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Psychedelics as Medicines for Substance Abuse Rehabilitation: Evaluating Treatments with LSD, Peyote, Ibogaine and Ayahuasca
Abstract
Substances known as psychedelics, hallucinogens and entheogens have been employed in ethnomedical traditions for thousands of years, but after promising uses in the 1950's and 1960's they were largely prohibited in medical treatment and human research starting in the 1970's as part of the fallout from the war on drugs. Nonetheless, there are a number of studies which suggest that these substances have potential applications in the treatment of addictions. While these substances are generally classified as Schedule I, alleging no established medical uses and a high drug abuse potential, there is nonetheless evidence indicating they might be safe and effective tools for short term interventions in addictions treatment. Evidence suggests that the psychedelics have a much greater safety profile than the major addictive drugs, having extremely low levels of mortality, and producing little if any physical dependence. This paper reviews studies evaluating the use of LSD, peyote, ibogaine and ayahuasca in the treatment of dependencies and the possible mechanisms underlying the indications of effectiveness. Evidence suggests that these substances help assist recovery from drug dependency through a variety of therapeutic mechanisms, including a notable "after-glow" effect that in part reflects their action on the serotonin neurotransmitter system. Serotonin has been long recognized as central to the psychedelics' well-known phenomenological, physical, emotional and cognitive dynamics. These serotonin-based dynamics are directly relevant to treatment of addiction because of depressed serotonin levels found in addict populations, as well as the role of serotonin as a neuromodulators affecting many other neurotransmitter systems.
... Owing much to this tradition, although frequently not acknowledging such roots, modern medicine has embraced the potential of psychedelic substances for the treatment of psychological disorders. This has included the administration of a range of substances, including LSD, psilocybin, ayahuasca, methylenedioxymethamphetamine (MDMA), and ibogaine, in conjunction with psychotherapy for the treatment of depression, anxiety, addiction, and post-traumatic stress disorder (PTSD; Goldsmith, 2007;Mithoefer, Grob, & Brewerton, 2016;Winkelman, 2014a). The scientific progress and clinical promise of the modern psychedelic medicine movement owes much of its success to the history of indigenous healing practices. ...
... Both ibogaine (Brown & Alper, 2017;Noller, Frampton, & Yazar-Klosinski, 2017) and peyote (Fickenscher et al., 2006) are being investigated in the treatment of substance use. Recent research demonstrates the safety and preliminary efficacy of LSD-assisted therapy in the treatment of end-of-life anxiety (Carhart-Harris, 2015), depression (Gasser et al., 2015), and in treating addiction (Winkelman, 2014a). While a great deal of important scientific questions remain, and none of the above substances have received FDA approval, the current practices of psychedelic-assisted psychotherapy set it apart from its troubled past and have increased the likelihood of being able to distinguish potential therapeutic effects. ...
Although obsessive-compulsive disorder (OCD) is associated with clinically significant distress, many OCD patients do not seek treatment. Studies show that Black Americans with OCD are even less likely to obtain treatment due to differences in access. This study explored demographic and symptom outcomes associated with mental health service use for obsessions and compulsions among a nationally representative sample of African American adults (n = 3,570). The analytic sample for this analysis is African Americans who endorsed either obsessions (n = 435) or compulsions (n = 543). Few respondents sought care from their doctor for obsessions (14.25%, n = 62) and even fewer sought care for compulsions (7.55%, n = 36). Respondents were significantly more likely to seek care for obsessions if they had poorer self-rated mental health and perceived impairment due to obsessions—however, they were significantly less likely to seek care for obsessions if they had a high school education or less. Additionally, respondents were more likely to seek care for compulsions if they had poorer self-rated mental health. Our findings suggest that demographic factors, such as level of education, can impact care-seeking behaviors and, therefore, treatment outcomes for African Americans with obsessive-compulsive symptoms. Knowledge of factors associated with OCD care-seeking behavior can help inform potential barriers to treatment and strategies to ensure equity in access to mental health care for this population. Clinical implications and future directions are discussed.
... It's been suggested that set and setting manifest the experiential outcomes (e.g., occurrence of a mystical experience) in a session much more than purely the ingestion of a substance does, which then rather serves as a catalyst of such experiences [49,63]. This is historically mirrored in indigenous peoples' use of psychedelic substances in structured ceremonial rituals that have long acknowledged the importance of context and preparation [49,64,65]. ...
This narrative review explores the utilization of psychedelic states in therapeutic contexts, deliberately shifting the focus from psychedelic substances back to the experiential phenomena they induce, in alignment with the original meaning of the term "mind-manifesting." The review provides an overview of various psychedelic substances used in modern therapeutic settings and ritualistic indigenous contexts, as well as non-pharmacological methods that can arguably induce psychedelic states, including breathwork, meditation, and sensory deprivation. While the occurrence of mystical experiences in psychedelic states seems to be the strongest predictor of positive outcomes, the literature of the field yields several other psychological processes, such as awe, perspective shifts, insight, emotional breakthrough, acceptance, re-experiencing of memories, and certain aspects of challenging experiences, that are significantly associated with positive change. We additionally discuss in detail mystical experience related changes in metaphysical as well as self-related beliefs and their respective contributions to observed outcomes. We conclude that a purely medical and neurobiological perspective on psychological health is reductive and should not overshadow the significance of phenomenological experiences in understanding and treating psychological issues that manifest in subjective realities of human individuals.
... From a therapeutic point of view, acute and long-term consumption of ayahuasca is linked to better mental and physical health and quality of life overall [21,31]. More specifically, the brew has been evaluated with positive results as a possible treatment for substance use disorders [62,73], as a rapid-acting antidepressant [21,53], as an anxiolytic agent [20,64] and other therapeutic potentials including promoting well-being, positive lifestyle changes, and enhancing coping strategies [34,51]. Corroborating these results, positive effects on mental health and enhanced cognitive flexibility have all been recently reported with the administration of other psychedelics such as psilocybin and LSD, both in normal and microdosing regimes [23,52,56]. ...
Although several studies have been conducted to elucidate the relationship between psychedelic consumption and cognition, few have focused on understanding the long-term use influence of these substances on these variables, especially in ritualistic contexts. To verify the influence of ritualistic ayahuasca consumption on the cognition of experienced ayahuasca religious users (> 20 years) and beginners (< 3 years), which participated in rituals of the Centro Luz Divina (CLD), a Santo Daime church in Brazil. Observational, descriptive, and cross-sectional study was carried out in which 48 people participated divided into three groups: (a) experienced ayahuasca users (n = 16), (b) beginner ayahuasca users (n = 16) and (c) control group (n = 16). All groups were matched by sex, age, and education and contained 8 women and 8 men. Cognition was assessed with the WASI (intelligence quotient), Digit Span (verbal working memory), Corsi Block-Tapping Task (visuospatial-related and working memory), Rey–Osterrieth Complex Figure test (visual perception, immediate memory), and Wisconsin Card Sorting and Five Digit Test (executive functions). Groups were homogenous in terms of sociodemographic characteristics, with participants presenting average intellectual performance. There was no evidence of cognitive decline amongst ayahuasca users. The experienced group showed higher scores compared to the less experienced group in the Digit Span and Corsi Block-Tapping tasks, which assess working verbal and visuospatial memories respectively. We confirmed the botanical identities of Psychotria viridis and Banisteriopsis caapi and the presence of the alkaloids both in the plants and in the brew. Short and long-term ayahuasca consumption does not seem to alter human cognition, while long-term use seems to be associated with improvements in aspects of working memory when compared with short-term use.
Much of the world's landmass is already known. Deep sea and outer space are beyond most people's reach. It feels like there are fewer places left to discover. Psychedelics, on the other hand, reveal worlds that remain largely obscure. Altered states offer modern, 21st-century audiences boundless opportunities to explore what a human being can experience. In this book, I show you how to become a capable discovery-maker, sample-collecting naturalist, and rational thinker of visionary phenomena.
In the same way European explorers left their shores 500 years ago in search of spice routes by using technologies to get to the other side of the world, you can use psychedelics to get to the other side of ordinary perception and back. Knowing how to gather data, conduct experiments, and make contact with the locals will equip you to chip away at the mystery. You will learn conceptual tools to shape your new mindset, taking an active, rather than passive, role.
If you ever wanted to make more sense of your experiences, now is the time. Find out how you can become part of the Psychedelic Age of Discovery.
Background/Aims
While most psychedelic substances are considered to carry a relatively low risk of acute or long-term harm, co-use with other psychoactive substances may increase health and social harm. Using a large international survey of adults who use psychedelics, we sought to comprehensively characterize psychedelic co-use.
Methods
We used data from the 2023 Global Psychedelic Survey, a web-based survey of adults ⩾21 with lifetime use of psychedelics. We explored patterns of co-use (prevalence, secondary substances used, timing, and motives of co-use) and examined sociodemographic and psychedelic use-related characteristics associated with co-use overall and by specific psychedelics.
Results
In total, 5370 respondents were included in this analysis, of whom 3228 (56.3%) reported typically co-using at least one of the 11 psychedelic substances of interest, with co-use lowest for ayahuasca (14.8%) and highest for nitrous oxide (54.5%). Cannabis and alcohol were the most common secondary substances. Depressants were the only secondary substance class that increased in use following psychedelic experiences. Greater experience with psychedelics was significantly associated with co-use, as was using for recreational purposes or to reduce/substitute the use of other substances. Personal exploration and therapeutic purposes for psychedelic use were negatively associated with co-use.
Conclusions
In this detailed analysis of psychedelic co-use, we observed high rates of co-use with certain psychedelics, specifically when used recreationally. Our findings highlight psychedelic-specific consumers for whom harm reduction messaging around co-use practices may be best tailored. Further research is justified to assess whether specific patterns of co-use might reduce or increase potential harms.
This narrative review explores the utilization of psychedelic states in therapeutic contexts, deliberately shifting the focus from psychedelic substances back to the experiential phenomena which they induce, in alignment with the original meaning of the term “mind-manifesting”. This review provides an overview of various psychedelic substances used in modern therapeutic settings and ritualistic indigenous contexts, as well as non-pharmacological methods that can arguably induce psychedelic states, including breathwork, meditation, and sensory deprivation. While the occurrence of mystical experiences in psychedelic states seems to be the strongest predictor of positive outcomes, the literature of this field yields several other psychological processes, such as awe, perspective shifts, insight, emotional breakthrough, acceptance, the re-experiencing of memories, and certain aspects of challenging experiences, that are significantly associated with positive change. Additionally, we discuss in detail mystical experience-related changes in metaphysical as well as self-related beliefs and their respective contributions to observed outcomes. We conclude that a purely medical and neurobiological perspective on psychological health is reductive and should not overshadow the significance of phenomenological experiences in understanding and treating psychological issues that manifest in the subjective realities of human individuals.
Purpose of Review
Self-awareness can be defined as the capacity of becoming the object of one’s own awareness and, increasingly, it has been the target of scientific inquiry. Self-awareness has important clinical implications, and a better understanding of the neurochemical basis of self-awareness may help clarifying causes and developing interventions for different psychopathological conditions. The current article explores the relationship between neurochemistry and self-awareness, with special attention to the effects of psychedelics.
Recent Findings
The functioning of self-related networks, such as the default-mode network and the salience network, and how these are influenced by different neurotransmitters is discussed. The impact of psychedelics on self-awareness is reviewed in relation to specific processes, such as interoception, body ownership, agency, metacognition, emotional regulation and autobiographical memory, within a framework based on predictive coding.
Summary
Improved outcomes in emotional regulation and autobiographical memory have been observed in association with the use of psychedelics, suggesting higher-order self-awareness changes, which can be modulated by relaxation of priors and improved coping mechanisms linked to cognitive flexibility. Alterations in bodily self-awareness are less consistent, being potentially impacted by doses employed, differences in acute/long-term effects and the presence of clinical conditions. Future studies investigating the effects of different molecules in rebalancing connectivity between resting-state networks may lead to novel therapeutic approaches and the refinement of existing treatments.
Introdução. A depressão afeta mais de 300 milhões de pessoas globalmente, é considerada uma das principais preocupações de saúde pública, sendo referida como o "mal do século". Caracterizada por diversos sintomas, desde tristeza profunda até pensamentos suicidas, o tratamento convencional envolve o uso de antidepressivos, frequentemente acompanhados de psicoterapia, mas a eficácia é variável e paliativa e a busca por melhores alternativas é urgente. Nesse contexto, a Ayahuasca, bebida psicoativa, utilizada há mais de 5000 anos por indígenas da Amazônia para cura física, mental e espiritual, emerge como uma potencial solução. Composta por duas plantas, o cipó Banisteriopsis caapi e as folhas de Psycotria viridis. Contendo compostos como DMT, a bebida tem sido estudada pelos benefícios terapêuticos que oferece. Objetivo. Realizar uma revisão da literatura sobre a ayahuasca no tratamento das causas e sintomas da depressão Método. Revisão narrativa. Resultados. O uso da ayahuasca está associado a melhorias na função cognitiva, níveis mais baixos de psicopatologia e relatos de bem-estar por usuários regulares, além de resultados promissores nos sintomas depressivos com apenas uma dose. Conclusão. Os trabalhos incluídos sugerem que a Ayahuasca não apenas pode aliviar os sintomas da depressão, mas também pode alcançar as raízes do distúrbio, proporcionando mecanismos psicológicos semelhantes ao mindfulness. Mais estudos são necessários para confirmar o alcance terapêutico da Ayahuasca na causa da depressão.
Reviews evidence for how entheogens (psychedelics) can be used to treat dependence on substances. Also see https://www.researchgate.net/publication/270654137_Psychedelics_as_Medicines_for_Substance_Abuse_Rehabilitation_Evaluating_Treatments_with_LSD_Peyote_Ibogaine_and_Ayahuasca
The public health impact of addiction, with its high relapse rates and the limited efficacy of available treatments, has prompted the search for alternative therapeutic approaches. In recent times, there has been renewed interest in the anti-addictive potential of psychedelics. Consumption of ayahuasca, the N,N-dimethyltryptamine-containing Amazonian plant tea, is experiencing unprecedented expansion. The ritual use of this brew, obtained from Banisteriopsis caapi and Psychotria viridis, in shamanistic and religious contexts is now popular in Europe and North America. Studies of long-term ayahuasca-church members in Brazil have recorded discontinuation of drug use after starting ayahuasca use. Furthermore, several centers that offer therapies based on ayahuasca as a means to treat addictive behavior claim higher success rates than more traditional approaches. In this chapter, we review the pharmacology of ayahuasca and the data available concerning its efficacy in the treatment of drug addiction. Although the therapeutic potential of ayahuasca, based on the evidence examined, is promising, the lack of systematic studies precludes firm conclusions. Ideally, research methodology should be improved, with future studies implementing well-planned clinical protocols with adequate controls, end-points, and follow-up.
Ayahuasca is a mixture of a least two psychoactive South American plants: the liana ayahuasca (Banisteriopsis caapi) which gives its name to the beverage; and the leaves of chacruna (Psychotria viridis). The ayahuasca beverage constitutes a unique preparation because of its pharmacological action in which the beta-carboline alkaloids of Banisteriopsis caapi, playing the role of MAO inhibitors, enable the visionary effects of the tryptamine alkaloids found in Psychotria viridis. This specific symbiotic action, which modern science identified just a few decades ago, has been empirically known for at least 3000 years by the Indigenous groups of the western Amazon, according to archaeological evidence (Naranjo P., 1983). This simple fact deserves our attention because it reveals the extraordinary investigative potential of these ethnic groups, based on the compilation of information from the subjective perspective, which challenges our conventional western approach that tends towards exclusive objectivity with a rational focus. In other words, the psychotherapeutic discoveries of these Amazonian Indigenous peoples are not the result of mere chance or erratic investigation following the trial and error approach (Narby 1998). It is significant that both families of alkaloids of ayahuasca are also present in our bodies (Strassman 2001) and affect the serotonergic system, which suggests the existence of a
natural, endogenous ayahuasca (Metzner et al 1999). Human use of use ayahuasca does not, therefore, constitute an external agent that could violate our physiology, but rather, it appeals to natural neuro-pharmacological processes, empowering them in ways that amplify their normal functions.
Preface: Extending Our Knowledge of Consciousness ix
Charles T. Tart
Chapter 1 Altering Consciousness: Setting Up the Stage 1
Etzel Cardeña
Chapter 2 A Paradigm for Understanding Altered Consciousness:
The Integrative Mode of Consciousness 23
Michael Winkelman
Part I: Historical Perspectives
Chapter 3 Consciousness Alteration Practices in the West from
Prehistory to Late Antiquity 45
Yulia Ustinova
Chapter 4 Spirit Possession and Other Alterations of Consciousness
in the Christian Western Tradition 73
Moshe Sluhovsky
Chapter 5 Altered Consciousness from the Age of Enlightenment
Through Mid–20th Century 89
Etzel Carden˜ a and Carlos S. Alvarado
Chapter 6 Reconceptualizing the Field of Altered Consciousness:
A 50-Year Retrospective 113
Julie Beischel, Adam J. Rock, and Stanley Krippner
Part II: Cultural Perspectives
Chapter 7 Eastern Approaches to Altered States of Consciousness 139
Jonathan Shear
Chapter 8 Shamanism and the Alteration of Consciousness 159
Michael Winkelman
Chapter 9 Altered Consciousness in Society 181
Charles Whitehead
Chapter 10 Spiritual Technologies and Altering Consciousness in
Contemporary Counterculture 203
Graham St John
Part III: The Humanities
Chapter 11 Altered Consciousness in Philosophy 229
Jennifer M. Windt
Chapter 12 Altered Consciousness in Religion 255
Antoon Geels
Chapter 13 Colored Inklings: Altered States of Consciousness
and Literature 277
Wendy E. Cousins
Chapter 14 Altered Consciousness in Performance: West and East 301
Phillip B. Zarrilli
Chapter 15 Altered Consciousness and Modern Art 327
Mark Levy
Chapter 16 Time Is the Key: Music and Altered States
of Consciousness 355
Jo¨rg C. Fachner
Examines diverse areas of the application of psychedelics in the treatment of health conditions.
This book examines shamanism from evolutionary and biological perspectives to identify the origins of shamanic healing in rituals that enhance individual and group function.
What does the brain do during "soul journeys"? How do shamans alter consciousness and why is this important for healing? Are shamans different from other kinds of healers? Is there a connection between the rituals performed by chimpanzees and traditional shamanistic practices?
All of these questions and many more are answered in Shamanism, Second Edition: A Biopsychosocial Paradigm of Consciousness and Healing. This text contains crosscultural examinations of the nature of shamanism, biological perspectives on alterations of consciousness, mechanisms of shamanistic healing, as well as the evolutionary origins of shamanism. It presents the shamanic paradigm within a biopsychosocial framework for explaining successful human evolution through group rituals. In the final chapter,"the author compares shamanistic rituals with chimpanzee displays to identify homologies that point to the ritual dynamics of our ancient hominid ancestors.
Introduction:
This paper reports results from a preliminary observational study of ayahuasca-assisted treatment for problematic substance use and stress delivered in a rural First Nations community in British Columbia, Canada.
Methods:
The "Working with Addiction and Stress" retreats combined four days of group counselling with two expert-led ayahuasca ceremonies. This study collected pre-treatment and six months follow-up data from 12 participants on several psychological and behavioral factors related to problematic substance use, and qualitative data assessing the personal experiences of the participants six months after the retreat.
Findings:
Statistically significant (p < 0.05) improvements were demonstrated for scales assessing hopefulness, empowerment, mindfulness, and quality of life meaning and outlook subscales. Self-reported alcohol, tobacco and cocaine use declined, although cannabis and opiate use did not; reported reductions in problematic cocaine use were statistically significant. All study participants reported positive and lasting changes from participating in the retreats.
Conclusions:
This form of ayahuasca-assisted therapy appears to be associated with statistically significant improvements in several factors related to problematic substance use among a rural aboriginal population. These findings suggest participants may have experienced positive psychological and behavioral changes in response to this therapeutic approach, and that more rigorous research of ayahuasca-assisted therapy for problematic substance use is warranted.
