The Therapeutic Potentials of Ayahuasca : Possible Effects against Various Diseases of Civilization
Ede Frecska, Petra Bokor and Michael Winkelman
Frontiers in Pharmacology, 2016, Vol 7, Article 35, 1-17.
Ayahuasca is an Amazonian psychoactive brew of two main components. Its active agents are b-carboline and tryptamine derivatives. As a sacrament, ayahuasca is still a central element of many healing ceremonies in the Amazon Basin and its ritual consumption has become common among the mestizo populations of South America. Ayahuasca use amongst the indigenous people of the Amazon is a form of traditional medicine and cultural psychiatry. During the last two decades, the substance has become increasingly known among both scientists and laymen, and currently its use is spreading all over in the Western world. In the present paper we describe the chief characteristics of ayahuasca, discuss important questions raised about its use, and provide an overview of the scientific research supporting its potential therapeutic benefits. A growing number of studies indicate that the psychotherapeutic potential of ayahuasca is based mostly on the strong serotonergic effects, whereas the sigma-1 receptor (Sig-1R) agonist effect of its active ingredient dimethyltryptamine raises the possibility that the ethno-medical observations on the diversity of treated conditions can be scientifically verified. Moreover, in the right therapeutic or ritual setting with proper preparation and mindset of the user, followed by subsequent integration of the experience, ayahuasca has proven effective in the treatment of substance dependence. This article has two important take-home messages: (1) the therapeutic effects of ayahuasca are best understood from a bio-psycho-socio-spiritual model, and (2) on the biological level ayahuasca may act against chronic low grade inflammation and oxidative stress via the Sig-1R which can explain its widespread therapeutic indications.
Keywords : addiction medicine, ayahuasca, diseases of civilization, dimethyltryptamine, oxidative stress
Ayahuasca, a psychoactive Amazonian sacrament, has raised increased scientific and lay interest during the last two decades. Traditionally ayahuasca has been used in Ecuador, Columbia, Peru, and Brazil, where it is also known as natema, hoasca, daime, yagé, or yajé. The decoction is prepared by simultaneously boiling two admixture plants, the Banisteriopsis caapi (Malpighiaceae) containing b-carboline type alkaloids such as harmine and tetrahydro-harmine; and most commonly Psychotria viridis (Rubiaceae), which provides the psychoactive alkaloid DMT (McKenna, 2004; Szára, 2007). Sometimes Psychotria viridis is substituted by otherDMT containing plants such as Diplopterys cabrerana (formerly B.rusbyana) of the family Malpighiaceae. The name ayahuasca is a compound word in Quechua language, where aya means soul, ancestors or dead persons and wasca (huasca) means vineor rope (Luna, 2011). Therefore, the most prevalent translation of the word is “vine of the soul”. Skeptics may prefer the other linguistic alternative : “rope of death”, but this paper will provide argumentsfavoringtheformerinterpretationabovethelatter one.
Ayahuasca has been used as a central element of religious, magical, curative, initiation, and other tribal rituals for millennia (Naranjo, 1986), originally by the indigenous groups and later by the mestizo populations of the region, who respect the brew a sasacrament and value it as a powerful medicine. The
indigenous and mestizo communities regularly use ayahuasca to treat physical ailments, mental problems and frequently handle their social issues, spiritual crises with the help of the brew. A Peruvian tradition called vegetalismo regards ayahuasca as one of the teacher plants that convey knowledge to humans (Luna, 1986), and considers the experience induced by its ingestion trabajo (work). In addition to its traditional and mestizo uses, ayahuasca also forms a central component of the rituals of three Brazilian syncretic churches : the Santo Daime, the União do Vegetal and the Barquinha. The history of these churches dates back to the first half of the 20 th century, and by now the yare present in 23 countries (de Rios and Rumrrill, 2008; Liesterand Prickett, 2012). Obviously there is a striking discrepancy between theindigenous South American and official Western view1 on ayahuasca use,which calls for scientific explanation and a healthy resolution.
Due to the growing popularity of the sacrament, masses of peoplefromallpartsoftheworldtraveltothe Amazon to participate in ayahuasca rituals. This unique phenomenon characterized by some as “drug-tourism” (de Rios, 1994) is not as frivolous pursuit as it sounds (Grunwell, 1998), since a significant number of travelers searches for spiritual and therapeutic opportunities.The principal motivations can be characterized as : seeking improved insight, personal growth; emotional healing; and contact with a sacred nature, deities, spirits and natural energies produced by the ayahuasca (Winkelman, 2005). The trend of popularization — known as the “globalization of ayahuasca” — flows both ways, as this Amazonian tradition spreads beyond its native habitat and gets adopted into non-indigenous circles of the Western world (Tupper, 2008) either within or outside of the context of syncretic churches.
During the last couple of years several publications have been written with the goal to summarize our knowledge about ayahuasca from various perspectives (seein Labate and Cavnar, 2014). The primary aim of this article is to give an overview about the facts and hypotheses related to the possible therapeutic mechanisms of the brew in light of recent advances of the field; with the secondary aim of addressing its known adverse effects. By adhering to a biopsychosociospiritual model (Bishop, 2009) the authors will explore every level in the following order : starting with biochemistry, neuropharmacology, physiology, brain imaging, then moving to the psychological effects, social ramifications, and finally addressing spiritual implications. Efforts are taken to keep a balance among the biomedical, psycho-social and spiritual aspects of healing since “Madre Ayahuasca, la sagrada-medicina (Mother Ayahuasca, the sacred-medicine)” is best understood within this quadrilateral framework.