Therapeutic Applications of Ayahuasca and Other Sacred Medicines
Michael J. Winkelman
chapter 1, in B. Caiuby Labate and C. Cavnar (eds.) : “The Therapeutic Use of Ayahuasca“,
Springer-Verlag Berlin Heidelberg 2014
Doi : 10.1007/978-3-642-40426-9_1
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 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 II1 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 Post Traumatic 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.