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Bubbling with Controversy: Legal Challenges for Ceremonial Ayahuasca Circles in the United States

Abstract

The use of ayahuasca has been spreading rapidly worldwide; however, no current statistics are available to provide a comprehensive understanding of the scope or pace of this expansion. In the United States, the expansion has included the appearance of the Brazilian ayahuasca religions Santo Daime and União do Vegetal (UDV), underground ceremonial circles, workshops with itinerant Amazonian shamans, and spiritual retreat centers. This trend has included the recent emergence of groups and organizations that publicly advertise “legal” ayahuasca ceremonies and retreats. This chapter maps the existence of a series of organizations and actors who have controversially claimed legal protection through incorporation as “branches” of the Native American Church (NAC). The legality, religious character, and sincerity of these churches are reviewed in light of governing law, such as the First Amendment of the US Constitution, the Religious Freedom Restoration Act (RFRA), the Controlled Substances Act (CSA), and pertinent court cases involving the UDV and the Santo Daime, as well as ethnographic accounts of the historical Native American Church. Finally, it examines a petition for a religious exemption from the CSA from Ayahuasca Healings and speculates on the possibilities of the future of ayahuasca legality in the United States.

Feeney, K., Labate, B. C., & Hudson, J. H. (2018). Bubbling with Controversy: Legal Challenges for Ceremonial Ayahuasca Circles in the United States. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 87-111. 10.1007/978-3-319-76720-8_6
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Undiscovering the Pueblo Mágico: Lessons from Huautla for the Psychedelic Renaissance

Abstract

The people of the Sierra Mazateca region of Mexico became internationally known in the 1950s for their ritual use of psilocybin mushrooms, and the Mazatec town of Huautla became a destination for mushroom seeking visitors. This chapter provides an overview of changing Mazatec and “outsider” discourses about mushrooms and the Sierra Mazateca over the last 60 years. It argues that “outsider” representations of the Sierra Mazateca and mushroom use—whether framed in terms of spiritual journeys or scientific research—tend to recapitulate some consistent patterns common to other forms of cultural tourism that owe more to the role of substances in marking distinctive cultural identities than to the effects of the substances themselves. It concludes by suggesting lessons from this history for the current moment, in which a discourse framing the use of psychedelic substances through universalizing narratives of science and individual health is becoming ascendant.

Feinberg, B. (2018). Undiscovering the Pueblo Mágico: Lessons from Huautla for the Psychedelic Renaissance. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 37-54. 10.1007/978-3-319-76720-8_3
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Who Is Keeping Tabs? LSD Lessons from the Past for the Future

Abstract

Psychedelics fell from medical grace nearly half a century ago, but recent activity suggests that some researchers are optimistic about their return. Are they at risk, however, of facing the same historic challenges with a new generation of psychedelic enthusiasts, or have the circumstances changed sufficiently to allow for a new path forward? The twenty-first-century incarnation of psychedelic research resurrects some anticipated hypotheses and explores some of the same applications that clinicians experimented with 50 years ago. On the surface then, the psychedelic renaissance might be dismissed for retreading familiar ground. A deeper look at the context that gave rise to these questions, though, suggests that while some of the questions are common, the culture of neuroscience and the business of drug regulation have changed sufficiently to warrant a retrial. A close look at the history of psychedelics encourages us to think carefully about the roles of regulators, the enthusiasm of researchers, and our cultural fascination and/or repulsion with mind-altering molecules.

Dyck, E. (2018). Who Is Keeping Tabs? LSD Lessons from the Past for the Future. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 1-17. 10.1007/978-3-319-76720-8_1
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Peyote’s Race Problem

Abstract

In the years since peyote became a controlled substance in Mexico and the US, a steady stream of advocates and activists have laid claim to two types of exemption, rooted in both US Law (the First Amendment) and International Law (the 1971 Vienna Convention on Psychotropic Drugs). Indigenous peyotists in particular have been largely successful in making a claim to a legal right to be exempt from national prohibitions on peyote possession and consumption. This has represented a significant advance in indigenous rights, yet in both contexts it has had the unpleasant effect of signaling that a drug that is otherwise so dangerous as to be prohibited should be permitted for Indians, because they are somehow essentially different from all other citizens. This, then, is Peyote’s Race Problem. The ways in which we have created a legal framework that makes peyote use licit among indigenous peoples has hardened a certain notion of profound, an unalterable difference to the point that Indian bodies are said to be incommensurably different from the bodies of others who might desire to consume peyote, but for whom it is deemed too dangerous. This notion of difference has been exacerbated by the increasing scarcity of peyote in the US and Mexico, which as further racialized the spaces where peyote grows.

Dawson, A. (2018). Peyote’s race problem. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 19-35. 10.1007/978-3-319-76720-8_2
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The Use of Salvia divinorum from a Mazatec Perspective

Abstract

Salvia divinorum is a medicinal and psychoactive plant endemic to the Sierra Madre Oriental of Oaxaca, Mexico. The Mazatec people have been using the leaves for centuries in ceremonies for its psychoactive properties and as a treatment for arthritis and inflammation, gastrointestinal problems, headaches, and addictions, among other uses. The active principle of Salvia divinorum, the terpene salvinorin A, is a uniquely potent and highly selective kappa-opioid receptor agonist and, as such, has enormous potential for the development of valuable medications. Among them, the most promising include safe and nonaddictive analgesics, neuroprotectors, short-acting anesthetics that do not depress respiration, antidepressants, anti-inflammatories, medications for the treatment of addiction to stimulants and alcohol, and drugs to treat disorders characterized by alterations in perception. The Mazatec consider Salvia divinorum to be a very powerful plant spirit that should be treated with utmost respect, and the preparation for the ceremony requires a strict regimen. They chew the fresh leaves at night while chanting and praying. In the Western use, the dry leaves are potentiated in extracts to be smoked. A lack of information about the appropriate doses and other considerations while smoking the extracts could result in overwhelming experiences due to the high potency and fast onset of the substance. For the Mazatec, smoking the plant is not the preferred mode. How could we create a bridge between the two perspectives? In this chapter, I will try to clarify the best ways to use Salvia divinorum for medicinal, psychotherapeutic, and inner exploration purposes.

Maqueda, A. E. (2018). The Use of Salvia divinorum from a Mazatec Perspective. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 55-70. 10.1007/978-3-319-76720-8_4
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Whole Organisms or Pure Compounds? Entourage Effect Versus Drug Specificity

Abstract

As the therapeutic use of sacred plants and fungi becomes increasingly accepted by Western medicine, a tug of war has been taking place between those who advocate the traditional consumption of whole organisms and those who defend exclusively the utilization of purified compounds. The attempt to reduce organisms to single active principles is challenged by the sheer complexity of traditional medicine. Ayahuasca, for example, is a concoction of at least two plant species containing multiple psychoactive substances with complex interactions. Similarly, cannabis contains dozens of psychoactive substances whose specific combinations in different strains correspond to different types of therapeutic and cognitive effects. The “entourage effect” refers to the synergistic effects of the multiple compounds present in whole organisms, which may potentiate clinical efficacy while attenuating side effects. In opposition to this view, mainstream pharmacology is adamant about the need to use purified substances, presumably more specific and safe. In this chapter, I will review the evidence on both sides to discuss the scientific, economic, and political implications of this controversy. The evidence indicates that it is time to embrace the therapeutic complexity of psychedelics.

Ribeiro, S. (2018). Whole organisms or pure compounds? entourage effect versus drug specificity. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 133-149. 10.1007/978-3-319-76720-8_8
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Ibogaine Acute Administration in Rats Promotes Wakefulness, Long-Lasting REM Sleep Suppression, and a Distinctive Motor Profile

Abstract

Ibogaine is a potent psychedelic alkaloid that has been the focus of intense research because of its intriguing anti-addictive properties. According to anecdotic reports, ibogaine has been originally classified as an oneirogenic psychedelic; i.e., induces a dream-like cognitive activity while awake. However, the effects of ibogaine administration on wakefulness (W) and sleep have not been thoroughly assessed. The main aim of our study was to characterize the acute effects of ibogaine administration on W and sleep. For this purpose, polysomnographic recordings on chronically prepared rats were performed in the light phase during 6 h. Animals were treated with ibogaine (20 and 40 mg/kg) or vehicle, immediately before the beginning of the recordings. Furthermore, in order to evaluate associated motor behaviors during the W period, a different group of animals was tested for 2 h after ibogaine treatment on an open field with video-tracking software. Compared to control, animals treated with ibogaine showed an increase in time spent in W. This effect was accompanied by a decrease in slow wave sleep (SWS) and rapid-eye movements (REM) sleep time. REM sleep latency was significantly increased in animals treated with the higher ibogaine dose. While the effects on W and SWS were observed during the first 2 h of recordings, the decrement in REM sleep time was observed throughout the recording time. Accordingly, ibogaine treatment with the lower dose promoted an increase on locomotion, while tremor and flat body posture were observed only with the higher dose in a time-dependent manner. In contrast, head shake response, a behavior which has been associated in rats with the 5HT2A receptor activation by hallucinogens, was not modified. We conclude that ibogaine promotes a waking state that is accompanied by a robust and long-lasting REM sleep suppression. In addition, it produces a dose-dependent unusual motor profile along with other serotonin-related behaviors. Since ibogaine is metabolized to produce noribogaine, further experiments are needed to elucidate if the metabolite and/or the parent drug produced these effects.
González, J., Prieto, J. P., Rodríguez, P., Cavelli, M., Benedetto, L., Mondino, A., … & Torterolo, P. (2018). Ibogaine Acute Administration in Rats Promotes Wakefulness, Long-Lasting REM Sleep Suppression, and a Distinctive Motor Profile. Frontiers in pharmacology9. 10.3389/fphar.2018.00374
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Psilocybin modulates functional connectivity of the amygdala during emotional face discrimination

Abstract

Recent studies suggest that the antidepressant effects of the psychedelic 5-HT2A receptor agonist psilocybin are mediated through its modulatory properties on prefrontal and limbic brain regions including the amygdala. To further investigate the effects of psilocybin on emotion processing networks, we studied for the first-time psilocybin’s acute effects on amygdala seed-to-voxel connectivity in an event-related face discrimination task in 18 healthy volunteers who received psilocybin and placebo in a double-blind balanced cross-over design. The amygdala has been implicated as a salience detector especially involved in the immediate response to emotional face content. We used beta-series amygdala seed-to-voxel connectivity during an emotional face discrimination task to elucidate the connectivity pattern of the amygdala over the entire brain.

When we compared psilocybin to placebo, an increase in reaction time for all three categories of affective stimuli was found. Psilocybin decreased the connectivity between amygdala and the striatum during angry face discrimination. During happy face discrimination, the connectivity between the amygdala and the frontal pole was decreased. No effect was seen during discrimination of fearful faces. Thus, we show psilocybin’s effect as a modulator of major connectivity hubs of the amygdala. Psilocybin decreases the connectivity between important nodes linked to emotion processing like the frontal pole or the striatum. Future studies are needed to clarify whether connectivity changes predict therapeutic effects in psychiatric patients.

Grimm, O., Kraehenmann, R., Preller, K. H., Seifritz, E., & Vollenweider, F. X. (2018). Psilocybin modulates functional connectivity of the amygdala during emotional face discrimination. European Neuropsychopharmacology. 10.1016/j.euroneuro.2018.03.016
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Assessment of Alcohol and Tobacco Use Disorders Among Religious Users of Ayahuasca.

Abstract

The aims of this study were to assess the impact of ceremonial use of ayahuasca-a psychedelic brew containing N,N-dimethyltryptamine (DMT) and β-carboline -and attendance at União do Vegetal (UDV) meetings on substance abuse; here we report the findings related to alcohol and tobacco use disorder. A total of 1,947 members of UDV 18+ years old were evaluated in terms of years of membership and ceremonial attendance during the previous 12 months. Participants were recruited from 10 states from all major regions of Brazil. Alcohol and tobacco use was evaluated through questionnaires first developed by the World Health Organization and the Substance Abuse and Mental Health Services Administration. Analyses compared levels of alcohol and tobacco use disorder between the UDV and a national normative sample (n = 7,939). Binomial tests for proportions indicated that lifetime use of alcohol and tobacco was higher in UDV sample compared to the Brazilian norms for age ranges of 25-34 and over 34 years old, but not for the age range of 18-24 years old. However, current use disorders for alcohol and tobacco were significantly lower in the UDV sample than the Brazilian norms. Regression analyses revealed a significant impact of attendance at ayahuasca ceremonies during the previous 12 months and years of UDV membership on the reduction of alcohol and tobacco use disorder.
Ribeiro Barbosa, P. C., Tofoli, L. F., Bogenschutz, M. P., Hoy, R., Berro, L. F., Marinho, E. A., … & Winkelman, M. J. (2018). Assessment of alcohol and tobacco use disorders among religious users of ayahuasca. Frontiers in psychiatry9, 136., 10.3389/fpsyt.2018.00136
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Ketamine Effects on EEG during Therapy of Treatment-Resistant Generalized Anxiety and Social Anxiety

Abstract

BACKGROUND:
Ketamine is swiftly effective in a range of neurotic disorders that are resistant to conventional antidepressant and anxiolytic drugs. The neural basis for its therapeutic action is unknown. Here we report the effects of ketamine on the EEG of patients with treatment-resistant generalized anxiety and social anxiety disorders.
METHODS:
Twelve patients with refractory DSM-IV generalized anxiety disorder and/or social anxiety disorder provided EEG during 10 minutes of relaxation before and 2 hours after receiving double-blind drug administration. Three ascending ketamine dose levels (0.25, 0.5, and 1 mg/kg) and midazolam (0.01 mg/kg) were given at 1-week intervals to each patient, with the midazolam counterbalanced in dosing position across patients. Anxiety was assessed pre- and postdose with the Fear Questionnaire and HAM-A.
RESULTS:
Ketamine dose-dependently improved Fear Questionnaire but not HAM-A scores, decreased EEG power most at low (delta) frequency, and increased it most at high (gamma) frequency. Only the decrease in medium-low (theta) frequency at right frontal sites predicted the effect of ketamine on the Fear Questionnaire. Ketamine produced no improvement in Higuchi’s fractal dimension at any dose or systematic changes in frontal alpha asymmetry.
CONCLUSIONS:
Ketamine may achieve its effects on treatment-resistant generalized anxiety disorder and social anxiety disorder through related mechanisms to the common reduction by conventional anxiolytic drugs in right frontal theta. However, in the current study midazolam did not have such an effect, and it remains to be determined whether, unlike conventional anxiolytics, ketamine changes right frontal theta when it is effective in treatment-resistant depression.
Shadli, S. M., Kawe, T., Martin, D., McNaughton, N., Neehoff, S., & Glue, P. (2018). Ketamine Effects on EEG during Therapy of Treatment-Resistant Generalized Anxiety and Social Anxiety. International Journal of Neuropsychopharmacology. 10.1093/ijnp/pyy032
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