Psychedelic medicines are proving to be effective adjunctive treatments for conditions like PTSD, major depression, substance abuse disorders, even generalized anxiety. In fact, MDMA and psilocybin have just become legal psychedelic treatments in Australia. MDMA appears to be near FDA approval in the USA and psilocybin is not far behind. Getting approved by the FDA first of all means a medicine has to be shown in controlled trials to be safe for use as prescribed. Then it has to be shown to be effective for treatment of specific conditions. A psychedelic medicine with not only years but centuries of use behind it is ayahuasca. When will ayahuasca become a legal psychedelic treatment?
How Are Psychedelics Used As Treatments?
If we are thinking about a psychedelic medicine like ayahuasca being OK for prescribed treatment in the US we should compare it to the two psychedelic medicines that are nearing legal use in the USA and are already used in Australia. Both psilocybin and MDMA are useful as adjunctive treatments. MDMA is for post-traumatic stress disorder and psilocybin is for major depression. In both cases the medicines work to make coaching or psychotherapy hugely more effective. Both of these medicines work in the human brain to multiply nerve connections. Both medicines only require one or two doses to help relieve patients of the burdens of either depression or PTSD. Unlike recreational use of psychedelics, the medicine is used in a carefully controlled and monitored setting. The goal is to help the patient work through the issues that lead to their problem of depression or PTSD. In each case the medicine relieves the anxiety and even panic that commonly occur when, for example, a military veteran tries to recall a combat situation from years before that still haunts them and causes flashbacks.
How Ayahuasca Is Used
Ayahuasca is a brewed drink made from the Banisteriopsis caapi vine, the Psychotria viridis shrub, and other ingredients such as Nicotiana rustica, and a Brugmansia or Datura species. All one needs to know is that the people in the Amazon River basin in Brazil, Peru, Colombia, Ecuador, Venezuela and as far west as Panama know these plants, how to harvest the leaves and stems, and how to brew the concoction called ayahuasca. The ingredients are harvested in the morning for evening ceremonies.
Depending on how much ayahuasca is taken by a person, the psychedelic experience can last for anywhere from two to six hours. Auditory and visual hallucinations are common as well as a sense of euphoria. Side effects include fear, paranoia, diarrhea, and vomiting. Most commonly ayahuasca, like psilocybin and MDMA today, has been taken with guide such as a religious shaman. Many individuals may partake in a ceremony. The point of taking ayahuasca in the traditional setting is to access a higher spiritual dimension or contact a being who can act as a healer or guide. Those who have studied ayahuasca say that the experiences of those using this psychedelic medicine are strongly affected by their individual cultures.
The point of the comparison to MDMA and psilocybin is that ayahuasca is traditionally used for and by people who are seeking direction and help in their lives and is used in a controlled and essentially therapeutic settings much like with MDMA and psilocybin today.
Is Ayahuasca Safe?
The first hurdle for FDA (Food and Drug Administration) approval is safety. For well over a century medicines in the USA have needed to be shown not to cause problems in the amounts and frequency used for treatment. Ayahuasca has been used for centuries. A report about ayahuasca consumption and deaths estimates that about 800,000 people a year have used ayahuasca. Ninety percent of these people were not indigenous to the Amazon basin but rather psychedelic “tourists.” Of an estimated four and half million who have taken this psychedelic medicine in recent years there have been fifty-eight deaths. Autopsies have not shown any deaths to be due to ayahuasca intoxication. In cases where ayahuasca has been implicated in deaths, most of them happened when minimal safety standards like amount given and preexisting illnesses were ignored prior to use.
Ayahuasca Will Need a Standardized Formula
In order to be tested in FDA trials, ayahuasca will need to have a standard chemical makeup. This means that the active ingredients will need to be determined and then synthesized or extracted from plant materials in a lab. Any and all formulas for ayahuasca will need to be tested separately and pass safety standards before being tested for effectiveness. Although ayahuasca appears to be both safe and effective, it will need to be tested in controlled situations and compared to standard treatments.