The Ethnopharmacology of Ayahuasca

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Ayahuasca is a psychotropic beverage used in medico-religious ceremonies by indigenous groups in the Amazon. It plays an important role in their spiritual, artistic and social lives. Some mestizo populations have also incorporated its use.

Ayahuasca is used by indigenous shamans for communication with spirits and prophecy. It also has a role in their art and social lives. However, Europeans initially viewed its use as communication with the devil due to religious influences.

The 'vegetalismo phenomenon' refers to the incorporation of ayahuasca use into healing ceremonies among mestizo populations in Peru, Ecuador, and Colombia, based on the author's fieldwork in the 1980s.

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The Ethnopharmacology of Ayahuasca, 2011: 1-21 ISBN: 978-81-7895-526-1


Editor: Rafael Guimarães dos Santos

1. Indigenous and mestizo use of ayahuasca.


An overview

Luis Eduardo Luna


Wasiwaska, Research Center for the Study of Psychointegrator Plants
Visionary Art and Consciousness, Florianópolis, Brazil

Abstract. Ayahuasca, a psychotropic beverage used by numerous


indigenous groups of the Upper Amazon, the Orinoco Basin and
the Pacific Lowlands of Colombia and Ecuador, has an important
role in their medico-religious, artistic and social lives. Its use was
later incorporated in healing ceremonies among the mestizo
population of Peru, Ecuador and Colombia. This chapter presents
an overview of such uses among some indigenous groups as well
as that of contemporary practitioners in the Peruvian Amazon
region.

1. Introduction
It is my intention to give an overview of indigenous use of ayahuasca, and
a discussion on the so-called vegetalismo phenomenon among the mestizo
population of the Peruvian Amazon. I will also add a brief commentary about

Correspondence/Reprint request: Dr. Luis Eduardo Luna, Wasiwaska, Research Center for the Study of
Psychointegrator Plants, Visionary Art and Consciousness. Florianópolis, Brazil
E-mail: [email protected] and www.wasiwaska.org
2 Luis Eduardo Luna

the so-called “ayahuasca tourism” phenomenon. The part related to the


indigenous realm is mostly based on written sources, as my first-hand
experience was limited to short stays with few indigenous groups1. The part
related to vegetalismo is mostly based on my own fieldwork during 1980-
1988. I was unfortunately not able to fully examine an excellent recent in
study on the phenomenon by Beyer[1].

2. Part I: Indigenous use of ayahuasca


2.1. European perception of sacred plants in the Americas

Although Europeans learned very early about the use of psychotropic


plants among the indigenous population of the Americas, they ignored their
properties, with exception of tobacco. These plants were used in a
spiritual/religious context, a realm that in Spain was in the hands of the
Catholic Church, which judged them as vehicles of communication with the
Devil, a perception that basically has not changed in our contemporary world,
in which Amerindian sacred plants have been, with exceptions, criminalized.
The first book written in Spanish in the New World (1497-8) was the
Chronicle of Catalan friar Ramón Pané’s, at the orders of Columbus, and
partially dedicated to the description of the believes and ceremonies of the
Taíno, on the island of La Española (now-a-days Haiti and Santo Domingo)[2],
an indigenous population originally from the Orinoco region who populated the
Antilles, taking with them the use of cohoba (Anadenanthera peregrina). Pané
was the first European to describe how their shamans “came out of their minds”
to communicate with the cenis or spirits.
Juan Cárdenas, a chronicler, wrote on 1591 in reference to peyotl
(Lophophora williamsii) that the natives who eat it “lose their senses, see
visions of terrifying sights like the devil, and are able to prophesy their
future with ‘satanic trickery’”[3]. In a religious manual of 1760 there were
questions that equated the eating of peyote with cannibalism[4].

1
From the onset I have to point out that my personal experience with indigenous use
of ayahuasca is restricted to one session – for me life changing – with Don Apolinar
Jacanamijoy, an Ingano “taita” whom I knew since childhood, and his son Roberto
Jacanamijoy; one period of a month in the Sibundoy Valley with two Kamsá shamans,
Don Salvador Chindoy and Don Miguel Chindoy, father and son; another month in
Santa Rosa de Pirococha, a Shipibo small settlement, under the care of Don Basilio
Gordon; perhaps half a dozen sessions with Don Benito Arévalo, a Shipibo, and later
a few with his son Don Guillermo Arévalo; finally two weeks with a Campa shaman
in Rio Palcazú, when I was in isolation doing the diet. The rest of my fieldwork,
carried out during 1981-1988, was with mestizo practitioners.
Indigenous and mestizo use of ayahuasca 3

There was a similar perception by the religious authorities regarding


ayahuasca. One of the earliest sources is from Father José Chantre y
Herrera in his history of the Jesuit missions from the late seventeen and
early eighteen centuries, who speaks about a “diabolic brew”[5].
Missionaries of the Montfortian Congregation, most of them Dutchmen,
established in 1914 among the Tukano, Desana, and Pira-Tapuka of the
Papurí River immediately prohibited the use of yajé and destroyed most of
its ritual paraphernalia[6]. This persecution by the part of religious
missionaries comes to our days. In the mid eighties I heard similar stories
in the Peruvian Amazon as carried out by members of the Summer Institute
of Linguistics, and in the nineties near Manaus, Brazil, a group of
Tukanos complained to me that Salesian missionaries prohibit them to take
caapi.

2.2. A question of terminology

The Quichua term ayahuasca (also spelled ayawaska), from aya = spirit,
ancestor and waska = vine, is not precise. In contemporary literature it is used
to refer to the concoction of Banisteriopsis caapi plus Psychotria viridis. It is
also sometimes used to refer to a beverage – a concoction or a cold infusion –
made of B. caapi plus Diplopterys cabrerana (known as chagropanga,
chiripanga or other vernacular names), which is locally known as yajé (also
spelled yagé). To complicate matters both the term ayahuasca and yajé are
used to refer to Banisteriopsis caapi by itself. I propose to use the term
ayahuasca, common in Peru, Bolivia, Brazil and parts of Ecuador, when
referring to the first preparation. The term yajé will designate the second
preparation. We use the term caapi when referring to a preparation made only
of Banisteriopsis caapi, as well as to the plant itself. Given that this vine is
the essential element, when referring to the whole phenomenon I will talk
about the caapi complex.
It is relevant to point out that indigenous groups distinguish several
“kinds” of vines to refer to what western botanists see as just one species.
This means they have a much more refined taxonomy, based not only on the
morphology of the plant, but also on its effects, which may differ according
to the type of soils it grows, the part of the plant used, the season and the
moon in which the vine is harvested, and other factors. Langdon examined
yajé classification among the Siona of the Colombian southeast[7]. There
hasnot been, as far as I know, any inter-ethnic comprehensive study focusing
on the vernacular taxonomy of Banisteriopsis caapi.
We have to view the caapi complex in the context of the use of other
psychotropic plants, such as tobacco, Anadenanthera and Virola snuffs, as well
4 Luis Eduardo Luna

as other plants, psychotropic or not, with religious/spiritual significance2. No


doubt many Amazonian indigenous groups have a great interest in mind-
altering plants. They are specialists in the pharmacology of consciousness.
A bibliographical investigation in 1986 resulted in references to the use
of B. caapi with or without additives among seventy-two indigenous groups
belonging to several linguistic families[10]. This list is most probably not
exhaustive. The use of B. caapi has been adopted in later times by some of
these groups, and it is still expanding, even outside of the Amazon area, for
example among the Guarani of southern Brazil[11]. Bravec de Mori argues
for the relative recent introduction of ayahuasca south of Iquitos[12]. The
point of dispersion of the use of Banisteriopsis caapi is not known, or when
this might have happened. The origin of its use may forever remain a
mystery.
We have no evidence of indigenous group using ayahuasca outside the
Upper Amazon. In the early nineties I heard that natives of Marajó, the large
island located at the mouth of the Amazon River (no specific ethnic group
was named) sold Banisteriopsis caapi to Umbanda (an Afro-Brazilian
religion) centers, to be used for herbal baths, and I saw it being cultivated for
this purpose at an Umbanda center in Porto Velho, in the Brazilian State of
Rondônia. No fieldwork in this area has been carried out on this subject.
Ayahuasca and yajé have many other vernacular names[10,13]. In
Brazil religious organizations that use ayahuasca as a sacrament call it
either santo daime or vegetal.

2.3. Importance of the caapi complex

Richard Evans Schultes (1915-2001), a pioneer in the study of


Amazonian psychoactive plants, summarizes thus the importance of caapi
among Indian tribes:

“Probably no other New World hallucinogen – even peyote – alters


consciousness in ways that have been so deeply and completely evaluated
and interpreted. Caapi truly enters into every aspect of living. It reaches
into prenatal life, influences life after death, operates during earthly
existence, plays roles not only in health and sickness, but in relations
between individuals, villages and tribes, in peace and war, at home and
in travel, in hunting and in agriculture. In fact, one can name hardly any
aspect of living or dying, wakefulness or sleep, where caapi
hallucinogens do not play a vital, nay, overwhelming, role”[14].

2
For a comprehensive discussion of the botany of ayahuasca see Ott[8,9].
Indigenous and mestizo use of ayahuasca 5

Reichel-Dolmatoff, whose studies of the Tukano indigenous groups of


the Colombian Vaupés threw new light to the role of caapi in those societies,
wrote the following:

“The use to which these hallucinatory trances are put by the different
Indian tribes varies from curing rituals to initiation ceremonies, and
from the violent frenzy of warriors to ecstatic religious experiences. In
all cases, it seems, yajé is thought to provide a means of being
transported to another dimension of consciousness, which, in the daily
life of the individual or of the group, acquires great importance. It would
seem, then, that without exploring this dimension, a knowledge of
aboriginal culture is impossible”[6].

It is not surprising that the origin of caapi is found in the myths3. Here
two examples. The first myth is from the Tukano of the Colombian Vaupés
territory, an agriculturist indigenous group that lived in relative isolation
when Reichel-Dolmatoff collected it in the late sixties[6], and which was
recited in many ceremonies. Here a highly abbreviated form based on the
narratives he collected:
It happened in the beginning of time, when Anaconda-Canoe was
ascending the rivers to settle mankind. Yajé woman, the first woman of
creation, had come with the men, the ancestors of the Tukano. She was
impregnated through the eye by the intense yellow light of the Sun Father,
the phallus, the Master of Yajé, in the House of Waters, the first maloca
[communal house], by a roaring and foaming fall. The woman left the maloca
while the men were preparing cashiri beer and gave birth to the yajé vine in
the form of the a radiant child. She then enters the maloca with her child, the
men becoming dizzy, seeing red colors, the blood of childbirth, and losing
their senses. The woman asked: “Who is the father of this child”? One man
had kept a clear head. He said: “I am his father”. He took one of his copper
earrings and broke it in a half, and with the sharp edge he cut the umbilical
cord, a large piece, which is why yajé comes in the shape of a vine. The
others grabbed him by his fingers, arms and legs, tearing him into peaces,
each getting his own kind of yajé, and which give their identity to various
groups within the Tukano and the rules by which to live.

3
When Steven White and I were preparing Ayahuasca Reader: Encounter with the
Amazon’s Sacred Vine [15], we noticed that the indigenous myths we found were
referring to B. caapi. We did not find any myth referring solely either to Psychotria
viridis or Diplopterys cabrerana. This is interesting given that it is the admixture
plants that contain the visionary alkaloid (DMT).
6 Luis Eduardo Luna

Even though at first sight we would have among the Tukano a heavenly
origin of caapi, the abode of Father Sun is in ahpikondiá, the underworld,
and the source from which all life springs and to which the souls of the
virtuous return after the body’s death. An underwater origin of nishi pai
(ayahuasca) is found among the Cashinawa and other indigenous groups of
the Pano linguistic family of the Peruvian and Brazilian Amazon. There are
several variations on this myth. Here in an abridged form, based on a
narrative collected by Lagrou in the Purus River[16]:
Yube, the ancestor of the Cashinahua, went hunting by a lake not far
from a genipap tree [Genipa americana, used by indigenous groups to paint
their bodies]. While he was hiding a tapir arrived, took a genipap fruit in his
mouth and threw it to the lake. An anaconda rose from the lake and as she left
the water turned into a beautiful woman, her body covered by genipap
designs. They made love. When Yube went back home he did not eat any of
the food his wife had prepared, nor was able to sleep, his mind on the
beautiful woman he had seen. The next morning he went to the lake, took
three pieces of fruit and threw them in the water, and as the woman came out
he tried to lay her down. The woman resisted and transformed into the
anaconda, almost suffocating him. Yube explained why he had come, and
lied saying he was single. The woman said that she was looking for a
husband. If he wanted to make love to her he had to live with her in the lake.
He agreed, made love to her, and the woman squeezed the sap of a leaf in his
eyes so that he would not be afraid. She had him climb on her back and took
him to her family in the lake. Yube got used to living with the anacondas,
work for his father-in-law and made three children with her wife. One day the
snake people were going to take nishi pai (ayahuasca) and his wife warned
him against taking it, but he insisted he would take it. He went with his
father-in-law to collect the vine and the leaves. When he drank the brew he
became afraid and cried: “The snakes are swallowing me”. The snake people
were offended and nobody wanted to speak with him any longer, nor gave
him food. He went to the forest where he met the little fish that told him he
was in great danger, as the snakes were going to kill him. The fish put the
juice from a leaf in Yube’s eye and took him to a stream where his previous
wife use to go to cry for him since he disappearance three years ago. She
recognized him, gave him food, and he lived there for a whole year hiding
from the snakes. Then a child was born. He went to the forest to find genipap
to paint his newborn child but it rained and the rivers began to rise. He
slipped into a stream and a snake, his youngest son, got hold of his big toe.
Then his oldest daughter swallowed his whole foot, and his snake wife
gulped down his whole body until his armpits. He cried for help, his kin
rescued him, but his bones were broken. He wanted to know when he was
going to die and asked them to bring all sorts of vines and leaves until he
Indigenous and mestizo use of ayahuasca 7

recognized the right ones to prepare nishi pai. He gave his people the brew,
who learned how to make it. During three nights he sang the songs he had
learned from the snake people and then he died. He was buried and kawa
leaves [Psychotria viridis] came out of his eyes and four kinds of vine grew
from his limbs. His people prepared the drink but did not know the songs.
One of the boys who had not taken the brew with the ancestor, but who had
listened carefully, remember the songs, which is the reason why the
Cashinahua know these songs.
Among Záparo and Peruvian mestizo vegetalistas the origin of the two
plants involved in the preparation of ayahuasca come from the bones and
blood (or simply from the grave) of a human being. A variation of this myth
was later incorporated as the central myth of the União do Vegetal, one of the
Brazilian organizations using ayahuasca.
The fact there are such myths may indicate that the caapi complex is
probably old, but we have no certainty, as the earliest unequivocal record is
from the eighteen century. The botanical distribution of Banisteriopsis caapi
encompasses a huge area, and it is easily cultivated, as exemplify by the use
of pildé, one of the vernacular names given to the beverage, by indigenous
groups of the Pacific lowlands of Colombia and Peru[6], where it must have
been introduced, as the plant could not have migrated naturally across the
Andes Mountains.
Recent studies are showing that large areas of the Amazon Basin were
probably heavily populated. Extensive areas of the so-called terra preta do
indio, anthropogenic soils of extraordinary quality for intense cultivation,
reveal perhaps large human populations. In Beni, in the Bolivian Amazon, huge
areas were dedicated to raised agricultural fields, dikes and reservoirs and fish-
corralling fences, demolishing the theory that the Amazon had not enough
protein to sustain large human populations[17,18]. Numerous geoglyphs in
Acre, in the Brazilian Amazon, reveal habitation – and therefore resources – in
areas paradoxically now dedicated to cattle ranching. Certainly the astonishing
ceramics found along the Amazon River (for example those of
Santarem and Marajó), which Fray Gaspar de Carvajal in 1513 praised
as “the best in the world, better than those of Malaga”4, reveal huge cultural

4
Here the original Spanish text: “En este pueblo estaba una casa de placer, dentro de
la cual había mucha loza de diversas hechuras, así de tinajas como de cántaros muy
grandes de más de veinti cinco arrobas, y otras vasijas pequeñas como platos y
escudillas y candeleros desta loza de la mejor que se ha visto en el mundo, porque la
de Málaga no se iguala con ella, porque es toda vidriada y esmaltada de todas colores
y tan vivas que espantan, y demás desto los dibujos y pinturas que en ellas hacen son
tan compasados que naturalmente labran y dibujan todo como lo romano”. (p. 69)
8 Luis Eduardo Luna

sophistication[19]. What role Banisteriopsis caapi may have had in culturally


diverse pre-Columbian Amazon we don’t know. Near Santarem were found
beautifully made ceramics with the jaguar and other shamanic motives in
which a small drink was used obviously ceremonially. As far as I know there
has been no identification of what drink these ceramics may have contained.

2.4. Indigenous spirituality and shamanism

Indigenous ayahuasca use can only be understood within the context of


indigenous spirituality. According to its worldview there is an underlying
spiritual aspect to everything that exists, an intimate relationship and even
dependency between the seen and the unseen, between the world of nature
and human creation on one side, and normally invisible and intelligent
forces. The preservation of the individual and the community, and therefore
human action, depends on finding the proper balance in this complex
reality. Sacred plants, such as ayahuasca, facilitate the perception of such
complexity. Gifted individuals may establish alliances with spiritual forces
and interact for the benefit (or detriment) of others. They are able to
interpret natural phenomenon finding hints that reveal the development of
unseen forces that determine human existence. They are curious, interested
in plants and animals, weather conditions, natural phenomena and the
traditions of his community. They are therefore the recipients of the myths,
narratives, songs, and spells. They have clear visions when under the
influence of sacred plants, or are able to shed light upon the visions and
experiences of others. They are intellectuals and humanists. These are the
shamans or payés, both feared and seek for when the situation thus requires
it. They undergo especial training, which implies dietary restrictions, the
avoidance of sex, sojourns with shamans of neighboring indigenous groups
and the acquisition of helping spirits, powerful objects, magical arrows and
metaphors that help them in their practice. They are both knowledgeable of
their natural environment as the masters of complex normally unseen
supernatural realms.

2.5. Types of rituals

Reichel-Dolmatoff[6] pointed out that among the Tukano there are two
kinds of caapi rituals. On one hand there are the great collective ceremonies
involving one or more exogamic units which involve dancing, singing, and
recitations, accompanied by rattles, flutes, fifes and other musical
instruments, and which emphasizes the divine origin of their social laws, also
the ceremonies connected with the individuals life cycle such as initiations
Indigenous and mestizo use of ayahuasca 9

and burials, and above all the ancestor-communication Yuruparí ceremonies.


On the other hand the more intimate sessions devoted to shamanic practices,
such as healing and divination, finding game or learning about the plans of
the enemy during warfare, and involving just a few individuals. He also
indicated that in the Vaupés only Banisteriopsis caapi was used in collective
rituals, while in shamanic séances, in which “special effects” are desirable,
Banisteriopsis rusbyana (and old name for Diplopterys cabrerana) was also
added. Collective rituals taking place in 1923 were described by Karsten
among the Shuar of Ecuador[20], particularly those related to victory feasts,
and in 1934 by Goldman among the Cubeo of the Colombian Vaupés
region[21], related to ancestor cults. Due to the missionary activity and other
western influences, most collective rituals do not exist any longer. It is the
intimate shamanic use that has been preserved and transformed, with external
influences, in the sessions of mestizo ayahuasqueros.

2.6. Uses of the caapi complex

Many publications have dealt in one way or another with the use of
yajé/ayahuasca by indigenous groups. It is not my intention to summarize
here such studies. I will rather present the main uses, taken from indigenous
groups belonging to several linguistic families and cultural subdivisions
(hunter gatherers, agriculturists, savanna dwellers, etc.). Not all elements are
necessarily present in each indigenous group, and some of them are deeply
intertwined, so that differentiation is difficult. This will give us an idea of the
range of uses among the indigenous populations of the Amazon and Orinoco
Basins, and the Pacific lowlands of Colombia.

2.7. Contact with the primordial spiritual realm

The main function of ayahuasca/yajé is to enter into contact with the


unseen side of reality. Harner[22], referring to the Shuar of the Ecuadorian
Amazon, points out that the true forces behind daily life are in the
supernatural realm, the true reality, and can only be accessed through the
psychedelic experience. For the Cubeo, according to Goldman[21], the
exaltation of intoxication and frenzied emotional experience is sacred, and
caapi is used primarily to enter into contact with the ancestors. Harner calls
this modified state of consciousness “shamanic state of consciousness”[23].
Winkelman[24] proposes the term “integrative consciousness” using a highly
convincing neurophenomenological approach to shamanism that bridges the
realm traditionally found within anthropological and religious studies, with
the neurosciences.
10 Luis Eduardo Luna

Traveling to other dimensions and helping others to undertake without


danger journeys to the other side of reality is the specialty of the shaman. In
the case of the Siona, according to Langdon[25,26], the shaman conducting
the ritual, through his songs, take the assembly into specific region of their
cosmos, each characterized by its particular sounds, rhythms, music, smells
and colors.
The process of entering the other side of reality may be experienced in
terms of dismembering, death, and resurrection, a common motive found in
shamanistic traditions globally. Referring to the Tukano of the Colombian
Vaupés, Reichel-Dolmatoff writes the following:

“Recognizing that the individual must pass from one dimension of


existence – or cosmic plane – to another to communicate with the
spiritual or invisible world, the Tukanos take caapi to effect this
transport. The trip represents to them the process of birth and breaking
through the wall that separates the two cosmic planes and signifies,
according to anthropological studies, the rupture of the placenta.
Drinking caapi is often interpreted as returning to the ‘cosmic uterus’.
Since they insist that they sometimes come to know death while under the
influence of the drug, the Tukanos consider the return to the cosmic
uterus as an anticipation of death which permits contact with the divinity
or visitation with the source and origin of all things”[6].

A related metaphor is found among the Kamsá of the Colombian


Putumayo. After birth the baby’s umbilical chord is severed, separating him
from his mother’s placenta. According to their view, yajé is like a new
umbilical chord connecting the person to the whole cosmos.

2.8. Transformation and communication with the animal and plant world

A common motive in shamanism everywhere is transformation into an


animal to perform certain tasks. In the Amazonian region one of the main
shamanic motives is that of jaguar transformation, especially to attack
enemies. In some cases the shamans may become other great predators, such
as the harpy eagle and the anaconda. These three animals crown the
Amazonian trophic pyramid. The shaman may either transform into an
animal, or an animal or a plant may adopt anthropomorphic features to
communicate with humans. We are here confronted with a radically different
epistemology, one that presupposes the possibility of perceiving the world
from the point of view of a non-human creature, something which cannot be
rejected as a totally far-fetched way of thinking, even though difficult to
Indigenous and mestizo use of ayahuasca 11

comprehend without direct experience of the states of consciousness in which


it is based. A dialogue of worldviews is needed, one that goes beyond
ethnographic curiosity and which accepts that other approaches to reality are
indeed possible. Western science, due to prejudices, is largely totally ignorant
about the possibility of acquiring actual information about the natural world
in non-ordinary states of consciousness.

2.9. Divination, healing and warfare

Getting information from other realms is indeed one of the main


functions of the caapi complex. It is used to locate animals in the forest, to
find out about relatives in distant places, to know the cause or etiology of
illness, to get to know the plans of the enemies, etc. When Karsten asked
the Shuar why they drink natéma, he got the following answer: “It is in
order that the people may not die away”. He then adds the following
commentary: “By this kind of divination they try to find out what dangers
are threatening the family, whether enemies are planning an attack against
them, whether evil sorcerers are operating against them, whether they will
be successful in their own undertakings, and so forth”[20].
Ayahuasca/yajé is used to diagnosis and to look for the deeper cause of
illness. Sometimes also the patient may take it to contribute to find the
etiology of the ailment. Sucking, blowing tobacco smoke over the patient or
over the medicinal plants used, songs and incantations are usually essential.
Some indigenous groups may use it in conjunction with other plants. Such
is the case of the Tukano, who use vihó, a DMT containing snuff prepared
from the sap of Virola species. Often medicinal plants are collected under
certain dietary conditions, for example before dawn and without having
eaten anything, as well as after invoking the spirits of the plants or making
offerings to them.
Given that illness is usually thought as the result of the action of an
animated agent, fighting it is part of the healing process. The shaman has
the double role of healer and sorcerer, protecting his community but at the
same time attacking its enemies, either by transforming into a jaguar, or by
sending back the illness to the person who sent it, or through helping spirit
animals.
It seems that among some indigenous groups caapi was used with
warfare. Spruce described in 1852 how the person who has taken caapi
would “bursts into a perspiration, and seems possessed with reckless fury,
seizes whatever arms are at hand, his murucú, bow and arrows, or cutlass,
and rushes to the doorway, where he inflicts violent blows on the ground or
the doorposts, calling out all the while, ‘Thus would I do to mine enemy
12 Luis Eduardo Luna

naming him by his name) were were this he!5’” Calavia[27] pointed out that
Yaminahua memories of life before the pax branca (the peace imposed by
whites), suggest a conception of ayahuasca that might seem strange or
perhaps even scandalous in another context: the plant-substance is a
bloodthirsty agent associated with war and vengeance that eventually is
tempered by the blood of a dead relative. It is also the instrument of an
aggressive shamanism in which therapy is defense and counter-attack.
Not keeping dietary prescriptions when hunting, having contact with
menstruating women or childbearing women, not paying respect to the spirits
when approaching special places in the forest, may cause illness.

2.10. Acquisition of songs and designs

In some indigenous groups there seem to be an intimate relationship


between the experiences in other realms through yajé/ayahuasca and visual
expressions in body painting and the patterns used in the ornamentation of
communal houses, weapons, paddles, stamping tubes, ceramics, and other
objects. Songs and dances are also said to derive from experiences on the
other side of this reality.
According to Father Plácido de Calella, a missionary who worked among
the Siona, in the beginning of the 20th century, “during these hallucinations
the shaman and the other participants claim to see large crows of people,
called “yajé people” (yagé-pai) and who sing and play musical instruments.
When the trance is over the men copy the design motifs of the body paint of
these spirit-beings and use them to adorn their own faces”[28]. Langdon later
confirmed this idea, while also by reporting that most Siona narratives can be
characterized as shamanic, in the sense that they deal with shamans and/or
with experiences in the occult world when dreaming or taking yagé.
Reichel-Dolmatoff[6], when discussing with a Tukano of the Colombian
Vaupés Territory the colorful designs on the exterior of one of the communal

5
It has always puzzled me the rapid reaction in the persons taking caapi described by
Spruce, who wrote: “This is all I have seen and learnt of aya-huasca. I regret being
unable to tell what is the peculiar narcotic principle that produces such extraordinary
effects. Opium and hemp are its most obvious analogues, but caapi would operate on
the nervous system far more rapidly and violently than either”. Such rapids effects are
not at all what I have observed throughout the years participating in yajé and
ayahuasca rituals, where usually between half and hour and an hours pass before
feeling the effects. Could it be that the type of diet held has such a direct diverse effect
among indigenous populations and more westernized participants? More studies are
needed to elucidate this apparent anomaly.
Indigenous and mestizo use of ayahuasca 13

houses, received the following explanation: “We see these things when we
drink yajé”. A subsequent study of the patterns reveled that certain motifs
had meaning, almost always phrased in terms of fertility symbolism. Reichel-
Dolmatoff compared Tukano designs with phosphenes (light patterns
originated within the eye and the brain) isolated by Knoll[6,29]. “The
similarities are such [he concludes] that there can be no doubt left: The
decorative patterns of the Tukano are almost whole derived from drug-
induced inner light experiences”. The geometrical patterns would only
represent the initial stage of neurophysiologic stimulation. A second stage
would be marked with the onset of figurative representations, in turn
culturally modeled.
Among the Shipibo of the Ucayali River (Peru), the extraordinary
designs that cover the ceramics, skirts, and previously other material objects
of this culture, are inspired by nishi-pai. According to Gebhart-Sayer the
shaman ascends to higher realms where he listens the melodies from the
spirits and sing with them. Those songs have a visual manifestation that the
women transmit in their art[30]. The Shipibo believe their bodies are covered
by invisible designs. Illness is the disruption of the patterns, and the songs of
the shaman restore their order and beauty. Healing is thus an aesthetic
endeavor. While doing fieldwork in Santa Rosa de Pirococha, a Shipibo
settlement by the Ucayali River, I asked Don Basilio Gordon, a shaman,
about the plants he used to heal his patients. He said that it is enough to know
the songs of the plants to be able to cure. The plants are needed only if you
do not know their song.

2.11. Promotion of social order

Caapi and other sacred plants are considered among some indigenous
groups as promoting social order. Brown[31,32] referring to the Aguaruna of
Peru writes: “Adults sometimes remark that their children control more
knowledge (e.g., the ability to read and write) because they attend school, but
that they are often “stupid” (anentáimchau, literally “without thought”)
because they no longer undergo the rigorous training linked to the use of
hallucinogenic plants. This lack of thought manifests itself in such antisocial
behavior as fighting with close kinsmen, attempting suicide, maintaining an
unseemly interest in sexual adventures, and otherwise affronting traditional
morality”. For the Aguaruna, it is not enough simply to know facts; one must
learn to think well by bringing together the body, the emotions, and the
intellect in the epiphanous context of the visionary experience.
According to Reichel-Dolmatoff yajé gave the Tukano their life, the rules
by which they should live, their way of life. Karsten reports that among the
14 Luis Eduardo Luna

Shuar “both men and women are, by drinking natéma, made strong and
clever for their different occupations and duties, the men for hunting, fishing,
war, etc., the latter for agriculture, for the education of the children, for the
care of the domestic animals, and for other domestic work incumbent on
them”[20]. For the Siona yagé is central to their notions of well being and
health, as well as their acquisition of knowledge[26].

3. Part II: Mestizo use of ayahuasca


3.1. The use of ayahuasca among the mestizo population of the Peruvian
Amazon

Although there has been missionary activity in the Amazon region


since the middle of the 16th century, the greatest and most devastating
western influence in this region took place during the so-called rubber
booms in 1879-1912 and 1945-47. The great demand of rubber caused by
the industrial revolution created chaos among indigenous populations,
many subjected to slavery and moved around to other Amazonian regions.
There was also a period of intense biological and cultural mixture of
westerners and the indigenous people. Practitioners appeared conducting
healing rituals in which indigenous Amazonian ideas and the use of
ayahuasca (and other plants) were integrated with Andean and Christian
beliefs. This is the so-called vegetalismo phenomenon, from vegetal, the
name given to plants with extraordinary properties, such as ayahuasca. I
dedicated several years to the study of this tradition in the period between
1981-1988, and was the subject of my doctoral dissertation and several
other publications[33,34].
My main informant and friend was Don Emilio Andrade Gómez, a
mestizo vegetalista who lived 12 kilometers from Iquitos, by the road that
now connects the city with Nauta, in the south, where he received patients
Tuesdays and Fridays, at times (not always) drinking ayahuasca. I became a
sort of apprentice, as well as that of Don José Coral, a vegetalista friend of
his, who lived a few kilometers away. This took place before the current
flux of westerners arriving to Iquitos in search for ayahuasca. As an
educated Westerner I think I was alone in this quest at that time. As a
mestizo (I was born in the Colombian Amazon, of non-Amazonian parents)
I was simply part of a tradition, now at least one hundred years old. Don
Emilio took ayahuasca for the first time in 1937 at the age of fourteen. His
teacher was Don Juan Hidalgo Nina, also a mestizo, who in turn had Don
José Benavides Sánchez as his teacher.
Indigenous and mestizo use of ayahuasca 15

3.2. Plant teachers

For me the greatest discovery was the concept of plant-teachers. Don


Emilio considered ayahuasca as one of many doctores, plant-teachers,
plants that give knowledge6. He called these plants doctores: ojé (Ficus
anthelmintica), toé (Brugmansia sp.), catahua (Hura crepitans),
clavohuasca (Tynanthus parunensis), ayahúman (Courupitas guianensis),
and many others. Don Emilio called them collectively as vegetales, hence
the name vegetalista, which refers to a person that has learned from those
plants. Within vegetalistas there are specialists in one or other plant, for
example tabaqueros, toeros. There are also paleros (specialists in certain
large trees, or palos), who have great reputation, or perfumeros, specialized
in the use of perfumes from certain plants in order to heal. The bark or
other plant of these trees may be added to the ayahuasca when it is being
prepared, or may be taken also independently. Don Emilio use to say that
he was only an “ayahuasquerito”, a little ayahuasquero, but there were
others with greater powers, those who learned from big trees in which
ayahuasca may climb and grow. These plants can also be taken for
medicinal purposes, or solely in order to make the body strong, not
necessarily to learn from them.

3.3. Initiation

In order to learn from the plants it is necessary to dietar (maintain a


certain diet). This term implies not only food restrictions, but also sexual
segregation (if possible isolation, or at least not having sexual intercourse)
and certain ritual procedures. The initiate must abstain salt, sugar, fruits and
fish containing much fat. Basically it should be manioc or rice, plantains,
and just a little fish from time to time. It is a process of purification that
opens the contact to the spirits of the plants. Vomiting is conceived as
helping the purification process. The shaman is there first of all to protect
the initiate. Sometimes, as a result from an illness, a person may go into
diet and isolation by himself (I use here the masculine, but there are also
cases of female practitioners), and in the process becoming a healer.
It is often said that the initiate is first tempted by spirits to receive
certain powers. If taken, the initiate may become a brujo, a sorcerer. If the
initiate refuse those powers and continue his training then he becomes a
healer.

6
The idea of ayahuasca as a teacher is present in Brazil among practitioners of Santo
Daime, “o professor dos professors”, “o mestre de todos os ensinos”[35].
16 Luis Eduardo Luna

3.4. Icaros, the magic phlegm and concepts of illness

In this tradition the essence of power and wisdom is in the icaros, the
songs the spirits of the plants (or other spirits) teach the initiate, either when
taking ayahuasca or other plants, or in the dreams that follow such ingestion.
Icaros may have various functions. They may be invoked for protection, to
call certain spirits, to heal particular illnesses, to travel to specific places, to
give strength or to diminish the effects of ayahuasca, etc. A vegetalista may
possess dozens of icaros, their complexity often being an indication of his
power. Icaros are an essential part of the work of a vegetalista. An icaro is
always sung over the ayahuasca brew before taking it, and ceremonies
basically consist of a vegetalista singing during several hours his icaros,
often accompanied by a schacapa, a bundle made of Pariana leaves, a
tradition found among indigenous practitioners such as the Kamsá or Ingano
in Colombia.
Icaros must often are learned directly from the plants, particularly during
the initiation period or when the vegetalista decides to spend time in isolation
to replenish his healing energies. They may be also learned from other
practitioners. It is said that icaros my leave a person all-together to go into
another one. They can be stolen from another person, or being forgotten due
to some sort of sorcery from the part of envious practitioners.
During initiation the neophyte may receive from his teacher (or from
plant-spirits) a magic phlegm called mariri, yausa or yachay. This is said to
be planted like a tree, growing inside the initiated to extract the illness from
his patients, which may be cause either by the intrusion of a pathogenic
object, often called a virote, the name given to the arrows Spaniards shot with
their crossbows, in an area where powder often got wet making fire weapons
unusable. It is also possible to harvest those virotes and keep them in the
phlegm for later use as a weapon. Sucking and blowing are essential elements
in a healing session, especially certain areas of the body such as the boca del
estómago (solar plexus), the top of the head, the temples, and along arms and
legs. As in other traditions, hiding an insect or a small thorn in the mouth and
pretending it was extracted from the body of a patient, is part of the tools of
the vegetalistas to elicit a psychosomatic response. Some practitioners may
use certain stones, called encantos, to help in the extraction of illness.
Illness may be also conceived as the result of soul loss due to fright or
sorcery. Since illness is conceived as caused by an animate agent – human or
supernatural –, healing is often associated with defense and counter-attack.
Vegetalistas are particularly vulnerable during ayahuasca sessions. Stories
about practitioners being wounded or killed during such sessions abound.
Protection is then necessary. Through certain songs – as is also the case with
Indigenous and mestizo use of ayahuasca 17

the Shipibo of the Ucayali River – the person may be covered by an arkana,
described as some sort of metal shirt covering the body of a person, thus
protecting her from pathogenic darts.
It is also normal, especially in difficult situations, to invoke Jesus and
Mary, angels with swords, animal protectors (Amazonian as well as lions,
elephants, and the like), soldiers with guns, war airplanes, flying saucers, etc.
Whenever a new symbol of power emerges, it is easily incorporated in this
highly syncretic tradition.
The concept of illness may apply also to bad luck in business or in love,
and special ceremonies are held to treat those situations that include the use
of magnets (to make the person attractive), perfumes and certain plants.
There are also ideas found in other parts of the Americas. For example certain
winds or vientos, or whirlpools may cause the illness. Unexpected encounters
with spirits may cause fevers and even death. In all situations icaros are
essential in the healing process as well as protecting the person from further
attacks.

3.5. Spirits

Seeing beings seems to be a universal feature of ayahuasca intake. Spirits


may adopt any shape, as indigenous people or as people from any part of the
world. They may be also animal, therianthropes, or completely alien and
believed to be of extraterrestrial origin or living in other realms within our
world, in the forest, the bottom of lakes or rivers, the interior of the Earth,
etc. Their dresses may seem royal, ancient or futuristic, luminous, huge or
small, benevolent or at times threatening, fully visible or composed of
appearing and disappearing lights of any colors. Often they communicate
telepathically, with gestures or with words (less common). Obviously, their
appearance depends on human culture.
The plasticity of Peruvian vegetalismo can be seen in the adoption of
modern technology. They may communicate with the language of radio, like
described by Chevalier[36], or in “computer language” as reported by
Beyer[1]. Don Emilio told me that the first time he took ayahuasca he saw
luxurious cars, trains, boats, helicopters and peoples of all kinds. Later he
saw “doctores” who came from all over the world: “They all came, French,
English, Americans, Chinese, Japanese, Spanish, Chileans, these doctors
were from all places”. The adoption of modern technology has been observed
by Chaumeil[37] in contemporary Yagua medical practices. He describes
innovations like telephones, parabolic antennae, syringes etc. as being used
by nowadays Yagua “shamans” for communication with spirits, for spiritual
operations.
18 Luis Eduardo Luna

Particular spirits are believed to live in the surrounding forests, lakes


and rivers. This was perhaps even more when I was conducting my
fieldwork than today, due to the continued deforestation and urbanization
process. The Chullachaqui (uneven foot in Quechua) may adopt the shape
of a relative or a friend to lure a person walking alone into his forest realm,
never to return. If this spirit is offended he may produce dangerous storms
or make people sick. The Chullachaqui is believed to have as its dwelling
in what they call supay chacras, areas where only Duroia hirsute grows, a
small tree that through its chemistry prevents the growth of other plants
nearby. The water realm is especially powerful. Mermaids may seduce men
or pink dolphins may seduce women to take them into their world. Two
giant serpents preside those two realms: the Sachamama or mother of the
forest, and the Yakumama or mother of the water. They are ambivalent with
respect of human beings, but vegetalistas may establish a rapport with them
for the benefit of their patients.

4. A comment on ayahuasca tourism


I would like to end with a brief commentary on the phenomenon
currently known as “ayahuasca tourism”, and which is taking place first of all
in the Peruvian Amazon, especially around Iquitos. It is an occurrence with
international repercussions, given the number of practitioners of many
nationalities emerging from this tradition that are conducting ceremonies in
non-Amazonian countries.
My knowledge of this phenomenon is superficial. In July 2005 I was
invited as a speaker to a conference in Iquitos, a city I had not visited for
many years. Having done fieldwork (and experiential training) in that area in
the early eighties, I was nearly shocked to see the buses full of people from
all over the world going to participate in ceremonies with this or that
indigenous or mestizo practitioner. Obviously much had happened during this
twenty-five year gap in which I had been absent.
New studies have emerged, most notably those of Dobkin de Rios, who
has taken what is in my view an extreme position. Given that DMT, the
visionary agent present in both Psychotria viridis and Diplopterys cabrerana
is an illegal substance, emanating from 1970 Control Substances Act of the
United States of America, she considers this phenomenon as a
manifestation of international drug trafficking. People arriving to Iquitos
are empty souls looking for a high, while most practitioners meeting the
demand simply charlatans looking for profit and taking advantage of female
participants[38,39]. I see this phenomenon in a different way, rather as a
Indigenous and mestizo use of ayahuasca 19

sort of continuation of the vegetalismo tradition turned international, with


positive as well as negative aspects. It is not my intention to examine here
such a complex phenomenon. I rather prefer to point out to a recent study,
which I find most welcomed. I am referring to Evgenia Fotiou’s doctoral
dissertation about ayahuasca tourism in Iquitos. She writes:
“Through my data I show that the western interest in ayahuasca is much
more than a pretext for drug use but rather is often perceived as a pilgrimage
and should be looked at in the context of a new paradigm, or rather a shift in
the discourse about plant hallucinogens, a discourse that tackles them as
sacraments, in sharp contrast to chemical drugs. Ritual in this context is
instrumental but not as something that reproduces social structure; rather it
fosters self transformation while at the same time challenging the
participants’ very cultural constructs and basic assumptions about the
world”[40].
Fotiou sees ayahuasca tourism as a two-way avenue in which indigenous
and mestizo ayahuasqueros absorb –once more- certain western ideas and
adapt their practices to the expectations of non-Amazonians, while people
from other countries adopt indigenous ideas about intelligent plant spirits and
the like. This is not at all something new. As we have seen earlier, exchange
of symbols and power metaphors have been an essential part of Amazonian
shamanism.
We are now in a phase beyond ayahuasca tourism. Ayahuasca is
becoming –in a modest scale, of course- a global phenomenon, with
practitioners coming from various traditions, such as the Brazilian religious
organizations, and with the absorption of a number of therapeutic techniques.
There is an increasing number of people who for one reason or another
decided to conduct rituals in their own settings.
It is my impression, corroborated by a study by Winkelman[41] that
more often than not most of the people taking ayahuasca now-a-days do it
with the intention of finding guidance from within, for personal growth, or
in search of spiritual experiences. Claudio Naranjo observed in 1967 when
doing experiments with harmaline, an alkaloid mostly found in trace
amounts, but also present in significant amounts in certain brews, pointed
out that “concern with religious and philosophical questions is
frequent”[42]. Shanon[43] has pointed out similar ideas regarding
ayahuasca intake among Westerners, a position I also ratify. More so, I
believe ayahuasca/yagé, as well as other sacred plant preparations from the
Americas and beyond, have extraordinary potential in the study of
consciousness and as cognitive tools. More studies should be conducted, as
well as public discussions as how to deal, in a positive way, with one of the
greatest discoveries of Amazonian people.
20 Luis Eduardo Luna

References
1. Beyer, S.V. 2009, Singing to the Plants. A Guide to Mestizo Shamanism in the
Upper Amazon, University of New Mexico Press, Albuquerque.
2. Pané, R. 1944, In: Historia del Almirante de las Indias Don Cristóbal Colón –
Colección de fuentes para la Historia de América, F. Colón, Editorial Bakel,
Buenos Aires, 163.
3. Cárdenas, J. 1591, Primera Parte des Segretos Maravilosos de las Indias, México.
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Hallucinogenic Use, Alfred van der Marck Editions, New York.
5. Chantre y Herrera, J. 1901, Historia de las Misiones de la Compañía de Jesús en
el Marañón español – 1637-1767, Madrid.
6. Reichel-Dolmatoff, G. 1975, The Shaman and The Jaguar – A Study of Narcotic
Drugs Among the Indians of Colombia, Temple University Press, Philadelphia.
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the Peruvian Amazon, Almqvist & Wiksell International, Stockholm.
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Jungaberle and B.C. Labate, (Eds.), Göttingen-Bern-Wien-Oxford, Hogrefe.
12. Rose, I.S., and Langdon, E.J. 2010, Diálogos (neo)xamânicos: encontros entre os
Guarani e a ayahuasca. Revista Tellus, 18, 83.
13. Rätsch, C. 2005, The Encyclopedia of Psychoactive Plants – Ethnopharmacology
and Its Applications, Park Street Press, Rochester.
14. Schultes, R.E. 1982., J. Psychoactive Drugs, 14, 205.
15. Luna, L.E., and White, S. 2000, Ayahuasca Reader – Encounters with the
Amazon’s Sacred Brew, Synergetic Press, Santa Fe.
16. Lagrou, E. 2000, In: Ayahuasca Reader – Encounters with the Amazon’s Sacred
Vine, L.E. Luna and S.F. White, Synergetic Press, Santa Fe.
17. Balé, W., and Erickson, C.L. (Eds.). 2005, Time and Complexity in Historical
Ecology: Studies in the Neotropical Lowlands, Columbia University Press,
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18. Erickson, C.L. 2005, In: Time and Complexity in Historical Ecology: Studies in
the Neotropical Lowlands, W. Balé and C.L. Erickson (Eds.), Columbia
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A. de Rojas (Eds.), Ed. de Rafael Díaz, Madrid.
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of the Jibaro Indians of Eastern Ecuador and Peru. Societas Scientiarum Fennica.
Commentationes Humanarum Litterarum VII. 1. Helsinki.
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Illinois Press, Urbana.
Indigenous and mestizo use of ayahuasca 21

22. Harner, M.J. 1972, The Jívaro: People of the Sacred Waterfalls, University of
California Press, Berkeley.
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Langdon and G. Baer (Eds.), University of New Mexico Press, Albuquerque.
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Schwartz (Eds.), Mouton Publishers.
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Responsibility, Anthropology News.
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Controversy – Ayahuasca in the Amazon and the United States, Praeger,
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Iquitos, Peru. Doctoral dissertation. Dept. of Anthropology, University of
Wisconsin-Madison.
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the Ayahuasca Experience, Oxford University Press.
T Transworld Research Network
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The Ethnopharmacology of Ayahuasca, 2011: 23-53 ISBN: 978-81-7895-526-1


Editor: Rafael Guimarães dos Santos

2. The notion of cure in the Brazilian


ayahuasca religions

Sandra Lucia Goulart


Assistant Professor at Cásper Líbero College, São Paulo, Brazil and researcher in NEIP
(Psychoactives Interdisciplinary Study Group), São Paulo, Brazil

Abstract. This article discusses concepts and practices of healing


in Brazilian religions which have in common the use of a
psychoactive beverage mainly known by the names of Daime,
Vegetal and Ayahuasca. These religions are elaborated from the
same set of cultural traditions which nonetheless unfolds in
different ways. All of them originate in the Brazilian Amazon
region and in some cases, these processes expand to other parts of
Brazil and abroad. We compare here the ways in which the healing
is experienced and explained in these religions, emphasizing the
representations concerning this beverage used in all of them. The
case of these religions points to the complexity of the relation
between both scientific and religious medicines.

1. Introduction
In this article we intend to develop an analysis of the therapeutic concepts
present in some religious cults emerged in the Brazilian Amazon region

Correspondence/Reprint request: Dr. Sandra Lucia Goulart, Assistant Professor at Cásper Líbero College, São
Paulo, Brazil and researcher in NEIP (Psychoactives Interdisciplinary Study Group), São Paulo, Brazil
E-mail: [email protected]
24 Sandra Lucia Goulart

starting from 1930. All these cults have in common the use of the same
psychoactive beverage, made by brewing a combination of two plants, a liana
whose scientific name is Banisteriopsis caapi and the leaves of a bush,
Psychotria viridis1. In all of them this beverage also receives different
designations. Thus, in some of them the beverage is named Daime, in others
as Vegetal. The main habitat of the Banisteriopsis caapi is the East of the
Andes, Peru, Bolivia, the whole Northwest of the Amazon, the Colombian
and Brazilian Amazon, Ecuador and Venezuela.
Outside the context of these Brazilian religions, the term ayahuasca is
one of the most known and used for such psychoactive beverage. The term is
quite widespread in Peru and comes from Quechua. Aya means persona, soul,
“espíritu muerto”, and Wasca means rope, “enredadera”, “parra”, “liana”.
The name is used to designate both the beverage and one of the plants
composing it: the liana Banisteriopsis caapi[1]. Therefore ayahuasca can be
literally translated to Portuguese, as “the rope of the spirits” or “the rope of
the dead” and also as “the liana of the spirits or the dead”. Nowadays, the
term “ayahuasca religions” is also used by many scholars to refer to cults
which have arisen in Brazil. Within the indigenous context, the beverage is
mainly consumed in the Pano linguistic trunk groups (Eastern Peru / South
Acre), Arawak (Peru), and Tukano (Colombia), receiving different names in
these different contexts. Nowadays, throughout the Amazon, there are about
seventy indigenous groups making use of this beverage. The contexts of these
practices vary considerably. Although there are extensive and ancient
indigenous and mestizo traditions in the use of this beverage, the emergence

1
The liana Banisteriopsis caapi contains three beta-carboline alkaloids: harmaline,
harmine and tetrahydroharmine. The plant species Psychotria viridis, a bush, has as its
active ingredient another alkaloid, DMT (N,N-dimethyltryptamine), substance
considered as the main responsible for the visionary effect or the hallucinogenic
aspect of this beverage. However, it is known that DMT has no effect when ingested
orally, as it is deactivated by an enzyme present in the human digestive tract, the
MAO (monoamine oxidase). Hence, precisely, the importance of the alkaloids present
in the liana, which has the function to temporarily disable the MAO, allowing the
DMT to activate the central nervous system, thus producing its visionary effects. It is
also important to remember that since 1971, the Convention on Psychotropic
Substances, signed in Vienna has included the DMT on its top list of forbidden drugs,
considered highly dangerous. The ban involves many intricate and controversial
discussions[2]. Just to mention some issues, it is worth noting that in addition to
Psychotria viridis, several other species also have certain amounts of DMT, such as
some kinds of fungi, fish and mammals, including man himself, but suffer no
prohibition.
Cure in the Brazilian ayahuasca religions 25

of organized, urban, non-indigenous, religions based on its consumption, is


an exclusive phenomenon of the Brazilian region.

2. Mestre Irineu’s daime


Historically, the first of these religions was organized by Raimundo
Irineu Serra in the city of Rio Branco, capital of Acre state, in 1930. He, who
would later become known as Mestre Irineu was native from the state of
Maranhão, Northeast of Brazil. As most Northeastern people, he migrated to
the Amazon region, still early in the first decade of the twentieth century, to
work with the extraction of rubber. It is during the period in which he works
as a rubber tapper, in a border region between Brazil, Bolivia and Peru that
Mestre Irineu gets in contact with a whole culture of the use of this beverage
which would be central in the new religious cult founded by him. Between
1915 and 1918, more specifically in Brasiléia, Mestre Irineu would have not
only his first experiences with ayahuasca, but also begin to develop the
principles of worship that would later become known by the names of Alto
Santo, Daime or Santo Daime2. That is when the use of the beverage provides
him a set of mystical experiences, which feature the vision of a female entity
that gives him the doctrinal basis of the new cult based on the use of the
beverage, now called Daime. This entity who would later be identified by
Mestre Irineu as the Virgin Mary, from the Catholic tradition, would have
clarified that the real name of that beverage was “Daime”, whose meaning
comes from a request or invocation made by those who consume the
beverage to the spiritual being who reigns it. Thus, the believers would ask:
“Give me light”, “Give Me Love”, “Give me wisdom”, “Give me health” etc.
This explanation of the name Daime, already points to the importance that the
psychoactive beverage takes in the definition of the religious experience of
this cult believers. It indicates that the Daime is assigned a crucial role in
obtaining mystical, doctrinaire teachings or healing revelations - spiritual or

2
Only in 1970, shortly before his death that Mestre Irineu had his group notarized as a
religious institution, under the name of CICLU (Centro da Iluminação Cristã Luz
Universal – Christian Enlightening Center Universal Light). Previously, in 1945,
Mestre Irineu received a property donation, the Custódio Freire colony, located in the
rural suburbs of Rio Branco. He shared this land among his followers and built his
church at this site. The location, the church and, in some situations, the cult itself,
became known as Alto Santo. However, over time and even with the emergence of
new groups in this religious tradition, the group originally founded by Mestre Irineu is
also identified in some situations as “Daime” or “Santo Daime”. In this article this
term will be frequently used in order to refer to the religion created by Mestre Irineu.
26 Sandra Lucia Goulart

material. During this period, in Brasiléia, Mestre Ireneu organized along with
two fellows from Maranhão: André and Antonio Costa, the Centro de
Regeneração e Fé (Center for Regeneration and Faith), which had as its main
point of practices the consumption of ayahuasca.
Nevertheless, the daimist cult only begins to be effectively organized in
1930, when Mestre Ireneu already lives in Rio Branco. At that time, he was
established in the district of Vila Ivonete, rural area of the Acre capital which,
in that period, housed rubber plants and small agricultural colonies, whose
tenants were mostly former rubber tappers. Mestre Irineu, as well as several
of the first members of his cult, had, by then, small colonies. As shown in
other studies[3-5], to a certain extent, the religious group founded by Mestre
Irineu, in Rio Branco, expressed both the material reorganization of former
rubber tappers that, in a new environment, began to engage in the agriculture
activity, as the rescue of a group of ancient regional cultural elements, which
were resignified according to this context. At this time, issues related to
health, disease and healing problems, gained prominence.
Accordingly, the cult founded by Mestre Irineu appears, initially as a
healing cult. In the early years that marked the organization of his religious
group in Rio Branco, Mestre Irineu performed especially “healing works”
with the Daime. It was through this kind of practice that he and his new cult
were gradually becoming known, gathering followers in the region. Many of
those who sought the guidance of Mestre Irineu, at that time, brought up
requests related to health problems and, in most cases, those were typical of
diseases from the region and from a social layer of low income, with little
access to the official medicine. Thereby, the first believers of the group
founded by Mestre Irineu were converted, especially as they felt their
misfortunes and ailments were cured or solved.
This was the case of Antonio Ribeiro (and part of his family), one of the
earliest supporters of the cult of Mestre Irineu. In an interview with me, his
daughter, Percília Ribeiro, reported that her father sought Mestre Irineu in
1934 because he suffered from malaria, and could not have it cured through
the conventional medical treatments. In her words:

“There was no medicine to cure that (...) Dad went only from home to the
hospital, just taking drugs... And none of them made him better (...) Then
he went to meet Mestre (...) It was when he took the Daime. Soon he was
cured (...)”

This kind of statement is often repeated among many of those who


became disciples of Mestre Irineu in those early days. For them, Mestre
Irineu’s guidance, using the Daime, was usually preferred and more valued
Cure in the Brazilian ayahuasca religions 27

when compared to a medicine considered poor, inefficient or even absent,


revealing the lack of access of a certain population to medical services. Often,
even when such access was possible, the narratives point to the existence of a
distance between the doctors’ speech and the universe of the patient, which
ended up hindering the cure. In some statements, the interviewees stated
similarly to the testimonial above that doctors would not “understand” or
“figure out” what were the illnesses which afflicted him, therefore not being
able to “find” the proper medicine needed to cure them. Also accordingly, the
Daime would appear, for these believers, both as a remedy and a kind of
oracle, through which one could have the “revelation” of the required
treatment for a particular case. The so “revealed” and prescribed remedies
could be from teas or herbal compresses to even allopathic pills and tablets.
In the same statement quoted above, Mrs. Percília Ribeiro tells that, besides
her father, she herself was cured with the use of Daime through Mestre
Irineu’s guidelines.
In her case however the cure came with the “revelation” of the “right
medicine”, obtained by Mestre Irineu through the use of the Daime. So she
tells us:

“One day Mestre Irineu told dad: 'look, this one here is her medication.
She’ll take a box and she’ll be better'. And I took all those pills, the
whole box, as Mestre Irineu said, and I finally got better. It was like that
... sometimes the medicine was the Daime, when not Mestre would see
one’s remedy. He would get one’s remedy through the Daime (...) It was
like that, and who was with Mestre did not need another doctor (...)”

The term “miração” seems to come from the Spanish verb “mirar” which
can be translated into English as “see” or “look”. In the border regions of
Brazil with Spanish-speaking countries such as Peru and Bolivia, the use of
words in two languages is usual, in this case Portuguese and Spanish. As
seen, the religious cult founded by Mestre Irineu is in its origin, related to the
cultural context of a border region among Brazil, Bolivia and Peru, and so,
perhaps, some expressions and categories of this religious universe refer to
the Spanish language. “Miração” is a daimist fundamental category, which
refers to the effects of the Daime, especially the visual ones, meaning the
pinnacle of the beverage effects, marking a crucial moment of contact
between the believer and the sacred world.
The idea of “see” the right remedy for a particular disease “through the
Daime”, seems close to a set of concepts sustaining the oldest uses of
ayahuasca, which preceded the formation of Mestre Irineu's cult. This is the
case of traditions that were largely formed from the upper Amazon
28 Sandra Lucia Goulart

watershed as a result of the contact among the indigenous Christianized


groups, riverside mestizo populations and mainly rubber tappers, who
began to occupy the region from the mid-nineteenth century. According to
Luis Eduardo Luna[1] it was exactly this cultural exchange among these
different groups that allowed the emergence of a new set of practices
around the use of the ayahuasca beverage. These new practices, developed
in a different context from the tribes or villages of the indigenous groups,
and started emphasizing the use of the ayahuasca for therapeutic purposes.
Mainly for the tappers who started to live in a new and hostile environment,
in poor survival conditions, the ayahuasca started to be configured as a
remedy for all kinds of ailments[1]. Thus, the new occupant groups of the
Amazon region resignified the uses of this beverage, originally drank by the
indigenous peoples. Studies such as Luna’s suggest that actually, the
consumption of the ayahuasca in this new context, deeply influenced by a
mestizo rubber tapping culture, becomes relevant when compared to its
ancient indigenous use. Also accordingly, Luna says his informers from the
Peruvian region often used to say that the “caucheiros” discovered the
ayahuasca[1]. Yet, Nunes Pereira[6] called the ayahuasca as “yerba del
cauchero” (cauchero’s herb).
Luna[1] studied the shamanic healers from the Peruvian jungle, mainly
from Iquitos and Pucallpa, locally called as “vegetalists”. The “vegetalists”
are so called because it is sustained that all their knowledge comes from the
spirits of certain plants, which would be the real teachers of these healing
agents. For this reason, these plants are called “doctors” or “master plants”.
From all of these, the ayahuasca is the most used and most relevant one.
There are many differences between the Peruvian ayahuasca vegetalism
and the Daime cult founded by Mestre Irineu, however at the same time,
there are common points between them. As argued before[3-5] the cult
founded by Mestre Irineu in the thirties in Rio Branco resulted in an
ambiguous process where some aspects of this vegetalist tradition were
abandoned or denied, while others were rescued and reinterpreted. The idea
of a symbiosis between man and vegetable species, expressed in the
vegetalist concept that all aspiring shamans should ritually turn into a “spirit
plant”[1] and the very notion of “teaching plans”, were essential elements in
the constitution of the new religion created by Mestre Irineu.
In the daimist cult the idea that the Daime is a plant that teaches,
therefore “teacher” par excellence, is reiterated in the hymns which organize
most of the rituals, the exegeses of the believers, their experiences drinking it,
and in the myths about the initiation of Mestre Irineu with the ayahuasca. The
concept, equally fundamental in this religious universe, of the Daime as a
crucial agent in the treatment processes as well as of the cure of several
Cure in the Brazilian ayahuasca religions 29

illnesses is associated with this idea of the Daime as a “plant that teaches”.
Accordingly, the Daime is a vegetable animated being that teaches and can
therefore reveal the presence of a disease, sometimes even unknown, in the
body of the one who ingests it. It can help the healing, working as a drug to
treat a specific disease, also having an oracle role when it points, in some
cases, to the need for administration of other drugs.
However, it is important to highlight that the elements of the traditions of
the Peruvian ayahuasca vegetalismo are resignified in the daimist cult, now
appearing associated with conceptions and practices of another cultural and
religious complex. Besides the ayahuasca vegetalism, a whole set of elements
of the so called popular Brazilian Catholicism was triggered for the formation
of the new religion founded by Mestre Irineu in Rio Branco, as highlighted in
other studies[3,5]. Based on the analysis made by different authors[7,8], it is
possible to identify in the organization of the Daime rituals, many aspects of
the tradition of popular Catholicism saint festivals, strongly disseminated
throughout the ancient rural Brazil. Ancient forms of worship, such as
celebrating a saint’s day with dance and a feast of typical regional food were
being associated with the use of the Daime. Therefore the “work of hymnals”
originates, which consisted in the gathering of the believers to sing and dance
hymnals in a set of specific dates, generally following the Christian calendar,
especially dates that celebrate some saints.
As mentioned, when Mestre Irineu begins to organize his cult in Rio
Branco, his ceremonies consisted primarily in healing “works” or
“sessions” with the Daime. The structure of these “works” involved a few
elements, the main one being the consumption of the Daime itself done
either by the patient as by other participants. Gradually, however, the ritual
structure of this religion becomes more complex. Mestre Irineu starts
summarizing his experiences with the Daime in hymns, songs that are
understood by these followers as a result of the connection with the
spiritual world. Over time, several of the early followers of the cult founded
by Mestre Irineu will also express their experiences with the Daime in the
same fashion “receiving” their own hymns. This first group of daimists, led
by Mestre Irineu, gradually organizes the whole ritual of this religion.
Meetings were made to “take” the Daime and sing with fervor the hymns
received by Mestre Irineu and some of his followers. The tradition of
festivals for Christian saints was followed with enthusiasm by both Mestre
Irineu and many of these early believers of the daimist cult. So, gradually,
some dates that celebrated Christian saints were selected for the times when
taking Daime and singing hymns were wanted. Thereby, a Daime ritual
calendar was being made and over time, the work of hymnals with their
specific dances was being elaborated.
30 Sandra Lucia Goulart

The meaning of the work with hymnals differs from the healing work
with the Daime, which marks the original mode of the daimist cult. While
these were made for specific cases, individual diseases, the work of
hymnals were made for the community of believers. They mark the meeting
of the whole brotherhood, affirm and strengthen the teaching, the doctrine
and morality principles of this religion as well as its mythology and finally
of all those elements that are emphasized in the hymns sung during such
ceremonies. Accordingly, giving visibility to the daimist community itself
as well as to the main foundations of this religion, which are not only
expressed but, above all, experienced and internalized by the believers who
participate in these works. However, this more collective character of the
work of hymnals does not stop them from being also related to therapeutic
and healing processes. Moreover, in a fashion, the very experience of
internalizing and living the doctrinal principles enables these ceremonies,
facilitating the emergence of such processes. These principles gain at this
time a more personal sense, being interpreted by each believer according to
their personal stories and experiences. For this reason, there are frequent
reports in which the person, during the hymnal work, taking the Daime,
finds out that he or she is sick, seeing in the “miração”, which is his or her
illness and in which body part it is located. Similarly, the stories describing
healings during hymnals are constant. There are several statements where
people say that, during the “miração” at the hymnal work they were
operated by spiritual beings and thus, cured. In order to illustrate that,
follows below a piece of an interview I did with a lady who joined the
Mestre Irineu’s religious group in Rio Branco in the 1960s. A native from
Rio Branco, said that she decided to convert herself after she got the cure
for both stomach and liver diseases that afflicted her at that time.

“I had a dream about Mestre Irineu’s church. Only I did not know where
the Mestre’s church was (...) I told my husband I knew where this place
from the dream was. He was the one who took me there (...) I got there, I
was kind of scared because I did not know (...) Then Mestre gave me
only a little Daime. I thought nothing would happen (...) After a while it
started (...) The miração came (…) that was when I got operated (...) I
found myself in a hospital, on an operating table. It was all clean, very
light. Two doctors arrived, accompanied by some nurses, with all the
equipment to operate. Then a lady came (...), a very enlightened being,
she smoked all over me. She did this smoking and handed me to those
spiritual beings, that operated on me (...) I received this treatment though
the Daime…from inside the Daime... And I’m here today (...)”
Cure in the Brazilian ayahuasca religions 31

These “spiritual” or “astral operations” testimonials are common among


the daimists. Something that can be noticed in this sort of statement is the
presence of metaphors relating to the official medicine and its officials such
as doctors or nurses as well as references to their work tools and acting
facilities, e.g. hospitals. Here is observed an ambiguity in these believers’
statements. On the one hand, there is a distrust regarding the official
medicine and its officials, as well as a misunderstanding of its logic, on the
other hand, there is a recurrence of the official medicine universe elements in
the construction of exegeses on therapeutic processes, and of obtaining
healing, experienced by those believers.
In this aspect we can make some analogies between the daimist cult and
other religious cults developed in Brazil. Firstly, many authors have pointed
to the importance of either healing or its quest aspects, as for the presence of
the imaginary related to the scientific or official medicine in the experience of
the believers of the religions practiced in Brazil. Regarding the so-called
African-Brazilian cults, such as Umbanda and Candomblé3, different
scholars have observed that the desire for a cure or relief for a number of
afflictions, also understood as organic, is a major cause of accession to these
cults. That is the finding of Paula Montero[11] in a study about diseases and
magic-religious therapeutic practices in the umbandist universe in São Paulo.
According to Montero[11], 45% of the interviewees claim to have become
umbandists “because of an illness”. José Guilherme Magnani[12], in a
research on the treatment of mental illnesses in Umbanda, made in terreiros4
from São Paulo, also makes a similar statement. For him, most people who

3
Umbanda and Candomblé are religions formed in Brazil from the intercrossing of
different elements from various traditions. Umbanda has been organized initially in
the Southeast of Brazil, in cities as Rio de Janeiro and São Paulo, according to some
researchers since the 1920’s[9]. Umbanda is composed of elements from African
religions, as well as practices from Brazilian indigenous traditions, popular
Catholicism and the Spiritism developed by Alan Kardec conceptions. Yet the
Candomblé started to spread at the end of slavery in 1888, particularly in the Brazil
Northeast. In the Candomblé originally from Iorubá (Nago) which initially spread in
Brazil, the Orishas - intermediaries between the supreme God (OLORUN) and men
who represent the forces of nature - are not worshiped. Currently, both the Candomblé
and the Umbanda are found all over Brazil, although some types of Candomblé are
yet stronger in the Northeast[10].
4
Terreiro means the place where all ritual cult activities are performed, the house,
with its yard and all the buildings. The term is used in different African-Brazilian
cults. Often with a similar sense, the terms “house” or “center” [10] can also be used.
32 Sandra Lucia Goulart

turn not only to Umbanda terreiros, but also to Candomblé houses and
spiritist centers5 do it for the healing of illnesses of the body or the soul[12].
At the same time, some of these authors also detect in the speech of
African-Brazilian cult followers, especially of Umbanda, the same ambiguity
we found in the case of the daimist cult in the matter of official medicine.
The African-Brazilian cult followers would express simultaneously a
dissatisfaction regarding the official medicine performance, including a
skepticism regarding their therapeutic results and conversely, the frequent use
of aspects specific to this medicine. In the same study mentioned earlier,
Paula Montero[11] tries to show how this process takes place, concluding
that the scientific medical speech and practice work either as a counterpoint
or as a model for Umbanda healing activities. Accordingly, for example,
fathers or mothers of a saint6 refer to themselves as “doctors” - either from
the soul or spirit - and the terreiro is often seen or called as an “emergence
room”, the apparel used by the followers is generally white, reminding to
some extent, the also white uniforms, of the official medical professionals.
Besides that, Montero and many others have often recorded the presence of
“spiritual operations” - similar to those described by the daimists - in the
healing statements from the umbandists. For Montero the ambiguous
relationship that Umbanda keeps with the world of official medicine is
explained by the fact that the magic-therapeutic practices applied by the first
must necessarily take into account the dominant position of the second. In
other words, while official medicine, official precisely for being dominant
and hegemonic, is self-referential, the popular medicines, such as those of
Umbanda, are subordinate. So they build their exercise through a constant
reference to the official medicine model.

5
Spiritist center here refers to the Kardecist religion. This was organized by Hippolyte
Rivail, a French pedagogue who adopted the pseudonym of Allan Kardec. From the
mid-nineteenth century, Kardec starts to structure his doctrine which he classified as,
religion, philosophy and science simultaneously; it is denominated spiritism due to the
belief in the intervention of spirits of the dead driving some phenomena in the world
of the living. Kardec’s Spiritism included a series of esoteric and spiritual beliefs that
circulated in Europe and the United States especially since the late eighteenth century,
as the theories of magnetism or the psyche. In Brazil, Kardec’s doctrine, also known
as Allan Kardec, diffuses from the late nineteenth century, primarily among urban
upper and middle layers, and then widely spread in different regions of the country
and among several sectors of the population.
6
The two designations are used to refer to spiritual leaders of African-Brazilian cults,
either in Umbanda or Candomblé.
Cure in the Brazilian ayahuasca religions 33

It is necessary to record that not only African-Brazilian cults, but several


religions developed in Brazil would be deeply linked to the demand for the
cure of diseases. Through different perspectives, studies which approach the
consolidation and growth of the kardecism in Brazil hold in this matter. We
can already see it in the classic study of Candido Procópio[13], on
mediumistic religions7 in Brazil. For this author, there would be in the
Brazilian society, a mediunic continuum, ranging from the African forms of
worship (such as Umbanda) to those more Westernized and white (such as
the orthodox spiritualism), being the different types of therapies for major
diseases, elements in the limiting points of this continuum. Other authors
highlight that the peculiarities of the kardecism in Brazil is a more
remarkably therapeutic feature. Liana Trindade[15], for example, examines
how, in the early expansion of kardecism in Brazil, kardecist notions and
ideas, such as the “magnetic fluid”, adapt and blend to the old magic-
therapeutic beliefs from the lower layers of society, as the belief in the
healing power of the spirits of the dead or their ancestors. Likewise, in the
tradition of the popular Catholicism, especially in the worshiping practiced
to the saints, the demands related to diseases and the search of their healing
are emphasized, as other authors have already demonstrated[8,16]. Even
religions that have grown more recently in Brazil, as the new protestant sects,
the so-called Pentecostal services, also maintains this therapeutic aspect,
since good part of its expansion is given in function of demands for the cure
of illnesses and varied misfortunes. It has even made some scholars classify
some religious cults such as the Brazilian Umbanda, Candomblé, Kardecism
and Pentecostalism as “cults of affliction”[17,18].
Accordingly, the cult founded by Mestre Irineu continues one of the main
forms of expression of the popular religiosity in Brazil which, as previously
seen, is strongly linked to the issue of healing. Similarly, as a manifestation
of popular medicines or therapies, comes also in a tense and ambiguous
relationship with the scientific, hegemonic medicine. Here it is important to
clarify that in both ayahuasca cults as in other religions, the constant
reference to elements and notions of the official medicine universe does not

7
The mediumistic religions are founded on the notion of “mediunity”, which is
understood as a gift which can express itself in different ways, through hearing,
vision, dreams, intuition of the presence of spirits and souls of the dead, or even
through incorporation of them in certain believers who are called mediums. These
notions come from the Kardecism, however they were widely adopted in the
Umbanda environment. In the kardecism, the typical mode of manifestation of the
spirits of the dead is given through the word[10,14].
34 Sandra Lucia Goulart

mean a simple incorporation or reproduction of the biomedical logic. Instead,


when it regards for example, the African-Brazilian cults, many authors state
that when aspects of the conventional medicine are used by their believers
they start having completely different meanings. Thus, Montero[11], despite
viewing an inevitable subordination in the therapeutic umbandist practices,
also contends that the Umbanda religious medicine acts in the gaps, the
interstices of the official medicine, to surreptitiously deny and overcome this
inferiority. The umbandist distinction between “material diseases” and
“spiritual diseases” would express this simultaneous movement of
affirmation and denial of the official medical practices domain. The material
illnesses would be related to the official medicine performance, while the
spiritual diseases would be from the religious sphere. From this perspective a
complementarity among official medical practices and religious therapeutic
practices is established. However, the assertion of this complementarity ends
up culminating in a second stage, into the idea of superiority of the religious
therapy. Montero shows that in the umbandist speech invariably, the official
medicine is seen as capable of treating only the consequences of the diseases,
while the religious sphere should have the role of treating their true causes.
Actually, this brings us to another aspect of the religious therapeutic
practices. As also shown by several studies, these practices tend to have a
broader purpose other than just treating an organic problem. It is exactly
because they have religious foundations, their answers and solutions are
linked to broader ordinations, i.e. to cosmological explanations. The religious
therapies offer an integrating principle[12], which enables the unfortunates to
relate their woes to a larger context, and thus start providing them sense and
coherence. The case of the daimist cult is no exception. Commonly these
believers understand that their diseases are somehow related to other
problems - not necessarily organic - which afflict them. They are seen
therefore as signals, indications of the need for a personal transformation
which implies in a change of behavior that concerns the subject’s life as a
whole. Accordingly, in a general way, every healing process in the context of
the daimist cult, involves a moral transformation of the patient. It is also in
this manner that diseases are often viewed as a necessary suffering or, as the
daimists say, “probations” which they must go through in order to transform
spiritually. In another excerpt of the same statement quoted earlier, of the
daimist who reports being operated spiritually “through the Daime”, we find
an example of this kind of logic.

“The Daime cured me (...) The Daime showed me everything that was
wrong in my life ... Because there was so much wrong ... with my family,
my children, with my husband, not only with me, you know ... That
Cure in the Brazilian ayahuasca religions 35

disease was like a burden, an ordeal, a suffering that I had to go through


to reach the Daime and leave that life I used to lead (...) After that I
decided to follow this doctrine and everything has improved in my life. It
was like the being who manifested to me and said at the end of my
operation, ‘here is your place. In this house, with these teachings, you’ll
be forever cured’”.

Here, the manifestation of the disease is intrinsically linked to the process


of conversion and transformation that it entails. Although the interviewee
reported earlier her disease was an organic state, i.e. that it was expressed
through an imbalance of some of the organs of her body (stomach, liver), in a
second part of the statement the disease is linked to broader situations of her
life and her “cure” is thereby the starting point for her conversion to the
daimist cult.
At this point we can identify some changes in the conceptions about
illnesses, healing and the role of the Daime in the therapeutic processes, in the
cult founded by Mestre Irineu, regarding the ancient traditions of the ayahuasca
use, as for example, the Peruvian vegetalism. The latter was based on an
extensive knowledge of the natural environment in its thorough classification
according to a hierarchy that associated and separated the different vegetable
species. Thus, the cure also implied into the respect to the classification of the
vegetable species, by making specific dietary requirements during the process
where the patient was submitted to a treatment with the vegetalist and the
ayahuasca. Furthermore, more generally, the use of the ayahuasca, within this
Peruvian context, has the meaning of a physical “cleaning”. Ayahuasca is even
called by many as “la purge”, emphasizing here its purpose is to detoxify the
body. In the specific case of the curator, i.e. the vegetalist, his initiation
involved the implementation of a longer and more strict diet, which included a
series of food prohibitions (including alcoholic abstinence), in addition to
sexual abstinence and the constant ingestion of the ayahuasca itself as well as
other psychoactive plants.
In the case of the daimist cult, there is also the requirement to hold a diet
for those who consume the Daime. This diet was one of the first ritual precepts
established by Mestre Irineu in the formation of his new cult in Rio Branco.
However, the diet set by the Mestre Irineu refers only to the alcoholic and sex
abstinence, three days before and after you drink the Daime. It does not imply,
as in the Peruvian vegetalism, in more classifications of nature and plant
species which led, in this case, to a number of other dietary requirements. It is
true that the initiation of Mestre Irineu with the ayahuasca would have required
a much longer and more restrictive diet regarding food consumption.
Testimonials of his initiation which occurred yet in the region of Brasiléia, say
36 Sandra Lucia Goulart

that the Mestre Irineu was isolated inside the forest for several days, consuming
in this period, only saltless manioc and the ayahuasca itself. Throughout his
isolation in the forest, it is told that Mestre Irineu acquired the power to
communicate with plants and animals. It was this diet and isolation in the forest
that led to the revelation of the foundations of the Daime doctrine, made by a
female entity to Mestre Irineu.
In the Daime cult however, only the requirements related to alcohol and
sex were kept. Moreover, they now gain a new meaning. Instead of being
linked to other dietary rules, resulted from a whole magic classification of
nature, these prohibitions refer to other morality. They are seen as a
“cleaning”, in a more general character. It is not just about detoxifying the
body, but rather “cleaning the impurities of the matter” so that the spirit can
reach the “astral”. “Matter”, “spirit” and “astral” are fundamental categories
of the daimist cosmology. “Matter” and “spirit” makes up a duality that
guides and means the believers’ life and his behavior in this religion. The
“matter” encompasses not only the physical body, but the whole sphere of
“material earth life” associated in the daimist perspective to a “world of
illusions”. The “spirit” opposes to the matter, pure and free from the
“illusions” of the earthly life. The spirit relates to the “astral” world, a higher
plan in which the spirit beings and deities live. Consuming the Daime is seen
as a means of approaching the “astral world”. For this, one must move away
from the “matter affection” and the “world of illusions”, which includes
“addictions” and “bad habits” as daimists and several of its hymns lyrics
often say. Sex, alcohol use, and attitudes that indicate greed, vanity, pride, are
classified as “bad habits” which bind us to the matter preventing the spirit
from reaching the “astral”.
Accordingly, both the diet related to the use of Daime as the conceptions
about diseases and their cures, in the daimist cult, are related to a more
ascetic morality, in which aspects seen as mundane or secular are devalued
and classified as inferior, impure or still sinful. The presence of some
elements of this morality in turn, binds the daimist cult to broader processes
that affected and transformed all the Brazilian old popular religious culture,
from the 1930s. Indeed, several scholars of the subject show that, during this
period, a new religious ethic emerges - in both urban and rural areas. This
new ethic is expressed in different ways, either through the transformation of
ancient religiosity as also through the emergence of new religions. Maria
Isaura Pereira de Queiroz[19], for example, tried to show how from that
moment a more ascetic moral came to dominate the popular Catholic
practices that were once deeply marked by the sacralization of the festive
aspects. Regarding in particular the Amazonian context, some authors, such
as Galvão[7], highlight the transformation of traditional religious forms, such
Cure in the Brazilian ayahuasca religions 37

as the beliefs in the Amazonian shamanism (pajelança amazônica)8 that


started to merge with Catholic practices or elements of the Kardecism which
began to spread at this time precisely. Also in the Peruvian region, we may
record a set of similar transformations in the practices of the ayahuasca
vegetalism. Thus, Luna[1] states that from the early twentieth century, a new
generation of vegetalists who incorporate a considerable amount of Christian
elements in their ayahuasca sessions (such as prayers and summons to the
Virgin Mary and Jesus) will be spread.
However, in spite of these changes, the religion of Santo Daime also
expresses many continuities in relation to earlier traditions of the ayahuasca
use, as the Peruvian vegetalism. Despite the distinctions between the meaning
of the daimista diet and the sense of the vegetal diet, the cult created by
Mestre Irineu is based on the use of a “spirit plant”. As mentioned before, the
Daime, this “divine being”, is understood as a plant that teaches and can heal
or disclose the proper remedies for certain diseases. It remains, therefore, the
idea of “conductor plant” in the vegetalist context. The use of the Daime is
not linked to thorough classifications of the natural environment and different
vegetable species (as in the vegetalism), but ultimately, the whole daimist
experience with the beverage implies in a process of properties absorption of
the latter by those who consume it. Thus, the Daime - the vegetable beverage
- has “strength”, “power”, “light”, “knowledge”, as emphasized, moreover, in
the hymns of that religion. By drinking the Daime during a “work”, the
believer aims precisely at achieving many of these properties of the beverage:
“strength”, “power”, “light” or “knowledge”. Simultaneously, the idea of
“transforming in the Daime” leads the religious experience of the believer in
this religion. As attempted to demonstrate earlier[3,5], the transformation in
the Daime beverage is a theme emphasized in the mythical statements
surrounding the initiation of Mestre Irineu with the ayahuasca. A common
notion to this religious world is that “Mestre Irineu” is the Daime itself. This
theme is reiterated in the personal experiences of each believer with the
beverage. Testimonials of the “miração” for example, are common in which

8
It is called Amazonian shamanism a set of practices and conceptions of the cabocla
population, which in Brazil express the results of the contact between the indigenous
peoples and other groups that occupied the Amazon. Cabocla populations have here a
more cultural sense. The Amazonian shamanism encompasses beliefs in spiritual
beings (the “enchanted ones”) that inhabit natural places such as rivers, forests etc., as
well as a whole concept of reciprocal relationships between men and natural
environment[7].
38 Sandra Lucia Goulart

those who drink the Daime, claim to have become the liana (i.e. in
Banisteriopsis caapi) or being transported to jagube and rainha plantations9.
There are other relations between Mestre Irineu’s Santo Daime cult and
the practices of the Peruvian ayahuasca vegetalism. So the great importance
that the music in the form of hymns, has in structuring the Daime ritual has
its parallel in the vegetalist context. The vegetalist healers, as shown by
Luna[1], organized their ayahuasca sessions through songs, called “icaros”.
These are magic musical melodies transmitted to the vegetalist through the
master plants themselves. Just as the icaros, the Daime hymns during the
rituals guide the experiences of the believers with the Daime, as well as the
sensations caused by its use, especially those expressed through visions. In
general, also in the Santo Daime context, a close relationship between the
process of transmission and the use of Daime hymns is established. The main
characteristic of the icaros is its healing power. The meaning of the term
itself already points to the healing function of these melodies. Icarus, from
the Quichua “ikaray”, means “blow smoke to heal”[1]. Likewise, the daimist
hymns are closely related to the healing processes experienced in this religion
scope. First because they are key elements in the structure and meaning of the
experiences of the believers with the Daime, allowing the internalization of
the doctrinaire principles of the religion in ritual moments. Second, because
there are specific healing hymns, sung by the community of believers in
specific ceremonies. Of course, as seen, the concepts of disease and cure
acquire new meanings in the daimist context. However, there is equally a
continuity regarding the vegetalist beliefs about the appearance of illnesses or
misfortunes. Thus, as the latter, especially in older daimist statements, the
record of stories about illnesses caused by the action of others through acts
such as the introduction of magic - through spell - of strange objects or
animals - mostly insects - in the patient's body is common.
In fact, what is important to emphasize here is that the Santo Daime religion
organized by Mestre Irineu in 1930’s in Rio Branco, relates to a broader context
of Amazonian traditions, which also embraces the use of ayahuasca. The
conceptions related to diseases and therapeutic processes, expressed in the cult
created by Mestre Irineu, establish a direct link with a shamanic ayahuasca
healing. This, according to Peter Gow[20], from about three hundred years, began
to be outlined in some Amazon regions most affected by the transformations
generated by the colonial contact and the rubber exploitation international
economy. This new shamanism would be more emphatically focused on the

9
Jagube and Rainha are designations created by these believers when referring to the
Banisteriopsis caapi liana plantations and the leaves of Psychotria viridis
respectively.
Cure in the Brazilian ayahuasca religions 39

purpose of healing and the ayahuasca would take a central role in it, being
conceived now, above all, as a therapeutic agent. So we also realize that in the
religion created by Mestre Irineu, the Daime is one of the key elements in the
explaining and ordering of diseases, misfortunes, and healings. More than that,
the beverage is the main source of the doctrinal and cosmological exegesis of this
religion. The difference related to other ancient Amazon ayahuasca traditions, is
that in the daimist cult, the cure involves a process of conversion to a religious
community, yet it is a religion that has at its core the experience with a vegetable
beverage, seen as a teacher plant that heals.

3. The cure in other ayahuasca religions


From the 1940’s other ayahuasca religions will start to appear in the
Amazon region. In 1945, the group created by Daniel Pereira de Mattos
(Mestre Daniel) also arises in Rio Branco, which will be known as
Barquinha. In 1961, the União do Vegetal or UDV10 appears, founded by
José Gabriel da Costa, Mestre Gabriel, in Rondônia, Porto Velho. In the
UDV the ayahuasca is called Vegetal, not Daime. While the Santo Daime and
the Barquinha cult have their formation processes related, the UDV had a
somewhat more autonomous development11.
There are different explanations for the term Barquinha. At first, it seems
to be associated with one of the jobs carried out by the founder of the cult who
before arriving in Acre, was a boat pilot. In addition, images and meanings
associated to the sea and its sailors are highlighted in this religion. The clothes
worn in rituals - called “uniforms” - resemble the sailors’ apparel, many of the
psalms sung in ceremonies speak constantly of a “boat”, navigation and the sea.
According to Araújo[22], Barquinha comes from the “boat” and is associated
with Mestre Daniels’ followers mission, while the sea, in this religion, is
associated with the tea itself, which is also called Daime here.
Mestre Daniel attended Mestre Irineu’s daimist cult for about ten years.
Over time, however, his experiences with the Daime led to the revelation that
he had another “religious mission”, which would only be fully accomplished
with the creation of a new cult around the use of the Daime[5,22]. This was

10
In 1970, the UDV is notarized by its founder, and its designation becomes Centro
Espírita Beneficente União do Vegetal - Beneficent Spiritual Center Vegetable Union
(CEBUDV).
11
On the history and cultural traditions formation that make up the religion of the
UDV, I recommend reading an article which I published in the magazine Fieldwork in
Religion[21].
40 Sandra Lucia Goulart

gradually being organized, at the beginning at Daniel’s own residence, located


in a rural forest area in Rio Branco. The use of the Daime was being introduced
gradually. It is said that initially, Mestre Daniel was locally known as a
“praying person” sought to take away “quebranto” from children and
“panama”12 from hunters, travelers and rubber tappers who passed through that
region. Some of these people became the first followers of his cult. The
prayers, the Daime, the received hymns, made people increasingly seek for
Mestre Daniel to be “cured”. “People were saying that in this part there was a
little old man, who prayed very well (...) That’s how his service was approved,
and he healed so many people”, says Antonio Geraldo, who was one of the
main leaders of this religion[24]. Over time, Mestre Daniel allied the
consumption of the Daime to their prayers and blessings. The ceremonies were
also becoming more complex. As in the case of the Santo Daime cult, they
began to involve the singing of hymns. Just as occurred with Mestre Irineu,
Mestre Daniel received his hymns in a process of mystical revelation
stimulated by the consumption of the Daime.
One of the most remarkable features of the ayahuasca religion founded
by Mestre Daniel is its evident approach in practices and beliefs from
African-Brazilian religions such as Umbanda. Many entities worshiped in
Barquinha groups come from the pantheon of these religions, such as preto-
velhos, caboclos, charms of the sea, mermaids, princes or orishas such as
Oxun, Iemanjá, Xango, which are revered in some kinds of Umbanda and
Candomblé13. Just as in African-Brazilian religions, in Barquinha these

12
As demonstrated by several authors, “panama” and “quebranto” consist in beliefs of
the Amazon culture quite often used to explain the origin of certain types of diseases
or misfortunes. The “panema” refers exactly to hunters’ bad luck in hunting or
fishing[7,23], while the “quebranto”, particularly affects infants and children,
referring to the breaking of rules that regulate and labels many social relationships,
such as neighborhood and kinship. In both cases, it depends on the actions of agents
as “healers” or “praying people”, who were characterized by the knowledge of
Catholic and other kinds of prayers as well as magical practices, linked to European
pagan and indigenous traditions. They used this knowledge to cure a whole range of
illnesses typical from the old Brazilian rural world.
13
In the Umbanda some of the Orishas originated in Candomblé are worshiped, but the
uniqueness of the umbandist religion is another type of entity, such as “preto-velhos”
and “caboclos”, which are purified spirits of the dead. “Preto-velhos” are the spirits of
former African slaves in Brazil and “caboclos” are the spirits of Native Brazilians.
They are not gods as the Orishas. While the latter express their incorporation in the
believers only through a kind of gesture and a dance, “preto-velhos” and “caboclos”
use the word to communicate with men, providing advice and acting to cure their
ailments. Today, there are in Brazil different types of Umbanda and Candomblé,
which adopt and merge in varying degrees, these various entities[10].
Cure in the Brazilian ayahuasca religions 41

beings express their presence through a mediunic manifestation. This is


understood, in general, as the ability of someone (the medium) to
communicate with spiritual beings and feel their presence. The forms taken
by this mediunic communication and the ways which spiritual beings
manifest themselves may vary.
In some Barquinha rituals, there is a dance - called “dance” or “play’ -
very similar to the “spins” of the African-Brazilian cults, in which spiritual
entities - called “guides” - appear to incorporate the mediums (the
“apparatus”) of “the house”14. In this case, the medium expresses his
mediumship by incorporating spiritual entities, which is given through a
typical way of dancing. However, at other Barquinha ritual moments, the
mediunic communication can be manifested in different ways. The “guides”
can speak through mediums, through lectures, or specific guidelines given to
those who consult them etc., thus transmitting their messages. In all these
cases, however the manifestation of these entities implies a certain degree of
transformation of the mediums, in particular their physical expression.
Therefore, the presence of the entity may be indicated by factors such as
changes in the voice tone, the use of certain expressions and a kind of
language, a particular facial expression or by the recurrence of certain props
and objects - such as certain apparel or the use of tobacco smoked in a pipe.
Anyway, these factors indicate that the “apparatus” is to a greater or lesser
degree, expressing traits that are not his but his “guide’s”, who manifests
itself somehow possessing his body at that moment.
The spiritual work highlighted by Mestre Daniel in Barquinha aimed
mainly at the mediunic development of the believers. This development of
the believers’ mediunic abilities is indeed intrinsically related to the process
of conversion to this religion. Though of course, not every Barquinha
follower is a medium, there are many cases where the entrance into that cult
is explained as the result of an “undeveloped mediumship”. This was in fact
the situation of various group leaders from Barquinha. In some cases, the
undeveloped mediumship was expressed initially by a disease that could
manifest itself through organic imbalances. However, this disease is being
explained as of an “spiritual order” and its healing will imply in a whole

14
“Spin”, “guides”, “apparatus”, “house” are all terms used in African-Brazilian cults,
especially in Umbanda. The “spin” is a ritual session that is shaped like a circle dance
in which spiritual entities come (down) the land and incorporate some of the believers.
These can be called “apparatus” or “horses”. In some cases, in Umbanda, the entities
who always incorporate the same “apparatus”, are called “guides”. “Home”, as seen,
may be synonymous for “terreiro” and “center”.
42 Sandra Lucia Goulart

ordination of the spirituality of the medium. Thus, for example, the disease
can mean the need for “indoctrination” of a soul, an entity, or even the
“baptism” of pagan entities15. In all these cases it is considered that these
beings are still considerably attached to the earthly, material life, and
therefore would need spiritual “light”. The work of the medium consists
precisely in providing “light” for such entities.
In a certain way, the disease is seen as a sign that the patient is an
undeveloped medium, whom different types of spirits attempt to
communicate with. The absence of specific codes for the performance of this
medium communication with the entities is what can generate the disease. In
this sense, the cure consists in training, organization and regularization of the
relations between the medium and its entities (his “guides”). As shown by
several authors[11], this way of explaining the disease and its cure is typical of
the umbandist universe.
Let’s take the example of Mrs. Francisca Gabriel who is now a group
leader in Barquinha, Rio Branco. As I reported in an interview, Francisca
Gabriel met Mestre Daniel and his cult in 1957, having sought them due to a
disease that afflicted her at the time. Although Francisca Gabriel has not
provided us with details about this disease, she ensured that on that occasion,
“she had already been undeceived by the doctors”.
According to her, Mestre Daniel prescribed her a treatment which
involved the combined use of “herbal” and “pharmacy medicines”. These
directions were the result of “revelations” received by Mestre Daniel’s
sessions with the Daime. Francisca Gabriel said, moreover, that her main
medicine at that time was the Daime. She tells Mestre Daniel recommended
her small daily doses of Daime - approximately three teaspoons - which she
took for several months. “He ensured that I was going to be good, but it
would take time. So, at first, he gave me just a little Daime. It was a small
dose of medicine”. The amount of Daime given to Francisca Gabriel
increased as her health improved. At the same time, the change in the dose
of Daime seemed to relate to the deepening of her “spiritual work”. As she

15
The idea of “baptism of pagan entities” implies in the conception that some beings
would be on a lower spiritual level and therefore in order to “evolve spiritually”
would need to be “indoctrinated”. This “indoctrination” implies in a series of changes
in the behavior of the entity and its way of manifesting when incorporated to its
“apparatus”. Many times, the manifestations linked to the use of material objects -
such as tobacco smoking or the consumption of alcoholic beverages such as cachaça -
as well as the recurrence of ritual practices implicating in the deaths of animals are
seen as expressions of little evolution. This kind of notion is present in a greater or
lesser degree, in some forms of Umbanda, and indicates a great influence in the latter,
of kardecism concepts.
Cure in the Brazilian ayahuasca religions 43

explained, “When I started to feel stronger, Mestre Daniel started to give


me more Daime, so I could develop my “preparo”, knowing the entities
that I had to work with”. The notion of “prepare” in this Barquinha
universe refers to the particular process of mediunic development which
certain believers (mediums) should go through. It is the “prepare” that
allows the organization and regularization of relations between a medium
and his “guides”, and its duration may even be long.
It is possible to notice in this short statement, similarities between the
processes of healing experienced by the followers of Barquinha and the Santo
Daime of Mestre Irineu. Thus, in both cases we find that the Daime beverage
has an important role in treating the disease, providing a remedy meaning, or
also functioning as an oracle, i.e. as a means of revealing the drugs and
procedures necessary for the healing. However, in Barquinha the Daime
importance as a therapeutic agent is qualified by many other factors and in
particular by the concept of mediumship. As seen, it is the development and
regulation of the mediunic ability of the medium that in many cases, can lead
to cure a disease. In this regard, it is important to clarify that, in Barquinha
the development of mediumship implies in a healing process for both the
medium and the spiritual entities which he works with. In order to regularize
their mediunic abilities through a series of guidelines, procedures and ritual
requirements (the “preparo”), the medium also does “charity work” for
entities which need to evolve spiritually. His mediunic enhancement leads to
the spiritual “indoctrination” of these entities. As explained by a leader of
another Barquinha group, Mr. Antonio Geraldo.

“(...) Sometimes a person with encosto showed up (..) Encosto16 is like this,
one feels the symptoms of a disease. Then the person goes to medical-
examination, takes medication, spends money here and there and nothing.
Until she comes to a center and finds out ... Sometimes it is a ghost of a
relative, someone who died of an illness and is there, leaning (...) Because
many times the person disembodies but finds no light, he or she is in the
darkness and then keeps trying to grab those who are in this world (...) It can
also be a being who needs indoctrination accompanying that person... They
are beings who are asking for help, charity”.

16
The notion of “encosto” comes from Umbanda and refers to the action provoked by
a spirit of a dead person (a “ghost”) in a person’s life, who was usually bonded to the
first. This action always produces negative effects, among them a possible disease. In
Portuguese it can mean support (“lean on someone”) or touch (“touching someone”)
and also having a pejorative sense as “being dependent on or economically exploit
someone”.
44 Sandra Lucia Goulart

However, once these entities are “indoctrinated” they can also start
healing those who need and seek their assistance through mediums. As a
matter of fact, the therapeutic action of these entities is actually what
underlies much of the set of practices and conceptions of Barquinha, similar
to what occurs in the Umbanda religion. As such, the cult of Barquinha is
characterized by a set of rituals in which certain spiritual entities,
incorporated in the mediums, provide guidance and advice to the believers,
focusing mainly on issues related to diseases and their cures. These rituals
are “charity works”, a designation that also comes from Umbanda. In them,
the entities serve all who seek for them during private appointments. They
speak through the bodies of mediums, and usually on these occasions
prescribe, for those who are sick, teas, herbal baths, natural compresses,
besides prescribing prayers, spiritual guidance and procedures. An essential
element of these appointments provided by the entities is the “spiritual
pass”. Identically to what happens in Umbanda, the mediums, now owned
by the entity, passes their hands all over the body of the sufferer or
unfortunate, many times also smoking him or her with his pipe or cigar.
The intent is to pass good vibrations to the patient, eliminating the bad
fluids that may be impregnating his or her body and spirit. Thus, the entity
gives the pass and usually finishes the appointment.
Whereas in the Santo Daime religion organized by Mestre Irineu, the
concept of mediumship is not set as an important element in defining the
relationship between the believers and spiritual beings. The idea that some
believers would have special attributes is not highlighted, which would
enable them to communicate more closely with spiritual entities. The
Daime assumes then, a key role in establishing the contact between the
believers and the spiritual world. It is the sacred beverage, “plant-spirit”
and “teacher plant” which allows the daimists during their ceremonies, to
deeper understand the meanings of their hymns, doctrine as well as
“elevating themselves” to the “astral”. In the cult founded by Mestre Irineu,
the Daime also inspires the revelation of hymns. While in Barquinha hymns
are understood primarily as the result of a mediunic process. The spiritual
entities are the ones who broadcast the lyrics and melodies of these songs to
mediums.
Therefore, compared to the Barquinha cult, in the religion created by
Mestre Irineu, the Daime also assumes a much more central role with
regard to the elaboration of concepts about diseases and their cures. The
very idea of Daime as a remedy or as a revelation channel of the disease
and its treatment is much stronger there than in the universe of Barquinha.
Even because as seen in Barquinha, there are other major players in the
disease solution process. The development of mediumship, the therapeutic
Cure in the Brazilian ayahuasca religions 45

action of spiritual entities, and the extensive recurrence of herbal


knowledge, expressed in prescriptions provided by these entities when
incorporated in mediums compete with the Daime, attenuating its
importance as a therapeutic agent.

4. Final remarks
A first aspect that we wish to emphasize here is that the ayahuasca cults
are consistent with a whole way of Brazilian religiosity closely related to
the matter of curing diseases. As mentioned, the desire to solve diseases is a
major reason for conversion into various religions developed in Brazil,
from the popular Catholicism to the current Pentecostal sects, as well as in
African-Brazilian cults, in the Kardecism, and also in typical practices of
certain regions, such as the caboclo Amazonian shamanism.
That even makes the theme of Brazilian religions bound to the study of
“religious medicines”, a term used by different authors to refer to the set of
concepts and practices, present in these cults, aiming at the relief and
explanation of diseases and several problems related to those[25]. In this
discussion, a point highlighted by some authors[11,26] is the existence of
an ambiguity in the relations that these religious medicines establish with
the scientific medicine, which is the official one. So we see that
Montero[11] detects this ambiguity in the umbandist healing practice,
which is understood by her as a popular religious medicine. For the fact that
they are in a subaltern and peripheral position, the therapeutic practices of
Umbanda cannot ignore the realm of scientific medicine and therefore
absorb many of its elements. Conversely, they subvert the biomedical logic
when resignifying notions of the latter. They end up, in fact, contesting
their subordinate position when asserting the religious superiority of their
explanation opposite to the biomedical explanation on the disease.
That same ambiguous process can be noticed in the ayahuasca religions
commented here. Thereby, it can be observed that the process of curing or
treating diseases experienced in both Santo Daime and Barquinha cults
imply in the frequent recurrence of expressions, characters (doctors, nurses
etc.), tools, procedures and concepts of the scientific medicine. At the same
time, the elements and the logic of biomedicine, since entering the universe
of these religions are submitted to its cosmological order. The physical
discomfort turns into “mediunic” which needs to be developed, or in an
“encosto” which has to be taken away from the “patient” and in an “ordeal”
required for a particular process of religious conversion. Thereby, as a
Barquinha group leader quoted in this article, “it ends up that the disease
wasn’t actually a disease”. Furthermore, therapies developed in these
46 Sandra Lucia Goulart

ayahuasca religions, from the perspective of their believers, process and


solve problems and diseases that the scientific medicine is unable to cure.
As seen in the testimonials exposed, many come to these cults
“undeceived” by the doctors or after having undergone various medical
treatments without obtaining relief from their woes, which will only occur
with the acceptance of new religious therapeutic practices.
A notion that expresses this ambiguous relationship between ayahuasca
religions and biomedical logic is the one of the “remedy”. We notice that
the idea of remedy appears frequently in testimonials of these religions
followers, to support explanations about treatments for varied diseases and
misfortunes. It is very much associated with the Daime - the beverage. Thus
in both Santo Daime and Barquinha, the Daime is seen as a remedy, i.e. a
drug that can treat and heal an organic disease. Various statements, quoted
here, highlight that idea. Many of these believers, as verified, say that
drinking the Daime cured them or that the Daime was their main remedy.
Continuing this kind of speech, also in many of these statements as seen,
the use of the Daime remedy is similar to the use of modern official
medicines. In this sense, the followers of these cults assert they have often
used the Daime, similarly to the medicines prescribed by doctors, in “low
doses”, and both Mestre Irineu as Mestre Daniel could decide, in
accordance with the case, whether to prescribe the use of the Daime or the
use of “pharmacy medicines”.
However, a more thorough analysis of these reports shows that the
Daime is a remedy for such believes in a very different fashion from the
drugs used by the scientific medicine. Therefore, as already seen, it is
said, for example, that Mestre Irineu often “saw” through the Daime
which “pharmacy medicines” patients should consume. The Daime
emerges then as a remedy of quite different characteristics from the
official medicine drugs. It is a drug-oracle that reveals, magically, the
existence of a disease, as well as how to cure it, discovering and pointing
out the procedures and medications needed for each case. It teaches,
explains, shows, enlights; in conclusion the Daime relates to the one who
consumes it. Both establish a relationship of communication. It is, after
all, a remedy that is a “plant-spirit” with “power”, “light” and
“knowledge”. That is why, for the believers of these cults, it can heal
better than the scientific medicine drugs.
Yet on the relation between religious and scientific medicine drugs, it
is worth remembering that after the end of slavery and the inauguration of
the Republican regime in Brazil, a new penal code would also be
established in this country in 1890. Where the illegal practice of medicine,
low spiritism, magic and shamanism are strictly prohibited
Cure in the Brazilian ayahuasca religions 47

institutionalizing the repression of these activities and classifying them,


generally, as quackery[27]17. This would directly affect the practices of
African-Brazilian cults early in their formation. It is the case of Umbanda
which as shown by several authors [9,11,27], suffered severe persecution at
the time of its appearance, even in the twenties of the last century, when
several of its practices involved healing and phytotherapy issues, labeled as
“low spiritism”, “faith healing” and “quackery”. The ayahuasca religions
were not immune to the impact of the new Penal Code. Thus, especially in
the period within the thirties and the fifties, any occasional persecution and
stigma suffered by Santo Daime and Barquinha cults in Rio Branco, were
related to the association between use of the Daime and “faith healing” or
“quackery” activities. In the case of Barquinha mainly, not just the use of the
Daime, but the recurrence to a variety of other plants for medicinal purposes
aggravated the identification of the cult as “faith healing”.
The evident approach of Barquinha with African-Brazilian cults such as
Umbanda, on the other hand stimulated the labeling of its rituals as “low
spiritism” or “voodoo”. As argued by authors such as Maggie[27] and
Negrão[9], among others, certain religions such as the African-Brazilian,
were stigmatized as involving the presence of a set of common therapeutic
practices whose struggle was of interest for the consolidation of an official
scientific medicine. It is also worth mentioning that these practices started to
be seen as signs of a “delayed” mentality and as an obstacle to the
consolidation of a more “white”, “rational” and “modern” new Brazilian
society18. Although these authors’ analyses are restricted to the African-
Brazilian cults, we can extend it to the ayahuasca religions, which arise more
or less at the same time as Umbanda, despite being in another region of the
country19.

17
Article 157 of the Penal Code established penalties for those who practiced the
“spiritualism, magic spells and their charms (...) to arouse feelings of hate or love,
inculcate cures for curable or incurable diseases, and finally to dazzle and overwhelm
the public credulity”. The penalty was 1-6 months in a prison cell[27].
18
That is the conclusion of Renato Ortiz on the process that led to the formation of
Umbanda and its adoption of aspects of the Kardecism which, according to the author,
would be more appropriate to the progress aspirations of this emerging Brazilian
society of the first decades of the twentieth century[28].
19
I developed this thought more thoroughly in another work[29]. On the analogy
between the processes of repression of the African-Brazilian and ayahuasca cults,
after the promulgation of the 1890 Criminal Code, see also article by Edward
MacRae[30].
48 Sandra Lucia Goulart

Also, the União do Vegetal, which appears in a later period, the sixties,
in Porto Velho, Rondônia, may be related at least in part, to the process by
which certain popular religious practices are being suppressed when
categorized as “faith healing” and both are associated to a delayed mentality.
In a way, maybe we can verify in this ayahuasca religion when compared to
the other two commented here, a major effort regarding a distance from a set
of therapeutic practices, understood as “quackery”. This is evidenced both in
some ritual practices of the UDV, as in attitudes and assumptions of its
followers, and especially in the pronouncements of its leaders as well as texts
and documents20 prepared by them and eventually addressed to an outside
audience. As I mentioned in an earlier work[21], this attitude is largely
explained due to the existence of affection to a science speech in the UDV21.
Although in the Brazilian Penal Code, the current ban on illegal medical
practice, the low spiritism, magic and shamanism remains, it is noteworthy
that the social image of the religious cults previously associated to these
practices, e.g. the African-Brazilian ones, changed significantly. One aspect
that points to this change is a greater membership of people from middle and
upper classes to Umbanda and Candomblé, from the seventies. Negrão, for
example, examined this process also showing how this period marks a growth
of Umbanda in Brazil, in terms of numbers of believers and religious
communities, also expressing a more positive impact of this religion and its
practices in the national press[9].

20
In the first official UDV publication, the book Hoasca - Fundamentos e
Objetivos[31] establishes a complete distinction between body and spiritual healings,
emphasizing that this institution is characterized by the use of the Vegetable only for
spiritual healing not to cure the material, i.e. the “body”. It is explicitly stated that the
UDV does not proclaim “the curative properties of the tea” and “does not practice or
spread faith healing actions”[31]. However, as shown in some investigations[5], the
UDV relation with healing practices connected to a phytotherapic knowledge is
ambiguous. On the one hand, this kind of scientistic speech marks a distance from
these practices, on the other hand, the presence of a number of elements in this
cult indicates continuity with the logic that reigned the recurrence to those
practices.
21
This is a scientificity ideal, very similar to the one which according to Renato
Ortiz[28] guided the consolidation and dissemination of the Kardecism in Brazil. In
this, according to Ortiz, concepts such as “science”, “evolution” of a “more conscious
mediumship”, as well as less material and spell - e.g. the use of herbs for healing, or
the artifacts, alcoholic beverages or tobacco by spiritual entities who were
demonstrating - practices fulfilled the role of signaling a link to this ideal of
scientificity[28,32].
Cure in the Brazilian ayahuasca religions 49

The case of the ayahuasca religions is a little different, since its


emergence, expansion and growth are given after cults such as Umbanda.
Moreover, its spread to other regions of Brazil besides the Amazon, involves
new aspects. Among these, the association of religion with the drug issue in
the contemporary society is highlighted. The expansion of these ayahuasca
religions and their greater visibility in the Brazilian society, do not coincide
with the outline of a positive social image of them. Instead, when they
become more visible, being no longer restricted to the Amazon region, they
begin to be analyzed by the Brazilian media in an extremely negative way.
However, despite this fact, as in the case of the African-Brazilian cults, the
spread of the ayahuasca religions also imply in a change of their believers’
sociocultural profile. When they reach the South and Southeast regions of the
country, they start being embraced by individuals from higher social classes
who express a very different lifestyle from those believers connected to the
origin of these religions. Not all ayahuasca religions are involved with this
movement of expansion and diversification of the profile of its followers. The
UDV and CEFLURIS (Centro Eclético da Fluente Luz Universal Raimundo
Irineu Serra), which is a division of the cult of Mestre Irineu’s Santo Daime
that emerged in Rio Branco, Acre, in 197822, are the most related to this
movement. Both the UDV and CEFLURIS have today groups in several
other countries. The CEFLURIS is present in countries such as Argentina,
United States, Japan, Spain, Portugal, Italy, Greece, England, Wales, France,
Belgium, Holland, Switzerland and Germany23. The UDV has followers in
the United States and Spain.
The fact that the ayahuasca cults embrace today believers of different
social strata brings new elements to the question on relations between
subaltern religious therapeutic practices and an official and hegemonic
scientific medicine. In this regard, we consider important to highlight that the
marginalization of some of the practices of these cults is sustained despite the

22
The CEFLURIS was created by Sebastião Mota de Melo, who was known by his
followers as “Padrinho Sebastião” and died in 1990. Sebastião Mota de Melo was
born in Amazonas state and was part of the group created and led by Mestre Irineu.
With his decease, he appeared as one of his possible successors. However, after a
series of conflicts and disputes concerning the successor of Mestre Irineu in the group
originally created, Sebastião Mota de Melo breaks with them and creates his own
Daime center in Rio Branco. Today CEFLURIS is run by his sons.
23
Alberto Groisman[33] asserts that by 1996 there were twenty-eight groups
associated with CEFLURIS in Europe and around five hundred people between
followers and occasional attendees of their rituals.
50 Sandra Lucia Goulart

change in the socioeconomic profile of their believers. This occurs due to


different factors. In particular, in contemporary complex societies we can
identify a great heterogeneity of behavioral patterns, not only determined by
economic conditions, which have a larger or smaller acceptance, according to
different situations and historical moments.
Regarding the recurrence of therapeutic activities it is possible to identify
those generally called alternative therapies in relation to biomedicine. The
recurrence of these alternative therapeutic approaches occurs relatively
frequently in these ayahuasca religion groups that express an expansion and
diversification motion of their socio-cultural followers. Rose[34], for
example, studied a group linked to CEFLURIS located in Minas Gerais
which has as one of its peculiarities, a strong presence of believers in the
health and medicine area who also work with this kind of therapy. The author
showed that an intersection between the uses and meanings of these
alternative therapies and the daimist spiritual therapies occurs.
As mentioned by other authors, nevertheless, the great difference between
official medical practices and magic-religious medicines is that the latter offer
principles and integrating responses to the misfortunes and illnesses experienced
by the subjects, making them more meaningful and bearable. The religious
medicine expresses a holistic view of the disease. Instead, the official medicine
therapies act from a logic of specialization that separates, divides and classifies
the sick body, understood as just a biological entity[12,35].
Finally, it is important to emphasize that the religious medicine expressed
through the cults discussed in this article is deeply marked by the use of the
psychoactive beverage called Daime or Vegetal in the different groups. As we
can see by what has been stated here, for the believers of these cults the referred
beverage ranges through a variety of meanings that infer and does not remit
necessarily to its psychoactive or pharmacological characteristics. However,
mainly from the expansion process of these religions, they are now identified, in
the more comprehensive society, to the use of a drug or hallucinogen.
At this point it is worth clarifying that in Brazil, the use of the ayahuasca
has been under threat of a legal ban in several occasions. In 1985, it was even
suspended, and the ayahuasca was on a list of psychotropic substances
prohibited for a period of almost one year. In 1987, however, after a long
survey conducted by a team of specialists from different scientific areas, the
use of the beverage was liberated again, but only for religious and ritual
purposes. The last document approved by the Brazilian government on this
issue in January 2010 (Resolution No 01, January 2010/CONAD)24, was

24
This resolution was published in the Diário Oficial da União (Federal Official
Gazette), No. 17 from January 26, 2010, page 58.
Cure in the Brazilian ayahuasca religions 51

prepared by CONAD (Conselho Nacional de Políticas sobre Drogas -


National Drug Council)25. The preparation of the document resulted from
discussions and assessments developed by a working group composed of
experts on the subject, especially in biomedicine but also in humanities and
counted also with the participation of representatives of major groups of these
religions. The CONAD document legally sanctions the religious use of the
beverage, based on the principle that assures the right to free exercise any cult
or faith, established in the Brazilian constitution. Furthermore, the document
contains a set of principles that constitute in recommendations for the
appropriate use of the beverage, which should be followed by all ayahuasca
cults. This document regulates the use of the ayahuasca in Brazil.
Concerning the therapeutic use of the ayahuasca, providing continuity to
a logic characterized by these cults, the CONAD document establishes that
first, the so-called healing activities practiced in these cults consist of an “act
of faith”, with a strict religious sense, a right therefore guaranteed by the
Brazilian constitution, and on which the state cannot intervene. In this aspect
the rules of CONAD continues the logic characterized by the ayahuasca cults,
remembering that it was also elaborated from the considerations of the
representatives of these cults’ perspective. Secondly, the CONAD regulation
determines that the use of the ayahuasca for therapeutic purposes other than
those strictly religious aiming at health or cure, are not allowed. The
document clarifies that the use of the ayahuasca for this other purpose can
only be made under confirmation of scientific research undertaken at
academic institutions.
It is true that the latest Brazilian government regulations on the use of the
ayahuasca partly continue the arguments of the ayahuasca cult believers, by
admitting that the therapeutic practices exercised in their contexts have a
strictly religious meaning. However, the logic and mindset that support these
practices differ considerably from the fundamentals that guide governmental
decisions and opinions. As we tried to show throughout this article, the
therapeutic activities of these cults merge different conceptions and practices,
implying both in a phytotherapic experimentalism as in spiritual explanations

25
CONAD is the regulatory agency of the Sistema Nacional de Políticas Públicas
sobre Drogas (National System of Public Policies on Drugs) - SISNAD - which is in
charge of the drugs policy in Brazil. Both were created in 1998 to replace other
agencies with a similar function. The CONAD is linked to the Presidential
Institutional Security Office and consists of members who participate in government
institutions as well as NGOs. Its function is to provide guidance, advice and
recommendations on the drugs subject
52 Sandra Lucia Goulart

of diseases and also in the recurrence to scientific medicine procedures. At


the same time, we saw that the elements of the scientific medicine, when part
of the set of ayahuasca cult practices are reinterpreted by them and submitted
to their cosmology. The Brazilian ayahuasca cults, accordingly, express and
consolidate a therapeutic knowledge that is not only from a different order
(religion) from that one perpetuated by biomedicine, but also stands as a
counterpoint to this one, by moving from a logic and from quite distinct
elements. With the present discussion we believe therefore, to be contributing
to the reflection between the possible relations between religious and
scientific medicines.

References
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T Transworld Research Network
37/661 (2), Fort P.O.
Trivandrum-695 023
Kerala, India

The Ethnopharmacology of Ayahuasca, 2011: 55-63 ISBN: 978-81-7895-526-1


Editor: Rafael Guimarães dos Santos

3. An overview of the literature on the


pharmacology and neuropsychiatric
long term effects of ayahuasca

José Carlos Bouso and Jordi Riba


Human Experimental Neuropsychopharmacology and Centre d’Investigació de Medicaments
(CIM-Sant Pau), Institut d’Investigacions Biomèdiques Sant Pau (IIB-Sant Pau), Barcelona, Spain

Abstract. The last two decades have seen a steady increase in the
number of publications devoted to ayahuasca. This fascinating
psychotropic plant tea has attracted the attention of biomedical and
psychological scientists. Researchers have gathered data on the
physiological impact of ayahuasca administration to humans and
have assessed the consequences of long term regular use. Acute
administration studies have provided information on the fate of the
alkaloids in the organism, the modification of vital signs,
neuroendocrine and immunological parameters and
neurophysiological variables. For the first time, neuroimaging
techniques have shown us which brain areas “light up” during the
most intense phases of the ayahuasca experience. Also, the
popularization of ayahuasca has raised concerns that its regular
use may cause neuropsychiatric and addiction-related problems for

Correspondence/Reprint request: Dr. Jordi Riba, Human Experimental Neuropsychopharmacology and Centre
d’Investigació de Medicaments (CIM-Sant Pau), Institut d’Investigacions Biomèdiques Sant Pau (IIB-Sant
Pau), Barcelona, Spain. E-mail: [email protected]
56 José Carlos Bouso & Jordi Riba

users. An increasing number of studies have tried to address these concerns. In the
present chapter we aim to give an overview of the available literature on the human
pharmacology of acute ayahuasca intake and on the neuropsychiatric and psychosocial
consequences of its long-term use.

1. The human pharmacology of ayahuasca


By temporarily modifying serotonergic neurotransmission, ayahuasca
exerts a powerful action on the central nervous system. These neurochemical
modifications constitute the basis of the unique experience reported by users.
Scientific inquiry into the workings of ayahuasca, and all psychoactive drugs
in general, is greatly advanced by the study of these substances in the only
species that can accurately report on the diverse facets of the psychedelic-
induced experience, i.e., human beings. By administering these compounds in
known dosages to carefully selected individuals valuable information has
been obtained on their impact on the human body and psyche.
The clinical investigation of ayahuasca was initiated by a field study
conducted in the early 1990s by Callaway, Grob, McKenna and colleagues,
and aimed to assess the subjective and physiological impact of acute
ayahuasca administration in regular users. In the study a 2 ml/kg dose of
ayahuasca was given to a group of 15 long-term members of a Brazilian
ayahuasca church known as União do Vegetal. Subjective effects were
measured with the Hallucinogen Rating Scale (HRS; an instrument originally
developed by Strassman and colleagues[1] to assess the effects of intravenous
dimethyltryptamine [DMT])[2]. The authors also assessed various
physiological parameters and the pharmacokinetic profile of ayahuasca
alkaloids[3]. The HRS measurements provided information on six different
spheres of the psychedelic-induced experience: Somaesthesia, reflecting
somatic effects; Affect, sensitive to emotional and affective responses;
Volition, indicating the volunteer’s degree of incapacitation; Cognition,
describing modifications in thought processes or content; Perception,
measuring visual, auditory, gustatory, and olfactory experiences; and, finally,
Intensity, which reflects the strength of the overall experience. Scores on the
six subscales showed that at the administered dose ayahuasca was able to
induce distinct psychedelic effects, with the intensity of the experience falling
on “the mild end of the spectrum when contrasted to the highly potent, short-
acting intravenous DMT”[2].
This pioneering study found measurable plasma levels of the four main
alkaloids (DMT, harmine, harmaline and tetrahydroharmine [THH]),
described their pattern of variation with time and how this related with time-
dependent modifications which for the most part reached a maximum
Pharmacology and neuropsychiatry of ayahuasca 57

between one and two hours and had disappeared at 24 hours after ayahuasca
ingestion[3].
More recently, research has been conducted by Riba and coworkers at the
Hospital de Sant Pau in Barcelona. Since 1999 this team has performed a
series of studies which have tried to better characterize the
neuropharmacological profile of ayahuasca. The group started by analyzing
the psychometric characteristics of the HRS and obtaining subjective ratings
of ayahuasca[4]. A pilot study was then undertaken to assess the tolerability
of ayahuasca within a range of dosages, from which safe and
pharmacologically effective doses were selected for subsequent studies
involving a larger number of volunteers[5]. A method to determine ayahuasca
alkaloids in plasma was perfected to now include several metabolites which
had not been measured previously in humans[6]. These initial efforts were
followed by a series of clinical trials which have provided information on the
pharmacokinetics, the subjective and cardiovascular effects of different doses
of ayahuasca[7], and various psychophysiological measures[8-11]. For the
first time in the centuries-long history of ayahuasca use, the neuroimaging
study conducted by this team[12] identified the brain areas specifically
involved in the genesis of ayahuasca effects. A review of their studies and
findings between 1999 and 2004 can be found in Riba and Barbanoj
(2005)[13]. In the last five years the same group has conducted additional
studies on the sleep, neuroendocrine and immunological effects of ayahuasca,
as well as on the pharmacology of repeated ayahuasca intake. Several of
these studies are still pending publication[14].
As would be expected from conventional drugs and somewhat in contrast
to popular belief, when administered in a clinical setting and carefully
controlling for expectancy (blind designs) ayahuasca was found to act in a
dose-dependent manner. This was the case for physiological (cardiovascular),
pharmacokinetic and psychological variables (assessed with the HRS; with the
ARCI – Addiction Research Centre Inventory, another rating scale to assess
subjective effects of drugs; and with VAS – Visual Analogue Scales, a simple
method to assess subjective effects of drugs consisting of 100-mm horizontal
lines with different labels as “any effect”, “good effects”, “liking”, “visions”,
etc., that subjects must mark depending on the intensity of a given effect as
experienced while under the effects of the drug). In these studies, DMT plasma
concentrations reached their peak coinciding with the maximum intensity of the
subjective effects. An unexpected result was the very low levels of harmine
found in plasma for the majority of participants. This is suggestive of intense
metabolism and also indicative that, at least in some people, the contribution of
harmine to the overall central effects of ayahuasca would be small[7].
Ayahuasca induced cardiovascular effects, basically consisting of elevations of
58 José Carlos Bouso & Jordi Riba

diastolic blood pressure. While these increases were moderate, caution should
be exerted by people who have elevated blood pressure or other cardiovascular
problems. This is even more relevant considering recent reports in the media
concerning the unexplained deaths of people participating in ayahuasca
rituals[15-17]. It should be noted that the clinical data which has been
published to date is from young healthy volunteers. Safety results might be
different in older people or individuals with pre-existing conditions.
At the psychophysiological level ayahuasca induces significant effects,
shifting the energy distribution in the electroencephalogram (EEG), i.e., the
spontaneous electrical activity of the brain, towards the higher end of the
power spectrum. This shift towards the so-called faster frequencies of the
EEG can be measured as an increase in the relative power of the EEG beta
band[10]. While this effect can be interpreted as reflecting enhanced Central
Nervous System (CNS) activity, this activation is unique to psychedelics and
different from that induced by traditional psychostimulants. Unpublished data
from a study comparing ayahuasca with d-amphetamine (d-AMPH), a
classical psychostimulant enhancing dopaminergic and noradrenergic
neurotransmission, show that d-AMPH has no effect whatsoever on relative
beta power[14]. Whereas both drugs share some sympathomimetic effects,
such as increasing pupillary diameter and elevating blood pressure, the
distinct effects of ayahuasca on the EEG would relate to its specific
serotonergic mechanism. Differences in neurochemical mechanism are also
evidenced by ayahuasca, but not d-AMPH, significantly increasing prolactin
levels (a hormone whose release is enhanced by serotonergic drugs and
inhibited by dopaminergic drugs). Despite these differences, both ayahuasca
and d-AMPH induce a stress-like reaction increasing cortisol levels, the
increment induced by ayahuasca being higher. Another interesting finding is
that ayahuasca is able to modulate the cell immune system. This effect
appears to be non-specific as both ayahuasca and amphetamine induce
similar time-dependent modifications on lymphocyte subpopulations: the
percentages of CD4 and CD3 cells decrease, while the percentage of NK cells
increase. These changes reach a maximum at around 2 hours post-
administration and return to baseline levels at 24 hours[14]. No studies have
yet assessed the possible impact of these acute physiological modifications
on the health of long term ayahuasca users.
Perhaps the most interesting finding from the mentioned clinical trials is
the identification of the brain areas where ayahuasca acts. Using the
neuroimaging technique SPECT (single photon emission tomography)
researchers found that ayahuasca acts almost exclusively on the cerebral
cortex without acting on subcortical areas. Ayahuasca increases the activity
of the anterior insula bilaterally, with greater intensity in the right
Pharmacology and neuropsychiatry of ayahuasca 59

hemisphere. It also hyperactivates the anterior cingulate/frontomedial cortex


of the right hemisphere, areas previously known to be implicated in somatic
awareness, subjective feeling states, the processing of emotional information
and emotional arousal. Additional increases were observed in the left
amygdala/parahippocampal gyrus, structures also involved in emotional
arousal and the processing of memories[12].

2. Neuropsychiatric long term effects of ayahuasca


Since personality and neuropsychological function are to a great extent
regulated by the prefrontal cortex, the study of personality,
psychopathological status and neuropsychological functions in long term
ayahuasca users is essential to ascertain whether regular ayahuasca use has
some impact on mental health.
A few studies have been conducted assessing the consequences of regular
ayahuasca use in the long term. The data available is limited and would need
replication in larger samples. One preliminary study led by Charles Grob
assessed personality and neuropsychological function using the TPQ
(Tridimensional Personality Questionnaire) and the WHO-UCLA Auditory
Verbal Learning Test. The questionnaires were administered to a sample of
15 regular users with more than 10 years of experience with ayahuasca and to
a comparison group of 15 non-users. No personality alterations or
neuropsychological deficits were found in the ayahuasca-using subjects,
though there were personality differences between groups, which the authors
did not interpret as pathological. No information was given as to whether the
scores fell within the normal range according to normative data[2]. A typical
problem with this kind of studies lies in the interpretation of results. It is
difficult to establish whether the scores obtained with the TPQ reflect the
impact of ayahuasca use or rather pre-use personality. In the study by Grob
and coworkers the authors also used the structured psychiatric interview
known as CIDI (Composite International Diagnostic Interview) and found
that 11 out of the 15 participants had a history of moderate to severe past
alcohol use. Five of them reported episodes of associated violent behavior
and a diagnosis of alcohol abuse disorder prior to their involvement with an
ayahuasca church. Four subjects also reported previous use of other drugs of
abuse, including cocaine and amphetamines, and 8 of the 11 subjects who
had a history of alcohol and other drug use and misuse were addicted to
nicotine at the time of their first ayahuasca session. According to the authors,
all these addiction problems resolved after they began their regular use of
ayahuasca. Ayahuasca participants did not meet diagnostic criteria either for
60 José Carlos Bouso & Jordi Riba

addiction or for any other psychiatric disorder at the moment of the


assessment.
A recent study on 32 regular ayahuasca users belonging to the Igreja do
Santo Daime in Oregon, USA, did not find psychiatric alterations as
measured by a series of rating scales and compared to normative US data. As
occurred in the study by Grob and colleagues[2], most of the ayahuasca users
had shown some psychiatric disorder or some drug or alcohol abuse disorder
in the past, which at the time of the assessment was not present. This was
interpreted again as a direct benefit of participating in the Santo Daime
ceremonies[18]. Since the subjects in this study were not compared with
matched non-users, the findings should be interpreted with caution.
Finally, two papers have been published regarding the long term
psychopathological and neuropsychological effects of regular ayahuasca in
adolescents. Each study involved 40 adolescents with a two-year history of
ayahuasca use, and a comparison group of 40 matched non-users. No
statistical differences were found in psychopathology scores[19] or in
measures of neuropsychological function[20]. In sum, while no deletereous
effects have been demonstrated, due to the small number of studies
conducted on regular ayahuasca users the potential impact of sustained
ayahuasca use on mental health remains an open question.

3. Additional studies
Several studies have assessed the impact of acute ayahuasca on
psychological traits and measures, psychopathology, personality and
spirituality, all in a naturalistic context.
In one study of first-time users of ayahuasca in the ritual context of the
Brazilian churches of the Santo Daime (19 subjects) and the União do
Vegetal (nine subjects), significant reductions of minor psychiatric symptoms
and positive changes in behavior were found in the four days following
ayahuasca use[21]. Another study found reductions in the scores of panic and
hopelessness one hour after ayahuasca ingestion, as compared to
baseline[22]. Still in another study, 49 participants without previous
experience with ayahuasca attended different ayahuasca ceremonies after
which quantitative and qualitative assessments of spiritual experiences were
conducted. The rating scales measuring changes in spirituality were not
significantly modified after the sessions, though many subjects experienced
spiritual themes according to the qualitative data obtained[23]. One study did
a six-month follow-up of participants who had consumed ayahuasca for the
first time in the context of a Brazilian ayahuasca church (Santo Daime and
União do Vegetal). The study found a general improvement in several
Pharmacology and neuropsychiatry of ayahuasca 61

psychological measures at the end of the study. Most of the subjects


continued to consume ayahuasca after the six-month study period.
Additionally, the authors found positive correlations between ayahuasca use
and positive psychological attitudes. Ayahuasca use did not appear to cause
any adverse effects[24]. Finally, a naturalistic study found that ayahuasca
alters binocular rivalry, a perceptual measure of cognitive processing[25].
One recently published study used the Addiction Severity Index (ASI) as
a measurement instrument. The ASI is a semi-structured interview designed
to assess the impact of drug use in a multi-dimensional fashion. It assesses
the participant’s Medical Status, Employment/Support, Drug and Alcohol
Use, Legal Status, Family/Social Relationships, and Psychiatric Status, and
provides general information on the participant’s current condition and
his/her level of deterioration. The ASI was administered to two different
samples of regular ayahuasca users. This study assessed the largest sample
studied to date, i.e., a total of 112 regular ayahuasca users. These users
belonged to two different ayahuasca churches – the Santo Daime and the
Barquinha – and they were assessed in two different settings – jungle and
urban-based, respectively. They had a 15-year history of use and they were
compared with 115 matched controls. Assessments were repeated one year
later as a follow-up. The study concluded that “the ritual use of ayahuasca, as
assessed with the ASI in currently active users, does not seem to be
associated with the psychosocial problems that other drugs of abuse typically
cause”[26]. This research group recently presented a conference paper[27]
reporting that they did not find evidence of neuropsychological deficits or
personality and psychiatric disorders in their sample.

4. Final remarks
Though no serious adverse events were attributed either to acute or
chronic ayahuasca use in the published studies reviewed, a note of caution
should be made regarding ayahuasca safety. The clinical trials cited in this
chapter were performed in healthy young volunteers who had extensive
experience in psychedelic drug use and did not present any sequelae derived
from this use. The conclusions cannot be extrapolated to the general
population, and especially not to ayahuasca-naive individuals. Ayahuasca has
shown to moderately increase several cardiovascular parameters and such
increases could have deletereous effects on people with cardiovascular
conditions. Furthermore, although only one subject in the clinical trials
suffered an episode of disorientation, a case report describes a patient who
presented a psychotic breakdown after acute ayahuasca intake. Antipsychotic
62 José Carlos Bouso & Jordi Riba

medication was needed until its remission, and the same individual suffered a
second psychotic crisis after subsequent ayahuasca use[28]. Other cases of
psychiatric adverse psychiatric reactions, including psychotic disorders, have
been reported following acute ayahuasca ingestion[29]. It is necessary to take
into account the anecdotal evidence available on its potential dangers in order
to get a complete picture of the possible negative psychiatric consequences.
Regarding the studies of long term effects, it should be noted that the
participant samples studied in the reviewed papers may have suffered from a
self-selection bias. This would mean that the assessed individuals may have
been those who did not experience any negative neuropsychiatric
consequences derived from their maintained ayahuasca use. Subject
experiencing adverse consequences might have given up ayahuasca use
altogether and would consequently not be accessible to researchers.
To conclude, the scientific investigation of ayahuasca has only found a
moderate risk associated to acute ayahuasca administration and has even
reported psychological improvements after long-term use. Future
investigation into the neuropsychiatric safety of regular ayahuasca use should
ideally also include people who used ayahuasca regularly in the past but
decided to discontinue its use.

References
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R.J., and Boone, K.B. 1996, J. Nerv. Ment. Dis., 184, 86.
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10. Riba, J., Anderer, P., Morte, A., Urbano, G., Jané, F., Saletu, B., and Barbanoj,
M.J. 2002, Br. J. Clin. Pharmacol., 53, 613.
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do Santo Daime. O Globo, November 18.
16. Gomes, H. 2010, A encruzilhada do Daime. Isto É, February 05.
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yagé. El Espacio, November 16.
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2008. Med. Sci. Monit., 14, SR15.
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and Doering-Silveira, E., 2005. J. Psychoactive Drugs 37, 129.
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C., Shirakawa, I., Bertolucci, P.H., and Da Silveira, D.X., 2005. J. Psychoactive
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2007, J. Ethnopharmacol., 112, 507.
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T Transworld Research Network
37/661 (2), Fort P.O.
Trivandrum-695 023
Kerala, India

The Ethnopharmacology of Ayahuasca, 2011: 65-74 ISBN: 978-81-7895-526-1


Editor: Rafael Guimarães dos Santos

4. Therapeutic perspectives on the acute and


post-acute effects of ritual experience with
ayahuasca: A case study

Paulo César Ribeiro Barbosa


Adjunct professor and member of the Mental Health Research Group
State University of Santa Cruz, Ilhéus, Bahia, Brazil

Abstract. Introduction: Psychedelics, which are currently


considered to lack medical efficacy and to be, as a rule, dangerous,
were once used as therapeutic adjuncts in the so-called psycholytic
and psychedelic therapies of the years between 1950 and 1970. The
expansion of religious use of the psychedelic drink ayahuasca in
Brazil and elsewhere has been increasing interest in the
investigation of ostensible therapeutic properties which are
attributed to this drink by its users.
Objectives: To explore the therapeutic potential of first
experiences with ayahuasca.
Methods: Case study, in which in-depth interview techniques
were used to elicit the parameters and meaning of first experiences
with ayahuasca in Santo Daime (CEFLURIS branch) and its
behavioral consequences in the following week.

Correspondence/Reprint request: Dr. Paulo César Ribeiro Barbosa, Adjunct professor and member of the
Mental Health Research Group, State University of Santa Cruz, Ilhéus, Bahia, Brazil
E-mail: [email protected]
66 Paulo César Ribeiro Barbosa

Conclusions: The states of consciousness induced by first experiences with


ayahuasca point to therapeutic potential because, according to the subject’s self-
report, they stimulated processes of self-knowledge and insight about aspects of the
subject’s biography. It was noteworthy that, unlike psycholytic and psychedelic
therapies, this insight occurred in association with feelings of peace and in the absence
of the visionary experiences typical of psychedelics. The tranquilizing properties of
ayahuasca, as well as aspects of the ritual and environmental setting, contribute to the
elaboration of interpretive hypotheses about the experience.

1. Introduction
Ayahuasca is a hallucinogenic drink made from the decoction of the root
bark and, sometimes, the outer layer of stems of the vine Banisteriopsis caapi
(which contains the harmala alkaloids harmine, harmaline, and
tetrahydroharmine), together with the leaves of the Psychotria viridis bush,
which contains the alkaloid N,N-dimethytryptamine[1]. The hallucinogenic
properties of this combination of alkaloids have been explained as a function
of their particular means of affecting the serotonergic system[2].
Ethnographic data have detailed the ritual use of the drink for magico-
religious purposes in the western Amazon basin by Amerindian and mestizo
populations[3-5].
Throughout the 20th century, emigrants from northeastern Brazil who
went to Amazonia assimilated Amerindian / Amazonian mestizo religious
use of ayahuasca to their existing religious beliefs. This cultural process
resulted in the advent of several modern urban religions, such as the Centro
Eclético Fluente Luz Universal Raimundo Irineu Serra [Raimundo Irineu
Serra Eclectic Center of the Universal Flowing Light] (also known as
CEFLURIS or Santo Daime), the União do Vegetal (also known as the
UDV), and the Barquinha, which are characterized by a combination of
Christian, Afro-Brazilian, reincarnationist Spiritism, and the use of
ayahuasca as means to spiritual development[6-10]. Over the last three
decades, UDV and Santo Daime temples spread beyond the Amazonian
region to the large cities in every region of Brazil. This process made the
ritual-religious use of ayahuasca accessible to a large number of people
whose predominant cultural background did not include the religious use of
hallucinogens.
Reactions to the use of ayahuasca among mental health professionals
have been polarized. On one side are those, supported by the currently
dominant perspective of mental health, who express concern about adverse
physical and mental effects resulting from the use of the drink[11,12]. On
the other side are those who consider the possible therapeutic uses of this
Therapeutic perspectives on ayahuasca 67

substance, supported by encouraging results in observational studies of


long-term users of ayahuasca[13,14] and by the programs of psycholytic
and psychedelic therapies based on the use of hallucinogenic substances.
These programs, in vogue at the end of the 1950s and the start of the 1960s,
proposed that positive transformations of daily behavior could result from
the insights produced by hallucinogens in therapeutic settings[15].
The psycholytic paradigm was dominant in Europe. This approach relied
on psychodynamic theories, advocated moderate doses of hallucinogens to
help reduce psychological defenses, and emphasized the imagistic effects of
the substances as symbolic resources to achieve insight[16]. The psychedelic
paradigm, which was predominant in North America, argued that the use of
high doses of hallucinogens could induce an intense, powerfully
transformative mystico-religious experience, and that this potential should be
used in psychotherapy[15,17].
This paper seeks to explore the therapeutic possibilities of ayahuasca
through a detailed report of a young woman’s first ritual experience with
ayahuasca in the CEFLURIS branch of Santo Daime in the city of São Paulo,
Brazil.

2. Methods
In 2005, we reported a study that evaluated the psychological effects of
first-time ayahuasca use in twenty-eight subjects. In that study, information
was collected about aspects of the set (prior individual attitudes toward the
experience with ayahuasca), the acute effects of the drink experienced during
the ritual, and the post-acute effects experienced in the week following the
ritual[18]. This work develops little-explored aspects of that project through a
detailed description of the case of Tanya (a pseudonym), one of the subjects
in that sample. Tanya is 37 years old, single, white, educated, and
professionally successful. She was born in the city of São Paulo and currently
lives in one of its upper-middle class neighborhoods. Tanya was evaluated
two days before her first experience with ayahuasca and seven days after it.
Semi-structured interviews were used for data collection. At T0 Tanya’s
motivations and expectations for the imminent experience with ayahuasca
were elicited, as well as her emotional state and her attitudes along various
psychosocial dimensions (family, professional and financial, interpersonal,
self-esteem, stressor events, and perceptions of her physical wellbeing. At
T1, the state of mood and attitudes were again elicited, as well as dimensions
of the ritual experience with ayahuasca: affectivity, thought process and
content, sense of identity, exteroception, enteroception, volition / control, and
68 Paulo César Ribeiro Barbosa

spatiotemporal sense. The analysis consisted in the identification of themes


that link each of the experiential dimensions in the three phases covered by
the investigation: prior to the experience with ayahuasca, the acute effects
(that is, experiences during the ritual), and the short-term, post-acute effects
(that is, during the week following the experience).
All novices to Santo Daime must go through a prior interview, conducted
by the religion’s acolytes, aimed at evaluating the candidate and giving
guidance about the procedures to be adopted during the ritual. Tanya’s
recruitment for the study took place within an agreement with the CEFLURIS
church that was to organize the ritual within which she would have her first
experience with ayahuasca. The person responsible for the interview was to
send the novice for evaluation.
As happens with the majority of novices, Tanya tried ayahuasca in a
CEFLURIS church, in a wooded area on the outskirts of São Paulo. The ritual
began at 9:30 p.m. and ended at 9:30 a.m. the next morning. Tanya ingested
four doses of the drink throughout the ritual, which, like the other rituals in
this denomination, was marked by constant singing of songs, called hymns,
in praise of God, Christian saints, nature, and moral virtues, and was
accompanied by the synchronized movement of all the participants (called
the bailado, or “dance”).

3. Results
3.1. Set: Motives for trying Daime and attitudes prior to the
experience

“I am going to try Daime to see if... It is a search for self-knowledge (...) to


understand why I fight with people who have nothing to do with my
problems.”

This was Tanya’s response when asked about her motives for trying
ayahuasca. Next, she related the situation that currently leads to her fighting
with people who have nothing to do with her problems. There had been a
recent romantic breakup, which involved a financial debt, incurred during
the relationship, that her ex-boyfriend owed her. Her ex-boyfriend’s
“run-around” in resolving the debt, and constant arguments about the
situation, constituted a source of much irritation and frustration for Tanya,
who could not bring the matter to a conclusion. This particular situation
was linked with feelings of low self-esteem, as for some time she had been
unable to bring about changes in her habits, such as dieting and stopping
smoking.
Therapeutic perspectives on ayahuasca 69

3.2. States of consciousness induced by the ritual use of ayahuasca


3.2.1. Transition to the states of consciousness induced by the ritual use
of ayahuasca

“At the beginning I looked around there and I thought, ‘What am I doing
here? This here doesn’t...this has nothing to do with me.’ And suddenly,
there I was. I was there, dancing with them, singing all the hymns and
feeling good about it. So I thought it was strange because, at first, like, I
got weirded out, you know? Later I was fine, I calmed down, kept going
like I had always been a part of that.”

This statement reveals that the initial phase of Tanya’s ritual experience
with ayahuasca was marked by a sense of transition between the ordinary
state of consciousness in which she found herself in the everyday and the
special consciousness experienced during the ritual. Two aspects stand out in
this phase:

1. Perplexity toward the apparent nonsense of going to an environment


that seems to have no relation to her way of life;
2. The sudden subsequent change, characterized by a sense of
familiarity with the environment and with ritual behaviors.

3.2.2. Stabilization of the state of consciousness induced by the ritual use


of ayahuasca

“I was feeling very good. I became quite calm during the whole
ceremony ... during the whole ‘work’ I felt very tranquil almost the whole
time (...) there was no kind of hallucination, things like that. I didn’t have any
of that. Absolutely nothing. The only thing I had was that I felt very, very
tranquil.”
“I didn’t think about my life outside at all, about the money my ex-
boyfriend owes me, work, nothing.”
“I thought a lot about my whole life. But not that I felt I was living
through it again. I was just thinking. Normal memories (...), all the things I
did and all the relationships I’ve had (...) from about seventeen years old.”
“I became very calm and I could examine a series of attitudes I had, of
things that I had done in my life, what I thought was right, what was wrong.
It was like I was having a conversation with myself the whole night. There
were no visions, no hearing things. I thought about all the relationships I’ve
had. That has always been a tough area for me, always very painful. So I
70 Paulo César Ribeiro Barbosa

thought about that, about why it’s like that. I found a good feeling to be able
to assess all of that. To be able to see that I was wrong about a bunch of
things, you know, in all the relationships that I’ve had. A kind of patterned
behavior (...) And all of a sudden I began to evaluate the things I did and I
saw that they were all similar, ‘no, wait a second, I’m wrong about some
things.’ I appeared as a very authoritarian and demanding person. Things
have to be the way I want, otherwise I’m not happy, I start a fight. I always
put that into every relationship. I don’t think you can be so radical; it can’t be
that thing like, ‘I know it all.’”
In these passages from Tanya’s interview an experience of stabilization
in a new state of consciousness is seen to follow the transition phase. The
stabilization is marked by three inter-related dimensions:

1) A state of peace lasting throughout the ritual;


2) Cessation of everyday worries, the ex-boyfriend’s debt being the
most dominant one at the time;
3) Memories of all her previous romantic relationships since
adolescence;
4) Insight resulting from the discovery of an authoritarian behavioral
pattern in all her relationships, and the recognition of the pattern’s
error.

The interview further emphasizes the negation of exteroceptive


experiences—visions, voices—which she had previously been told were
typical effects of ayahuasca.

3.2.3. Return to the everyday

“(Throughout the week) I felt well in relation to this because I saw that I
am not like this, for example, with my friendships. With my friends, I don’t
have this authoritarianism, I don’t have this...you know, this thing of saying,
‘no, it has to be my way.’ I have very good friendships, I like my friends a lot.
So, since I can’t put myself across in romantic relationships like this, which is
something that always bothered me (...) I thought about this a lot all week.”
“This week I felt much calmer. I didn’t get irritated so easily with things.
I had that conversation with the guy [she refers to a conversation with her ex-
boyfriend about his debt to her]. Every time it was a fight, I’d get irritated
and in a bad mood. It was the same conversation I’d had. It was, like, calm,
tranquil. I didn’t fight. He even thought it was weird. He even said, ‘man, did
something happen to you?’ I said, ‘no.’ He said, ‘are you alright?’ I said, ‘I’m
great.’”
Therapeutic perspectives on ayahuasca 71

Two dimensions stand out in Tanya’s narrative about her return to daily life:

1) Assimilation and continuity of insights about her behavior in


romantic relationships, comparing them with her behavior with
friends;
2) Change in attitude in dealing with the problem of the ex-boyfriend’s
debt, substituting serenity for ire, anguish, and anxiety.

4. Discussion
Tanya’s case raises intriguing questions about the use of psychedelics in
general, and of ayahuasca in particular, as therapeutic resources. On one side,
Tanya’s experiences during the ritual and her behavior in the following week
corroborate proposals for the use of psychedelics as therapeutic adjuncts
based on their capacity to facilitate associative and mnemonic processes[19].
However, these experiences are very far from the psycholytic and
psychedelic models, cited in the introduction, which advocate visionary and
mystical experiences induced by hallucinogens as catalysts of insight and
behavioral change[15,16].
Tanya emphasized the absence of any extraordinary visual phenomena
throughout her experience with ayahuasca, and nowhere in her report is there
any reference to numinous experiences or mystical ecstasies. Rather, the state
of calm established by the experience reconfigured the earlier state of
“immersion” in the conflicted situation. Feelings of anguish and ire were
substituted by a state of critical emotional distancing that allowed rational
consideration of, and learning about, her behavior in romantic relationships.
The presence of insight associated with states of peace and, at the same time,
with the absence of phenomena considered typical of psychedelics, raises
new interpretive possibilities about the therapeutic potentials of the ritual use
of ayahuasca.
The central role played by the state of peace in configuring Tanya’s
experience dovetails with growing evidence that one of the key effects of
ayahuasca may be the induction of states tending toward the anxiolytic
spectrum, including the arousal of states of serenity[18] and attenuating the
effects of panic signals[20]. Throughout the history of research into the
functioning of ayahuasca’s alkaloids, scholars have found harmine and
harmaline to have sedative, CNS-depressing properties[1]. However, these
properties have been obscured by the surprising discovery that beta-
carbolines inhibit the activity of the enzyme monoamine oxidase, turning the
potent N,N-dimethyltryptamine (DMT) orally active, and explaining the
72 Paulo César Ribeiro Barbosa

reason for the powerful visionary effects that ayahuasca frequently provokes.
Thus, the role of the beta-carbolines in the subjective effects of the drink was
relegated to a secondary plane, in which they performed the basic function of
MAO inhibition to permit the action of what came to be considered the
central psychoactive substance in ayahuasca, DMT.
In recent years, however, the function of the beta-carbolines in ayahuasca
psychoactivity has been reconsidered. It has been suggested that the role of
IMAO of the beta-carbolines in ayahuasca, by increasing the bioavailability
of serotonin in the CNS, may oppose and modify the violent visionary and
dissociative effects typical of pure DMT use[21], allowing greater insight
into the experience[2]. Might it not be useful to ask whether, in Tanya’s
experience, the activation of associative and mnemonic processes in
combination with states of peace may have occurred as a function of the
combination of the psychedelic qualities of DMT with the tranquilizing
properties of the beta-carbolines? As sedatives, might the latter have a key
modulating function in the drink, softening the effects of the DMT[18] and
contributing to the emergence of insights?
Aspects of the ritual setting and environment also seem to have a
decisive influence on the configuration of Tanya’s experience. Her initial
perplexity before the absurdity of finding herself in an environment with no
relationship to her life, followed by a rapid, radical change to a sense of
familiarity and adoption of ritual behaviors, and her consequent stabilization
in a pattern of calm and reflection on her life are meaningful indications of
how changes in environment and behavior may influence the configuration of
states of consciousness.
In States of Consciousness, Charles Tart[22] offers an explanatory model
of the dynamics of changing states of consciousness that considers the question
of environmental and behavioral influences. According to this model, the
stabilization of a given state depends on a semi-arbitrary adaptation to
environmental demands. The expression semi-arbitrary signals the fact that
consciousness, if it must on the one hand respond appropriately to certain
unavoidable environmental discomforts—no one of sound mind questions the
consequences of a jump from a 50-meter cliff—on the other hand, it is
constituted through the specific demands of our socio-cultural milieu, which
select, from among the multiplicity of possible experiential configurations in
the field of consciousness, those which are adapted to the performance of
socially constructed and sanctioned roles. Therefore, according to Tart[22],
there is a constant feedback loop between the maintenance of a given
configuration of states of consciousness and environmental demands.
Thus, Tanya’s movement from her habitual environment to a strange
one may have contributed to the change in configuration of her state of
Therapeutic perspectives on ayahuasca 73

consciousness. Her initial perplexity may reflect disorientation stemming


from the mismatch of configuration of her state of consciousness to a
completely novel environment. The urban locus of the feedback which
maintained quarrelsome attitudes and feelings of anguish and low self-
esteem were left behind. In their place, nature and a ritual marked by
expressions of praise for moral elevation mitigated those conditions,
opening the way for the reconfiguration of a state marked by serenity and
self-reflection.

5. Conclusions
A notable limitation of this study is the fact that Tanya’s evaluation was
restricted to a one-week period, which imposed restrictions on the breadth of
the biographical points raised and, consequently, on the ability to make
inferences about the impact of the ritual experience of ayahuasca on her life.
It should be taken into account, however, that as one would expect in using
case studies, the objective of this report was the exploration of new
phenomena and associations, which, in this study, meant the exploration of
new associations involving the possibilities for therapeutic use of ayahuasca.
In this way the study revealed that Tanya’s experience with ayahuasca
represented an unequivocal rupture, at least temporarily, with a prior
dysfunctional state, and an unequivocal experience of insight involving
awareness of problematic aspects of her own behavior.
The novelty consisted in the fact that these experiences occurred in
association with a mood state marked by serenity, and in the absence of the
visionary, mystical, and symbolic characteristics propounded by the
psychedelic and psycholytic therapeutic projects. This fact points toward the
systematic exploration of “extra-hallucinogenic” aspects to the therapeutic
possibilities stemming from the ritual use of ayahuasca: the sedative
properties of the drink and the environmental and ritual setting.

References
1. Ott, J. 1994, Ayahuasca Analogues, Natural Products Co., Kennewick.
2. Callaway, J.C. 1999, In: Ayahuasca: Hallucinogens, Consciousness and the Spirit
of Nature, R. Metzner (Ed.), Thunder’s Mouth Press, New York, 250.
3. Luz, P. 2002, In: O Uso Ritual da Ayahuasca, B.C. Labate and W.S. Araújo
(Eds.), Mercado de Letras, Campinas, 37.
4. Dobkin de Rios, M. 1989, J. Psychoactive Drugs, 21: 91.
5. Reichel-Dolmatoff, G. 1975, The Shaman and the Jaguar: A Study of Narcotic
Drugs Among the Indians of Colombia, Temple University Press, Philadelphia.
74 Paulo César Ribeiro Barbosa

6. Araújo, W.S. 1999, Navegando Sobre as Ondas do Daime: História, Cosmologia


e Ritual da Barquinha, Editora da Unicamp, Campinas.
7. Brissac, S.C.T. 1999, A Estrela do Norte Iluminando até o Sul: Uma Etnografia
da União do Vegetal em um Contexto Urbano, Museu Nacional/Universidade
Federal do Rio de Janeiro.
8. Labigalini Jr., E. and Dunn, J. 1995, Psychiatr. Bull., 19, 313.
9. MacRae, E. 1992, Guiado Pela Lua: Xamanismo e Uso Ritual da Ayahuasca no
Culto do Santo Daime. Brasiliense, São Paulo.
10. Labate, B.C. and Araújo, W.S. 2004, O uso ritual da ayahuasca, 2th ed., Mercado
de Letras, Campinas.
11. Cazenave, S.O.S. 2000, Ver. Psiquiatr. Clín., 27, 32.
12. Sá, D.B.G.S. 1996, Discursos Sediciosos 2, 145.
13. Grob, C.S., Mckenna, D.J., Callaway, J.C., Brito, G.S., Neves, E.S., Oberlaender,
G., Saide, O.L., Labigalini, E., Tacla, C., Miranda, C.T., Strassman, R.J., and
Boone, K.B. 1996, J. Nerv. Ment. Dis., 184, 86.
14. Groisman, A. 1991, Eu Venho da Floresta: Ecletismo e Práxis Xamânica no Céu
do Mapiá, Masters Dissertation, Universidade Federal de Santa Catarina.
15. Bravo, G. and Grob, C.S. 1989, J. Psychoactive Drugs 21, 123.
16. Sandison, R. 1997, Psychedelia Britannica, Melechi, A. (Ed.), Turnaround,
London, 53.
17. Grinspoon, L. and Bakalar, J.B. 1979, Psychedelic Drugs Reconsidered, Basic
Books, New York.
18. Barbosa, P.C.R., Giglio, J.S., and Dalgalarrondo, P. 2005, J. Psychoactive Drugs,
37, 193.
19. Strassman, R.J. 1995, J. Nerv. Ment. Dis., 183, 127.
20. Santos, R.G., Landeira-Fernandez, J., Strassman, R.J., Motta, V., and Cruz,
A.P.M. 2007, J. Ethnopharmacol., 112, 507.
21. Strassman, R.J., Qualls, C.R., Uhlenhuth, E.H., and Kellner, R. 1994, Arch. Gen.
Psychiatry, 51, 98.
22. Tart, C. 1975, States of Consciousness. Dutton, New York.
T Transworld Research Network
37/661 (2), Fort P.O.
Trivandrum-695 023
Kerala, India

The Ethnopharmacology of Ayahuasca, 2011: 75-85 ISBN: 978-81-7895-526-1


Editor: Rafael Guimarães dos Santos

5. The therapeutic potential of harmine and


ayahuasca in depression: Evidence from
exploratory animal and human studies

Flávia de Lima Osório1,2, Ligia Ribeiro Horta de Macedo1,2


João Paulo Machado de Sousa1,2, Joel Porfírio Pinto1,2
João Quevedo2,3, José Alexandre de Souza Crippa1,2
and Jaime Eduardo C. Hallak1,2
1
Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of
São Paulo; 2National Institute for Translational Medicine (INCT-TM), CNPq , Brazil
3
Laboratory of Neurosciences, Postgraduate Program in Health Sciences, Health Sciences
Unit, University of Southern Santa Catarina, 88806-000 Criciúma, SC, Brazil

Abstract. The high prevalence and the socio-functional impairment


associated with depressive disorders, added to the limitations of
currently available treatments, justify the search for novel
pharmacological strategies for the management of depression. This
chapter presents the major results of animal and human studies
conducted by a group of Brazilian researchers concerning the
antidepressant potential of harmine, an alkaloid belonging to the
group of β-carbolines and present in Ayahuasca (AYA), a tea with
hallucinogenic properties used for religious and medicinal purposes

Correspondence/Reprint request: Dr. Jaime Eduardo C. Hallak, Department of Neurosciences and Behavior
Ribeirão Preto Medical School, University of São Paulo, Brazil. E-mail: [email protected]
76 Flávia de Lima Osório et al.

by peoples from the Amazon. The results obtained thus far suggest that harmine and
other substances present in AYA might have antidepressant-like effects in the central
nervous system of animals and human patients, pointing out the possibility of the
therapeutic use of AYA in humans.

1. Depressive disorders – Clinical aspects


Depression is a highly frequent psychiatric disorder with a lifetime
prevalence of 17%, being twice as prevalent among women as compared with
men. Onset usually occurs in the third decade of life, but the disorder can
affect individuals at any age. It is a recurring condition and around 20-25% of
patients become chronically ill[1]. Depressive disorders are associated with
intense suffering, high morbidity rates, and increased mortality[2]. According
to a study of the World Health Organization (WHO), depression is currently
the fourth leading cause of morbidity and, within a ten-year period, it might
rank second among the disorders affecting productive life[1].
According to the current Diagnostic and Statistical Manual of Mental
Disorders published by the American Psychiatric Association (DSM-IV)[3],
the diagnosis of a depressive episode requires the presence of depressed
mood and/or anhedonia for a minimum of two weeks, accompanied by at
least four of the following symptoms: significant weight loss or gain (5% of
body weight); psychomotor agitation or retardation; insomnia or
hypersomnia; fatigue or diminished energy; low self-esteem or inappropriate
feelings of guilt; difficulties to think, concentrate or make decisions; and
thoughts of death and suicide ideation or attempt. The symptoms must be
associated with significant suffering and/or impairment in social,
occupational or other functional areas, cannot be caused by a general medical
condition or substance use, or fulfill the criteria for a mixed episode (episode
in which the diagnostic criteria for both depression and mania are
simultaneously satisfied).
Clinically, depressive disorders are divided into single episode (if only
one episode has occurred in life), recurring (when at least two episodes
occurred), and chronic (if an episode lasts for two years or more)[3]. In terms
of severity, depressive episodes are divided into mild, moderate, and severe.
In mild episodes, few or no additional criteria besides those necessary for
diagnosis are fulfilled and functional impairment is minor; in severe episodes
a variety of symptoms are present, with significant functional impairment and
possible association with psychotic symptoms; in moderate episodes, both the
number of symptoms and the ensuing functional impairment lie on an
intermediate level between the two former categories[3].
Harmine, ayahuasca and depression 77

2. Etiologic factors and neurobiology of depression


The vulnerability to develop depression is connected with environmental
factors such as early parental loss, childhood history of traumatic events,
personality traits, family and personal history of depression, recent traumatic
events, and genetic factors[1].
One of the main hypotheses to explain the neurobiology of depression
was proposed following the discovery of the mechanisms of action of early
antidepressant agents, which were accidentally discovered in the 1950s
during the development of antihistamine (imipramine → tricyclic
antidepressant) and antituberculosis (iproniazid → monoamine oxidase
(MAO) inhibitor) drugs. Added to this, the comprehension of the action of
three substances on the central nervous system (CNS), namely, imipramine
(inhibiting neuronal reuptake of noradrenaline and serotonin), reserpine
(depleting monoamines and causing depressive symptoms), and
amphetamine (releasing noradrenalin and inhibiting its neuronal reuptake,
causing euphoria) led to the proposition, in the 1960s, of the classic
monoamine theory of depression, according to which the disorder would be
caused by decreased availability of noradrenaline and serotonin in the
brain[4].
These discoveries were followed by the development of new
antidepressants, with similar mechanisms of action but better side-effect
profiles and easier management, which are widely used in today’s practice,
such as serotonin and noradrenaline selective reuptake inhibitors[5].
The serotonergic and noradrenergic systems, which are involved in the
pharmacology of antidepressants, project from nuclei located in the brain
stem onto wide areas in the midbrain. Noradrenergic neurons project from the
locus coeruleus, whereas serotonergic neurons project from the raphe
nuclei[4]. Fourteen serotonin receptors, divided into seven classes, have been
identified to date. Together with other neurotransmitters, serotonin mediates
such diverse aspects as mood, anxiety, sleep, body temperature, eating and
sexual behavior, gastrointestinal motility, and others[6].
Many antidepressant drugs act primarily by increasing extracellular
concentrations of serotonin, which leads to alterations in many receptors,
resulting in therapeutic effects secondary to late neurochemical alterations.
The activation of pre-synaptic 5-HT1A receptors in the raphe nuclei normally
leads to decreased serotonin release. Antidepressant drugs that act by
inhibiting the reuptake of serotonin cause the desensitization of these
receptors, thus stimulating the release of serotonin by neurons and increasing
the serotonergic neurotransmission. This hypothesis would explain the time
78 Flávia de Lima Osório et al.

required for antidepressant drugs to present their therapeutic effects, since


these are dependent on neurochemical adaptations[6].

3. Treatment of depression
A number of alternatives are available today to treat depression,
encompassing antidepressant drugs, psychotherapy, electroconvulsive
therapy, and other somatic treatments.
In respect to the pharmacological management of the disorder, it is clear
that the discovery of antidepressants in the 1950s brought about a revolution
in the treatment of depression, standing out among the other therapies
available[2]. Currently, different classes of antidepressant agents are
available, which are classified according to their effects on the neuronal
synapse, their action on MAO or on their chemical structure.
Tricyclic antidepressants (TCA) and MAO inhibitors (MAOI) are known
as “first generation” or “classic” antidepressants. Both these groups act by
increasing the extracellular availability of monoamines – TCAs via inhibition
of serotonin and noradrenaline reuptake, and MAOIs via inhibition of the
metabolism of these neurotransmitters[7]. Besides the action described above,
which is responsible for their therapeutic effects, TCAs act upon many other
receptors, presenting antimuscarinic, antihistaminic, and anti-α2 adrenergic
effects that may cause undesirable reactions such as urinary retention,
constipation, orthostatic hypotension, weight gain, and somnolence.
Additionally, TCAs block the sodium channels, interfering on nervous
transmission and being potentially arrhythmogenic[4,7]. Concerning MAOIs,
their main adverse effect is the risk of hypertension crises triggered by the
intake of food containing tyramine, a sympathomimetic amine occurring in
large quantities in certain foods and which is metabolized by MAO[4].
Newer antidepressants have been designed to be more selective. Among
these are the selective serotonin reuptake inhibitors (SSRIs: fluoxetine,
paroxetine), selective noradrenaline reuptake inhibitors (reboxetine),
serotonin-noradrenaline reuptake inhibitors (venlafaxine, minalcipran,
duloxetine), and other antidepressants with multiple mechanisms of action,
such as mirtazapine, which acts as a pre-synaptic α2-noradrenergic antagonist
and as an antagonist of serotonin receptors (5-HT2 e 5-HT3), and
nefazodone, which acts both by inhibiting the reuptake of serotonin and
noradrenaline and by antagonizing α2 and 5-HT receptors[7]. Although the
side-effects of these drugs are not as significant as those of earlier
antidepressants, they are still present in more recently developed
psychopharmacological agents[3].
Harmine, ayahuasca and depression 79

The efficacy of newer antidepressants is not different from the efficacy


of compounds developed earlier, and although around 80% of the patients
respond to the treatment with antidepressants, only 50% present full
remission[5].
In summary, the limitations associated with the currently available
pharmacological treatments of depression are: low response rates, side-
effects, and time required until therapeutic effects are attained. Thus, novel
pharmacological strategies, especially those with acute effects, would have an
important impact on the treatment of depression[8].

4. Ayahuasca
Ayahuasca (AYA) is a beverage with hallucinogenic properties used for
religious and medicinal purposes by peoples of South America, markedly in
the Amazon, and there is evidence of its use since antiquity[9]. Ayahuasca is
made from sections of the Banisteriopsis spp. vine usually boiled with other
plants. The species of these plants most commonly used in the preparation are
Banisteriopsis caapi and Psychotria viridis[10]. Banisteriopsis caapi
contains the alkaloids harmine, tetrahydroharmine (THH) and, in a lower
quantity, harmaline, all of which belong to the group of β-carbolines; whereas
Psychotria viridis supplies the hallucinogenic substances tryptamine N,N-
dimethyltryptamine (DMT) [10-12].
The hallucinogenic effect of AYA derives from the potent serotonergic
action of DMT in the CNS, particularly on 5-HT2A and 5-HT2C
receptors[10,13-15]. The psychoactive effects of AYA are thus mediated by
the action of β-carbolines, specifically harmine and harmaline, which act
upon MAO [9,10,12]. Tetrahydroharmine (THH), the second most
concentrated β-carboline in AYA, acts as a weak serotonin reuptake and
MAO inhibitor[10].
Peripheral inhibition of MAO allows the proper levels of DMT in the
beverage to reach the CNS, causing intense – however short-lasting –
perceptual, cognitive, and affect alterations. The main of such alterations are
a predominant sensation of well-being; a fleeting feeling of apprehension;
complex thoughts; novel experiences about one’s identity; vivid images
(visible even when the eyes are closed); visual alterations of color, shape, and
movement of objects; a sensation of having a clearer perception of sound;
and an altered sense of touch. These subjective effects start 35-40 minutes
after the ingestion of the tea, reaching maximal intensity between 90 and 120
minutes and ending after 4 hours[11,12,16]. Differently from what happens
with other hallucinogenic substances, the repeated administration of DMT is
80 Flávia de Lima Osório et al.

not associated with the development of tolerance to its psychotomimetic


effects, and there is no desensitization of 5-HT2A receptors[13,17].
Scientific investigations on AYA from the perspective of its interest to
pharmacology and mental health began in the 1970s. Investigations involving
members of the União do Vegetal (Vegetal Union) religious group
underscored the high prevalence of psychiatric disorders prior to the
beginning of the ritual use of the beverage, comprising particularly alcohol
and substance abuse and dependence, but also depression and social phobia.
Nevertheless, there are no reports of members presenting with current
psychiatric disorders at the time of evaluation, with reports of remission
following the beginning of the use of the tea. It is important to highlight that
there were no reports of recurrent substance use since the beginning of tea
intake (for periods over 10 years) and that there are no reports of AYA
abstinence[10,11].
One study investigated the acute effects of the ingestion of AYA in
members of the Santo Daime (Holy Daime) religion using measures of
anxiety, panic, and hopelessness. The authors found that those participants
who were under the effects of AYA had lower ratings of these symptoms
compared with participants receiving placebo[18].
Together, these reports encourage the investigation of the possible
therapeutic applications of AYA in humans.

5. Ayahuasca and depression


5.1. Antidepressant-like effects of β-carbolines and serotonergic agonists

Harmine, the β-carboline with the highest concentration in AYA,


interacts with distinct systems: in the CNS, harmine actions have been
reported on MAO-A, 5-HT2A and imidazoline receptors (I1 and I2 sites), and
cyclin-dependent kinases (CDK1, 2, and 5), but its wide pharmacological
spectrum also includes antiplasmodial, antimutagenic, and antigenotoxic
activity, and antioxidative, antidiabetic, and antiplatelet properties[19].
Animal studies conducted by Brazilian researchers investigated the
antidepressant-like effects of harmine. Fortunato and colleagues[20] used the
depression-inducing forced swimming test in rodents to compare the
behavioral and molecular effects of acute harmine administration with
imipramine and placebo. The forced swimming test is performed using a
cylindrical water tank in which the animal is placed and behavioral
parameters are measured (immobility, climbing, and swimming time).
Figure 1 shows that acute treatments with harmine and imipramine were
associated with decreased immobility time and increased swimming and climbing.
Harmine, ayahuasca and depression 81

Figure 1. Effects of acute administration of harmine and imipramine on immobility


time (a); swimming time (b), climbing time (c), number of crossings (d), number of
rearings (e) and BDFN levels (f) in the hippocampus of rats subjected to the open-
field test (adapted from Fortunato et al, 2009).

The acute treatment with harmine, but not imipramine, was also associated
with increased levels of brain derived neurotrophic factor (BDNF) - which
has an antidepressant action in the brain - in the rat hippocampus. Since these
findings could reflect a general increase in spontaneous locomotor activity,
the rats were submitted to the open-field test, and harmine and imipramine
were not found to provoke increased spontaneous locomotion, which
indicates a specific action of both compounds on the behavioral parameters
related to depression in the forced swimming test.
Another study, also conducted by Fortunato and colleagues[19], was aimed
at assessing the antidepressant properties of harmine using an animal model
known as chronic mild stress (CMS). This model is believed to induce
anhedonia (loss of interest or pleasure), a major feature of depression, reflected
by the decreased intake of sucrose by rats. During a 40-day period, the animals
were submitted to the following stressors: food and water deprivation, forced
82 Flávia de Lima Osório et al.

swimming, flashing light, isolation, physical restraint, and cold. Figure 2 shows
that the test was successful in inducing anhedonia, in addition to increasing
adrenal gland weight and ACTH and BDNF levels. The administration of
harmine was associated with reversal of all these effects.
The findings of these studies lend support to the view that harmine
is an important candidate for the pharmacological management of
depression and encourage new studies involving the use of this compound
in humans.

Figure 2. Effects of the CMS procedure on sweet food consumption (A), number of
crossings (B), rearings (C), adrenal gland weight (D), adrenocorticotropic hormone
(ACTH) (E), and BDNF levels in hippocampus (F) in rats chronically treated with
harmine or saline(adapted from Fortunato et al, 2010).
Harmine, ayahuasca and depression 83

5.2. Therapeutic trials with AYA in humans

Taking into account the positive findings concerning the antidepressant-


like effects of harmine in animal studies and the components and mechanisms
of action of AYA in the CNS, studies with humans are currently underway to
investigate their therapeutic potential in people with depression.
An exploratory study was conducted involving three female participants
with a clinical diagnosis of recurring depressive disorder and current
mild/severe depressive episode without psychotic symptoms. The subjects
had not been in treatment with antidepressants for two weeks and received an
oral dose of 2ml/Kg of AYA. The participants’ mental state was assessed by
means of psychiatric scales, including the Hamilton Depression Scale
(HAM-D), 10 minutes prior to AYA administration and 40, 80, 140, and 180
minutes after intake, as well as on days 1, 2, 7, 14, and 28 after drinking the
tea.
The distribution of the subjects’ scores in the HAM-D is shown in Figure 3.
A significant decrease in the scores over time can be seen, starting at 40
minutes after intake, pointing out a reduction in depressive symptoms
regardless of episode severity. A sustained reduction in the scores of
depressive symptoms is observed from day 1 (of around 79% in relation to
baseline) to day 14 (around 66% below baseline), when an expressive
increase in depressive symptoms is seen towards baseline levels.

Figure 3. Effects of AYA intake on the final score of the HAM-D.


84 Flávia de Lima Osório et al.

The items suffering the greatest variations over the duration of the
experiment were those related to depressed mood, guilt feelings, suicidal
ideation, difficulties at work activities, psychic anxiety, and genital
symptoms.
It is important to mention that, although adverse effects associated with
AYA were not systematically evaluated, they were not spontaneously
reported by the participants during the evaluation period. Effects associated
with psychotic experiences, related to thought and sensory-perceptual
alterations, were punctual and short-lived, signalizing the safety and good
tolerability of AYA mentioned by some authors[9-12,16].
The data of the latter study suggest that AYA has antidepressant
properties - mediated by its action on serotonergic pathways - that seem to
have an acute profile. However, this evidence must be considered with
caution because of the intrinsic limitations of exploratory studies involving
small samples. Future investigations involving larger samples and control
groups are warranted in order to further our current knowledge on the
therapeutic potential of AYA and its side-effect and action profiles over a
larger time span.

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Harmine, ayahuasca and depression 85

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T Transworld Research Network
37/661 (2), Fort P.O.
Trivandrum-695 023
Kerala, India

The Ethnopharmacology of Ayahuasca, 2011: 87-95 ISBN: 978-81-7895-526-1


Editor: Rafael Guimarães dos Santos

6. Possible risks and interactions of the


consumption of ayahuasca and cannabis in
humans

Rafael Guimarães dos Santos


PhD candidate in Pharmacology at the Universitat Autònoma de Barcelona, Spain
Human Experimental Neuropsychopharmacology and Centre d’Investigació de Medicaments
(CIM-Sant Pau), Institut d’Investigacions Biomèdiques Sant Pau (IIB-Sant Pau), Barcelona, Spain

Abstract. There is not much literature regarding the possible


effects and interactions of the pan-Amazonian hallucinogenic brew
ayahuasca and cannabis, except for some anthropological research.
One specific Brazilian religious group had used both substances as
sacraments in the past, so here it is reported a brief theoretical
scientific overview of the possible interactions and risks between
those two substances in humans. The main risks were found to be
associated with the possible occurrence of cardiac problems,
anxiety and panic reactions, and also psychotic reactions.
Nevertheless, some “positive” and neutral interactions are also
commented.

Correspondence/Reprint request: Rafael Guimarães dos Santos, PhD candidate in Pharmacology at the
Universitat Autònoma de Barcelona, Spain; Human Experimental Neuropsychopharmacology and Centre
d’Investigació de Medicaments (CIM-Sant Pau), Institut d’Investigacions Biomèdiques Sant Pau
(IIB-Sant Pau), Barcelona, Spain. E-mail: [email protected]
88 Rafael Guimarães dos Santos

1. Introduction
Ayahuasca and cannabis are psychoactive substances that have been used
for therapeutic and ritual objectives by different human groups. Nevertheless,
cannabis had been used ritually by one branch of the Santo Daime religion, a
Brazilian ayahuasca religious group[1-3]. This branch, called CEFLURIS,
used to call cannabis as Santa Maria (Saint Mary or Holly Mary).
The use of Santa Maria, it should be noted, is officially forbidden within
the rituals of this group since the 1980s in Brazil, because in this country
cannabis is illegal. In this specific religious group, it is important to say that,
according to one of its leaders, ayahuasca works with the spiritual male
energy of Christ, and cannabis represents the female energy of the Virgin.

2. Possible psychological, psychiatric and neuropsychological


interactions
Up to this moment, there are limited studies about the possible risks or
“positive” interactions between ayahuasca and cannabis. It is possible,
however, to consider some characteristics of each substance.
One possibility is that the effects of cannabis would potentiate the
psychoactive properties of ayahuasca, producing an experience with more
hallucinogenic properties, since both substances can produce these kinds of
effects[4,5]. In fact, in pre-clinical studies, there is lack of cross-tolerance
between Δ9-tetrahydrocannabinol (THC), cannabis extract, mescaline and
lysergic acid diethylamide (LSD-25 or LSD)[6]. Also, in clinical studies,
there is lack of cross-tolerance between THC and LSD[7]. Mescaline, LSD
and DMT have similar mechanism of action[8]. According to these data, it is
possible to speculate that a lack of cross-tolerance would also happen
between ayahuasca and cannabis. Finally, consumption of ayahuasca and
cannabis have been considered by members of CEFLURIS to produce “very
good effects”, and, according to them, the consumption of cannabis after
ayahuasca would propitiate “visions”[1].
It is also possible to speculate that the consumption of cannabis could
alleviate some possible anxiety produced by some kinds of ayahuasca
experiences[9,10], since cannabis can produce relaxation[11,12]. The
consumption of cannabis after ayahuasca in the CEFLURIS context have
been described to “lead to a felling of ‘unblockedge’” and act as a “soother in
moments of difficulty”[1]. Nevertheless, the consumption of both substances
could produce cases where people would feel extremely anxious, or with
panic, or even with psychotic symptoms, especially, but not exclusively,
Ayahuasca and cannabis risks and interactions 89

those with genetic or psychological predisposition. This hypothesis is based


on several arguments.
First, there are several studies that suggest that the most common adverse
reactions to hallucinogens are anxiety episodes, or even panic episodes and,
in rare cases, prolonged psychotic reactions[13-18]. In the case of ayahuasca,
the incidence of psychopathology seems to be rare, in adults or even in
adolescents[19-24]. Nevertheless, Lima and collaborators[20,21] showed data
from 951 ayahuasca consumers, from three Brazilian cities, on the period
from 1995 to 2000, and registered 20 psychiatric events (2.1% in the total
population), where 7 cases were psychotic reactions (0.73% in the total
population). Other study[23] reported that in a period of five years, a
Brazilian ayahuasca religious group registered, in an estimated 25000
ayahuasca doses, 13 to 24 cases (0.052-0.096%) where ayahuasca might have
contributed in a psychotic episode.
Second, other studies showed that ayahuasca can produce, in some
people, anxiety and feelings of “suspiciousness” and “threat”, even in a
controlled setting[9,10]. Like with other hallucinogens, those episodes seem
to be rare and can be controlled without the necessity of medical
intervention[16].
Third, some investigations suggest that cannabis can also produce acute
episodes of anxiety, panic, or even experiences with psychotic symptoms,
especially in people with predispositions or in novice consumers, and other
studies speculate that the chronic use of cannabis can even produce
psychosis, although a causal relations is still controversial[4,25-32].
Finally, there is one case report where the consumption of ayahuasca and
cannabis produced a psychotic episode[33].
From a neuropsychological perspective, the chronic consumption of
cannabis can produce some subtle deficits, especially in memory[31,34-36,].
In the case of ayahuasca, studies with adults or even with adolescents did not
found any neuropsychological deficit[19,37]. In fact, the adult study showed
that ayahuasca consumers produced better results than the controls in one of
the memory tests[19].
The consumption of ayahuasca in combination with cannabis could
produce, for example, no ill effects at all, and ayahuasca could, maybe, act as
a “neuroprotetor” against the effects of cannabis. In fact, there is evidence
that the hallucinogens 5-methoxy-N,N-dimethyltryptamine (5-MeODMT)
and 2,5-dimethoxy-4-iodoamphetamine (DOI), which have a mechanism of
action similar to DMT, attenuated the THC-induced impairment of spatial
memory[38]. Moreover, the authors even suggested that this kind of drugs
could be effective in the treatment of THC-induced memory deficits. Of
90 Rafael Guimarães dos Santos

course, this is just a hypothesis, and further studies are urgent needed to
clarify this topic.
Finally, regarding the potential to produce a dependence syndrome, there
is no evidence that ayahuasca can produce it[39]. In fact, there is some
limited evidence that ayahuasca can be used to treat dependence[2,19]. In the
case of cannabis, it is suggested that about 10% of its users will became
dependent on it[28,31]. Considering these factors, there is no apparent reason
to assume that ayahuasca might enhance the dependence potential of
cannabis. On the other hand, the ritual use of ayahuasca might, maybe,
protect against the dependence potential of cannabis[2]. Of course, further
studies are needed to better explore this topic.

3. Possible physiological interactions


On the clinical level, one obvious possibility is that the antiemetic
properties of cannabis[12,40,41] would alleviate or even eliminate the nausea
and the emetic properties of ayahuasca[5,42]. In Colombia ayahuasca is
known as la purga (“the purge”).
Still on a clinical level, Riba et al.[10] assessed the effects of ayahuasca
in a single-blind placebo-controlled clinical study in which three increasing
doses of encapsulated freeze-dried ayahuasca (0.5, 0.75, and 1 mg DMT/kg
body weight) were administered to six healthy male volunteers with prior
experience in the use of the brew. The laboratory analyses conducted after
each session did not find any clinically relevant alterations in hematological
indices or biochemical indicators of liver function or other standard analytical
parameters (cellular counting, plasmatic bilirubin, and hepatic enzymes).
Another clinical evaluation did not show any clinically relevant findings
among long-term (at least 10 years) consumers of ayahuasca in all organic
systems evaluated: neurosensory, endocrine, circulatory (cardiac/respiratory),
gastrointestinal (digestive), hepatic and renal, suggesting the absence of any
injurious effect induced or caused by long-term ritual use of ayahuasca[43].
Compared to the controls, there were no significant differences in the blood
analysis in several parameters tested – hemoglobin, hematocrit, total
leukocytes, glycemia (during fasting), creatinine, sodium, potassium,
calcium, bilirubin (total, direct and indirect), alkaline phosphatase, glutamic
oxalacetic transaminase (GOT), glutamic piruvic transaminase (GPT), lactate
dehydrogenase (LDH) and cholesterol (total and HDL fraction) – except for
the platelets, which, although significantly higher in the control group
(359.000/mm3 compared to 271.000/mm3; p<0.05), were all inside the
normality limit.
Ayahuasca and cannabis risks and interactions 91

In this same study, seven electrocardiographic alterations were found in


the ayahuasca group: one case of right branch bundle block, one of left
branch bundle block, one of diffuse ventricular repolarization disturbance,
and four of sinusal bradycardia. Among the controls, there was only a case of
sinusal bradycardia. Although these alterations were not clinically relevant,
and even considering the possibility that the cases of right and left branch
bundle block could be attributed to other factors not evaluated in the study
(such as Chagas’ disease), more studies are needed to better clarify these
findings.
Riba and Barbanoj[44] reported that in their pilot and final study
combined [10,45], two volunteers showed systolic blood pressure values
above 140 mm Hg at some point and four showed diastolic blood pressure
values above 90 mm Hg, the diagnostic criteria for hypertension. One
volunteer showed heart rate values above 100 bpm, the diagnostic criterion of
tachycardia. The maximum values recorded at any time point were 146 mm
Hg for systolic blood pressure, 96 mm Hg for diastolic blood pressure and
101 bpm for heart rate. Other study also showed that the acute cardiac effects
of ayahuasca are moderate, although in this study there were also values of
diastolic blood pressure above 90 mm Hg[46].
Riba and Barbanoj[44] concluded in view of the moderate cardiovascular
effects found in their studies that ayahuasca seems relatively safe from a
cardiovascular point of view, but they also reported that the results refer only
to single dose administrations in young healthy volunteers and recorded in
the absence of any physical exercise. They suggested that the cardiovascular
picture could be different following repeated dose administration, while
performing physical exercise such as dancing, if ayahuasca were ingested by
older individuals or by those with cardiovascular conditions/dysfunctions.
Repeated administration, dancing, and older people taking ayahuasca is a
very common practice in ayahuasca religions. Nevertheless, there is no
published data on clinically relevant cardiovascular alterations associated
with acute or even long-term ayahuasca consumption. Indeed, the evidence
available suggests its safety in long-term adult use[43].
In the case of cannabis, the consumption of this substance, even in a
chronic way, does not seem to commonly produce clinically relevant
alterations[12,28,31,40]. Nevertheless, the act of smoking cannabis produces
an acute, rapid, and consistent rise of 20-100% in heart rate, which begins
around 10 minutes after smoking and lasts for two to three hours[28,47,48].
After repeated use, there is the development of tolerance for this effect,
although it disappears rapidly after stop smoking[28,31,47]. Cardiac
alterations of clinical value are not common among cannabis consumers;
92 Rafael Guimarães dos Santos

although there are some rare cases where serious cardiac problems were
documented[31,47].
Taking into consideration these data, it is possible to speculate that the
cardiac effects of cannabis could potentiate the moderate cardiac effects of
ayahuasca. This effect could be even more intense considering that in some
ayahuasca rituals there is dancing for several hours.
Finally, it must be considered that there are some adverse reactions that
can potentially happen when people present some health conditions that are
not indicated when consuming a monoamine oxidase inhibitor (IMAO):
severe damage to the liver or kidneys, hypertension, cardiac problems, and
brain pathologies[49]. Some of these same preoccupations also can be
applied to cannabis consumption, and, of course, for the consumption of both
substances together.

4. Conclusions
Even considering the positive descriptions of some users of ayahuasca
and cannabis[1], these cases and studies are very limited in number and do
not present hard evidence, from a scientific point of view. Also, the majority
of interactions described here were not investigated rigorously, so the
evidence points only to speculative potential risks of the combination of
ayahuasca with cannabis.
The main risks appear to be the production of anxiety reactions, panic
attacks, psychotic episodes, and cardiac problems. Nevertheless, except for
the case of a psychotic episode, where there is a case report published[33], all
the other risks are only hypothetical.
It would be wise to advise people with predisposition to psychotic
symptoms not to consume ayahuasca with cannabis. It is also important to
note that the ayahuasca religious have their own guidelines to prevent people
with psychological/psychiatric problems to consume the brew[20,21,50].
Finally, it must be acknowledged that some of the people who consume
ayahuasca with Santa Maria also enjoy this combination[1].

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37/661 (2), Fort P.O.
Trivandrum-695 023
Kerala, India

The Ethnopharmacology of Ayahuasca, 2011: 97-99 ISBN: 978-81-7895-526-1


Editor: Rafael Guimarães dos Santos

7. Ayahuasca and psychosis

Rafael Guimarães dos Santos1 and Rick J. Strassman2


1
PhD candidate in Pharmacology at the Universitat Autònoma de Barcelona, Spain
Human Experimental Neuropsychopharmacology and Centre d’Investigació de Medicaments
(CIM-Sant Pau), Institut d’Investigacions Biomèdiques Sant Pau (IIB-Sant Pau), Barcelona, Spain
2
Department of Psychiatry, University of New Mexico School of Medicine
and Cottonwood Research Foundation, Taos, New Mexico, USA

Ayahuasca is a botanical hallucinogenic beverage used by indigenous


groups throughout the Northwestern Amazon. Active ingredients include the
tryptamine hallucinogen DMT, and beta-carboline monoamine oxidase
inhibitors which allow for oral activity of DMT[1]. In Brazil, its use occurs
also within syncretic religious organizations and its religious consumption is
protected by law[2]. In the last decades, religious use of ayahuasca has spread
from South America to the United States and Europe. In these new
environments, therapeutic and recreational use also occur.
Here we report the case of a young adult male, who experienced two
psychotic paranoid episodes – separated by one year – during and after
participation in ayahuasca rituals. Neither the subject, Mr. A, 21 years old at
the time of his first episode, nor his parents had a history of psychosis. He
had consumed other hallucinogens (LSD and psilocybin) on multiple occasions,

Correspondence/Reprint request: Rafael Guimarães dos Santos, PhD candidate in Pharmacology at the
Universitat Autònoma de Barcelona, Spain; Human Experimental Neuropsychopharmacology and Centre
d’Investigació de Medicaments (CIM-Sant Pau), Institut d’Investigacions Biomèdiques Sant Pau
(IIB-Sant Pau), Barcelona, Spain. E-mail: [email protected]
98 Rafael Guimarães dos Santos & Rick J. Strassman

and had been a nearly-daily marijuana smoker for the preceding six years
with no significant adverse effects. At the time, he was obtaining graduate
training in a Brazilian university. Before the first episode, he had already
used ayahuasca “more or less twice per month, for about two years,”
sometimes using marijuana concurrently, without incident.
During one particular ayahuasca ritual, he again combined its use with
marijuana and experienced very intense paranoid and suicidal ideas – “these
people are going to kill me in order to make me a human sacrifice;” “I will be
operated upon and they will open my body;” “I have sinned and the spirits
are persecuting me;” “I should kill myself right now before they do.” These
feelings were so intense that he superficially cut himself with a sharp-edged
ceremonial item during the ayahuasca ritual. Symptoms persisted for two to
three weeks and resolved after treatment with risperidone, 6 mg daily,
gradually being reduced to 0.5 mg daily. Treatment lasted approximately one
year, during which time he did not use any psychoactives, and remained free
of paranoid symptoms. After discontinuing risperidone, he resumed
participation in ayahuasca rituals. During the third of these subsequent
sessions, while not using concurrent marijuana, he again experienced similar
paranoid and suicidal ideation, which persisted for another two to three
weeks, which again responded well to a similar course of risperidone
maintained for the next year.
Regular use of ayahuasca in research and naturalistic settings has not
been routinely associated with psychopathological reactions[3]. One
literature review[4] reported that over a five-year period there were
documented between 13 and 24 cases in which ayahuasca may have
contributed to an undefined psychotic incident. These were reported from a
cumulative estimated 25,000 ayahuasca sessions, and represent a rate less
than 0.1% (0.052-0.096%). This is comparable to the incidence of transient
psychoses reported by Cohen in his 1960 survey of researchers who had
administered LSD in a controlled environment[5].
Given the low incidence of, but potentially high morbidity associated
with, transient drug-induced psychosis, both research and religious use of
ayahuasca should be contraindicated in people with a history of psychosis.

Acknowledgement
The editor is grateful to the British Journal of Psychiatry for the
authorization for the reprint of this text in the present book. The original
citation for this text is: Santos, R.G., and Strassman, R.J. 2008, Br. J.
Psychiatry (Online), 3 December. Available at
http://bjp.rcpsych.org/cgi/eletters/190/1/81-a#22556.
Ayahuasca and psychosis 99

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4. Gable, R.S. 2007, Addiction, 102, 24.
5. Cohen, S. 1969, J. Nerv. Ment. Dis., 130, 30.

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