Plant based assisted therapy for the treatment of substance use disorders - part 1. The case of Takiwasi Center and other similar experiences.

Abstract

Objective. This article aims to give an overview of the major American centers using traditional herbal medicine or their derivatives in the treatment of substance dependence. Methodology. For the purpose of this article we have considered a small number of plants hailing from South, Central and North America. The research has been based on scientific literature, information exchange with treatment centers, internet searches and the personal experience of the authors. Results and discussion. Results show the relevance of certain psychoactive plants well known also for inducing modified states of consciousness (MSCs) including Ayahuasca, Coca, Wachuma, Tobacco, Psilocybe mushrooms, Salvia divinorum and Peyote. Conclusions. Plant based assisted therapy for the treatment of substance use disorders appear to be a promising field of research, although validation of the clinical outcomes need to be improved for the majority of the analyzed cases.

Full text

PLANT BASED ASSISTED THERAPY FOR THE TREATMENT
OF SUBSTANCE USE DISORDERS - PART 1. THE CASE OF
TAKIWASI CENTER AND OTHER SIMILAR EXPERIENCES
MATTEO POLITI*
FABIO FRISO**
JACQUES MABIT***
Recibido: 9 de abril de 2018
Aprobado: 14 de mayo de 2018
ABSTRACT
Objective. This article aims to give an overview of the major American centers
using traditional herbal medicine or their derivatives in the treatment of substance
dependence. Methodology. For the purpose of this article we have considered a small
number of plants hailing from South, Central and North America. The research has
been based on scientic literature, information exchange with treatment centers,
internet searches and the personal experience of the authors. Results and discussion.
Results show the relevance of certain psychoactive plants well known also for inducing
modied states of consciousness (MSCs) including Ayahuasca, Coca, Wachuma,
Tobacco, Psilocybe mushrooms, Salvia divinorum and Peyote. Conclusions. Plant
based assisted therapy for the treatment of substance use disorders appear to be a
promising eld of research, although validation of the clinical outcomes need to be
improved for the majority of the analyzed cases.
Key words: plant-based assisted therapy, substance use disorders (SUDs), drug addiction,
traditional and complementary medicines.
* PhD in Chemistry and Technologies of Bioactive Substances. Scientific Director of Takiwasi Center, Tarapoto,
Peru. E-mail: matteo.politi@takiwasi.com. orcid.org/0000-0002-1185-8569.
Google Scholar
** Communications Degree. Communications Manager of Takiwasi Center, Tarapoto, Peru. E-mail: comunicacio-
nes@takiwasi.com. orcid.org/0000-0001-5427-956X Google Scholar
*** Medical Doctor. Executive President of Takiwasi Center, Tarapoto, Peru. E-mail: takiwasi@takiwasi.com.
orcid.org/0000-0003-3412-3167.
Google Scholar https://scholar.google.com.pe/citations?hl=es&user=OpY7IzMAAAAJ
Cultura y Droga, 23, (26), julio-diciembre 2018, 99-126
ISSN: 0122-8455 (Impreso) ISSN: 2590-7840 (En línea)
Politi, M., Friso, F. and Mabit, J. (2018). Plant based
assisted therapy for the treatment of substance use
disorders - part 1. The case of Takiwasi Center and other
similar experiences. Revista Cultura y Droga, 23 (26),
99-126. DOI: 10.17151/culdr.2018.23.26.7.

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TERAPIA ASISTIDA POR PLANTAS PARA EL
TRATAMIENTO DE LOS TRASTORNOS POR USO DE
SUSTANCIAS - PARTE 1. EL CASO DEL CENTRO TAKIWASI
Y OTRAS EXPERIENCIAS SIMILARES
RESUMEN
Objetivo. Este artículo tiene como objetivo dar una visión de los centros en las
Américas que utilizan plantas medicinales tradicionales o sus derivados en el
tratamiento de la dependencia a sustancias. Metodología. A tal n, hemos considerado
un número reducido de plantas provenientes de América del Sur, América Central
y América del Norte. La investigación se ha basado en la literatura cientíca, el
intercambio de información con los centros de tratamiento, las búsquedas en internet
y la experiencia personal de los autores. Resultados y discusión. Los resultados
muestran la relevancia de ciertas plantas psicoactivas bien conocidas también por
inducir estados modicados de conciencia (EMC) como ayahuasca, coca, wachuma,
tabaco, hongos psilocibios, Salvia divinorum y peyote. Conclusiones. La terapia
asistida por plantas para el tratamiento de trastornos por uso de sustancias parece
ser un campo de investigación prometedor, aunque la validación de los resultados
clínicos debe mejorarse para la mayoría de los casos analizados.
Palabras clave: terapia asistida por plantas, trastornos por uso de sustancias (TUS),
drogadicción, medicinas tradicionales y complementarias.
INTRODUCTION
Today, the Diagnostic and Statistical Manual of Mental Disorders (DSM) identies
Substance Use Disorders (SUDs) as primary mental health disorders (Robinson &
Adinoff, 2016). Mental and substance use disorders in 2010 were the leading cause
of years lived with disability worldwide (Whiteford et al., 2013). The World Health
Organization considers that about 11.8 million people are suffering from illicit drug
dependence worldwide, while according to the United Nations Ofce on Drugs,
there are an estimated minimum of 190,000 cases of premature deaths from drugs
each year, the majority attributable to the use of opioids (UNODC, 2017). In 2016

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alone in the U.S. there were around 60,000 deaths due to opioid overdose (Katz,
2017). Thus, it becomes clear that the scale of the problem is that of a real public
health emergency, as declared by U.S. government in October 2017 (Merica, 2017),
indicating as well that the current biomedical approach does not provide effective
answers.
Addiction care is currently focused on substitution treatments, such as methadone and
buprenorphine (Subutex) in the case of heroin, which seem limited and ineffective.
The inefciency of methadone substitution treatment has been clearly demonstrated
by a study performed by Scotland’s leading drugs expert (Methadone fails 97% of
drug addicts, 2006). The report, compiled by Neil McKeganey, Professor of Drug
Misuse Research at the University of Glasgow, shows that three years after receiving
methadone only 3% of addicts remained totally drug-free.
On the other hand, complementary and traditional medicine offer a huge variety
of diverse treatments for SUDs (Jilek, 1994; Lu et al., 2009; Sarkar & Varshney,
2017), and since few decades there is an increasing interest particularly in the
development of therapeutic protocols based on medicinal plants or their chemical
derivatives from botanicals such as iboga, ayahuasca, peyote, psilocybin mushrooms,
and coca leaves, among others (Winkelman, 2014; de Veen et al., 2017; Brown,
2013; Nunes et al., 2016; Hurtado-Gumucio, 2000). The promising effectiveness
of plant-based treatments may be due not only to their pharmacological effects
including the induction of modied states of consciousness (MSCs), but also to the
ritual framework in which such plants are administered (including dance, music,
rhythm, drums, isolation, fasting, etc.) (Lanaro et al., 2015; Talin & Sanabria, 2017;
Winkelman, 2003).
Within the ritual context, the MSC provides access to realities of the invisible world
(Mabit, 2010) and allows the discovery of active elements in the unconscious of
the person that often lead to the identication of the cause that trigged the addictive
behavior in the rst place. MSCs facilitate rehabilitation by boosting the process of
taking awareness of the inner problem and offer great support to the psychotherapeutic
approach. The material that emerges during MSCs requires a symbolic interpretation
in the style of dream interpretation and allows at the same time the patient to go
beyond verbal expression and verbal limitations. Those patients with low capacity
for symbolization, and for whom verbal therapies are less effective, benet from

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the visionary induction, as registered in the Takiwasi Center by Jacques Mabit
(2007) and Anne Denys, who points out the importance of the “symbolic deaths”
experienced during Ayahuasca rituals and their healing power in opposition to the
“peak experiences” of drug consumption (Denys, 2005). In addition, studies show
that the mystical dimensions of these experiences appear to be related to positive
outcomes and persisting personality changes have been demonstrated as well
(Bogenschutz & Pommy, 2012).
The addiction phenomenon directly involves ethnic groups that traditionally used
sacred plants to induce MSC and are now strongly affected by substances such as
alcohol, which represents for them an imported product taken out of context (Mabit,
2001). The use of psychotropic plants for ceremonial purposes in Latin America has
been documented for thousands of years with no report showing the presence of
massive addiction disorders in traditional societies (EFE, 2012). Traditionally the
consumption of psychoactive substances was the result of a long and careful process
of observation and experimentation, which allowed to recognize those plants capable
of producing the desired effects and to specify the most adequate procedures related
to the way of introducing them into the organism, mainly with religious purposes
(García Díaz, 2002). The emergence of a new economic and political order radically
changed the situation, with psychoactive substances transformed into goods and
products, sometimes designed to keep pace with the frantic rhythm of modern
society, as in the case of cocaine, leaving completely aside the ceremonial, religious
and ritual aspects (Mabit, 2018). Addiction in traditional societies, therefore, seems
to be consequence of a failed meeting between indigenous cultures and the Western
world.
In response to the problem, the same communities are trying different methods to
reconnect with their ancestral roots and codes: the healers of the Peruvian coast treat
their alcoholics through the ritual use of mescaline cactus, with a high success rate
(Chiappe, 1976; Seguin, 1979), see for example the astonishing 68.44% recovery
rate registered by Campos (1957); the re-introduction of traditional native culture
and spirituality has a profound impact on the recovery of many communities
devastated by alcohol consumption as in the famous Alkali Lake experience (Bopp
& Bopp, 2011); the Natives of North America quickly and signicantly reduce
the incidence of alcoholism in their reserves by reviving their ancestral practices
that include the ritual use of peyote and tobacco (Hodgson, 1997). As part of this

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movement, the Takiwasi Center organized in 2015 the “Intercontinental meeting of
indigenous leaders on addiction and culture” (Mabit & Berlowitz, 2017), with the
aim of discussing the issue of addiction and elaborating new solutions that must arise
from the same indigenous societies since these are indicating to be more effective
compared with conventional approaches. Such kind of events are typical contexts of
medical pluralism and syncretism, were the circulation of plants, people, and ideas
as an asymmetric creative process is conceived, and where savants from different
nations negotiate power, interact, and recongure knowledge (Cueto & Palmer,
2014).
A key factor to understanding the benet of a culturally-focused treatment (Rowan et
al., 2014) is recognizing the meaning of indigenous wellness, from which the use of
herbal therapy derived, which is understood as a harmonious relationship of all the
parts of the person, including mind, body, emotion, and spirit. Traditional medicine
interventions often address wellness in a holistic sense, taking into special account
rituality, and considering that harmonious relationships are necessary not only
between individuals and societies but also with the environment and the spiritual
world (invisible world, spirits, non-human entities) (Chaumel, 1983; Regan, 2011),
in contrast to Western biomedical approaches that focus on the absence of disease
and imply mind-body separation in treating illnesses such as addiction.
- Main Research Objectives
This article aims to give an overview on the centers that use traditional herbal
medicine or their derivatives in the treatment of substance dependence, mentioning
the most promising initiatives for drug addiction treatment that include in their
protocols certain well known psychoactive plants. In general, there are few proposals
of centers formally constituted and with published scientic data that use therapeutic
practices inspired by traditional medicines to cure drug addiction. This precisely
opens the opportunity to point out that this empty space is lled with isolated personal
initiatives, that receive poor or none government aid, despite encouraging results and
growing scientic interest on the subject. Most of the initiatives rely on personal
experiences and researches, which have nonetheless the potential to be replied at
larger scale. On the other hand, some of the plants considered for this article are not
yet used within a treatment center, but the promising results on a pharmacological
level could lead to the conception of experiences oriented towards their application

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in the context of a therapeutic community. The present article represents the rst part
of a much-extended overview work and will be followed by a second part in which
will be given space to plants hailing from other continents like Iboga and less-known
cases that nevertheless represent interesting proposals in the eld of drug addiction
treatment based on medicinal plant based assisted therapy.
MATERIALS AND METHODS
For the purpose of this article we have considered a small number of plants hailing
from South, Central and North America. Medicinal practices are considered traditional
when consumed in the country and culture of origin and become complementary
and alternative when transferred to other contexts (Gureje et al., 2015). This is the
case of most of the medicinal plants and practices, which, beyond the country of
origin, are used in the treatment of addiction both in the original and in western
contexts. This overview is centered on innovative initiatives, which can come from
individuals or institutions, regarding the use of plants and herbal preparations in
the treatment of addiction. The authors belong to the Takiwasi Center, a pioneer
experience in the use of Ayahuasca for the treatment of substance use disorders and
mental health problems (Mabit & González, 2013; Horák et al., 2014; Berlowitz et
al., 2018). Just as Takiwasi is a pilot experimental project with a high component of
innovation, in the same way other similar experiences were investigated, which are
bearers of innovation, beyond the clinically relevant results that in some cases may
not be available yet.
The present research has been carried out mostly by interviewing one the founder
of Takiwasi Center and co-author JM, by recalling his knowledge, contacts and
experiences on drug addiction treatment centers focused on the use of traditional
plant medicine at a global scale. In some cases, such centers were contacted again
(mainly by e-mail) to rene, amplify or conrm the overall acquired information.
Data concerning Takiwasi Center were acquired mostly through unstructured
interviews with different personnel from the therapeutic team including medical
doctors, traditional healers, and psychotherapists. The internal library, which presents
a huge amount of information and rst-hand research data about Takiwasi organized
mostly as nal year master thesis or PhD thesis, was also consulted. Finally, scientic
literature and internet searches were also used to complete the overall information
acquired during the research.

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The information presented refers mainly to the use of medicinal plants in the treatment
protocols of each center and to the general interaction of different therapeutic
practices. This has been done to put in evidence the great value of a transcultural
therapeutic approach and the inner evolutionary component of traditional and
complementary medicines.
RESULTS AND DISCUSSION
Ayahuasca-assisted treatment
- Takiwasi Center
The Takiwasi Center in Tarapoto, Peru, has been working for 25 years for the
treatment of people confronting problems of drug addiction and mental health
through the use of Traditional Amazonian Medicine (TAM), acting as a therapeutic
community recognized by the national health authority to which must give account,
as dened by the Peruvian Law Nº 29765. Takiwasi has been the rst center to use
TAM in the treatment of addiction. The Center was founded in 1992 after 6 years of
preliminary research centered in the active observation of the work of Amazonian
healers (shamans), especially regarding the ritualized use of medicinal plants for the
treatment of coca paste, cannabis, cocaine and alcohol consumers. In the treatment
protocol elaborated, ayahuasca1 plays a fundamental role, associated with the ritual use
of many other plants and inspired by the ancestral practices of the Peruvian Amazon
such as purges, diets, plant baths, suctions, exhalations, etc. These resources are
inserted in a dynamic that includes a psycho-therapeutic accompaniment and living
together within a community of residents. This innovative approach is generating
growing interest in scientic community (Brierley & Davidson, 2012) and is seeking
validation through the implementation of an international research named Ayahuasca
Treatment Outcome Project (ATOP); this is a multi-site research with sub-projects in
South America (Mexico, Brazil, Peru), aimed at the evaluation of the effectiveness
of ayahuasca-assisted treatment for alcohol and drug dependence. This approach
rmly places the project in the broader context of efforts to integrate traditional
medicine and complementary and alternative medicine with the Western approaches
to health care.
1 A psychoactive brew of ancestral origins used by the indigenous tribes of the Amazon and composed of the
ayahuasca vine (Banisteriopsis caapi) and a complement plant (most often Psychotria viridis).

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Apart from Ayahuasca, which is considered to be on the top of the plant hierarchy
according to Amazonian cosmovision and which is gaining attention within the
scientic community (Hamill et al., 2018; Nunes et al., 2016), several other herbal
medicines are used in the therapeutic protocol of Takiwasi. The plants used at
Takiwasi can be divided into different groups, according to their effects and purpose:
1. Emetic plants: used in ritual context they permit not only physical but also
emotional and spiritual cleansing with each plant acting on a precise somatic
zone having its symbolic correspondence. Besides their general purifying
and detox effect, each plant centers its effect on certain organs, corporal
regions or physiologic systems. Thus, we can nd: Rosa Sisa (Tagetes
erecta) used to clean up nerve and the mind from excessive rationalization;
Azucena (Lilium spp.) useful for sexual cleanse and balance; Verbena
(Verbena spp.) that works on the liver and the anger condensed in it; Sauco
(Sambucus peruviana) used to clean up the respiratory system; and Yawar
Panga (Aristolochia didyma) for a complete cleanup. Yawar Panga proves to
be very useful particularly in the rst detoxication phase of the treatment
for drug addiction. Its emetic properties, and cathartic to a lesser degree,
make it an excellent means of purication. It especially allows patients to
disable the withdrawal syndrome, both in its physical and psychological
aspects, especially anxiety (Mabit, 2014).
2. Adjuvants or containment plants: these plants are given to addict patients on
a daily basis to gradually prepare them, physically and psychically, for the
ayahuasca sessions and the diets. They work on the regulation of the nervous
system and metabolism in general and have a gentle effect of detoxication.
Among them the main ones are Camalonga (Strychnus spp.) and Mucura
(Petiveria alliacea), which are excellent protectors and puriers also on an
energetic level. Some of the diet plants are also consumed in this context,
although the mode of preparation and administration is different.
3. Master plants: used during specic ritual ceremonies, they can provide
psychotropic experiences. Apart from ayahuasca, tobacco (Nicotiana rustica)
and coca (Erythroxylum coca) are also used in extract form to allow the
detoxication of individuals addicted to their modern, addictive derivatives.
They are known as “master plants” due to their ability to activate certain

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psychical functions (concentration, stimulation of the memory, capacity to
make decisions, etc.) that the patient perceives as revelations or “teachings”.
4. Diet plants: the ingestion of these plants takes place in a ritualized context
and is accompanied by a series of physical and psychical restrictions (dietary
and behavioral rules, isolation, etc.). For drug addict patients, the therapeutic
practice of the “dieta” (diet) with the consequent intake of diet plants can be
very useful to integrate the experiences lived during the weekly session of
ayahuasca and to gain awareness on the hidden causes that have originated
their emotional, existential or spiritual problems that led them to drug
consumption. According to the personal evaluation of the individual made
by the therapeutic team, the patient can be given: Ushpawasha sanango
(Tabernaemontana undulate), that works on the “memory of the heart”, to
metabolize memories of emotional importance and regain balance; Chiric
Sanango (Brunfelsia grandiora) that helps increase self-condence and lose
fears towards the outside world; Ajo Sacha (Mansoa alliacea) that strengthens
will and decision-making; Chuchuwasha (Maytenus macrocarpa) that teaches
righteousness and heal transgenerational wounds; Bobinzana (Calliandra
angustifolia) that enhances rooting and emotional stability; Uchusanango
(Tabernaemontana sananho) that teaches righteousness and humbleness.
5. Bath plants: these are aromatic and relaxing herbs and owers used for
energetic cleansing. This is a necessary step before the Ayahuasca session
and a useful tool of the treatment protocol. This category includes Toé
(Brugmansia suaveolens), Hierba Luisa (Cymbopogon citratus), Ruda (Ruta
graveolens) and Wachuma (Echinopsis pachanoi).
6. Sauna plants like Ajo Sacha, Eucalipto (Eucalyptus globulus labill) and
Ruda are essentially used for initial detoxication and to reduce withdrawal
syndrome.
7. Refreshing plants, called frescos are used in response to an inammation,
especially after taking ayahuasca. These include Lancetilla (Commelina
diffusa), Llantén (Plantago major), Malva (Malva sylvestris) and Albahaca
(Ocimum basilicum). These plants can be used in raw preparation, for
example crushed in cold water, to be ingested or for head baths.

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It is worthy to note that the majority of these plants which come from the traditional
Amazonian pharmacopoeia are still poorly studied using modern scientic
approaches, especially within the context of drug addiction treatment. The
innovative and pioneering use of medicinal plants has led Takiwasi to become an
international reference and many government institutions from Latin America have
been getting in contact with the center for years to try and set up similar proposals
for the treatment of addiction in their countries. In this sense a joint proposal with
Ecuador’s CONSEP (National Council for the Control of Narcotic and Psychotropic
Substances) reached an advanced stage. Other contacts were made with the National
Council for Narcotics Control (CONACE) of Chile, the National Anti-Drug Ofce
(ONA) of Venezuela and the National Council on Drug Policies (CONAD) of Brazil.
This shows the interest in complementary and traditional medicine, although also the
lack of political stability has prevented the proposals from transforming into more
concrete actions.
The use of herbal medicines goes along with psychotherapeutic accompaniment,
spiritual awakening and a marked ritual framework, being rituals a fundamental
component of the overall activities during the treatment, other than necessary to
unleash the healing power of the plants. The results of the treatment based on an
internal evaluation (Giove, 2002) and on external researches (Denys, 2013) are
promising: the study conducted by Rosa Giove on about 200 ex-patients showed
a recovery rate of 54%, which reaches 67% considering only the patients who
completed the whole treatment; while the interviews based on the Addiction
Severity Index (ASI) conducted on 15 ex-patients by Anne Denys concluded that
there had been a perception of major improvement in the overall status of 53% of
the participants, minor improvement in 33% of the cases, and status unchanged in
14% of the ex-patients interviewed. Studies on Takiwasi’s treatment protocol are
constantly being undertaken (Berlowitz et al., 2018; O’Shaughnessy, 2017) and the
ongoing ATOP research project aims at a more detailed evaluation of its efcacy.
- El Emilio
El Emilio Foundation (http://www.elemilio.org.ar/) is located in Cosquín, Argentina,
and works since more than 20 years in the treatment of addictive behaviors associated
with legal and illegal drugs consumption. Professor César Rabbat is the founder and
director of the center which counts on the authorization from the local Ministry of

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Health. The protocol is inspired on the philosophy of native peoples of the region
(Comechingones and Sanavirones) and the use of ayahuasca and medicinal plants
from the Cordoba highlands, such as Suico (Tagetes minuta) and Palo amarillo
(Aloysia gratissima), mixed together with a combination of spirituality, healthy
diet, natural environment, physical activity, yoga, meditation, individual, group and
family therapy (Rabbat, 2017). The main objective of the protocol is to promote the
integration of the classic therapeutic community with natural and cultural alternatives
for the prevention and approach of addiction. Similarly to Takiwasi, also in this case
the treatment model consider the integration of traditional herbal medicine, Western
psychotherapy and oriental practices oriented at mental wellbeing, thus creating
a bridge between ancestral wisdom and modern world, in which the exchange of
knowledge is mutual and productive.
- Encamino
Encamino (www.encamino1320.org) is a non-prot association located in Uruguay
and directed by clinical psychologist Daniel Lapunov. The project is the result of
several years of research and practical work in different organizations dedicated
to the treatment of addictions in Uruguay. The therapeutic team is made up of
professionals specialized in psychic health and addiction treatment. In the clinical
approach of the association, modern psychology is combined with ancestral
knowledge such as Chinese medicine and traditional Amazonian medicine of Peru,
homeopathy and phytomedicine. Ambulatory care is provided through group therapy
and individual psychotherapy. In group therapy, the work is focused on the three
sorrows of addiction, as mentioned by Lapunov: the setting, the companions of
consumption and the character that they have created (Lapunov, 2008). A weekly
session of Chinese medicine (acupuncture) is also offered, while phytomedicine is
used to face symptoms such as depression and anxiety. In this case the patients are
administered medicinal plants from Uruguay in the form of extracts. Some of the
plants used are Melisa (Melissa ofcinalis), Pasiora (Passiora incarnata) and
Valeriana (Valeriana ofcinalis). The association also offers a temporary inpatient
treatment protocol through retreats in the Peruvian Amazon made in coordination
with the Situlli center, Tarapoto (www.centrositulli.com). In these retreats a work is
carried out in conjunction with vegetalista doctors with the objective of achieving a
physical and psychic detoxication through the intake of plants from the Peruvian
Amazon. The work with plants that expand consciousness, such as Ayahuasca,

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allows the reconstruction of the personality of the individuals and facilitates the
meeting and reconnection with their own essence and their true identity.
- Nierika A.C.
Nierika (www.nierika.info) is a non-prot multidisciplinary association established
in Mexico that aims to preserve the indigenous knowledge and traditions linked to the
ceremonial use of sacred plants with therapeutic and spiritual purposes. The center
receives residential and ambulatory patients and is run by Armando Loizaga Pazzi,
psychologist and specialist in addictions, and Anja Loizaga-Velder, psychologist
specialized in humanistic and transpersonal psychology and ethnopsychotherapy.
Armando Loizaga has worked in the eld of treatment and prevention of addictions
in Mexico since 1991. He was director and coordinator of several clinical programs
that considered the management of addictions from the cognitive-behavioral
perspective. He has also collaborated with traditional medicine organizations in the
study of cross-cultural treatments and worked as psychologist at Takiwasi in 1997-
1998. Based on this experience, he has started to study the therapeutic potential
of Ayahuasca in the treatment of addictions and founded Nierika. Anya Loizaga-
Velder has studied and collaborated with traditional doctors for more than twenty
years. She also wrote her master’s thesis, PhD thesis and several articles on the
use of Ayahuasca for the treatment of addictions (Loizaga-Velder, 2012). Nierika, is
participating together with the Takiwasi Center in the project ATOP.
- Centro Savia Terra
Savia Terra (https://www.saviaterra.com/) is a therapeutic center located in Santiago,
Chile, focused on detoxication, personal growth and human development. The
center promotes a model which draws on the millennial wisdom and knowledge
of indigenous ancestral traditions and on the scientic methods of medical and
psychotherapeutic treatments. Ambulatory treatment for depression, stress and
addictions is offered. The program includes: individual and group psychotherapy,
therapeutic hypnosis, diets and purges of purication, detoxication and revitalization
with Amazonian medicinal plants, including Ayahuasca, shamanic healing rituals
and complementary therapies.

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- Centro Boliviano de Solidaridad VIDA
Centro Boliviano de Solidaridad VIDA has been dedicating for 25 years to the
rehabilitation of people with addictive behaviors and is currently the only therapeutic
community in Bolivia that uses medicinal plants. It has a team of psychiatrists,
psychologists, addiction therapists, amautas (teachers) and shamans. Like most
of the therapeutic communities of South America in its beginnings it was greatly
inuenced by the Italian therapeutic model “Progetto Uomo” (The Human Project),
where shock therapy was central, and shouting was used to implement it. This model
has changed very little in most of Bolivian rehabilitation institutions, with very low
success rates (12% / 15%). In an effort to improve these frustrating statistics and with
the desire of incorporating a broader perspective regarding the problem of addiction,
VIDA begun to experiment with other types of approaches incorporating techniques
such as Zen meditation, Thai Chi and ancestral Andean rituals. Finally, a couple of
years ago the center incorporated ancestral medicinal plants such as ayahuasca, San
Pedro, tobacco and since August 2017 also ibogaine. All of them are administered
according to the Amazonian Andean rituals except ibogaine. The representatives of
the center consider that the greatest contribution of the incorporation of the Andean
philosophy is to give back to the patients a sense of pride and respect towards their
ancestors. The most notorious difference observed by therapists since this holistic
model began to be applied is the number of patients who complete the process
and reintegrate themselves into society. There is no scientic literature or studies
conducted so far that can support what has been reported by VIDA’s staff.
- IDEAA
The Brazilian Instituto de Etnopsicología Amazónica Aplicada – IDEAA has been
created by Spanish psychiatrist Josep Maria Fábregas (Labate et al., 2009). IDEAA
combines therapeutic techniques derived from Amerindian shamanic traditions,
Santo Daime religion, schools of Gestalt therapy and humanistic and transpersonal
psychology. IDEAA treats mainly with dependency problems but can also receive
patients with other disorders of a psychological and physical nature. The Institute’s
therapists and patients live together in a small community group. The therapeutic
program includes manual work, ayahuasca sessions and experience integration group
sessions. The main objective of IDEAA is to engage the individual in a process of
introspection and self-knowledge. In this sense, the program also includes individual

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sessions with ayahuasca, as well as oriental contemplative practices, such as Zen
Meditation and Yoga.
- Associação Benecente Luz de Salomão
The association ABLUSA, led by psychiatrist Wilson Gonzaga, has been using
Ayahuasca since 1999 in rituals specically aimed at street dwellers of the city of São
Paulo, Brazil, in order to help them improve their life quality (Mercante, 2009). The
participants in ABLUSA ayahuasca rituals are mainly alcoholics and crack addicts,
and the visions experienced during the ceremonies help them identify their problems
and consider making changes in their habits. The concept behind ABLUSA treatment
proposal is to take care of the human being as a whole, in a holistic way, while seeking
to put in evidence the deepest causes that lie behind the emergence of these addictive
processes. Also, the proposal of spirituality, which is linked to the Ayahuasca rituals,
is almost always very welcomed among these patients, thus resulting in positive
outcomes in terms of recovery (Gonzaga, 2012). Another initiative has been put in
place by Wilson Gonzaga since 2008 when he started providing psychiatric care in
the public health network of three municipalities, as well as riverside communities,
in the Manaus region. He later created a boat clinic to take patients to the Amazon
to try a different treatment proposal: healing through immersion in the nature and
traditional medicines, including ayahuasca.
- The Recovery Center Caminho de Luz
Caminho de Luz (http://casacaminhodeluz.org.br/) is a non-prot institution co-
founded by José Muniz de Oliveira in 2001 in Rio Branco, Brazil. It aims to recover
and reintroduce alcohol and other drug dependents in the society with the use of
ayahuasca in spiritual sessions (Mercante, 2013). This work is carried out through
participation in mutual aid meetings, individual attendance, practice of spirituality,
educational, recreational, work, and activities, among others. It is constituted by two
distinct institutions: the residential house itself, where the people are being treated,
and the “community” that welcome people who couldn’t return home after the end
of their treatment, such as former homeless. The treatment is based entirely on the
Vegetal, the local denomination of ayahuasca. As soon as they reach the center, the
patients start taking three daily doses of the brew for detoxication: in the morning,
after lunch and at dusk.

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- The Spiritual Center Céu da Nova Vida
Céu da Nova Vida (http://www.ceudanovavida.com.br/) is located in the State of
Paraná, Brazil. It is directed by Father André Volpe Neto, a former patient of the
center Céu Sagrado (Holy Heaven), another Brazilian center that treats drug addicts
through Ayahuasca and is linked to the Santo Daime Church (Mercante, 2013). Santo
Daime is a Brazilian ayahuasca religion founded by Raimundo Irineu Serrain in
the early 1930s in the State of Acre. Members of Santo Daime, called “daimistas”,
consider ayahuasca a medicinal sacrament. It has been observed that in Santo
Daime, especially in the line of Father Sebastião, the abusive consumption of illicit
psychoactive substances and alcohol is not tolerated. In general, most “daimistas” do
not drink and there is a kind of general perception that “Daime cures dependence on
drugs and alcohol” (Labate et al., 2009).
A substantial difference between the Brazilian centers observed and other mentioned
experiences like Takiwasi or El Emilio lies on the fact that the latter use a variety
of plant medicines in the treatment protocol, while Brazilian centers mostly only
focus on ayahuasca. This seems due to the fact that these centers emanate from the
main Brazilian ayahuasca churches: Santo Daime, União do Vegetal and Barquinha.
These therapeutic communities were created after one of the rst studies performed
(Callaway et al.,1994) showed how many practitioners had abandoned the use of
alcohol and other drugs, such as cocaine, as a consequence of their participation in
Ayahuasca rituals (Grob et al., 1996). These ndings have been conrmed by later
studies (Halpern et al., 2008). Also, a study conducted on adolescents belonging to
a Brazilian Ayahuasca church concluded that ayahuasca was a factor of protection
against the consumption of alcohol (Doering-Silveira et al., 2005a).
In Brazil we could observe the original experience as well represented by the
alternative project of rehabilitation of inmates promoted by the NGO Acuda
(Associação Cultural e de Desenvolvimento do Apenado e Egresso) that includes
the intake of ayahuasca (Duarte Bomm, 2016; Romero, 2015). The president of
Acuda, Luiz Marques, being a disciple of the Chilean psychiatrist Claudio Naranjo,
had the idea to incorporate the use of this sacred brew into the therapeutic process
of resocialization of inmates. This project is developed with the authorization of the
local justice authorities. Many of the inmates are or have been addicted to substances
and from this experience a Center called “Chácara Divina Luz” has also been created.

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Among its activities the center includes treatment addressed to ex-inmates suffering
from chemical dependency, but cares are available also to the whole community in
general.
The potential of Wachuma
The plant named by Catholics as San Pedro was originally known among indigenous
populations as Wachuma or Huachuma (Echinopsis pachanoi). This cactus, that
belongs to the same family of peyote, grows in the Andes, in Southern Ecuador, Peru,
Bolivia and in some areas of Argentina and Chile. Its main psychoactive component
is mescaline. For centuries, throughout the coast and highlands of northern Peru,
healers have been holding night sessions, called Mesas con San Pedro (Tables with
San Pedro), in which both the healer and the patients ingest wachuma (Dobkin de
Rios, 1979). A recent study was dedicated to verifying the therapeutic properties
of this traditional Peruvian medicine procedure as performed by the healer Marcos
Carbajal (Reyna Pinedo et al., 2010). The use of wachuma in the treatment of drug-
addiction is conned to few experiences and initiatives that employ it in combination
with other therapeutic techniques.
- Runa Wasi
An interdisciplinary group of professionals led by psychologist Sacha Domenech
founded in 2001 the civil association Runa Wasi (http://runawasi.blogspot.pe/), in
Buenos Aires, Argentina. The initiative follows the experience of the community
Ayllu Tinkuy created in the 90s by Domenech (1996), who has been trained as
socio-therapeutic operator in therapeutic communities by the “Progetto Uomo”,
and as practitioner of traditional Peruvian medicine.
In Runa Wasi, outpatient addiction and HIV treatment are offered, based on three
main axes:
1) Verbal and academic psychotherapy that prefers an existential, gestalt and
transpersonal approach rather than psychoanalytic. This is developed in weekly
therapeutic sessions;
2) Individual and group corporal psychotherapy workshops;
3) Individual and group ceremonies with purgative plants (Tobacco);

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Apart from this, ayahuasca and wachuma ceremonies are also offered. in the case of
wachuma, a Temazcal ceremony is also carried out, prior to the intake. According to
Domenech, both ayahuasca and wachuma are plants that catalyze and enhance the
patients’ therapeutic process, giving a more dynamic sense to the latter. Wachuma
particularly is a plant that works in the very deep affective level of the patient’s
relationship frame. Runa Wasi currently counts with a team of eight therapists,
therapeutic companions and one psychiatrist for emergency cases. Approximately
between 80 to 100 patients per week are attended, 30% of which are addicts
consisting mainly of adults, aged between 30 and 35 years old, with polydrug use,
including alcohol, cocaine, designer drugs and marijuana. Usually these patients
have tried before a conventional treatment in their search for cure and well-being,
before resorting to Runa Wasi.
- Agustin Guzmán
A personal initiative that doesn’t receive formal support by the authorities is that of
Agustín Guzmán in Peru. 25 years ago, Guzmán began researching and experimenting
with the medicinal properties of Wachuma, thus discovering its anti-depressive
properties (Guzmán, 2012). Being an alcoholic himself, Guzmán was treated of
his illness after taking wachuma and later he was formed as healer and started to
treat alcoholics. He uses wachuma combined with hot springs to treat depression,
HIV, addictions to alcohol, cocaine and other drugs. Guzmán administers wachuma
in two different modalities. The rst one is the most common and consists of an
intake of approx. 250 ml of wachuma that places the person in a state of trance
that lasts approximately 12 hours. During this phase to combat the chills that the
person often feels, they are immersed in a pool with thermo-medicinal water, at a
temperature of 35 degrees. Guzmán’s treatment is normally carried out at an altitude
of 3,000 meters or more. After several intakes of Wachuma, the Temazcal ceremony
is also incorporated in the process to continue the detoxication. The whole therapy
normally lasts one month. The other way to administer wachuma as suggested by
Guzmán is to ingest a spoonful of the extract of the plant diluted with water every
night before going to sleep. This process is slower and can be done by the patient at
home. After a week some changes starts to be noticed, especially during the oneiric
state in which unsolved negative experiences from the past begin to emerge to be
unraveled.

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Coca leaf to treat cocaine addiction
Another sacred plant of the native people of South America could be used to treat
modern drug addiction. An empirical observation gives account of the Coca leaf
chewing as therapy for cocaine addiction treatment, as suggested by Jorge Hurtado
(2000). Hurtado is a Bolivian psychiatrist that has conducted several studied between
the 80’s and 90’s and later from 1995 until 2005 by giving to cocaine paste addict
patients, candies prepared with coca leaves. These special candies were supposed
to facilitate the task of ingesting coca in its natural form, since chewing coca leaves
requires a technique and patience that not everyone has. According to Hurtado
thanks to the coca leaves 30% of the patients showed improvement in their mental
state and their social adaptation after only 12 months of treatment and he presented
these results at the International Forum on Coca Leaf, held in Popayán, Colombia,
in August 2016. A similar approach has been proposed by the controversial Peruvian
psychiatrist Teobaldo Llosa, who recommends the use of coca leaves for the
treatment of cocaine addicts. Its treatment is known as “substitution of consumption”
or “cocalization therapy” (Llosa & Chang-Fung, 2007; Llosa, 2010) and consists in
the ingestion of capsules of coca our (or variations), with or without the addition of
alkaline substances, accompanied by a cup of coca tea, prepared with one or two bags
in boiled water. In the Takiwasi Center, coca is used as well, this time in its medicinal
extract form as a diet plant given to drug addicts during the dieta, as it reduces the
withdrawal syndrome, restores normal sleep and increases dream activity.
Native American Church and the incorporation of Peyote
Native Americans have been struggling with alcohol abuse disorders and other
dependencies for centuries, since their encounter with the western world (Prue,
2013). To respond to this dening problem ve overlapping movements have
provided a framework for alcoholism recovery within and across Native American
tribal cultures from the 18th and 19th centuries. The leaders of these movements like
the Delaware Prophets, the Shawnee Prophet and the Kickapoo Prophet, having
experienced their own recovery path from alcoholism, were inspired on a return
to ancestral traditions to face this problem. As consequence, new abstinence-based
Native religions were formed in the 19th century, including the Native American
Church (White, 2000). These religions constitute the most enduring frameworks for
alcoholism recovery within Native communities. Native American Church members
currently use peyote in their church services.

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The peyote religion possesses several attributes that make it particularly suitable as a
treatment for the multiple social and psychological problems of the Indian alcoholic
(Albaugh & Anderson, 1974). Although Indians in central and northern Mexico have
ingested it for different purposes for thousands of years, only in the last century the
use of peyote spread to tribes throughout North America in the form of rituals of
the Native American Church. The avowed purpose of participation in the Peyote
Cult is to allay physical and mental distress and to combat alcoholism by enhancing
health and strength through communication with the spiritual level made accessible
by the ritual context. The success of the Native American Church in rehabilitating
Amerindians from alcohol and opiate dependence and the safety of ritual peyote use
have been attested by experienced clinicians (Jilek, 1994).
John Halpern (Webb, 2011) is another researcher on the subject that has been able to
verify that peyote is benecial in the treatment of alcoholism and drug abuse among
American Indians, adding that setting is also crucial to the effective use of peyote.
An experience that comfort Halpern’s research is that of the Na’nizhoozhi Center,
a substance-abuse clinic located in Gallup, New Mexico, whose patients are almost
entirely Native Americans. The center offers conventional therapies and programs
such as Alcoholics Anonymous, as well as different traditional Indian healing
ceremonies. Peyote is not given to patients during on-site church sessions, but staff
members encourage clients to participate in regular peyote ceremonies once they
leave the clinic. Interestingly, the clinic’s internal records indicate that those who
participate in Indian healing ceremonies have better treatment outcomes than those
who have participated in Alcoholics Anonymous (Horgan & Tzar, 2003), although
there’s still no ofcial publication on the subject.
Research on Salvia divinorum and SUD
Salvia divinorum is another Latin American sacred plant with potential to be used
in the treatment of addiction. An expert on the subject is Ana Maqueda, research
assistant and PhD candidate, Sant Pau Institute of Biomedical Research, Department
of Pharmacology, Therapeutic and Toxicology. She is also founder and director of Xka
Pastora, in Mexico. Xka Pastora (http://xkapastora.org/) is a non-prot organization
dedicated to promoting the further study and research of S. divinorum, whilst also
striving to integrate its traditional therapeutic uses into western medicine. This plant
is endemic to the Sierra Madre Oriental of Oaxaca, Mexico, and member of the

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Lamiaceae family. The rst scientic report about the existence of the plant appeared
in 1939, though the native inhabitants of the area, the Mazatec people, have been
using the leaves of S. divinorum for its medicinal and psychoactive properties for
centuries (Maqueda, 2017). In the indigenous Mazatecs language the plant is known
as Xka Pastora. Mazatec traditional doctors use S. divinorum for the treatment of
arthritis, inammations, headaches, gastrointestinal problems, bacterial infections,
addictions, and as a general revitalizing tonic. They consume the fresh leaves of
the plant by chewing them and apply them as a cataplasm. Mazatec healers also do
ceremonies with the leaves for its psychoactive properties, as a mean of modify their
state of consciousness and thus be able to diagnose and treat mental and spiritual
problems.
Currently, it is possible to nd in the scientic literature pre-clinical evidences
suggesting anti-addictive effects of S. divinorum at pharmacological level (dos
Santos et al., 2014). Salvinorin A, opioid receptor agonist extracted from S.
divinorum, has been identied as a potential therapy for drug abuse and addiction,
having demonstrated anti-addiction effects by attenuating dopamine release and
dopaminergic activation, sensitization, and other neurochemical and behavioral
alterations associated with acute and prolonged self-administration of addictive
drugs (Kivell et al., 2014). In some ways we can say that S. divinorum could function
as a punisher of drug self-administration, although, as far as we know, there are no
studies yet regarding the therapeutic usage of Salvinorin A on humans.
Research on psilocybin and SUD
Psilocybin (4-phosphoryloxy-N, N-dimethyltryptamine) is the major psychoactive
alkaloid of some species of mushrooms traditionally used by the indigenous
populations of Mexico in religious ceremonies to bring about visions and noesis, or
divine knowledge (Letcher, 2007). Though we have no knowledge about registered
care centers that use it as alternative therapy for drug addiction, it may provide a
new treatment option for substance use disorder patients, given the benecial results
observed in recent clinical and pharmacological studies. Nichols et al. (2016)
conducted studies to quantify acute effects of psilocybin in alcohol-dependent
participants and to provide preliminary outcome and safety data, while other teams
of researchers (Thomas, Malcolm, & Lastra, 2017; de Veen et al., 2017; Bogenschutz
et al., 2015) have analyzed the pharmacological structure and clinical adaptability,

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getting to the conclusion that psilocybin has a low risk of toxicity and dependence
and can be used safely under controlled clinical conditions. Large effects related
to depression and anxiety symptoms resistant to conventional therapies were also
observed. Psilocybin is considered to have the potential to reduce alcohol or tobacco
use and increase abstinence rates in addiction. Psilocybin-assisted therapy appears
promising, so that there are valid reasons to further investigate the therapeutic
efcacy and safety of psilocybin as a potential SUD treatment.
CONCLUSION
Traditional medicinal practices that involve the use of herbal therapy indicate to be
an interesting eld of research if we consider all the studies that are being carried
out and the promising anecdotal results in terms of effectiveness in the treatment of
drug abuse disorders observed in some centers. Still, we observe the need for more
scientic research on the data recorded by each center/experience and consequent
validation through publication, taking into consideration the difculties that may
arise in bridging together traditional and modern concepts of efcacy (Gone, 2012).
In this aspect, Takiwasi thanks to its more developed organizational structure, is
one of the fewest centers that can show concrete results, although preliminary, as
mentioned above. The positive outcomes claimed by these initiatives stands in
opposition to the poor results of conventional treatments in the face of this serious
issue that is now affecting people worldwide. The use of these resources could
contribute enormously to the elaboration of new approaches to the problem. Pioneer
and intercultural experiences come from every corner of the world and are carriers
of hope for a great number of people that are looking for a new and effective answer
to their cry for help.
By going beyond their country of origin and being transferred and adapted to other
contexts these traditional herbal medicines have converted into complementary
practices, and the main characteristic of their application is to be performed in
articulation with other therapeutic practices, such as Yoga, Zen meditation and
Western psychotherapy, for instance. This reminds us that when a traditional
medicine is alive, it can progressively evolve including elements from other cultures,
as it happened for example with the Amazonian rituals which over the centuries have
incorporated habits from the Catholic tradition such as prayers, saints and hymns
(Mabit, 2018). The experiences of different centers such as, El Emilio, Runa Wasi,

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Encamino, VIDA and Takiwasi indicate that the interactions of multiple therapies
within the concept of medical pluralism can greatly benet the patients’ treatment
outcome and we consider they are showing a path to follow as new reference models
in the global search for mental wellness and good living.
All herbal therapies used or with potential to treat drug addiction come from an
ancestral knowledge linked to the ritual use of psychoactive plants, rituality often
considered as a mandatory aspect to be taken into account for the therapy to be
effective. The induction of modied states of consciousness within a ritual framework
(with the use of tools such as plants, chants, drums, isolation, fasting, etc.) is then
crucial to understand the effectiveness of a treatment, as in the case of the Ayahuasca
ritual that plays a key therapeutic role, being a space in which somatic, symbolic and
collective dimensions are blended (Talin & Sanabria, 2017).
The popular use of traditional medicine, including sacred plants, to treat addiction
problems is widespread in the Americas and most of the centers mentioned have
been created as a consequence of the observation of this use and its efcacy, which
has also been conrmed by several academic studies, as in the case of Ayahuasca.
According to Takiwasi’s experience, one of the key aspects that pushes people to
undertake a treatment is taking awareness of their underlying problem, process that
often starts after an experience with psychoactive plants in a ritual context. This
massive resorting to traditional healing methods stands in opposition to the general
rejection of conventional treatments which seems to be unsatisfactory, both in terms
of quality, number of people reached and outcome results.
We can also observe cases in which the personal experience of an individual going
through issues of drug abuse or alcoholism and getting cured by a natural element
such as a plant, has led the very same person to set out on important discoveries
or initiatives. Unfortunately, the lack of ofcial support from the authorities
considerably limits the signicance, the extent of the research and the dissemination
of the results of these encouraging experiences. It is striking to observe that most of
these psychoactive plants or their derivatives are generally considered illicit drugs
in developed countries and, in some cases, they can even become drugs of abuse
once decontextualized from the original ways of use. This clearly indicates that the
problem does not lie in the plants themselves, but has to do with the people, i.e.
culture, and their way of approaching them.

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On one side, we have observed several centers and experiences that use herbal
medicines in their treatment protocol while following at the same time the guidelines
transmitted by the traditional knowledge where this use has originated, especially
focusing on ritual and spiritual aspects. This is mainly the case of ayahuasca that is
used in religious or therapeutic environments. On the other side we have observed
as well that a huge number of scientic studies on plants such as S. divinorum
and psilocybin mushrooms, instead of leading to the creation of treatment centers
inspired by their traditional uses, seems to point at extracting the primary alkaloids
or molecules of interest for the pharmaceutical industry to produce conventional
medicines. In doing so, they leave completely aside the ancestral norms of use and
ritual context, despite the fact that this seems a necessary aspect to be taken into
account for the medicine and the treatment to be effective and safe. Another example
in this sense is that of Iboga, which, together with its alkaloid ibogaine, is the plant
that has been studied for the longest time for its anti-addiction properties reported by
many researchers, including Roman Paskulin (Goutarel, 1992; Paskulin et al., 2006;
Brown, 2018). A chapter on this plant and its use in the treatment of addictions will be
dedicated in the second part of the present article. There are still new elds that need
to be explored in deep, as in the case of Chinese herbal medicines (Lu et al., 2009),
the 100 hundred herbs detoxifying complex formula of the Buddhist Monastery
Tham Krabok which remains unknown (Mabit, 1993), or the “Diet plants” used by
the Takiwasi Center, for instance. Although the latter are supported by a thousand-
years-old traditional use they are still largely unstudied by the scientic community,
that seems to prefer, for example, focusing on trying to produce a prescription drug
from ibogaine still 50 years after its discovery.
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