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Basic Info

Ayahuasca is a decoction of the Amazonian vine Banisteriopsis caapi. Its chemical ingredients are known as harmalines. Some ethnic and religious groups add the Psychotria viridis plant to ayahuasca, which has visionary effects and whose active component is dimethyltryptamine (DMT).

The word “ayahuasca” is a Quechua term composed of two words: aya, which means “corpse, dead, dead human body.” and waskha, which means “rope, cord, braided or twisted wire.” Thus, it has commonly been translated as “the vine of the dead” or “the rope of the dead.”

The word ayahuasca refers to both the preparation made with Banisteriopsis caapi to brews wherein which other Amazonian medicine plants are added, which today is most common.

Other names that diverse communities and groups use for the preparation are: Caapi, Dápa, Mihi, Kahí, Natem, Pindé, Yajé, Daime, Vegetal, among many others.

Many different recipes exist for the preparation of ayahuasca, and some preparations contain only the B. caapi vine, although this is not common. Ingredients added to the decoction depend on the region in which it is prepared, the curandero or vegetalista that cooks it, and the intention or effects that are desired. Over 100 different botanical species that have been used as additives to ayahuasca have been documented.

The most popular additive in the West is Psychotria viridis, which results in the combination most commonly understood as ayahuasca – that of B. caapi and P. viridis. Diplopterys cabrerana is another common plant that is used instead of P. viridis, depending on availability in the region.

B. caapi contains beta-carbolines (harmine, harmaline and tetrahydroharmine) and P. viridis and D. cabrerana are sources of dimethyltryptamine (DMT). The combination of these alkaloids allows DMT to have an oral effect because in the absence of beta-carbolines the DMT would be degraded by monoamine oxidase (MAO) present in the human body.

Banisteriopsis caapi is a vine of the Malpighiaceae family that grows throughout the amazonian forest. Its structure is that of woody, braided vines that climb different trees, with large leaves that can reach 18 cm long and 8 cm wide. The plant is referred to as ayahuasca, caapi, or mariri, among other names.

Popularly known as chacruna, Psychotria viridis is a perennial shrub from the Rubiaceae family, the same family as coffee, which produces fruit similar to coffee beans. It grows in the jungles and rainforests of Central and South America, although it is most commonly found in the Amazonian areas of Peru and northern Bolivia. It can reach up to 5m in height.

 

 

Origin/History

The origin of the use of ayahuasca, as well as the origin of its use, are unknown. Different authors have proposed varying theories about the origins of ayahuasca, and since the expansion of ayahuasca, popular culture has tended to emphasize the ancient origins of the use of the decoction by native Amazonian peoples.

Some authors have proposed that the use of ayahuasca dates back 5000 years, others date its first use to between 500 BC and 500 AD. Other theories point to much more recent origins.

Unlike other New World drugs, such as psilocybin mushrooms, datura, peyote, psychoactive rapés or ololiuqui seeds, there are no archaeological remains that demonstrate the existence of the ancestral use of ayahuasca. The use of the former can be proven, given that there are drawings in codices with representations, reports from missionaries of their use, sculptures and, in the case of rapé, remains of instruments for its use. However, this is not the case for ayahuasca.

The first accounts in which the word ayahuasca appears are those of Jesuit missionaries who, in 1737 and 1740 respectively, travelled through the Napo River area. The use of ayahuasca for curative and divinatory purposes is mentioned in their reports. There is an earlier account from another Jesuit at the end of the seventeenth century, in which he mentions a “diabolical brew,” while not explicitly mentioning ayahuasca.

The first modern and scientific report of the use of ayahuasca was in 1851, in which Richard Spruce documented the use of the medicinal concoction in Brazil. Then, in 1857 Manuel Villavicencio wrote the first known account of a subjective experience with ayahuasca.

It is significant and surprising that there are no references reference to the use of any type of potion or brew (as indeed there are to other substances) in earlier accounts of colonizers and missionaries who exhaustively traveled the Amazon basin as well as the Napo River, which seems to be the most plausible place for the first use of ayahuasca.

Brabec de Mori has proposed a centuries-long history of the use of ayahuasca, based on an analysis of the icaros, the songs used during ayahuasca ceremonies. According to this author, the Tucano people of the Napo River basin began to use ayahuasca in relatively recent times, and both its use and the songs expanded from there. Brabec de Mori analyzed similarities between the icaros of different tribes, and compared them with other traditional songs of these peoples. While the traditional songs were very different among the groups, their icaros were very similar, which led to him to conclude that they have a recent common origin.

B. caapi grows in the Amazon lowland forest, from the south of Bolivia to the north of Panama, in the Amazon of Peru, Ecuador, Colombia and Brazil. It seems reasonable to assume that the use of B. caapi predated the use of it in combination with P. viridis, and that it was used as a purgative. It also seems reasonable that different indigenous groups added different plants to this decoction, and that it was through these experiments that the powerful effects of the combination with chacruna were discovered.

Indigenous peoples who used ayahuasca traditionally or who use it today include: Guahibo, Shipibo-Conibo, Shuar, Colorado, Ingano, Siona, Kofan, Witoto, Tukano, Desana, Yakuna, Ashaninka, Kaxinawa, and many others .

 

The Ayahuasca Churches

Another context for ayahuasca use that has arisen in the last century encompasses the ayahuasca churches, such as the Santo Daime (with its multiple branches), the União do Vegetal (UDV), and Barquinha. These churches are syncretic religious sects that combine shamanic, esoteric, spiritualist and Christian elements, among others, around the ritual use of ayahuasca, daime or hoasca, as the drink is called in these settings.

These churches appeared at the beginning of the 20th century, founded by Raimundo Irineu Serra (later known as Mestre Irineu), a rubber tapper who, after spending time in the jungles of the state of Acre of Brazil, began to officiate ceremonies with ayahuasca. Irineu spent time with healers who taught him how to collect the necessary plants and to prepare ayahuasca. He spent time alone in the jungle experimenting with the decoction, and in his visions he received “hymns,” ritual songs transmitting teachings and that are sung during the “trabalhos” (Portuguese for “works”) as the Santo Daime members refer to their ayahuasca ceremonies.

This doctrine grew more sophisticated and became the Santo Daime, which the evolved into different branches, growing in terms of numbers of followers and expanding internationally. One of the most widespread branches, and what is commonly known as the Santo Daime, is the ICEFLU (Igreja do Culto Ecléctico da Fluente Luz Universal or Church of the Eclectic Cult of the Fluent Universal Light), formerly CEFLURIS. This group was founded by Sebastião Mota de Melo (known as padrinho Sebastião).

The União Do Vegetal is a church with origins that are more urban than the Santo Daime, founded by José Gabriel da Costa (known as Mestre Gabriel), which also arose in the state of Acre.

The third main church is the Barquinha, although it has not expanded internationally and exists only in Rio Branco, in the state of Acre, Brazil. The Barquinha was founded by Mestre Daniel.

Some estimates suggest that the number of people belonging to these religions is more than 25,000 worldwide. The Santo Daime and the UDV have expanded internationally and groups can be found in countries as diverse as Brazil, the United States, Canada, Spain, Holland, Germany, and even Japan. In some of these countries, churches have legal protection of their religious practices, including the use and importation of ayahuasca.

 

 

Chemical composition and dosage

As indicated above, ayahuasca is a preparation of different plants, although the usual combination is made with the Banisteriopsis caapi vine and the leaves of  Psychotria viridis. The vine is usually crushed or pulverized and cooked together with the leaves in a process that can be very elaborate, until the desired amount and concentration is obtained.

The alkaloids present in ayahuasca potions are a combination of beta-carbolines and tryptamine derivatives.

Beta-carbolines
B. caapi contains the beta-carbolic alkaloids harmine, harmaline and tetrahydroharmine (THH). These alkaloids perform a specific effect as reversible inhibitors of monoamine oxidase-A (MAO-A), which allows DMT to be active orally.

The oral dose of harmine that causes perceptible effects is around 8 mg/kg.

Analysis of ayahuasca brews have found harmine at quantities of about 158mg per dose, which would be equivalent to a dose of about 2mg/kg for a person weighing around 70kg. This amount is sufficient to cause the inhibitory effects of monoamine oxidase, which allows the DMT to be orally effective.

In their bioassays, Jonathan Ott and other authors found that the minimum amount of harmine needed to induce the oral activity of DMT was about 70mg to 150mg, or around 1mg/kg to 2mg/kg.

Tryptamines
The leaves of P. viridis (or D. cabrerana) contain the alkaloid derived from the tryptamine N, N-dimethyltryptamine. DMT is a potent substance with visionary effects when administered intravenously or vaporized, but that is orally inactive because it is degraded by the MAO present in the stomach and liver. There are more than 50 known plants that contain DMT in varying amounts and it is possible that it is also found in the nervous system of mammals, including the human brain.

DMT dosage oral administration (in combination with harmalines)
The dose range of DMT in the presence of harmalines or other MAO inhibitors varies from 0.5mg/kg to 1mg/kg. So, for a person weighing 70kg the doses would be the following:

  • Threshold dose: 30mg
  • Average dose: 50mg
  • High dose: 70mg

Ayahuasca dosage
Ayahuasca is usually dosed or administered in varying amounts, depending on the potency or concentration of the decoction, which is usually known by the healer/curandero or group who brewed it. The concentrations of alkaloids in ayahuasca vary widely. Callaway conducted an analysis of ayahuasca from the UDV, Santo Daime, Barquinha, and Shuar peoples, and the alkaloid ranges present were as follows:

  • DMT concentration: between 0.16mg/mL and 14.15mg/mL (although some samples did not contain any DMT)
  • THH concentration: between 0.49mg/mL and 23.80mg/mL
  • Harmaline concentration: between 0.01mg/mL and 0.9mg/mL
  • Harmine concentration: between 0.45mg/mL and 22.85mg/mL

Customary dosages depend on the tradition. In the Santo Daime doses tend to be between 50 and 100 ml, among the Shuar from 20 to 30 ml, in the UDV from 100 to 200 ml.

In ayahuasca ceremonies, two or three doses are usually consumed, distributed over the multi-hour session.

 

Other added substances
In many instances, other plants are added to the ayahuasca brew, depending on the region, indications and intentions. Traditionally, ayahuasca cooked by the Santo Daime, UDV and Barquinha (known as Daime, Vegetal or hoasca) contains only B. caapi and P. viridis, while it is more common to find other plants in addition to these two in the preparations of the indigenous peoples of Peru, Ecuador and Colombia.

The following are some of the plants that are usually added to ayahuasca and their main alkaloids:

Nicotiana rustica: The tobacco plant, with purgative and psychoactive effects. Contains nicotine.
Brugmansia suaveolens: Known as toé or floripondio. Contains tropane alkaloids, such as scopolamine and hyoscyamine, that have hallucinogenic effects with dangerous toxicity.
Brunfelsia grandiflora: Known as chiric sanango. Used as a medicinal plant in the Peruvian vegetalista tradition, and as a plant used for “dietas.”

 

 

Effects

Ayahuasca is a powerful visionary substance due to its alkaloids – dimethyltryptamine (DMT) and beta-carbolines. Although it appears that the most prominent effects are due to DMT and not to beta-carbolines, since studies carried out with beta-carbolines have been inconclusive, the effects of each alkaloids will be described separately below.

DMT is a 5-HT2A serotonergic receptor agonist and its effects are described as being similarly to those of the so-called “classical psychedelics” (LSD, psilocybin, mescaline). DMT, when not administered in combination with MAOIs and taken intravenously or smoked, produces intense and immediate effects, including:

  • An immersive experience
  • Intense visual phenomena with both open and closed eyes
  • Kaleidoscopic visions
  • Changes in time perception
  • Alteration of auditory perception
  • Profound and spiritual, as well as terrifying, experiences
  • Experience of contact with entities

The psychoactive effects of THH, harmine and harmaline are not well defined. Although the importance of them in ayahuasca preparations as monoamine oxidase inhibitors is clear, their contribution to the subjective effects is not well understood. Different studies have reported disparate effects of harmaline. Authors such as Claudio Naranjo and Alexander Shulgin have reported psychoactivity and hallucinogenic effects, while Jonathan Ott reported simply sedative effects like those experienced with diazepam, and other authors have not found any psychoactive effects at all.

Interestingly, within the shamanic worldview the plant is credited with endowing wisdom to the decoction and that which allows learning is Banisteriopsis caapi, ayahuasca, being the plant that contains beta-carbolines, while it is believed the leaves of the Psychotria viridis simply provide visions and color. This indicates an entirely different conception of the desired effects depending on the culture of those who use ayahuasca.

The general effects of ayahuasca can be understood as a combination of the effects of the different alkaloids it contains rather than as a mere oral activation of DMT.

The effects produced by ayahuasca can include:

  • Perceptual and cognitive changes
  • Distortion of temporal perception
  • Visions with eyes open and closed
  • Increase in associative thinking
  • Introspection
  • Increase in autobiographical memories
  • Mood elevation
  • Profound and spiritual experiences
  • Experiences of anxiety, fear and even terror
  • Experiences of contact with entities or spirits

 

On the physical level, the following effects may be experienced:

  • Dizziness
  • Physical discomfort
  • Nausea and vomiting
  • Diarrhoea
  • Seizures (rarely)

 

The anxiolytic, antidepressant and anti-addictive effects of ayahuasca and other 5-HT2A agonists such as LSD and psilocybin have been reported in controlled settings.

 

 

Legal Status

The psychoactive alkaloid present in ayahuasca, dimethyltryptamine (DMT), is a Schedule I controlled substance according to the 1971 United Nations Convention on Psychotropic Substances. As such, DMT is considered a substance whose use, manufacture and sale are prohibited – except for very limited medical and scientific uses. However, the ayahuasca decoction itself is not under international control, which has been confirmed by the International Narcotics Control Board (INCB). In practice this has been interpreted in different ways by governing bodies and at the national level ayahuasca has been subject to three different legal approaches.

The first approach has been applied by countries where certain contexts for ayahuasca ayahuasca are permitted, and sometimes regulated – such as religious use for churches in Brazil, the United States and Canada – or traditional use in Peru, where it is considered a national cultural heritage (Peru made areservation for these traditional uses of ayahuasca when signing the the 1971 Convention). Countries that exhibit the second approach – wherein ayahuasca is specifically prohibited – include France (whose regulatory lists include various plants used in the decoction) and Russia, where ayahuasca is considered illegal because all plants containing psychoactive ingredients are prohibited.

The third legal approach encompasses countries where there is a legal void with regards to ayahuasca – it is not specifically prohibited, but it is not permitted, and several people have been prosecuted for receiving the brew by mail or bringing it with them on a plane. This is the case in countries such as Portugal, Mexico, Israel and Spain, the country which has the highest number of legal incidents related to ayahuasca recorded in recent years. It is important to be well informed about the legal status of ayahuasca in each country to prevent possible legal incidents – the Ayahuasca Defense Fund’s legal map is a good tool for this.

 

 

Prevalence of use

Although the use of ayahuasca has expanded globally in recent years, and the number of people who use it is rising, ayahuasca continues to be a substance that is not widely used.

According to the Global Drug Survey carried out in 2015 and 2016, only 527 people out of the 96,901 who participated claimed to have used ayahuasca at some time in their lives. This represents 0.57% of the sample. It could be argued that the sample has a considerable bias given that it is based on people who have self-selected, and who have encountered the survey through their online communication networks. It could be argued that people who use ayahuasca may use different communication channels and therefore may have not been aware of nor answered the survey.

The subjective observations by ayahuasca community participants is that the number of retreats and events where the use of ayahuasca is offered has increased greatly in the last five years in Europe, the United States, Latin American countries, and especially in Peru, where centers offering retreats with ayahuasca have multiplied and ayahuasca tourism has increased to become an important part of the economy, especially in the Iquitos region.

 

 

Health and risk reduction

Studies in both animals and healthy humans have shown that ayahuasca is a safe substance both physically and psychologically when its composition is known, and when it is administered in controlled doses, in appropriate environments and with the necessary support.

There are some risks associated with the consumption of ayahuasca that should be considered in case one is considering using this decoction. Some of these risks are physical, due to the pharmacology of the substance and possible interactions, and others are psychological, due to the nature of the experience that ayahuasca can induce.

 

Physical Health

Some of the physical risks of ayahuasca are related to the presence of beta-carboline which have an inhibitory effect on MAO-A. In theory, the combination of MAO-A inhibitors with certain foods containing high amounts of tyramine could produce a hypertensive crisis, and the combination of MAO-As with other chemical substances (medications, drugs) can involve significant risks. The combination of MAOIs with SSRIs (selective serotonin reuptake inhibitors), other antidepressants, or tryptophan beforehand could produce a serotonergic crisis called serotonin syndrome. While this risk is posited theoretically – there are no documented cases of such interactions – most guidelines regarding the consumption of ayahuasca highly recommend avoiding this combination.

For the same reason, combining of ayahuasca with ginseng, hypericum or with drugs and medications such as dextromethorphan, amphetamines and MDMA, can be potentially dangerous and should be avoided.

Some providers of ayahuasca sessions are offering retreats in which ayahuasca and Bufo alvarius are also used. Ayahuasca is usually ingested a few hours before or after smoking this toad poison, which contains bufotenin and 5-MeO-DMT. This combination carries certain risks that must be considered in order to avoid adverse reactions, and it is recommended to wait 24 hours between the use of each substance. For more information:
http://news.iceers.org/es/2017/05/alerta-bufo-alvarius-con-ayahuasca/

 

Psychological health
The psychedelic effects of ayahuasca can be very intense and the experience can be quite immersive, therefore it is not uncommon for reactions of fear and anguish to occur during parts of the experience. These situations are usually transient and resolve themselves during the experience or after the effects of the substance subside.

However, some people do experience adverse effects following the experience, particularly if it was especially difficult, if the setting in which they took ayahuasca was not safe, or if they did not receive adequate support during and after the experience.

The occurrence of a difficult psychological reaction is the main risk associated with the use of ayahuasca. Reactions can include panic attacks, fear of dying or going crazy, terrifying encounters with entities/spirits, and in some cases symptoms of psychosis.

Studies of long-term ayahuasca use found that people who have used ayahuasca for at least 15 years scored lower on psychopathology scales than the control group, and higher on life purpose and markers of wellbeing. However, we must bear in mind that there is a bias in the selection of people who participated in these study as the people for whom ayahuasca did cause problems did not continue consuming it and were therefore not included in the study.

Other studies have investigated the occurrence of serious adverse effects, such as psychotic reactions that last more than 48 hours, which are serious episodes even if they occur with very low frequency. These episodes have not occurred in controlled research settings where participants have passed a physical and psychological screening. People with a family history of psychotic episodes, or with diagnosed mental disorders such as schizophrenia, bipolar disorder, and depression with psychotic symptoms are at higher risk of suffering such adverse reactions and it is recommended that they refrain from using ayahuasca.

Important elements to take into account to reduce risks and maximize the potential benefits are: choosing the appropriate place and setting within which to take ayahuasca, as well as the person that will lead the session. Ayahuasca is usually used within ritualized contexts and the person facilitating the session can have a powerful influence on how the experience unfolds, the dynamics generated by the group, safety, as well as the maintenance of ethical and responsible boundaries with participants. The number of reports of malpractice by facilitators of ceremonies is growing, due to lack of knowledge, experience, and training, as well as a lack of ethical and respectful interactions with participants. It is therefore recommended to inform oneself extensively about the group or place with whom one intends to take ayahuasca, the format of the ceremonies, the number of participants and assistants, as well as asking about the training, experience and references of the person who will guide the ritual.

For an overview of the most important aspects to maximize the safety of the ceremonies in which ayahuasca is used, consult the ICEERS Good Practice Guide:
http://iceers.org/Documents_ICEERS_site/Safety&Ethics/Ayahuasca-Good_Practice_Guide_ICEERS2014.pdf