FOUR
Ayahuasca
Teacher Plant
Substance: Ayahuasca, aka yagé or hoasca
Active Compound(s): N,N-dimethyltryptamine and Banisteriopsis caapi as a monoamine oxidase inhibitor (MAOI)
Schedule: I*23
Sharing Ideas with a Pioneering Researcher
My first interview about ayahuasca is with Dr. Charlie Grob, with whom we talked in chapters 2 and 3 about his work on MDMA and psilocybin. As I mentioned in those chapters, I had the privilege of first meeting Charlie Grob at my home in the early 1990s, during something called the “Friday night meetings.” These monthly meetings were an opportunity for the very small number of brave researchers in the psychedelic community, from far and wide, to socialize and share ideas. You might think of it as a miniconference. It is a great honor to include the third and final part of his interview.
Hard Science in the Amazon
Charles Grob, MD
Excerpt from November 29, 2011
CHARLES S. GROB, MD, is director of the Division of Child and Adolescent Psychiatry at Harbor-UCLA Medical Center and Professor of Psychiatry and Pediatrics at the UCLA School of Medicine. In the early 1990s he conducted the first government-approved psychobiological research study of MDMA (see chapter 2) and was the principal investigator of an international research project in the Brazilian Amazon studying ayahuasca. He has also completed an investigation of the safety and efficacy of psilocybin treatment in advanced-cancer patients with anxiety and published his findings in the January 2011 issue of the Archives of General Psychiatry (see chapter 3). He is the editor of Hallucinogens: A Reader (2002) and the coeditor (with Roger Walsh) of Higher Wisdom: Eminent Elders Explore the Continuing Impact of Psychedelics (2005). He is a founding board member of the Heffter Research Institute.
Therapeutic Properties of Ayahuasca
RLM: You went down to the Brazilian Amazon and studied ayahuasca. What can you tell us about its potential use in psychotherapy?
Charles Grob, MD (CG): Ayahuasca is a fascinating compound. It’s a decoction*24 of two plants that grow in the Amazon. Nothing happens when either plant is taken by itself, but when the two plants are brewed together and ingested, a very powerful four-hour altered state experience ensues.
I went down to Brazil with my friend and colleague Dennis McKenna, the ethnobotanist who had established a liaison with the União do Vegetal [UDV]—one of the legal Brazilian syncretic ayahuasca churches down there that’s had permission from the government since the mid ‘80s to utilize ayahuasca as a psychoactive sacrament—but only for their religious ceremonies. It’s never used for recreational purposes.
We conducted, in many respects, a state-of-the-art study under very challenging conditions in the Amazon, in the city of Manaus. We had each of the fifteen subjects recruited at random from the UDV. They had to be members for at least ten years. We examined basic physiologic parameters like heart rate, blood pressure, electrocardiogram, and pupillary diameter. We used indwelling intravenous catheters, and we took blood samples out every thirty minutes for pharmacokinetics assessment on and analyses of neuroendocrine secretion. We also did structured psychiatric diagnostic interviews. For the psychiatric assessment, we used matched control populations that had never taken ayahuasca, and then we did diagnostic interviews. I did open-ended life-story interviews. We did neuropsychological testing. We did personality testing. And we got some very interesting results.
First and foremost, the subjects in the ayahuasca religion—part of the UDV—were very high-functioning individuals. They were very impressive. Whereas some of them had significant history of psychopathology prior to their entry into the UDV, it all had appeared to remit. This included severe alcohol and drug addiction. It included severe history of mood disturbance and antisocial behaviors. These individuals, over their time in this religion where they ingested ayahuasca in group ritual context at least twice monthly, had seemingly transformed.
U.S. Supreme Court Rules
Ayahuasca Is Legal for Church Members
RLM: Tell the listeners again what the UDV is.
CG: União do Vegetal translates as Union of the Plants in Portuguese. It’s the name of this religion that came into being approximately sixty years ago. It was founded by a man named Mestre Gabriel, who had interacted with indigenous people in the deep Amazon rainforest in the 1940s while working as a rubber tapper. He discovered the use of ayahuasca, came back to an urban center in eastern Brazil, and developed the structure for a religion that utilized ayahuasca as a psychoactive sacrament. The UDV was illegal from its formation in the early ‘60s until the mid ‘80s, when their use of ayahuasca as a ceremonial sacrament was sanctioned under law.
So it’s legal in Brazil. I should also mention that subsequently a branch of the UDV was established in Santa Fe, New Mexico, and a few other cities around the United States. They were shut down in the late ‘90s by U.S. Customs and the DEA. The UDV filed a formal protest that their freedom of religion rights had been violated, so the case went to federal court in New Mexico. I was the expert medical witness for the UDV, so I was very involved in the case. To my surprise the Republican conservative federal judge ruled on behalf of the UDV, agreeing that their freedom of religion rights had been violated and also that the government had not made a successful case as to the relative dangers of ayahuasca to human users.
The Justice Department appealed the decision, and it went to the panel for the Circuit Court of Appeals in Denver. It ruled two to one in favor of the UDV. Then it was appealed again and went to the full appeals court, which ruled nine to five on behalf of the UDV. Then it was appealed again and went to the full U.S. Supreme Court in February 2006. Chief Justice John Roberts wrote his first decision as Chief Justice, and he wrote for a unanimous majority. Actually, the court voted unanimously to support the defense of the freedom of religion of the UDV. In that case, at least, it was interesting to see that freedom of religion trumps the drug war.
RLM: What are the practical implications of that Supreme Court decision in terms of people being part of that church?
CG: There are only a few hundred members of the UDV in the United States—in Santa Fe and a few other cities—and I believe the decision literally pertains only to the UDV. There is a second ayahuasca religion from Brazil, the Santo Daime, which is in a few places around the country. But the strict interpretation of the original Supreme Court decision is that it simply addresses members of the UDV and is not a blanket sanction for ayahuasca use.*25
Despite Impressive Results, No Research in the United States
RLM: Tell us a bit more about your view on ayahuasca’s potential as a psychotherapeutic agent.
CG: Well, it’s a fascinating compound. I was really impressed when I was down in Brazil. Subsequently I’ve met other people and have interviewed individuals who had led very disreputable lives—had a lot of psychopathology, often with very severe alcohol abuse or drug abuse or serious antisocial behavior—and they had in some way or another found their way to this ayahuasca religion. They started to participate in these group ceremonies and had profound psycho-spiritual epiphanies that led to dramatic transformations of their personality and their conduct. Many of them had gone from functioning on a very marginal level to being pillars of the community.
The UDV members that I met and interacted with in Brazil and in the United States—and I did spend quite a bit of time with them back in the ‘90s and early 2000s—were very impressive individuals.
I felt there was a great potential to utilize ayahuasca as part of a treatment program for severe alcoholism and drug abuse. I should mention that there is one long-standing clinic in the Peruvian Amazon at Tarapoto—the Takiwasi clinic run by a French physician Jacques Mabit—that for some thirty years has been treating Peruvian coca paste addicts. These are individuals who’ve become quite addicted to a commonly distributed form of the coca plant, or an intermediary product between coca and cocaine, that’s highly addictive and in quite widespread use in poor communities in Peru. They’ve had a very interesting and seemingly functional and longstanding treatment center in Peru.
I’ve been hoping for some time that it would be possible to conduct a study along those lines in the United States, but there have been no studies conducted as yet on ayahuasca in the United States. The only studies have been from outside the United States. There have been the Brazilian studies*26 and also some important work coming out of a laboratory at the University of Barcelona in Spain.†7
Also recently there have been some efforts in British Columbia to start an ayahuasca treatment program for drug addiction. However, it seems that at this point in time, those efforts may have stalled out through concern from authorities that this is an unscheduled compound. So the future of that program is still up in the air.
Bottom Line: Funding Needed
RLM: Is the main reason that there has been no research on ayahuasca in the United States a matter of funding or is it still political?
CG: Funding. I think there’s some antipathy toward looking at plant products, and here you have a combination of two different plants—one of which is highly hallucinogenic. There’s been no formal policy decision made. There have only been limited applications to conduct studies, and I’m aware of only one new program that’s going forward from a very reputable academic-based research program that might have some greater level of success. If that’s the case, I think that could open this field up. Even with the regulatory agencies being more or less amenable to approving well-thought-out studies and making sure that sufficient attention is given to safety, funding is your biggest limitation. Studies are fairly pricey, and private moneys are minimal these days.
An Immediate Connection with a Fellow Psychonaut
When the American ethnopharmacologist, research pharmacognosist, lecturer, and author Dennis McKenna came to visit us at Wilbur Hot Springs, California, for the first time, I felt as though a lifelong family member had just dropped in. It was friendship at first sight with the man who had explored the depths of the Amazon and the depths of his mind at one and the same time.
McKenna is a founding board member and the director of ethnopharmacology at the Heffter Research Institute, a nonprofit organization concerned with the investigation of the potential therapeutic uses of psychedelic medicines. I’m grateful to have had a chance to do the following interview with him about his work with ayahuasca.
Plants Meet People
Dennis McKenna, PhD
September 20, 2011
DENNIS MCKENNA, PHD, is an ethnopharmacologist who has studied plant hallucinogens for over forty years. Outside of scientific circles he is best known as the brother of Terence McKenna, a cultural icon in the psychedelic community. Together they are coauthors of The Invisible Landscape: Mind, Hallucinogens, and the I Ching and Psilocybin: Magic Mushroom Grower’s Guide—A Handbook for Psilocybin Enthusiasts. He is also the author of a memoir, Brotherhood of the Screaming Abyss: My Life with Terence McKenna, published in 2012.
A North American in a South American Paradigm
The Scientific Responsibilities of an Ethnobotanist
RLM: Tell us some personal experiences, please. How many times do you think you’ve taken ayahuasca in your lifetime?
Dennis McKenna, PhD (DM): I don’t really keep count—I’ve taken it many times.
RLM: More than one hundred?
DM: I am sure. But I’ve been working with it for thirty years, and for an ethnobotanist working in the field, it’s pretty much impossible not to take it—nor would it even be scientifically responsible not to take it. This is participant observation-type anthropology—if you want to understand how to use it in the indigenous context, you have to get down with the people that are using it and use it with them. You have to look through their lens and join the kinds of realities that it opens up to you. My experience with ayahuasca has been both professional and personal. I went to South America back in the ‘80s as a graduate student at the University of British Columbia with the objective of approaching this in a rigorous fashion—looking at the chemistry and pharmacology of ayahuasca and the plants used to produce it. That was the subject of my thesis.*27
Vomiting: The Safeguard against Overdosing
RLM: Can you overdose on ayahuasca?
DM: It’s difficult to do that. There may be a lethal dose but you’d be hard pressed to consume it. You’ve got your own built-in safeguard, which is that it causes you to vomit. You couldn’t possibly keep down a toxic dose of ayahuasca. These medicines are not toxic to the system. In general, the concern is more about the psychological effect, and that you can control—with the right kind of preparation and the right set and setting. You’re deliberately inducing an altered state. The question is, “What do you do with that state?” That’s where shamanism comes in. They deliberately induce altered states and use that as an opportunity for healing. So that’s what we have to learn from shamanism if we’re going to ever do this right in biomedicine.
Mind-Body Medicine
The Hoasca Study
DM: I spent time in South America. I collected many samples and analyzed those in the lab and published the results. And then, almost ten years later with some other colleagues, I initiated this biomedical study of ayahuasca with one of the Brazilian churches—what’s been called the Hoasca Study. They call it hoasca, not ayahuasca, in Portuguese. This was probably the most extensive study to date on the possible therapeutic uses of ayahuasca. They use it in a religious context, but there is no doubt that many of the volunteers we interviewed felt it was very important in curing them of their dysfunctional issues—usually either alcoholism or other addictions, but other kinds of what you might call “diseases of the spirit” as well. There is no doubt, in that supporting context, that ayahuasca was beneficial for these people.
RLM: It improved their mind-body health?
DM: Virtually all of them in our study section were in a bad place when they joined the church. They would usually join the UDV at the urging of a friend, because they were having domestic problems, or addiction problems, or they were getting into trouble with the law. They were in a dysfunctional place—not a spiritually balanced place. They felt their ayahuasca experience was what saved them, in the context of the church’s supportive environment where there is opportunity for integration and processing of the experience among the members. They often felt that it turned their lives around as long as they stayed on the straight and narrow—which meant taking ayahuasca regularly and staying in the church.
RLM: How regularly?
DM: Their practice is once every two weeks. That’s just how they do it, and that’s probably about right.
RLM: So we’re talking about a therapeutic dose twenty-six times a year roughly to stay on what you call the “straight and narrow.”
Not for Everyone
RLM: I heard something you said, and I saw it underlined in red before me, and that was “processing of the experience after the experience.” That sounded very important when you said it.
DM: It’s very important, and it is an aspect of psychedelic medicine that you don’t get with other medicines, even psychopharmaceuticals. Biomedicine these days is pretty much about psychopharmaceuticals. We have a whole pharmacopoeia of these things. There’s rarely any follow-up.
RLM: “Go home. Take this every single day, and I’ll see you in a month for fifteen minutes.”
DM: You can’t say that with psychedelics. You can’t say, “Take two of these LSD tablets and call me in the morning.” I mean . . . you could say that—and I guarantee you, you’re going to get a call in the morning. But seriously, you cannot separate these substances’ therapeutic use from the context—whether it is a shamanic context, or a psychotherapeutic context, or some combination of those. You have to have a supportive context. Timothy Leary, Ralph Metzner, and the others were absolutely right when they emphasized set and setting. The important thing is that the setting is chosen carefully—that it’s a safe environment where you won’t be distracted. Whether it’s a shaman’s hut in the Amazon, or in a clinic, or on top of a mountain; those are the key variables. It’s also important to be clear about why you are doing it and what you bring to the table. That is set—your intention. Is it therapeutic? Is it just a learning experience? Is it recreational? All of these are legitimate reasons, but it’s important to be clear about the reason for taking it.
RLM: Do we know enough about how to determine who is a candidate for this kind of experience?
DM: If you want to be in an FDA-approved clinical study, then you will be thoroughly screened. They have a protocol to evaluate people before they ever receive the medicine, and if it looks like they have psychological problems or physical problems, there’s a long list of exclusion criteria. By the time a person has cleared all those and is ready to have the trial, you can be reasonably confident that they can handle it, that there are no psychological problems that can’t be dealt with, that they don’t have preexisting psychosis, and that they’re physically able to handle it. That’s the value of clinical studies. They don’t just go into it half-cocked if you will.
Unregulated Mind-Body Medicine Abroad
DM: One of the aspects of ayahuasca that perhaps other psychedelics like psilocybin, for example, don’t bring is very much a sense that it is mind-body medicine. It certainly works on the mind, but it also works on the body, and some of the research with the UDV supports this—you know, it’s good for you. Not only is it good for your head, but it’s good for your immune system, for example.
RLM: Would you say the same thing about LSD?
DM: The work hasn’t been done, but it’s less so. LSD is more cerebral. Ayahuasca gets in there and fixes your body. There is an I-thou relationship set up in the experience. You definitely have a feeling that it is fixing physical problems. In some of the more radical episodes that people have described, the spirit doctors come and open up your chest and take out your heart and work on it and put it back in.*28
RLM: God, you make it sound so good. I wish I could go to Safeway and buy a bunch and just take some tonight.
DN: Well, but then it wouldn’t work! You have to have the shaman and the context.
RLM: The set and the setting.
DM: Ideally, people go to South America and find these healing centers, and they have the experience. That’s probably a good model. The problem with that is now ayahuasca tourism is quite popular, and so they’re not all on the up and up. I mean sometimes the ayahuasca is not good quality. You kind of have to know the ropes down there to know who the good shamans are and which ones are charlatans.
RLM: There’s no FDA for ayahuasca down there?
DM: There’s no FDA regulation of ayahuasca in South America, although there are discussions in Peru that there should be something like a union or a council of ayahuasqueros. If you’re a member of the union then you’re in good standing.*29
RLM: Sure, or maybe eventually there will be consumer reports.
DM: Something like this. There is a need for quality control because now it’s getting so popular that everybody is jumping on board. The real ayahuasqueros—because it’s not something that you get into casually—have to know what they’re doing, and there’s quite a lot of training that goes into it.
RLM: I just want to underline something you said that’s also in Jim Fadiman’s latest book, The Psychedelic Explorer’s Guide, and that’s the importance of set and setting—preparing the day before to take the medicine with the proper person and then having time to process it the next day. Isn’t that important for what you’re talking about?
DM: Those are the key things to keep in mind.
Cheerleader for Psychedelic Research
As we know from chapter 2, Rick Doblin is by far the world’s foremost cheerleader for psychedelic research. As I mentioned before, I met him in 1985 at Esalen, where he was full of enthusiasm for his dream. He planned on going to Harvard, getting a PhD, and then founding a pharmaceutical company that would fund research around the world into psychedelics. He accomplished all of these things and more. His insights into ayahuasca in the following interview are invaluable.
The Science of the Sacred
Rick Doblin, PhD
March 2, 2013
RICK DOBLIN, PHD, is the founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS). He received his doctorate in public policy from Harvard’s Kennedy School of Government, where he wrote his dissertation on the regulation of the medical uses of psychedelics and marijuana. His professional goal is to help develop legal contexts for the beneficial uses of psychedelics and marijuana, primarily as prescription medicines but also for personal growth for otherwise healthy people, and eventually to become a legally licensed psychedelic therapist.
From the Amazon to the Laboratory
Standardizing Ayahuasca for Scientific Analysis
RLM: Let’s talk about ayahuasca. Jordi Riba has been conducting some research in Spain.
Rick Doblin, PhD (RD): Yes, Jordi is in Barcelona, and for the past fifteen years he has been able to work with ayahuasca. In its normal state, ayahuasca is a tea made of two different plants. In a research setting the dose has to be standardized so that it’s reliable and repeatable, so that you can understand the results and compare them to each other. Jordi Riba and his team in Spain have a large batch of ayahuasca. They freeze dry it and encapsulate it in powder form. It’s standardized and stays stable, so in that form it can be used in clinical research. Jordi has concentrated on what are called Phase I studies, which try to assess the safety, the mechanism of action, and basically how these drugs work—the metabolism of the drug, not therapeutic applications. He’s creating a basis of scientific information about the safety and about possible uses that will facilitate future research with ayahuasca in therapeutic uses.
We worked with a team on a study where a Peruvian shaman came up to British Columbia and worked with First Nations people who have a high incidence of alcoholism and drug abuse. The Canadian psychiatrist Gabor Maté, MD, facilitated the process. They focused on the treatment of addiction, and they have gotten some remarkable results that are just being published.
Unfortunately, because ayahuasca contains DMT, a Schedule I drug, Health Canada sent a message to Gabor Maté saying that if he were to continue this work they would take away his medical license, and it would be considered a crime. But they also said that they would be open to trying to facilitate research through Health Canada.*30
We actually had a donor interested in making some of this freeze-dried encapsulated ayahuasca and then trying to work through the Health Canada regulatory system to get it accepted for use, but the Peruvian shaman refused to do the work. They said that ayahuasca comes in a traditional format—this tea—and they didn’t want it manipulated in this scientific way in a Western therapeutic context.
What’s Driving the Popularity of Ayahuasca?
RLM: Why is there so much interest in ayahuasca both nationally in our country as well as in Europe now? One hears that it is attracting a great amount of attention.
RD: It is, and there’s a couple of different reasons for it. One of the main reasons is that the use of ayahuasca began in a religious context. Much of the use in the United States has been spread by two different churches—primarily the União do Vegetal [UDV] or the Union of the Plants and also by the Santo Daime. These two religions have defended a religious right to use it—particularly the UDV, which went all the way to the U.S. Supreme Court. Jeffrey Bronfman from the Canadian Bronfman family, who was the president of the UDV in the United States, spent about $3 million of his own money on legal fees and actually won a unanimous ruling in the Supreme Court, saying that his church had a religious right to use it—although the DEA still had to work out some ways to regulate it. So I think many people who would be reluctant to break the law to use LSD or MDMA would take ayahuasca.
There’s a reasonable claim to be made that much of the use is religious and protected by religious freedom. So I think there’s a way in which a lot of people are comfortable, you could say, in this gray area with ayahuasca.
RLM: But what are people looking for when they’re taking ayahuasca—what’s the goal?
RD: They’re looking for deeply profound spiritual experiences and a sense of connection, a sense of energy, a sense of being in touch with their own unconscious and their own deeper levels of the mind.
One advantage of ayahuasca is that it’s relatively short acting—a couple of hours. LSD or psilocybin is a six- to eight-hour experience. Sometimes people will take ayahuasca all night in a religious setting, but they’re drinking cups of tea every couple hours. UDV ceremonies actually begin at 8 p.m. and end at midnight, at which point people are pretty well grounded again. But during that process it’s very profound and intense. For a period of about an hour and a half there is this sense of light and energy—a sense of warmth. There’s a lot of body energy. A lot of people do have nausea and vomiting. I mean, the ayahuasca tastes vile; it really tastes horrible. But there’s that kind of physicality that is grounding, and so it’s not as abstract of an experience as LSD.
RLM: The neuroethnobotanist Stephan Beyer, PhD, author of Singing to the Plants [Albuquerque: University of New Mexico Press, 2009], told me that ayahuasca was originally used as an emetic because the food and the water supplies down in the jungles were so compromised that they needed to find something that they could take to immediately get them to regurgitate, and that was one of the origins of the use of ayahuasca. It is very interesting that there is that emetic aspect.
Medicine or a Sacrament?
RLM: Do you see a future therapeutic and medicinal potential for this particular substance?
RD: Definitely. There’s a fundamental question that we need to address first, and that is whether this is a sacred substance that should only be used in a religious context or this is a more neutral substance. Is this just a series of chemicals that has a religious framework put over it? Can it validly be used outside of a religious context, in a Western therapeutic context?
RLM: Great question for future research.
RD: I think it can, and I think the context makes an incredible amount of difference in the outcome of the experience. There’s a certain kind of religious pride, you could say, or even religious egotism, where people will say, “You know, this substance is sacred, more than anything else.” But if we want to look at it, everything is sacred.
RLM: That’s right. Everything on the Earth is sacred.
RD: These tools—these substances—have a more powerful ability to generate spiritual experiences in the sense of connection and moving beyond our own ego. Things that people have repressed—that they haven’t wanted to see about themselves or others—tend to come to the surface. You can look at the Western scientific endeavor and Enlightenment—the centuries-long tradition that has brought us this ability to understand the universe around us—as sacred as well. Therefore, I answer this question by saying, “Yes, these substances can be used in a variety of different contexts, including a desacralized, not religious but therapeutic context.”
I think ayahuasca has tremendous potential because of the series of things it does in a relatively short period of time—bringing people to these profound states. With sufficient support, it can be channeled into a religious or a therapeutic setting. I think both are equally valid when approached with respect.
DMT
Ayahuasca’s “Spirit Molecule”
RLM: The active ingredient in ayahuasca is N,N-dimethyltryptamine, or DMT. What can you tell us about Rick Strassman’s research on dimethyltryptamine in New Mexico?*31
RD: Well, Rick was the first person that was able to restart research with psychedelics, and he got permission in 1990. He approached it outside of a religious context, in a hospital setting—a scientific setting. He administered it intravenously, where it comes on faster. It’s more disorienting. He found that people had a range of experiences. At the higher doses people were more frightened than they were enlightened.
The experience of DMT when taken intravenously is very short acting. The beauty of ayahuasca is that the DMT is deactivated in the gut, so it’s not active orally, but when you mix it with an MAOI—a monoamine oxidase inhibitor—it inhibits the digestion of it in the gut and makes it orally active. When it’s orally active it has a longer onset. It lasts longer, and you can learn more from it. You have a period of time to get adjusted to it. You can stay in the space for forty-five minutes to an hour and a half, and then you can come down over the next hour or forty-five minutes to sort of integrate it.
By using intravenous administration—where it just hits you out of the blue, and you’re in a really different state very quickly—it’s not surprising that Rick Strassman talked a lot about people’s fears and anxieties and that they had doses that were too high. He also talked a lot about people having the sense of energy spirits or that they were somehow in contact with these plants’ energies—these spirits, or aliens. I think he went a bit far in his speculations that these were actually entities that existed independently of us somewhere and that the ayahuasca helped people to see them. Although I think it was a classic blindness. If you are a researcher giving people drugs intravenously in a hospital setting, and then subjects have these images of aliens experimenting on them, it’s not that hard to suggest that maybe it’s just symbolically what’s actually going on with them in the hospital.
Know Before You Go
Risks of Ayahuasca Tourism
RLM: What are some of the dangers of ayahuasca?
RD: There have been a small number of people who have died. Some of the shamans have what you could call a poly-pharmacy. They will mix nicotine—tobacco—and other things in with the ayahuasca. Sometimes people have gotten nicotine poisoning and died.
RLM: Were the deaths you’re aware of only in South America?
RD: Some were here in the United States, and some were in Canada. There is a recent tragic story of a young man who went down to Peru for an ayahuasca ceremony, where the model that they use is not so much a therapeutic or supportive model but more like a vision quest. They give people ayahuasca in a little hut in the jungle, and then they spend the next few days there. This young man died. The shaman tried to cover it up and buried him, but eventually it came out. These are remarkably rare circumstances.
We should also recognize that there are loads of people that are allergic to aspirin and die from it, and yet we consider it to be one of the safest drugs that we have. People are allergic to and die from penicillin. The dangers of ayahuasca are primarily psychological rather than physiological.
Present scientific research on ayahuasca is mostly anecdotal evidence gleaned over generations from shamans in South America. There is yet to be a series of scientifically controlled double-blind studies. Given that Jordi Riba in Barcelona has created a method of calibrating dosage*32 there will likely be new studies on the horizon, but it will be very slow growing. All scientists researching psychedelics report a minimum of funding for expensive research.
At the very same time people all over the world are using ayahuasca for healing and consciousness expansion in sub rosa gatherings, and the feedback continues to be overwhelmingly positive. While situations requiring medical intervention for ingestion of ayahuasca are rare, there is a measurable amount of risk involved with this substance. In distinction to LSD, psilocybin, and MDMA, there have been inconclusive deaths attributed to ayahuasca reported in South America. We are warned about the existence of South American tourist shamans who exploit their geography and local reputation by advertising ayahuasca seminars to the world.
Those considering joining an ayahuasca seminar are well advised to carefully research all medicines they are taking for potential negative interactions (some severe), to be prepared for a lengthy journey, and most of all to follow the proper procedures as described in this book.
Stunningly, some people have already trained themselves to move through daily life and do critical thinking under the effects of large doses of LSD by taking increasing doses over time. (The astrophysicist Carl Sagan and the founder of Apple are examples.) Only shamans function with volitional intention under the influence of ayahuasca.