Ayahuasca, Yet Another Prohibited Medicine

Ayahuasca, Yet Another Prohibited Medicine

This article originally published at http://the-libertarian.co.uk/

Readers have presumably all heard of LSD and the drug commonly known as ecstasy, and I have written here previously about their medical uses. There is another substance being investigated for the treatment of some of the same medical issues, however, and it is similarly restricted by a severe prohibition in US federal law.

Ayahuasca is the common name for a traditional drink composed of elements including the Banisteriopsis caapi vine, usually in combination with another plant, a shrub called Psychotria viridis. The shrub contains the main psychoactive ingredient, known as dimethyltryptamine or DMT. The shrub’s leaves, however, have no effect when consumed orally on their own. They must be combined with monoamine oxidase inhibitors or MAOIs. Such substances, similar to early types of antidepressants, can be found in the Banisteriopsis caapi vine.

Ayahuasca

Ayahuasca / photo credit: http://www.iceers.org

The drink has been traditionally consumed for centuries in the Amazon rainforest regions of Peru, Ecuador, and Colombia among indigenous tribes such as the Shipibo. Several more recently developed churches in Brazil, such as Santo Daime and the União do Vegetal or UDV, treat the beverage as a sacrament and attribute medicinal qualities to it. Currently several clinics in Peru such as the Nihue Rao Centro Espiritual offer rituals including the mixture to visitors from anywhere in the world. This has been successfully applied to treatment-resistant cases of conditions including depression and post-traumatic stress disorder or PTSD.

The effects of the drug have generally been described as intense. Nausea and vomiting are very common side effects; in fact, ayahuasca is sometimes known simply as “la purga,” or “the purge.” Disturbing visions are also often reported, although users often find that these result in valuable insights into their own psychology. Perhaps not coincidentally, the drug has never been popular in the illicit drug market, so those using it illegally often produce it themselves.

Research on ayahuasca, unlike research on LSD or psilocybin, does not date back to the 1950s. Although it was first formally described by the Harvard-trained ethnobotanist Richard Evans Schultes in the 1950s,  formal studies of the substance did not begin until 1993. The first clinical trial on the drug was conducted in 1999 in Spain using capsules of freeze-dried ayahuasca, and the literature on the topic is still limited.

However, consistent anecdotal evidence has certainly prompted scientific interest in the use of ayahuasca. It is currently being formally investigated for several purposes including the treatment of drug addiction. One study on a group of indigenous people in British Columbia showed positive results from a single dose of ayahuasca in terms of drug abuse, particularly a reduction in cocaine use and in craving for drugs. A characteristic quotation explaining its relevance to drug abuse comes from one of the participants in this study. “With my last experience with ayahuasca,” he reported, “I really faced myself….my fear, my anger, which really, I think is a big part of my addictions…running away from myself pretty much, and I think I overcame that in the ceremonies.” Asked to rate the positive impact of the experience on their lives from 1 to 10, the average response was 7.95. One clinical psychologist conducted a study involving interviews with 14 therapists who had used the substance in the treatment of addiction, as well as 15 drug-dependent individuals who had consumed ayahuasca themselves. She similarly found that an improved insight into their own psychology and behavior was a common reported benefit. Similarly to the use of MDMA for PTSD, the ability to relive traumatic memories without the usual negative emotions was also reported. In fact, a formal study of ayahuasca for PTSD is also being planned with the Paititi Institute in Peru.

There has also been study of the neurological mechanisms by which it seems to help users end their dependence on various substances, including several brain scan techniques applied to determine how activity in various areas of the brain is affected. Ayahuasca seems to have beneficial effects on levels of serotonin, a chemical in the brain which is also targeted by modern antidepressants and which is critical for the regulation of mood and sleep.

The main active ingredient, DMT, is explicitly listed in Schedule 1 of the international drug prohibition treaty known as the Convention on Psychotropic Substances. This is the most restrictive classification in the Convention, and implies that it is “claimed to create a serious risk to public health,” and its “therapeutic value is not currently acknowledged” by the relevant United Nations authorities. This is arguably binding on virtually the entire world; there are only 11 nations who are not parties to this convention. However, the UN International Narcotics Control Board clarified in 2001 that although the pure substance DMT is prohibited, ayahuasca itself is not, nor are its component plants. Individual nations are thus free to determine their own laws on ayahuasca.

Ayahuasca is actually legal in Brazil. Under Brazilian law, ayahuasca was prohibited in 1985, but the UDV quickly sued. This resulted in two separate government investigations into the substance, neither of which found any definite negative effects from its use. As a result, ayahuasca and its components were removed from the list of banned substances in 1992.

In the United States, a shipment of ayahuasca, intended for a US branch of the UDV, was seized by US Customs on its way from Brazil in 1999. This let to a court case which concluded in a 2006 Supreme Court ruling allowing religious use of the drink by the church. A district court judge in the US state of Oregon made a similar ruling in 2009 regarding another Brazilian ayahuasca-using church, Santo Daime.

However, outside of these relatively small groups, not only DMT but the drink itself continues to be treated as a Schedule I prohibited substance in the US. This makes scientific study of the drug within the country quite difficult. The legal status of ayahuasca itself in other countries is not as clear, regardless of their laws on DMT. However, Hungarian-born physician Dr. Gabor Maté, organizer of the Canadian study previously mentioned, has had similar difficulty in Canada with the legal status of ayahuasca. Based on the DMT content of the drink, he received a federal cease-and-desist letter in response to the research.

The implications of its legal status notwithstanding, neither a high potential for abuse nor any other threat to public health have ever been substantiated for ayahuasca. The best evidence available, on the contrary, suggests significant medicinal value. Schedule I in the US should be revised to explicitly exempt ayahuasca, allowing neuroscience and medicine greater access to this promising substance.