The Therapeutic Use of Ayahuasca

Therapeutic applications of the psychedelics or hallucinogens found cross-culturally involve treatment of a variety of physical, psychological, and social maladies. Modern medicine has similarly found that a range of conditions may be successfully treated with these agents. The ability to treat a wide variety of conditions derives from variation in active ingredients, doses and modes of application, and factors of set and setting manipulated in ritual. Similarities in effects reported cross-culturally reflect biological mechanisms, while success in the treatment of a variety of specific psychological conditions points to the importance of ritual in eliciting their effects. Similar bases involve action on the serotonin and dopamine neurotransmitter systems that can be characterized as psychointegration: an elevation of ancient brain processes. Therapeutic Application of Sacred Medicines in the Premodern and Modern World Societies worldwide have discovered therapeutic applications of psychoactive plants, often referred to as sacred medicines, particularly those called psychedelics or hallucinogens. Hundreds of species of such plants and fungi were used for medicinal and religious purposes (see Schultes et al. 1992; Rätsch 2005), as well as for a variety of psychological and social conditions, culture-bound syndromes, and Thanks to Ilsa Jerome for providing some updated references for this paper. M. J. Winkelman (&) Retired from the School of Human Evolution and Social Change, Arizona State University Tempe Arizona, Caixa Postal 62, Pirenópolis, GO 72980-000, Brazil e-mail: michaeljwinkelman@gmail.com B. C. Labate and C. Cavnar (eds.), The Therapeutic Use of Ayahuasca,  2014 1 a range of physical diseases (see Schultes and Winkelman 1996). This review illustrates the range of uses and the diverse potential of these substances for addressing human maladies. The ethnographic data on indigenous uses of these substances, combined with a brief overview of some of the modern medical studies, illustrate that a wide range of effects are obtained with these plants. These cultural therapies involve both pharmacological and ritual manipulations. Highly developed healing traditions selectively utilized different species of the same genus, different preparation methods and doses, varying admixtures, and a variety of ritual and psychotherapeutic processes to obtain specific desired effects. The wide range of uses of these plants suggests that they can contribute new active ingredients for modern medicine, particularly in psychiatry. As was illustrated by our illustrious contributors to Psychedelic Medicine (Winkelman and Roberts 2007a, b), there are a number of areas in which psychedelics have been established in treating what have been considered intractable health problems. While double-blind clinical trials have been sparse (but see Griffiths et al. 2006), this is not due to the lack of evidence for efficacy, but rather the administrative prohibitions that have drastically restricted clinical research. Nonetheless, using the criteria of phases of clinical evaluation, Winkelman and Roberts (2007c) concluded that there is at least Phase II evidence for the effectiveness of most of these psychedelics, supporting the continuation of more advanced trials. Furthermore, their success with the often intractable maladies, ranging from depression and cluster headaches to posttraumatic stress disorder (PTSD), obsessive-compulsive disorders, wasting syndromes, and addictions justifies their immediate use with these desperate patient populations. In addition, the wide variety of therapeutic uses found for these substances in cultures around the world suggest the potential for far greater applications. Therapeutic Uses of Psilocybin-containing ‘‘Magic Mushrooms’’ The Aztecs called these fungi teonanacatl, meaning ‘‘food of the gods’’; there is evidence of the use of psilocybin-containing mushrooms from many different genera in ritual healing practices in cultures around the world and deep in prehistory (see Rätsch 2005). One of the best documented therapeutic uses of psilocybin involves Maria Sabina, the Mazatec ‘‘Wise One’’ (Estrada 1981). Several different Psilocybe species are used by the Mazatec, as well as mushrooms of the Conocybe genera. In addition, other psychoactive plants are also employed, including Salvia divinorum Epl. and tobacco (Nicotiana rustica L., Solanaceae). 1 Phase II studies or trials use small groups of selected patients to determine effectiveness and ideal doses for a specific illness after Phase I trials have established safety (lack of toxicity) and safe dose ranges. 2 M. J. Winkelman