
Objectives. This article examines drumming activities as complementary addiction
treatments and discusses their reported effects.
Methods. I observed drumming circles for substance abuse (as a participant), inter-
viewed counselors and Internet mailing list participants, initiated a pilot program, and
reviewed literature on the effects of drumming.
Results. Research reviews indicate that drumming enhances recovery through in-
ducing relaxation and enhancing theta-wave production and brain-wave synchronization.
Drumming produces pleasurable experiences, enhanced awareness of preconscious
dynamics, release of emotional trauma, and reintegration of self. Drumming alleviates
self-centeredness, isolation, and alienation, creating a sense of connectedness with
self and others. Drumming provides a secular approach to accessing a higher power and
applying spiritual perspectives.
Conclusions. Drumming circles have applications as complementary addiction ther-
apy, particularly for repeated relapse and when other counseling modalities have failed.
(Am J Public Health. 2003;93:647–651)
Complementary Therapy for Addiction:
“Drumming Out Drugs”
| Michael Winkelman, PhD, MPH
Mark Seaman and Earth Rhythms
of West Reading, Pa
Seaman is recovering from addiction; he
began drumming as a way to express himself
and become part of a community. He was
searching for natural altered states of con-
sciousness. His engagement with drums led to
a personal transformation and an involve-
ment with the recovery industry through
counselors he knew at the Caron Foundation
in Wernersville, Pa.
3
They wanted to expose
adolescents in substance abuse treatment to
drumming. The counselors said that these
shut-down, angry, disenfranchised youth came
alive as drumming gave them an avenue of
expression. Initially, his programs were closely
tied to the therapeutic process. Now, however,
they are offered as recreational activity, and
use drumming to create healing energy.
Activities. Seaman’s programs begin with his
drumming as people enter the room. They
pick up drums and are free to play them as
they choose. He then introduces warm-up ex-
ercises to make people feel comfortable with
the drums, teaching people how to hit the
drums without emphasizing anything techni-
cal. A vocal element is introduced to engage
the group in coordinated chanting/singing ac-
tivities to get their energy going. He allows
people to play spontaneously to lay the
groundwork for nonverbal communication
and asks participants to show how they feel
through playing a rhythm on the drums. Call-
and-response activities are used to connect the
group. A subsequent activity gives each partic-
ipant the opportunity to briefly use the drum
to express feelings. The group engages in the
creation of improvisational music that pro-
duces a feeling of great accomplishment and
engages a “letting go” process through visuali-
zation. Seaman ends his program with an ap-
plication of the Alcoholics Anonymous’ 11th
step (meditation), using meditation music and
a variety of percussion instruments to rein-
force a visualization process to connect with a
higher power. “I get people relaxed, give them
permission to leave their body and go on a
journey. I talk about forgiveness, acceptance
and surrender. I work [on] release of guilt
from the wreckage that they have produced
through their addictions. The visual imagery
connects with the inner child, to release bag-
gage, to awaken true potential, to image con-
tact with higher power that covers and em-
braces them in a space of joy and healing.”
Effects. The participants enthusiastically re-
ceive the drumming. Staff emphasized that
the youths particularly need drumming when
Recent publications
1–8
reveal that substance
abuse rehabilitation programs have incorpo-
rated drumming and related community and
shamanic activities into substance abuse treat-
ment. Often promoted as “Drumming out
Drugs,” these programs are incorporated in
major rehabilitation programs, community
centers, conference workshops and training
programs, and prison systems. Although sys-
tematic evaluations of the effectiveness of
drumming activities are lacking, experiences
of counselors and clients indicate that drum-
ming can play a substantial role in addressing
addiction. Evidence suggesting that drumming
enhances substance abuse recovery is found
in studies on psychophysiological effects of
drumming
9–13
and the therapeutic applications
to addictions recovery of altered states of con-
sciousness,
14
meditation,
15–19
shamanism,
20,21
and other shamanic practices.
22–24
METHODS
This report is based on information ac-
quired from observations of drumming activi-
ties in substance abuse programs; interviews
with program directors and counselors about
the effects and experiences induced; a pilot
program introducing drumming for recovering
addicts; and on-line discussions and published
material on drumming effects. Because of
confidentiality issues, the programs observed
did not permit interviews with clients. Clients’
perspectives were provided by the directors
and counselors involved in the program.
RESULTS
The following summarizes research done
during 2001 on programs in Pennsylvania,
Virginia, Wisconsin, and Missouri. Participant
observation was carried out in the first 2 lo-
cations; interviews and published material
were used for descriptions of activities and as-
sessment of their effects at all sites.
American Journal of Public Health | April 2003, Vol 93, No. 4648 | Research and Practice | Peer Reviewed | Winkelman
RESEARCH AND PRACTICE
group dynamics are stressed because of con-
flict within the group, and when the group’s
sense of unity and purpose is disrupted by a
client’s relapse to drugs. Seaman finds that
drumming pulls a group together, giving a
sense of community and connectedness. The
terminal meditation activity induces deep re-
laxation, eases personal and group tensions,
and often leads to strong emotional release.
Seaman suggests that drumming produces an
altered state of consciousness and an experi-
ence of a rush of energy from the vibrations,
with physical stimulation producing emotional
release. Because addicted people are very
self-centered, are disconnected, and feel iso-
lated even around other people, the drum-
ming produces the sense of connectedness
that they are desperate for, he says. “All of us
need this reconnection to ourselves, to our
soul, to a higher power. Drums bring this out.
Drums penetrate people at a deeper level.
Drumming produces a sense of connected-
ness and community, integrating body, mind
and spirit.” Seaman’s program is designed to
induce a spiritual experience that is upbeat
and fun. Meditation, “letting-go,” and “re-
birthing experiences” allow people to leave
behind the things they don’t want (e.g. their
addictions) and engage the themes of recov-
ery within the dynamics of group drumming.
Ed Mikenas and the Lynchburg Day
Program
Ed Mikenas
6,25
has a background as a musi-
cian, music therapist, and substance abuse
counselor; he has also taken training from the
Foundation for Shamanic Studies. He first dis-
covered the positive effects of drumming for
recovery when he worked as a substance
abuse counselor at a group home for girls.
Mikenas’ interest in drumming preceded this
program, beginning with a concert for the Part-
nership for Prevention of Substance Abuse.
Currently, his programs are provided in col-
leges, after-school programs, city programs,
and psychology and addiction conferences.
The drumming reinforces other programs for
both prevention of and recovery from addic-
tion in a community context. Drumming em-
phasizes self-expression, teaches how to re-
build emotional health, and addresses issues of
violence and conflict through expression and
integration of emotions, says Mikenas.
Activities. Mikenas uses group drumming in
substance abuse counseling to activate and re-
inforce the recovery process. Participation as a
group leader or follower induces experiences
that can mirror the recovery process—confi-
dence, uncertainty, insecurity in leading, secu-
rity in following, desire for change, or novelty.
Drumming activities allow spontaneous ex-
pressions of leadership skills. Mikenas exposes
participants to a variety of percussion instru-
ments and helps them learn basic sounds,
rhythms, and complex polyrhythmic dances.
Sessions begin with warm-ups on bass tones to
give safe and easy exercises and to coordinate
the group. These are followed by edge tones
at greater acceleration and the use of stop and
start signals. More complex movements (heel-
to-toe, switching hands, slap tones) are then
introduced, emphasizing the use of the non-
dominant hand. Mikenas uses Afrocentric tra-
ditions, particularly Afro-Cuban and Brazilian
rhythms and the Afro-Caribbean Yoruba-
based religions.
25
The gods are used as repre-
sentations of archetypes to help people access
their unconscious dynamics and connect their
experiences with spirituality and community.
Mikenas says that these spiritual experiences
connect clients with a “higher power” and
reestablish connections with their “natural
selves.”
Effects. Mikenas finds that the activities of
drumming produce entertainment, an altered
state of consciousness, and an energy that
draws people in. Drumming also provides op-
portunities for coordinating sound and move-
ment to assist in mental, physical, and emo-
tional development processes. The pulse of
drumming in a context that combines self-
expression helps coordinate activities and
solve problems, says Mikenas. Drumming
gives an opportunity to learn leadership and
discover one’s own potentials. The drum’s
sounds, rhythms, and energy elicit emotional
issues and may work as an “eraser” to remove
effects of trauma. Mikenas suggests that “with
drumming, a group of people go from chaos
and noise to an orderly sense of feeling all the
same. Drumming helps express and address
unhealthy emotional reactions that allow
drugs to appear to meet emotional needs.” He
says drumming entrains the brain and stimu-
lates pleasurable feelings without drugs.
“Drumming makes you feel good. When they
connect, it makes them glow. It helps people
fit in. Drumming teaches nurturing, respect,
participation, and personal relationships.
Drumming changes speaking, feeling, and act-
ing, and helps you learn to act from the
heart.” Because group drumming gives partici-
pants different roles, individuals have to coor-
dinate their parts. Therefore, they must focus
on others. This gives them an experience with
working together in a structured way. Mikenas
says that a structured positive learning experi-
ence in lives that are often chaotic helps par-
ticipants establish contact with themselves and
connect with the collective consciousness.
Mikenas considers benefits of drumming to in-
clude enhanced sensorimotor coordination
and integration, increased bodily awareness
and attention span, anxiety reduction, en-
hanced nonverbal and verbal communication
skills, greater group participation and leader-
ship skills and relationship building, and self-
skills for self-conscious development and so-
cial and emotional learning.
25
Myron Eshowsky’s Shamanic Counseling
Approach
Myron Eshowsky was trained as a sha-
manic counselor by the Foundation for
Shamanic Studies. His experiences, beginning
in the mid-1980s, range from inpatient psy-
chiatric acute care settings to private practice,
community mental health centers, and pris-
ons. Eshowsky worked with adults in a com-
munity mental health center in Madison, Wis,
employing shamanic counseling approaches
to apply spiritual perspectives to address psy-
chological, emotional, and spiritual problems.
1
His success led the drug/alcohol unit of his
agency to refer clients with a history of severe
addiction and significant mental health issues.
He subsequently worked with at-risk youth
and gangs at an alternative high school and
provided programs for mental health centers,
community-based antiviolence groups, hospi-
tals, health maintenance organizations, public
schools, and prisons.
1,2,26,27
Activities. The shamanic drumming pro-
grams provided by Eshowsky include a mix of
activities—story telling, journeying, healing
work, dancing, spiritual divination, and group
ceremonies. He engages adolescents in drum-
ming activities and teaches them to journey on
their own; he also often journeys himself to do
April 2003, Vol 93, No. 4 | American Journal of Public Health Winkelman | Peer Reviewed | Research and Practice | 649
RESEARCH AND PRACTICE
healing work. Eshowsky uses shamanic jour-
neying
28
to find out information about clients,
their power animals, spiritual intrusions, and
soul loss.
29
These shamanic activities may pro-
vide healing (e.g., “soul retrieval”) or informa-
tion subsequently used in ritual therapeutic in-
teractions that involve other family members
to provide community support. He uses cere-
mony and ritual to provide a context for clients
to connect with their issues while simultane-
ously placing them in a global context. He says
that this provides healing and a sense of be-
longing that helps clients define who they are.
Effects. Participants report that drumming
and shamanic journeying calm them down
and help them deal with their high-stress
lives. “Drumming helps them to experience a
kind of peacefulness and provides a spiritual
learning context that allows them to talk
about their deeper concerns. It provides an
opportunity for being heard that they don’t
often feel [they have].” Eshowsky reports that
participants have a major reduction in crack
cocaine and marijuana use as well as a reduc-
tion in drug-related violence and contact with
the criminal justice system. This also en-
hances their school participation and per-
formance. Eshowsky’s work with shamanic
healing is often effective for people in desper-
ate situations, when other counseling modali-
ties have failed; he reports a number of re-
markable recoveries.
1,2,26,27
A particularly
successful application has been with youth in
street gangs, for whom application of the prin-
ciples of core shamanism has been useful in
providing healing and spiritual justice by ad-
dressing issues of despair and powerlessness.
Daniel Smith’s Shamanic Approach
Daniel Smith
7
is the former director of the
Center for Addictive Behaviors and program
director of the Herman Area District Hospital
Alcohol and Drug Unit in St. Louis, Mo. After
years of use of shamanic drumming tech-
niques and training by the Foundation for
Shamanic Studies, Smith introduced drum-
ming into his work as a licensed clinical social
worker in a substance abuse rehabilitation
program. He has taught drumming and
shamanic techniques as an alternative and
complementary therapy for addiction at well-
ness events, professional trainings, large con-
ferences, and weekend retreats.
Activities. Incorporation of core shamanic
principles within managed care has created
tensions, but Smith says that he has found an
uneasy acceptance among the staff of the psy-
chiatric settings through bridging activities
such as yoga, breath work, music therapy,
mask making, and addressing issues of the
inner child and family-of-origin dynam-
ics.
13 , 15–19,30,31
Smith uses the shamanic ap-
proach for clients who repeatedly relapse. For
clients who know what they need to do for re-
covery but cannot achieve sobriety, the con-
cepts of soul retrieval, depossession (e.g. exor-
cism), extraction, power animal, and spirit
retrieval may be applicable.
20
Smith focuses on
“rebirthing,” a kind of “spiritual surgery” akin
to what Alcoholics Anonymous calls a spiritual
awakening. This experience causes the ad-
dicted person to undergo a profound change
in his or her response to life, says Smith.
Music and dance activities are used for
both cognitive restructuring and physical ex-
ercise. Smith finds that yoga activities pro-
duce mental–physical bridging and the inte-
gration clients need to detoxify their bodies.
He says breath work produces mental–
physical integration and takes clients into al-
tered states of consciousness. Mask making
and rituals help solidify powers accessed in
the nonordinary reality experiences; mask
wearing incorporates helping spirits and the
changes in personality necessary to create a
new sense of self as a recovering person, says
Smith. Shamanic techniques are introduced
and reinforced through rituals with symbols
of flight (birds, feathers) that help prompt vi-
sionary experiences reflecting common
themes in recovery—symbolically flying from
the hells of addiction and soaring through the
sky. The technique to which Smith attributes
the greatest success in working with chronic
recidivists is “shapeshifting,” which borrows
from techniques of Perkins.
32
Rituals orient
clients and help provide a sense of calm, a
sense of inner balance, and connection with a
greater power. Stone (rock) divination proce-
dures are used: clients look for answers to
their questions through what they see in a
rock. This process allows them to connect
with the power of the universe, to externalize
their own knowledge, and to internalize their
answers; it also enhances their sense of em-
powerment and responsibility, says Smith.
Effects. Smith says that drumming and
shamanic activities address addiction through
reintegrating aspects of the self in rituals for
soul retrieval and power animal retrieval.
Through these activities, people gain access to
traumatic assaults that have driven their abu-
sive relations with drugs. Spirit world jour-
neys provide direct access to these early ex-
periences in a context that reduces barriers to
awareness. Ancestor spirits or other helpful
spirit guides and allies encountered in rituals
and journeys facilitate the resolution of
trauma. These experiences are healing, bring-
ing the restorative powers of nature to clinical
settings. Shamanic activities bring people effi-
ciently and directly into immediate encoun-
ters with spiritual forces, focusing the client
on the whole body and integrating healing at
physical and spiritual levels.
Pilot Program at the Phoenix Shanti
Group
Before conducting the research reported in
the previous sections, I presented a shamanic
drumming circle based on the principles of
core shamanism
28,33,34
to clients of the
Phoenix Shanti Group as part of MPH intern-
ship activities. These clients were HIV-
positive, and most were addicted to crack co-
caine, methamphetamine, or opiates. These
drumming activities were not part of regular
program activities but were offered as a vol-
untary supplemental activity. The shamanic
drumming activities were explained to the
group in terms of their potential for inducing
relaxation and natural altered states of con-
sciousness that substitute for drug-induced
highs. Suggestions for successful participation
from the clinical director that were conveyed
to the group included explaining the need for
consistent attendance to achieve positive re-
sults. Additional recommendations included
journaling of the session experiences to inte-
grate them and chart the client’s development.
A few clients attended drumming groups
held immediately after mandatory group ses-
sions, but most declined. None of the clients
currently in the intensive treatment program
at Shanti attended the regular weekend
evening sessions offered across more than a
year, although some of Shant’s prior clients
(graduates of the program) did attend. This
lack of voluntary participation in supplemen-
American Journal of Public Health | April 2003, Vol 93, No. 4650 | Research and Practice | Peer Reviewed | Winkelman
RESEARCH AND PRACTICE
tal activities suggests that successful introduc-
tion of drumming activities in rehabilitation
requires that they be incorporated into the
mainstream of the program. Clients’ interest
will likely be strongly affected by the attitudes
expressed by regular counselors.
On-Line Discussions: drumminggroups@
yahoo.com
Inquiries posted to an on-line drumming In-
ternet mailing list provided additional impor-
tant information about the use of drumming
in rehabilitation and on the relationships be-
tween community drumming activities and
drug use. One respondent said, “I have found
that music, especially drumming, creates that
same kind of bonding and interdependent
unity without putting chemicals and smoke in
my body. I really like being high on commu-
nity drumming and want to share that.” An-
other noted, “There is no doubt in my mind
that the drum circle and other musical initia-
tives are having a positive effect on the whole
community. Drumming prevents children from
getting into the drug culture, creating some-
thing positive and creative that children can
identify with at an early age to build up their
confidence and self-esteem. A sense of belong-
ing to a community is the best protection
there is. Drum circles give them tools to create
a sense of community purpose and grounded-
ness in their lives.”
In contrast, others commented on wide-
spread drug use in drumming circles. Many
drum circles accept (or fail to challenge and
exclude) the use of drugs before, during, and
after drumming sessions. This tolerance
makes existing community drumming circles
an uncertain source of support for maintain-
ing sobriety. Successful use of drumming to
guide and maintain sobriety probably re-
quires the creation of programs specifically
designed for the recovering community.
Physiological Effects of Drumming
Drumming produces a variety of physical
and psychological effects. A recent popular
book on drumming reviews research suggest-
ing the positive effects of drumming in the
treatment of a wide range of physical condi-
tions, mental illness, and personality disor-
ders.
5
Drumming enhances hypnotic suscepti-
bility, increases relaxation, and induces
shamanic experiences.
35
Drumming and other
rhythmic auditory stimulation impose a driv-
ing pattern on the brain, particularly in the
theta and alpha ranges.
9–12,33,35
The en-
hanced θ- and α-wave entrainment produced
by drumming typifies general physiological ef-
fects of altered states of consciousness
33,35,36
and meditation.
19
ASCs involve a mode of
consciousness,
33
a normal brain response re-
flected in synchronized brain-wave patterns in
the theta (3–6 cycles per second [cps]) and
alpha (6–8 cps) ranges. This response is pro-
duced by activation of the limbic brain’s sero-
tonergic circuits to the lower brain. These
slow-wave discharges produce strongly coher-
ent brain-wave patterns that synchronize the
frontal areas of the brain with ascending dis-
charges, integrating nonverbal information
from lower brain structures into the frontal
cortex and producing insight.
33
Physiological changes associated with ASC
facilitate healing and psychological and physi-
ological well-being through physiological re-
laxation; facilitating self-regulation of physio-
logical processes; reducing tension, anxiety,
and phobic reactions; manipulating psychoso-
matic effects; accessing unconscious informa-
tion in visual symbolism and analogical repre-
sentations; inducing interhemispheric fusion
and synchronization; and facilitating cogni-
tive–emotional integration and social bonding
and affiliation.
33
CONCLUSIONS
Drumming produces physiological, psycho-
logical, and social stimulation that enhances
recovery processes. Drumming induces relax-
ation and produces natural pleasurable expe-
riences, enhanced awareness of preconscious
dynamics, a release of emotional trauma, and
reintegration of self. Drumming addresses
self-centeredness, isolation, and alienation,
creating a sense of connectedness with self
and others. Drumming provides a secular ap-
proach to accessing a higher power and ap-
plying spiritual perspectives to the psychologi-
cal and emotional dynamics of addiction.
Drumming circles have important roles as
complementary addiction therapy, particu-
larly for repeated relapse and when other
counseling modalities have failed.
Drumming circles and other shamanic al-
tered state of consciousness activities can ad-
dress multiple needs of addicted populations.
These include
8
• Physiological dynamics, inducing the relax-
ation response and restoring balance in the
opioid and serotonergic neurotransmitter
systems
• Psychodynamic needs for self-awareness
and insight, emotional healing, and psycholog-
ical integration
• Spiritual needs for contact with a higher
power and spiritual experiences
• Social needs for connectedness with others
and interpersonal support
Drumming may reduce addiction by pro-
viding natural alterations of conscious-
ness.
8,18–19
Shamanic drumming directly sup-
ports the introduction of spiritual factors
found significant in recovery from substance
abuse.
21, 37–39
Because recidivism is wide-
spread, treatment success may mirror the nat-
ural recovery rate,
40
and current methods
have little success,
41
the use of drumming and
other altered states of consciousness as com-
plementary therapies with considerable prom-
ise is justified.
Drumming groups may also aid recovery
by enhancing health through their effects on
social support and social networks. The
health implications of social support have
been increasingly recognized.
42–43
These
forms of support are of considerable signifi-
cance for well-being in an increasingly atom-
ized society in which traditional family- and
community-based systems of support have be-
come seriously eroded. Thus, deliberate en-
hancement of social support is a potentially
significant contributor to physical, emotional,
and mental health. The social support avail-
able from community drumming circles is one
such source. These social effects are not
merely palliative but constitute mechanisms
for producing psychobiological effects. Central
to these effects is an amelioration of the stress
response, a significant factor in drug use and
recidivism.
19
The use of drumming as part of substance
abuse rehabilitation is far more widespread
than the few cases reviewed here might sug-
gest. Incorporation of drumming within Na-
tive American treatment programs has been
repeatedly mentioned to me. A recent book
reviewing the scope of research on the effects
April 2003, Vol 93, No. 4 | American Journal of Public Health Winkelman | Peer Reviewed | Research and Practice | 651
RESEARCH AND PRACTICE
of drumming reports on programs in New
York and California in which drumming is in-
corporated into addictions treatment.
5
The
Foundation for Shamanic Studies has several
decades of experience in applying shamanic
altered state of consciousness in both training
and therapy.
20
They have identified a variety
of contexts in which shamanic approaches
may be useful in reducing substance abuse.
The physiological effects of drumming and
the positive effects of group drumming expe-
riences on recovery that are attested to by
counselors who have incorporated these ac-
tivities into substance abuse rehabilitation
programs provide a compelling rationale for
the utilization and evaluation of this resource.
Winkelman
8
suggests a variety of ways in
which the shamanic paradigm and altered
states of consciousness can be applied to sub-
stance abuse rehabilitation.
About the Author
Michael Winkelman is with the Department of Anthropol-
ogy, Arizona State University, Tempe.
Requests for reprints should be sent to Michael Winkel-
man, PhD, MPH, Department of Anthropology, Box
872402, Arizona State University, Tempe, AZ 85287-
2402 (e-mail: michael.winkelman@asu.edu).
This article was accepted May 20, 2002.
Acknowledgments
The research was supported by a National Institute of
Drug Abuse postdoctoral fellowship awarded to the in-
vestigator through the Arizona Center for Ethnographic
Research and Training.
I thank the individuals who made this research pos-
sible, particularly Scott Reuter and the Phoenix Shanti
Group; Mark Seaman of Earth Rhythms, West Reading,
Pa; and Ed Mikenas of Urban Wilde, Lynchburg, Va.
Human Participant Protection
Research was approved by the institutional review
board of the Arizona State University and by the Shanti
internal review board.
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