Could Ayahuasca Help With Addiction?

Recently, using psychedelics for healing has risen in national conversation. And one substance in particular has dominated the discussion: Ayahuasca.

In conversation with Ariel Levy of The New Yorker, self-help guru Tim Ferris said that in San Francisco, “Ayahuasca is like having a cup of coffee. I have to avoid people at parties because I don’t want to listen to their latest three-hour saga of kaleidoscopic colors.”  While the description paints a humorous picture of changing fads, it indicates how this fringe drug is growing in popularity.

Aside from recreational use, in his book How to Change Your Mind, Michael Pollan describes how researchers are currently studying the use of ayahuasca and other psychedelics in a clinical setting to address deep mental health issues, including depression, anxiety, addiction, and PTSD.

Koorosh Rassekh, founder of Evo Health and Wellness, describes his personal experience participating in an Ayahuasca ceremony in Mexico:

What is Ayahuasca?

Ayahuasca is a psychotropic brew that, when ingested, induces several hours of a dream-like altered state of consciousness characterized by intense visual, auditory, ideational, and emotional effects.

Although DMT (dimethyltryptamine), the main psychoactive substance in ayahuasca, is a Schedule I controlled substance in the United States, its usage domestically has increased substantially over the past few decades. 

More traditionally, however, ayahuasca has been used in ritual contexts by Amazonian indigenous and mestizo populations. People travel from all over the world to participate in ayahuasca ceremonies led by guides known as ayahuasqueros. These ceremonies often take the form of multi-day retreats where participants experience a series of psychedelic trips and process them together.

Participants report a wide range of reactions to the experience. Some find the experience with ayahuasca to be terrifying and deeply unsettling, and others report it to be among the most meaningful experiences of their lives, allowing them a new perspective on longstanding issues. 

Pollan talks about how both “set” and setting” critically influence a person’s experience on psychedelics. Set is the mental state or expectations one brings to the experience, and setting is the environment in which the trip takes place. Also, those with a personal or family history of psychosis are at greater risk for psychedelic use to trigger psychotic episodes or ongoing psychosis. With ayahuasca, as well with as any other substance, mind-altering activity, or psychiatric drug, it’s important to seek professional advice and consultation and to assess risk. Pollan provides resources around psychedelics on his site.

Gabor Maté and Ayahuasca-Assisted Therapy for Addiction

Dr. Gabor Maté is well-known for his writings on ayahuasca-assisted therapy for substance use disorders. Having spent twelve years working with people dealing with addiction in Vancouver’s Downtown Eastside, Maté is a physician with a unique perspective:

“[A]ddiction is neither a choice nor a disease, but originates in a human being’s desperate attempt to solve a problem: the problem of emotional pain, of overwhelming stress, of lost connection, of loss of control, of a deep discomfort with the self.
In short, it is a forlorn attempt to solve the problem of human pain.
Hence my mantra: “The question is not why the addiction, but why the pain.”
Gabor Maté, MD, “BEYOND DRUGS: The Universal Experience of Addiction”

Dr. Maté views addiction as a coping mechanism in response to pain. Much of Maté’s views on addiction are inspired by the results of Bruce K. Alexander’s “Rat Park” experiment which suggested that drugs and alcohol themselves play much less of a role in driving addiction than the environment and conditions that an individual must face.

By allowing people to dig deep into their psyches, Maté writes that ayahuasca may be a holistic alternative that enables addicts to directly confront the trauma that drives their addictions.

Compelling Results, More Research Needed

In recent decades, researchers have been exploring the potential for ayahuasca-assisted therapy to be used as a treatment for problematic substance use, depression, anxiety, PTSD, and other mental health issues.

Sponsored by the Multidisciplinary Association for Psychedelic Studies Canada (MAPS), Gerald Thomas, Ph.D in collaboration with Gabor Maté, led a study on ayahuasca-assisted therapy for addiction.

Over the course of a four-day retreat facilitated by Maté, twelve subjects from a rural First Nations community participated in four days of group counseling and two expert-led ayahuasca ceremonies. Subjects were interviewed prior-to and six months after the retreat and statistically significant improvements were found in hopefulness, empowerment, mindfulness, and quality of life meaning and outlook in addition to self-reported reductions in problematic alcohol, tobacco, and cocaine usage.

This study was small and far from conclusive, but its compelling results surfaced the need for more research. At the end of the MAPS study, Thomas writes:

“Given the potential to decrease the personal suffering and social costs associated with addiction, further research on ayahuasca-assisted addiction treatment is warranted.
Clinical trials with people who have had poor outcomes with conventional psychological or pharmacological addiction treatments would help determine which adjunct therapeutic approaches might produce the best outcomes for particular populations, and further our understanding of ayahuasca-assisted treatments for problematic substance use.”
Gerald Thomas, PhD, “Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada”

More research is necessary around ayahuasca-assisted therapy and also in the healing potential of other psychedelics. Studies have shown encouraging results where psychedelics have been used for terminal cancer patients facing death, for those struggling to quit smoking, and for those looking to combat alcohol dependence. Yet relatively few studies on the clinical use of psilocybin and LSD have completed phases 2 and 3 of trials.

Overall, ayahuasca-assisted therapy is just one example of the unmined potential to discover new ways of healing and change how we talk about addiction and recovery.

Evo Health and Wellness is an outpatient addiction treatment program that respects where you are and where you want to go. Clients set goals that work for them, whether they include complete abstinence or moderation. Evo sees success as lasting change in the client’s life, including physical health, movement towards personal goals, and their sense of connection and purpose. Evo’s program integrates psychotherapy, psychiatry, life coaching, and somatic therapy. Learn more about Evo’s program.

NOTE: Evo does not provide or recommend ayahuasca-assisted therapy to its clients. We do believe strongly that another way is possible in addiction treatment. We are interested in further research and dedicated to exploring holistic and alternative treatment modalities for addiction and mental health issues.

Sources

Bogenschutz MP et al. “Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study.” Journal of Psychopharmacology, March 29, 2015, (3):289-99.

Dos Santos, Rafael G. et al. "Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies." Therapeutic Advances in Psychopharmacology, volume: 7 issue: 4, page(s): 141-157. Article first published online: February 23, 2017; Issue published: April 1, 2017

Johnson MW et al, “Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction.” Journal of Psychopharmacology, November 28, 2014, (11):983-92.

Lee, Stephanie. "BEYOND DRUGS: The Universal Experience of Addiction." Dr. Gabor Mate, April 5, 2017.

Levy, Ariel. "The Drug of Choice for the Age of Kale." The New Yorker, September 12, 2016. 

Pollan, Michael. How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and TranscendencePenguin Press, May 15, 2018.

Pollan, Michael as quoted in “'Reluctant Psychonaut' Michael Pollan Embraces The 'New Science' Of Psychedelics,” Fresh Air, NPR. May 15, 2018

Tierney, John, “Hallucinogens Have Doctors Tuning In Again,” New York Times, April 11, 2010.

Thomas, Gerald et al. "Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada." Current Drug Abuse Reviews, 6, 000-000, 2013.