tag:theconversation.com,2011:/global/topics/ayahuasca-6916/articlesAyahuasca – The Conversation2023-12-12T19:53:39Ztag:theconversation.com,2011:article/2187842023-12-12T19:53:39Z2023-12-12T19:53:39ZCanada owes its veterans new mental health tools: Access to psychedelic therapies is overdue<iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/canada-owes-its-veterans-new-mental-health-tools-access-to-psychedelic-therapies-is-overdue" width="100%" height="400"></iframe>
<p>The Canadian Senate Subcommittee on Veterans Affairs recently released a striking report entitled <a href="https://sencanada.ca/en/info-page/parl-44-1/veac-psychedelic-therapies/"><em>The Time is Now: Granting Equitable Access to Psychedelic Therapies</em></a>. </p>
<p>To address high rates of suicide and post-traumatic stress disorder (PTSD) among veterans, the report calls on Veterans Affairs Canada (VAC) to immediately implement “a robust research program funded by VAC and the Department of National Defence (DND) in partnership with Health Canada, the Canadian Institutes of Health Research, and all other relevant partners.”</p>
<p>With psychedelic research, Veterans Affairs Canada has a real chance to live up to its mandate “to provide exemplary, client-centred services and benefits that respond to the needs of veterans, our other clients and their families.” </p>
<p>As a psychedelics researcher with an interest in veteran health, I couldn’t be happier, especially with the Senate focus on timeliness, equity and access. </p>
<p>Not only is <a href="https://www.researchgate.net/publication/372244882_Knowledge_Synthesis_in_the_Science_of_Psilocybin_Scoping_Reviews_of_Clinical_and_Preclinical_Research">my PhD on the therapeutic application of psilocybin</a>, but my father was a veteran of the Canadian Forces, as is my brother and two uncles and both of my grandfathers. I grew up on Canadian Forces bases.</p>
<h2>Canada’s veterans</h2>
<p>Lt. Col. (ret’d) Jack Shore, my father, graduate of the <a href="https://www.btb.termiumplus.gc.ca/tpv2alpha/alpha-eng.html?lang=eng&srchtxt=APPRENTICE%20SOLDIER">Soldier Apprentice Program</a> and a United Nations Peacekeeper in the <a href="https://peacekeeping.un.org/sites/default/files/past/onucB.htm">Congo mission</a> of the early 1960s, passed away as I was working as a guest co-editor of a special edition of the <a href="https://jmvfh.utpjournals.press/toc/jmvfh/current"><em>Journal of Military, Veteran and Family Health</em></a>. The theme of the edition is “Therapeutic use of psychedelics, entheogens, entactogens, cannabinoids and dissociative anesthetics for military members and veterans.” </p>
<p>While my Dad rarely talked about his time in the Congo, he experienced what we would now recognize as moral injury, and most likely PTSD. These conditions directly shaped our family life and upbringing. That was before Sudan, Rwanda, the Yugoslav wars and Afghanistan.</p>
<p>My childhood on bases occurred in time of relative peace, but Canada has now had a few generations of soldiers experience active combat. </p>
<p>The <a href="https://patientsmedicalhome.ca/resources/best-advice-guides/best-advice-guide-caring-for-veterans/">629,000 veterans living in Canada have rates of depression, anxiety and substance use disorder that are higher than the civilian population</a>. <a href="https://doi.org/10.1002/jts.21956">One in seven is living with PTSD</a>. Veterans are <a href="https://www.mcgill.ca/maxbellschool/files/maxbellschool/ofha_veteran_homelessness_policy_brief_-_2023.pdf">two to three times more likely</a> to experience homelessness compared to the general population. </p>
<h2>Duty of care</h2>
<p>To veterans of the Canadian Forces and to their families, we owe a duty of care, and not just to provide services and access to novel treatments. We also have a duty to care enough to do the science well and to tackle the public policy challenges (including regulatory drug reform) necessary to provide Canadian veterans with effective care.</p>
<blockquote>
<p>“It is the Government of Canada’s duty to assure veterans that it is doing everything in its power, immediately, to respect its solemn commitment to support, at any cost, those who chose to defend us with honour.” — <a href="https://sencanada.ca/en/info-page/parl-44-1/veac-psychedelic-therapies/">The Subcommittee on Veterans Affairs, Senate of Canada</a> </p>
</blockquote>
<p>The role of the VAC includes paying for the cost of health-care benefits and other services for veterans through the <a href="https://www.canada.ca/en/treasury-board-secretariat/topics/benefit-plans/plans/health-care-plan.html">Public Service Health Care Plan</a> and supplemental treatment benefits. While this single-payer provider model has advantages, it relies heavily on VAC staff and managers to assess and approve plans of care. </p>
<p>Developing a psychedelics research program for veterans should be seen as a public health priority. It will most likely require an independent panel of experts and stakeholders, including veterans, to help shape the agenda in a timely manner for the VAC. </p>
<h2>Psychedelic therapies</h2>
<p><a href="https://cimvhr.ca/">The Canadian Institute for Military and Veteran Health Research</a> (CIMVHR), founded in 2010, is well positioned as the Canadian hub for military, veteran and family health research to provide the infrastructure to foster collaboration, ensure stakeholder engagement and work on the knowledge translation so necessary to rapidly developing the capacity and expertise of Canadian researchers.</p>
<p>We can build on the work of the U.S. Department of Veterans Affairs, which is <a href="https://clinicaltrials.gov/study/NCT05876481?term=Veteran&intr=Psilocybin&rank=1">currently conducting several psilocybin trials</a>, and the long-standing work of <a href="https://maps.org/">MAPS (Multi-disciplinary Association of Psychedelic Studies)</a> in advancing MDMA-assisted therapy for PTSD towards regulatory approval. We can also listen to the experts, such as Canada Health Research Chair in Mental Health Disparities Monnica Williams, who are calling for <a href="https://doi.org/10.1007/s11469-023-01160-5">greater equity and improved inclusion of BIPOC veterans and researchers</a>. </p>
<blockquote>
<p>“When we have tried everything in our toolbox but still cannot help our patients, it is truly time for some new tools.” —<a href="https://jmvfh.utpjournals.press/toc/jmvfh/9/5">Monnica Williams</a>, Canada Health Research Chair in Mental Health Disparities </p>
</blockquote>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-potential-of-psychedelics-to-heal-our-racial-traumas-218233">The potential of psychedelics to heal our racial traumas</a>
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</em>
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<p>Psychedelic ketamine appears to have <a href="https://doi.org/10.1192%2Fbjo.2021.1061">positive but short-lived outcomes</a> in the treatment of mood disorders, and ketamine clinics require evaluation given recent <a href="https://www.fda.gov/drugs/human-drug-compounding/fda-warns-patients-and-health-care-providers-about-potential-risks-associated-compounded-ketamine">FDA warnings</a> about risks of commercialized mental health telemedicine and take-home doses.</p>
<p>Ultimately, the Canadian public may want to reconsider the policy framework that still severely limits access to these promising compounds for researchers, clinicians and those in need. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/albertas-new-policy-on-psychedelic-drug-treatment-for-mental-illness-will-canada-lead-the-psychedelic-renaissance-195061">Alberta’s new policy on psychedelic drug treatment for mental illness: Will Canada lead the psychedelic renaissance?</a>
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</em>
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<hr>
<p>Veterans have taken it upon themselves to support each other and to advocate for change. <a href="https://heroicheartsproject.org/">The Heroic Hearts Project</a> helps veterans access psychedelic therapies and has long championed the potential benefits of plant medicine ceremony.</p>
<p><a href="https://www.heroicheartsproject.ca/">Heroic Hearts Canada</a>, which aims to provide Canadian veterans with equitable access to safe, effective and affordable psychedelic therapies, has recently partnered with University of Calgary for some <a href="https://www.ucalgary.ca/research/participate/study/16168/are-you-veteran-canadian-armed-forces-have-you-investigated-working-psychedelics-legally">important observational research</a>.</p>
<h2>Faster progress to medical use</h2>
<p>The time lag from drug discovery to patient care is often decades, prompting the expression “<a href="https://doi.org/10.1186/s41231-019-0050-7">valley of death</a>” to refer to the gap between bench science and bedside care. </p>
<p>Given the real mental health needs of Canadian veterans, and the known limits on effectiveness for current standards of care, we must aim for quicker progress towards medical use, <a href="https://www.unodc.org/res/WDR-2023/WDR23_B3_CH2_psychedelics.pdf">as both the United States and Australia have done</a>. However, this progress must not be at the expense of safety and quality, and definitely not simply for commercialization. </p>
<p>Thought needs to be given to the development, evaluation and quality assurance of accessible programs for veteran-centred care, with Veterans’ voices at the table. It is time for more emphasis on psychedelics-related <a href="https://doi.org/10.1016/j.psychres.2019.04.025">implementation science</a>, the study of methods to promote the uptake (and identify barriers) of research findings into routine clinical use in order to improve effectiveness of health services.</p>
<p>There is <a href="https://healthsci.queensu.ca/source/Psychedelics%2520Research/Psychedelic%2520Medicine%2520Report%2520-%2520Final.pdf">robust and mounting evidence to support regulatory approval for MDMA and psilocybin-assisted therapies</a>. Their availability and uptake by clinicians and the public is only a matter of time. </p>
<h2>The need for more diverse research</h2>
<p>Research funds now are best allocated towards large Phase 3 trials that treat wider cross-sections of the veteran community, to begin to assess the safety and efficacy of interventions such as the naturally ocurring and culturally significant psychedelic compounds <a href="https://doi.org/10.1080/00952990.2023.2220874">ibogaine and 5-MeO-DMT</a> <a href="https://www.proquest.com/openview/2d897baa8a8203979eaf5ee7deb9037e/1?pq-origsite=gscholar&cbl=18750&diss=y">and ayahuasca</a>, and to invest in knowledge translation, program evaluation and training researchers and clinicians. </p>
<p>Apart from new biomedical research, it is time we recognized the widespread personal use of psychedelics, including among veterans, and develop safer use guidelines for psychedelics like those in place <a href="https://www.canada.ca/en/health-canada/services/substance-use/alcohol/low-risk-alcohol-drinking-guidelines.html">for alcohol</a> and <a href="https://doi.org/10.1007/BF03404169">cannabis</a>.</p>
<p>While the Senate report does not mention cannabis, it is worth noting that veterans in Canada have been <a href="https://dimensionsretreats.com/dimensions-retreats-algonquin-elevate-veterans-only/#:%7E:text=The%2520program%2520does%2520not%2520include,mind%252Dbody%2520practices%2520in%2520nature.">approved for treatment with cannabis-assisted therapy</a>. </p>
<p>This includes the use of <a href="https://doi.org/10.1177/0269881121997099">cannabis as a psychedelic</a> and mimics the <a href="https://doi.org/10.1007/s40429-021-00401-8">preparation-session-integration protocols</a> of psychedelic therapies. This intervention is also worth rapid evaluation and possible expansion. </p>
<p>Given the pressing needs of Canadian veterans and the limitations of our current tools, the need for research on psychedelic therapies, as well as for timely and equitable access, is urgent.</p><img src="https://counter.theconversation.com/content/218784/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ron Shore worked for, and consulted to Dimensions Health Centres in 2021 and 2022; he continues to own shares in the company.</span></em></p>One in seven Canadian veterans is living with PTSD. Developing a psychedelics research program for veterans should be a public health priority.Ron Shore, Research Scientist, Queen's Health Sciences and Assistant Professor, Department of Psychiatry, Queen's University, OntarioLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2044422023-10-02T12:27:51Z2023-10-02T12:27:51ZPsychedelics plus psychotherapy can trigger rapid changes in the brain − new research at the level of neurons is untangling how<figure><img src="https://images.theconversation.com/files/549891/original/file-20230924-22-cjkf2k.jpg?ixlib=rb-1.1.0&rect=1516%2C67%2C5741%2C3842&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New research hints at how psychedelics can trigger rapid, lasting change.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/psychedelic-drug-royalty-free-image/1306005226">wildpixel/iStock via Getty Images Plus</a></span></figcaption></figure><p>The <a href="https://www.verywellmind.com/what-is-brain-plasticity-2794886">human brain can change</a> – but usually only slowly and with great effort, such as when learning a new sport or foreign language, or recovering from a stroke. Learning new skills <a href="https://doi.org/10.1056/NEJMcibr1100496">correlates with changes in the brain</a>, as evidenced by neuroscience <a href="https://theconversation.com/cognitive-flexibility-is-essential-to-navigating-a-changing-world-new-research-in-mice-shows-how-your-brain-learns-new-rules-204259">research with animals</a> and functional brain scans in people. Presumably, if you master Calculus 1, something is now different in your brain. Furthermore, <a href="https://doi.org/10.1152/japplphysiol.00515.2006">motor neurons in the brain expand and contract</a> depending on how often they are exercised – a neuronal reflection of “use it or lose it.”</p>
<p>People may wish their brains could change faster – not just when learning new skills, but also when overcoming problems like anxiety, depression and addictions.</p>
<p>Clinicians and scientists know there are times the brain can make rapid, enduring changes. Most often, these <a href="https://doi.org/10.1016/S0079-6123(07)67012-5">occur in the context of traumatic experiences</a>, leaving an indelible imprint on the brain.</p>
<p>But positive experiences, which alter one’s life for the better, can occur equally as fast. Think of a <a href="https://doi.org/10.3389/fpsyg.2021.720579">spiritual awakening</a>, a <a href="https://doi.org/10.1177/0022167819892107">near-death experience</a> or a <a href="https://doi.org/10.1037/emo0000442">feeling of awe in nature</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="a road splits in the woods, sun shines through green leafy trees" src="https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549892/original/file-20230924-29-mhzjw2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A transformative experience can be like a fork in the road, changing the path you are on.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/germany-bavaria-franconia-spessart-track-in-forest-royalty-free-image/634474863">Westend61 via Getty Images</a></span>
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<p>Social scientists call events like these psychologically transformative experiences or <a href="https://doi.org/10.1177/0269881120959637">pivotal mental states</a>. For the rest of us, they’re forks in the road. Presumably, <a href="https://doi.org/10.1002/9781118591277.ch18">these positive experiences</a> quickly change some “wiring” in the brain. </p>
<p>How do these rapid, positive transformations happen? It seems the brain has a way to facilitate accelerated change. And here’s where it gets really interesting: Psychedelic-assisted psychotherapy appears to tap into this natural neural mechanism.</p>
<h2>Psychedelic-assisted psychotherapy</h2>
<p>Those who’ve had a psychedelic experience usually describe it as a mental journey that’s impossible to put into words. However, it can be conceptualized as an <a href="https://en.wikipedia.org/wiki/Psychedelic_experience">altered state of consciousness</a> with distortions of perception, modified sense of self and rapidly changing emotions. Presumably there is a relaxation of the higher brain control, which allows deeper brain thoughts and feelings to emerge into conscious awareness.</p>
<p><a href="https://theconversation.com/psychedelic-medicine-is-on-its-way-but-its-not-doing-shrooms-with-your-shrink-heres-what-you-need-to-know-208568">Psychedelic-assisted psychotherapy</a> combines the <a href="https://theconversation.com/medication-can-help-you-make-the-most-of-therapy-a-psychologist-and-neuroscientist-explains-how-209200">psychology of talk therapy</a> with the power of a psychedelic experience. <a href="https://doi.org/10.1056/NEJMp2300936">Researchers have described cases</a> in which subjects report profound, personally transformative experiences after one six-hour session with the psychedelic substance psilocybin, taken in conjunction with psychotherapy. For example, <a href="https://nyulangone.org/news/single-dose-hallucinogenic-drug-psilocybin-relieves-anxiety-depression-patients-advanced-cancer">patients distressed about advancing cancer</a> have quickly experienced relief and an unexpected acceptance of the approaching end. How does this happen?</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="glowing green tendrils of a neuron against a black background" src="https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/548902/original/file-20230918-27-lsrzu2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Neuronal spines are the little bumps along the spreading branches of a neuron.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Dendriticspines.jpg">Patrick Pla via Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Research suggests that <a href="https://theconversation.com/where-are-memories-stored-in-the-brain-new-research-suggests-they-may-be-in-the-connections-between-your-brain-cells-174578">new skills, memories</a> and attitudes are encoded in the brain by new connections between neurons – sort of like branches of trees growing toward each other. Neuroscientists even call the pattern of growth <a href="https://dictionary.apa.org/arborization">arborization</a>. </p>
<p>Researchers using a technique called <a href="https://doi.org/10.1038/nmeth818">two-photon microscopy</a> can observe this process in living cells by following the formation and regression of spines on the neurons. The spines are one half of the synapses that allow for communication between one neuron and another.</p>
<p>Scientists have thought that enduring spine formation could be established only with focused, repetitive mental energy. However, a lab at Yale recently documented <a href="https://doi.org/10.1016/j.neuron.2021.06.008">rapid spine formation in the frontal cortex of mice</a> after one dose of psilocybin. Researchers found that mice given the mushroom-derived drug had about a 10% increase in spine formation. These changes had occurred when examined one day after treatment and endured for over a month.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="diagram of little bumps along a neuron, enlarged at different scales" src="https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=267&fit=crop&dpr=1 600w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=267&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=267&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=335&fit=crop&dpr=1 754w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=335&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/551075/original/file-20230928-21-8ym7k7.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=335&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Tiny spines along a neuron’s branches are a crucial part of how one neuron receives a message from another.</span>
<span class="attribution"><span class="source">Edmund S. Higgins</span></span>
</figcaption>
</figure>
<h2>A mechanism for psychedelic-induced change</h2>
<p>Psychoactive molecules primarily change brain function through the receptors on the neural cells. The serotonin receptor 5HT, the one famously <a href="https://doi.org/10.1186/s13041-017-0306-y">tweaked by antidepressants</a>, comes in a variety of subtypes. Psychedelics such as DMT, the active chemical in the plant-based psychedelic <a href="https://www.britannica.com/science/ayahuasca">ayahuasca</a>, <a href="https://doi.org/10.1126/science.adf0435">stimulate a receptor cell type</a>, called 5-HT2A. This receptor also <a href="https://doi.org/10.1017/S0954579417001274">appears to mediate the hyperplastic states</a> when a brain is changing quickly.</p>
<p>These 5-HT2A receptors that DMT activates are not only on the neuron cell surface but also inside the neuron. It’s only the 5-HT2A receptor inside the cell that facilitates rapid change in neuronal structure. <a href="https://doi.org/10.1126/science.adg2989">Serotonin can’t get through the cell membrane</a>, which is why people don’t hallucinate when taking antidepressants like Prozac or Zoloft. The psychedelics, on the other hand, slip through the cell’s exterior and tweak the 5-HT2A receptor, stimulating dendritic growth and increased spine formation.</p>
<p>Here’s where this story all comes together. In addition to being the active ingredient in ayahuasca, <a href="https://doi.org/10.1038/s41598-019-45812-w">DMT is an endogenous molecule</a> synthesized naturally in mammalian brains. As such, human neurons are capable of producing their own “psychedelic” molecule, although likely in tiny quantities. It’s possible the brain uses its own endogenous DMT as a tool for change – as when forming dendritic spines on neurons – to encode pivotal mental states. And it’s possible psychedelic-assisted psychotherapy uses this naturally occurring neural mechanism to facilitate healing.</p>
<h2>A word of caution</h2>
<p>In her essay collection “<a href="https://www.harpercollins.com/products/these-precious-days-ann-patchett?variant=40104586641442">These Precious Days</a>,” author Ann Patchett describes taking mushrooms with a friend who was <a href="https://theconversation.com/psychedelics-may-better-treat-depression-and-anxiety-symptoms-than-prescription-antidepressants-for-patients-with-advanced-cancer-201937">struggling with pancreatic cancer</a>. The friend had a mystical experience and came away feeling deeper connections to her family and friends. Patchett, on the other hand, said she spent eight hours “hacking up snakes in some pitch-black cauldron of lava at the center of the Earth.” It felt like death to her. </p>
<p>Psychedelics are powerful, and none of the classic psychedelic drugs, such as LSD, are approved yet for treatment. The U.S. Food and Drug Administration in 2019 did <a href="https://theconversation.com/fda-approves-promising-new-drug-called-esketamine-for-treatment-resistant-depression-111966">approve ketamine</a>, in conjunction with an antidepressant, to treat depression in adults. Psychedelic-assisted psychotherapy <a href="https://doi.org/10.1038/s41591-021-01336-3">with MDMA (often called ecstasy or molly) for PTSD</a> and <a href="https://doi.org/10.1056/NEJMoa2206443">psilocybin for depression</a> are in Phase 3 trials.</p><img src="https://counter.theconversation.com/content/204442/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dr. Higgins is an unpaid member of the safety board for the Multidisciplinary Association for Psychedelic Studies (MAPA) for their phase 3 trials with MDMA for PTSD.</span></em></p>Change in the brain usually comes with plenty of effort over time. Neuroscientists are working to understand how psychedelic drugs provide a shortcut that seems to rely on existing brain systems.Edmund S. Higgins, Affiliate Associate Professor of Psychiatry & Family Medicine, Medical University of South CarolinaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1946962023-06-09T12:29:31Z2023-06-09T12:29:31Z‘From Magic Mushrooms to Big Pharma’ – a college course explores nature’s medicine cabinet and different ways of healing<figure><img src="https://images.theconversation.com/files/531019/original/file-20230608-20480-dlan6s.jpg?ixlib=rb-1.1.0&rect=428%2C512%2C4455%2C2984&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People for millennia have used what grows around them as medicine.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/dangerous-mushroom-royalty-free-image/463172611">LorenzoT81/iStock via Getty Images Plus</a></span></figcaption></figure><figure class="align-right ">
<img alt="Text saying: Uncommon Courses, from The Conversation" src="https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=375&fit=crop&dpr=1 600w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=375&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=375&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=471&fit=crop&dpr=1 754w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=471&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=471&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><a href="https://theconversation.com/topics/uncommon-courses-130908">Uncommon Courses</a> is an occasional series from The Conversation U.S. highlighting unconventional approaches to teaching.</em> </p>
<h2>Title of course:</h2>
<p>“From Magic Mushrooms to Big Pharma”</p>
<h2>What prompted the idea for the course?</h2>
<p>I’m from the foothills of the Appalachians in southern Ohio, where my Grandma Mildred would go out into the woods, which she called her medicine cabinet, to find herbs to use as medicine. <a href="https://scholar.google.com/citations?user=DhbiqSMAAAAJ&hl=en&oi=ao">I grew up to be an anthropologist</a>, interested in how people around the world heal themselves. In the 1990s, I did my dissertation research in Ecuador and learned how Indigenous people in the Choco region used <a href="https://doi.org/10.1007/s00213-019-05446-2">ayahuasca and other medicines from the forest</a> to assist in the grieving process.</p>
<p>With the <a href="https://mjbizdaily.com/map-of-us-marijuana-legalization-by-state/">legalization of cannabis in many states</a> and <a href="https://doi.org/10.3390/jof8080870">increased research</a> on <a href="https://doi.org/10.1007/s13311-017-0542-y">how “nontraditional” drugs can assist</a> people with post-traumatic stress disorder, depression and <a href="https://doi.org/10.2174/15733998113099990003">addiction issues</a>, it seemed like an opportune time to create this course. It’s part of a new interdisciplinary minor at Western Illinois University called “<a href="http://www.wiu.edu/academics/cannabis/culture/">Cannabis & Culture</a>” that offers students a foundation for understanding the social and cultural context, history and politics of nature-based medicine use in the United States and around the globe.</p>
<h2>What does the course explore?</h2>
<p>The course looks at how different peoples and cultures use nature-based medicines to heal themselves. First we establish that there are <a href="https://doi.org/10.1038/sj.embor.7400693">many ways of knowing the world around us</a>, just as there are many ways to heal ourselves. Some of us rely on Western medicine, others pray, yet others turn to Indigenous or traditional ways of healing that are rooted in nature.</p>
<p>We talk about the ways Western medicine now seeks to validate substances that have been used for healing for centuries, like research into how <a href="https://doi.org/10.3390/molecules27123877">ginger and turmeric can alleviate inflammation</a>, or the ways cannabis can <a href="https://doi.org/10.1016/j.yebeh.2016.09.040">reduce or even eliminate some epileptic seizures</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/530983/original/file-20230608-27-tlrr54.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="closeup of five dots of blood on the shoulder of a man without a shirt" src="https://images.theconversation.com/files/530983/original/file-20230608-27-tlrr54.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/530983/original/file-20230608-27-tlrr54.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/530983/original/file-20230608-27-tlrr54.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/530983/original/file-20230608-27-tlrr54.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/530983/original/file-20230608-27-tlrr54.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/530983/original/file-20230608-27-tlrr54.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/530983/original/file-20230608-27-tlrr54.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Kambô frog medicine is a shamanic medicinal ritual that originates among Amazonian tribes who use the poisonous excretion from the <em>Phyllomedusa bicolor</em> tree frog to cure illness.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/kambo-frog-poison-medicine-for-body-detox-royalty-free-image/1065635962">GummyBone/iStock via Getty Images Plus</a></span>
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<p>We also examine how the <a href="https://doi.org/10.1111/j.1471-8847.2006.00168.x">pharmaceutical industry has</a> <a href="https://www.northatlanticbooks.com/shop/biopiracy/">exploited Indigenous peoples’ ethnobotanical knowledge</a> <a href="https://doi.org/10.1155/2021/8898842">and landscapes for monetary gain</a>.</p>
<p>Using the Amazonian giant leaf frog, or kambô (<em><a href="https://amphibiaweb.org/cgi/amphib_query?where-genus=Phyllomedusa&where-species=bicolor&account=amphibiaweb">Phyllomedusa bicolor</a></em>), as a case study, students learn that at least 15 Indigenous groups have long histories of using the frog’s secretion for its analgesic, antibiotic and wound-healing properties. <a href="https://news.mongabay.com/2022/05/amazon-frog-highlights-appropriation-of-indigenous-knowledge-for-commercial-gain/">Eleven patents related to <em>P. bicolor</em> have been granted</a> – all of them in rich countries. Indigenous people have not been compensated for their knowledge.</p>
<h2>Why is this course relevant now?</h2>
<p>The current generation of young people are <a href="https://magazine.medlineplus.gov/article/teens-are-talking-about-mental-health">open about mental health issues</a>, and many people are looking for new ways to deal with anxiety, grief, PTSD and depression. My students can discuss their health concerns and learn about alternatives to what they may be accustomed to.</p>
<p>At this politically and racially polarized moment in the U.S., the course also provides the opportunity to discuss how <a href="https://doi.org/10.1089/can.2019.0063">racism, misogyny and discrimination against people of color</a> have influenced scientific research.</p>
<h2>What’s a critical lesson from the course?</h2>
<p>Over the course of the semester, students begin to recognize that there is no one right way of healing. More importantly, there is no one right way of being human. It is my hope that students leave seeing that everything is connected, integrally linked to humanity’s relationship to nature. </p>
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<a href="https://images.theconversation.com/files/531020/original/file-20230608-17666-2vej3s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="rows of marijuana crop inside a greenhouse with two agricultural workers" src="https://images.theconversation.com/files/531020/original/file-20230608-17666-2vej3s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/531020/original/file-20230608-17666-2vej3s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/531020/original/file-20230608-17666-2vej3s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/531020/original/file-20230608-17666-2vej3s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/531020/original/file-20230608-17666-2vej3s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/531020/original/file-20230608-17666-2vej3s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/531020/original/file-20230608-17666-2vej3s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">In some parts of the U.S., cannabis is now just another agricultural crop.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/large-amounts-and-endless-rows-of-marijuana-crop-stand-news-photo/1254375856">Mark Abramson/The Washington Post via Getty Images</a></span>
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<h2>What materials does the course feature?</h2>
<ul>
<li><p>Scientific materials provided by the <a href="https://maps.org/">Multidisciplinary Association for Psychedelic Studies</a>, a nonprofit that provides some of the only scientific research on psychedelics in the U.S. and promotes awareness of these drugs</p></li>
<li><p>“<a href="https://www.penguinrandomhouse.com/books/529343/how-to-change-your-mind-by-michael-pollan/">How to Change your Mind</a>,” by Michael Pollan and the accompanying <a href="https://www.imdb.com/title/tt21062540/">Netflix series</a> </p></li>
<li><p>Work of ethnobotanist Mark Plotkin, including his Ted Talk “<a href="https://www.ted.com/talks/mark_plotkin_what_the_people_of_the_amazon_know_that_you_don_t?language=en">What the people of the Amazon know that you don’t</a>”</p></li>
</ul>
<h2>What will the course prepare students to do?</h2>
<p>Studying how different cultures approach problems that plague all humans, like being sick and healing our ill, demonstrates to students that there are many ways the world over to solve problems. This course views different approaches not as a problem to be overcome but as a resource that can yield new ways of thinking and new opportunities – a definite advantage in the professional world. I hope students also learn to become advocates for their own health and well-being.</p><img src="https://counter.theconversation.com/content/194696/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather McIlvaine-Newsad does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>An anthropology course explores how peoples and cultures around the world use nature-based medicines to heal.Heather McIlvaine-Newsad, Professor of Anthropology, Western Illinois UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1993842023-02-10T13:52:21Z2023-02-10T13:52:21ZUse of psychedelics to treat PTSD, OCD, depression and chronic pain – a researcher discusses recent trials, possible risks<figure><img src="https://images.theconversation.com/files/508513/original/file-20230206-29-xiko4j.jpg?ixlib=rb-1.1.0&rect=89%2C0%2C7336%2C3540&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There are some possible health issues with the drugs, including cardiovascular risks.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/creative-background-royalty-free-image/1352156068?phrase=PSYCHEDELICS&adppopup=true">wildpixel/iStock via Getty Images Plus</a></span></figcaption></figure><p><em>New research is exploring whether psychedelic drugs, taken under strict medical supervision, might help in treating post-traumatic stress disorder, chronic pain, depression and obsessive-compulsive disorder. SciLine interviewed <a href="https://profiles.ucsf.edu/jennifer.mitchell">Dr. Jennifer Mitchell</a> – a professor in the Departments of Neurology and Psychiatry & Behavioral Science in the School of Medicine at the University of California, San Francisco – to discuss what scientists have found so far about the effectiveness of these drugs in treating these disorders and how they might safely be administered.</em></p>
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<figcaption><span class="caption">Dr. Jennifer Mitchell discusses psychedelic medicine.</span></figcaption>
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<p><em>The Conversation has collaborated with SciLine to bring you highlights from the discussion, which have been edited for brevity and clarity.</em></p>
<p><strong>What are psychedelic drugs and how do they work?</strong></p>
<p><strong>Jennifer Mitchell:</strong> Psychedelic <a href="https://www.verywellmind.com/types-of-psychedelic-drug-22073">basically means “mind manifesting</a>,” suggesting that the compound assists one in uncovering subject matter that perhaps is otherwise deeply hidden from the conscious mind. </p>
<p>It’s a slightly different term from hallucinogen, which you see used almost interchangeably at times with the term psychedelic. </p>
<p>A hallucinogen by definition is something that makes you see, hear, smell something that isn’t otherwise there, so you can imagine there’s a lot of overlap between psychedelics and hallucinogens. </p>
<p><strong>Which types of psychedelic drugs are being studied by researchers for potential therapeutic use?</strong></p>
<p><strong>Jennifer Mitchell:</strong> The two most well studied drugs at this point are MDMA and psilocybin. </p>
<p><a href="https://nida.nih.gov/publications/drugfacts/mdma-ecstasymolly">MDMA</a> is being evaluated mainly for treatment of post-traumatic stress disorder treatments, and <a href="https://adf.org.au/drug-facts/psilocybin/">psilocybin</a> mainly for treatment of resistant depression and major depressive disorder. </p>
<p>MDMA is the furthest along because there’s phase 3 data (data from late-stage research) and the possibility that a new drug application would be submitted to the FDA sometime later this year. </p>
<p><a href="https://www.dea.gov/factsheets/lsd">LSD</a> is also being evaluated for a number of different indications, most notably obsessive-compulsive disorder. </p>
<p>And then a couple of sort of heavier hitters are now being tested in primarily healthy control populations, including drugs like <a href="https://clinicaltrials.gov/ct2/results?cond=&term=mescaline&cntry=&state=&city=&dist=">mescaline</a> and <a href="https://clinicaltrials.gov/ct2/results?cond=&term=ayahuasca&cntry=&state=&city=&dist=">ayahuasca</a>.</p>
<p><strong>What have scientists discovered about whether these drugs are effective in treating health problems like PTSD or chronic pain?</strong></p>
<p><strong>Jennifer Mitchell:</strong> The drugs so far <a href="https://doi.org/10.1038/s41591-021-01336-3">appear to be quite effective</a>. I think one key, though, is that they’re typically being administered in conjunction with some form of psychotherapy. </p>
<p>So it’s important to keep that in mind when we look at the <a href="https://doi.org/10.1016/j.eclinm.2022.101809">results from some of these recent trials</a> that these are not drugs that are being administered in isolation. You are not taking home a bottle of pills and taking those twice a day as you would, say, an antidepressant. These are administered in a very particular way.</p>
<p><strong>What is involved in therapeutic treatment using these drugs?</strong></p>
<p><strong>Jennifer Mitchell:</strong> Typically, prior to taking the drug at all, subjects participate in a number of preparatory sessions so that they understand a little bit about what is going to happen on an experimental session day. </p>
<p>And then subjects come into a room that looks very much like a comfortable living room, and they spend all day there. The drug is administered typically in the morning. For psilocybin, you’re looking at a six-hour dosing session, and for MDMA, an eight-hour dosing session. </p>
<p>You are in the company of a group of trained providers: therapists, psychedelic facilitators, psychiatrists and clinical research coordinators.</p>
<p><strong>What are the potential risks of using psychedelic drugs for therapeutic purposes?</strong></p>
<p><strong>Jennifer Mitchell:</strong> One concern we’ve had is cardiovascular risk, and so we are taking great care in some of the clinical trials at present <a href="https://doi.org/10.1002/cpdd.796">to evaluate cardiovascular burden</a>, including heart attack risk, during and after the experiment. This evaluation includes tracking the heart rate and blood pressure of the participants.</p>
<p>In addition, researchers are worried about suicidality, in part because these are treatment-resistant populations that we’re starting off with, and so there’s a concern that perhaps, if they’re destabilized – either by the psychedelic, or just by tapering off their other meds in order to be part of a psychedelic trial – that we could run the risk of suicidality. </p>
<p>Lastly, I think the FDA has been concerned about the possibility that psychedelics are addictive, and so we’ve been following up with study participants to ensure that they aren’t engaging in drug seeking or drug taking outside of the study.</p>
<p><strong>What do we know about the safety of taking psychedelics outside the clinical context?</strong></p>
<p><strong>Jennifer Mitchell:</strong> I think we’ve all heard stories from the ‘60s and '70s of people taking psychedelics and <a href="https://www.verywellmind.com/what-is-a-bad-trip-22071">having very bad experiences</a>. What we know now is that the environment in which you take the psychedelic is of the utmost importance. It’s not appropriate at this point to try to take some of these substances or replicate some of these protocols on your own without oversight. </p>
<p><em>Watch the <a href="https://www.sciline.org/mental-health/psychedelic-medicine/">full interview</a> to hear more about psychedelic medicine.</em></p>
<p><em><a href="https://www.sciline.org/">SciLine</a> is a free service based at the nonprofit American Association for the Advancement of Science that helps journalists include scientific evidence and experts in their news stories.</em></p><img src="https://counter.theconversation.com/content/199384/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer Mitchell has received funding from MAPS and currently serves on the Research Advisory Panel within the California Department of Justice.</span></em></p>The early research suggests the drugs might be effective for some conditions. But scientists have safety concerns.Jennifer Mitchell, Professor of Neurology, University of California, San FranciscoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1944752022-11-16T18:59:28Z2022-11-16T18:59:28ZAyahuasca: just how safe is this psychoactive brew?<p>Psychedelic drugs are experiencing something of a renaissance. It’s no longer a case of turning on, tuning in and dropping out, as the <a href="https://en.wikipedia.org/wiki/Turn_on,_tune_in,_drop_out">hippy mantra</a> went in the 1960s. Tripping – whether on <a href="https://www.theguardian.com/science/2019/jun/10/magic-mushrooms-treatment-depression-aztecs-psilocybin-mental-health-medicine">magic mushrooms</a>, <a href="https://www.nytimes.com/2017/01/07/style/microdosing-lsd-ayelet-waldman-michael-chabon-marriage.html">LSD</a> or <a href="https://www.washingtonpost.com/health/2022/11/08/national-park-toad-sonoran-desert-hallucinogenic/">psychedelic toads</a> – is now part of the global wellness industry. It’s a way to “find yourself” or deal with a mental health or spiritual crisis.</p>
<p>A psychoactive brew is also part of the mix, but perhaps for the more dedicated “<a href="https://www.urbandictionary.com/define.php?term=psychonaut">psychonaut</a>”. Because the effects are quite extreme, westerners who take ayahuasca usually do so in ceremonies led by a shaman known as an <em>ayahuasquero</em> or <em>curandero</em>. These ceremonies have been covered in Netflix shows such as <a href="https://www.netflix.com/gb/title/81044208">(Un)Well</a>.</p>
<p>Ayahuasca is a traditional South American drink used in religious ceremonies. It can be made in a wide variety of ways, but typically, components of two plants – <em>Banisteriopsis caapi</em> vines and the leaves of the chacruna bush – are combined to produce a bitter “tea” that is drunk during the ceremony. </p>
<p>One component is an LSD-like drug called DMT. The other is a monoamine oxidase inhibitor (MAOI), a chemical that prevents the metabolism (breakdown) of the DMT. A DMT “trip” usually lasts 35 to 45 minutes, but the MAOI makes it last much longer (<a href="https://www.healthline.com/health/how-long-does-dmt-last">around four hours</a>).</p>
<p>Ayahuasca has been studied to determine if it can help with a variety of mental health issues, such as <a href="https://pubmed.ncbi.nlm.nih.gov/26976063/">depression, anxiety or addiction</a>, and many studies report positive effects. However, few studies have focused on the side-effects, and these studies are often small with participants only from South America. </p>
<p>A <a href="https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000438">new study</a>, published in the journal PLOS Global Public Health, has sought to remedy this gap in the knowledge. Using an online questionnaire, the researchers sought to examine the side-effects of ayahuasca in a much larger and more geographically diverse population. </p>
<p>The study ran from 2017-19 and over 10,000 respondents from more than 50 countries took part. Although most of the respondents came from Brazil (47%), significant numbers came from Europe (24%) and North America (15%). </p>
<p>The most common physical side-effects were nausea and vomiting (62% of respondents reported this), headache (17%) and abdominal pain (13%). Two per cent of participants needed medical attention for these physical issues. Mental health side-effects were also common: 42% reported “emotional-cognitive” side-effects (such as having nightmares or disturbed thoughts), and 38% reported altered perception. </p>
<p>The physical side-effects are most commonly found in older people and in people with higher lifetime use of ayahuasca. They were also more common in those with existing health conditions, those with a previous alcohol use disorder, and in those using ayahuasca unsupervised. </p>
<p>Mental health or cognitive side-effects were most often reported by people with previous anxiety issues and lower lifetime use of ayahuasca.</p>
<figure class="align-center ">
<img alt="Ayahuasca ceremony." src="https://images.theconversation.com/files/495620/original/file-20221116-22-fdsctf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/495620/original/file-20221116-22-fdsctf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/495620/original/file-20221116-22-fdsctf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/495620/original/file-20221116-22-fdsctf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/495620/original/file-20221116-22-fdsctf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/495620/original/file-20221116-22-fdsctf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/495620/original/file-20221116-22-fdsctf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ayahuasca ceremonies have grown in popularity.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/costa-rica-central-america-jul-29-1148543567">Cassiohabib/Shutterstock</a></span>
</figcaption>
</figure>
<p>Given that these people had ingested a monoamine oxidase inhibitor (most often harmine or a related compound) and a hallucinogen (DMT), it is not surprising that effects are seen on mental health and perceptions. Both types of drugs have well-known effects on the brain.</p>
<p>It is these very changes in perception and thought that are considered important in these religious events; the psychedelic experience contributing to spiritual growth. But the physical side-effects can also be considered important to the ceremonies, with vomiting and diarrhoea as a type of spiritual cleansing (“purging”).</p>
<h2>Is it worth it?</h2>
<p>So, do the potential positive effects on mental health and wellbeing outweigh the side-effects of taking ayahuasca?</p>
<p>Despite the reported positive effects of taking ayahuasca, the physical side-effects are very common. These side-effects may be reduced by the proper use of ayahuasca in legitimate ceremonies overseen by experienced religious leaders as part of group worship. </p>
<p>However, there are effective drugs to treat anxiety and depression, and they have a better side-effect profile than ayahuasca. These pharmaceuticals have gone through many years of research and have been tested in randomised controlled trials (the gold standard of clinical testing). Ayahuasca has not yet gone through such rigorous large-scale trials. </p>
<p>There is a resurgence of interest in psychedelics as legitimate clinical options, including <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00943/full">LSD</a> and <a href="https://www.bmj.com/content/379/bmj.o2623">psilocybin</a>, and they are considered to be <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61462-6/fulltext">relatively safe</a>. It may be that future research shows a clinical use for ayahuasca and where it might outperform currently approved medications, but we are not there yet.</p><img src="https://counter.theconversation.com/content/194475/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Colin Davidson does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Many studies have looked at the potential benefits of ayahuasca, but few have analysed its side-effects.Colin Davidson, Professor of Neuropharmacology and Head of School of Pharmacy & Biomedical Sciences, University of Central LancashireLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1005792018-08-15T23:02:57Z2018-08-15T23:02:57ZThe real promise of LSD, MDMA and mushrooms for medical science<figure><img src="https://images.theconversation.com/files/229652/original/file-20180727-106496-1ceklm9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Scientific pursuits need to be coupled with a humanist tradition — to highlight not just how psychedelics work, but why that matters. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Psychedelic science is making a comeback. </p>
<p>Scientific publications, therapeutic breakthroughs and cultural endorsements suggest that <a href="https://www.theglobeandmail.com/life/health-and-fitness/article-after-decades-of-dormancy-psychedelic-research-makes-a-comeback/">the historical reputation of psychedelics</a> — such as lysergic acid diethylamide (LSD), mescaline (from the peyote cactus) and psilocybin (mushrooms) — as dangerous or inherently risky have unfairly overshadowed a more optimistic interpretation. </p>
<p>Recent publications, like Michael Pollan’s <a href="https://www.penguinrandomhouse.com/books/529343/how-to-change-your-mind-by-michael-pollan/9781594204227/"><em>How to Change your Mind</em></a>, showcase the creative and potentially therapeutic benefits that psychedelics have to offer — for mental health challenges like depression and addiction, <a href="http://www.sciencemag.org/news/2016/12/hallucinogenic-drugs-help-cancer-patients-deal-%20their-fear-death">in palliative care settings</a> and for personal development. </p>
<p>Major scientific journals have published articles showing <a href="http://www.maps.org/resources/psychedelic-bibliography">evidence-based reasons for supporting research in psychedelic studies</a>. These include evidence that <a href="http://journals.sagepub.com/doi/full/10.1177/0269881116675513">pscilocybin significantly reduces anxiety in patients with life-threatening illnesses</a> like cancer, that MDMA (3,4-methylenedioxy-methamphetaminecan; also known as ecstasy) <a href="http://journals.sagepub.com/doi/abs/10.1177/0269881112464827">improves outcomes for people suffering from PTSD</a> and that <a href="http://journals.sagepub.com/doi/abs/10.1177/0269881111420188">psychedelics can produce sustained feelings of openness that are both therapeutic and personally enriching</a>. </p>
<p>Other researchers are investigating the traditional uses of plant medicines, such as ayahuasca, and exploring <a href="https://www.sciencedirect.com/science/article/abs/pii/S0361923016300454#!">the neurological and psychotherapeutic benefits of combining Indigenous knowledge with modern medicine</a>.</p>
<p>I am a medical historian, exploring why we now think that psychedelics may have a valuable role to play in human psychology, and why over 50 years ago, during the heyday of psychedelic research, we rejected that hypothesis. What has changed? What did we miss before? Is this merely a flashback?</p>
<h2>Healing trauma, anxiety, depression</h2>
<p>In 1957, the word <em>psychedelic</em> officially entered the English lexicon, introduced by <a href="https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1749-6632.1957.tb40738.x">British-trained and Canadian-based psychiatrist Humphry Osmond</a>. </p>
<p>Osmond studied mescaline from the peyote cactus, synthesized by German scientists in the 1930s, and <a href="https://link.springer.com/chapter/10.1007%2F978-1-4614-0959-5_22">LSD, a laboratory-produced substance created by Albert Hofmann at Sandoz in Switzerland</a>. During the 1950s and into the 1960s, more than 1,000 scientific articles appeared as researchers around the world interrogated the potential of these psychedelics for healing addictions and trauma. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/229658/original/file-20180727-106496-gys7ad.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/229658/original/file-20180727-106496-gys7ad.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/229658/original/file-20180727-106496-gys7ad.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/229658/original/file-20180727-106496-gys7ad.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/229658/original/file-20180727-106496-gys7ad.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/229658/original/file-20180727-106496-gys7ad.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/229658/original/file-20180727-106496-gys7ad.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In this January 1967 file photo, Timothy Leary addresses a crowd of hippies at the ‘Human Be-In’ that he helped organize in Golden Gate Park, San Francisco, Calif.</span>
<span class="attribution"><span class="source">(AP Photo/Bob Klein)</span></span>
</figcaption>
</figure>
<p>But, by the end of the 1960s, most legitimate psychedelic research ground to a halt. Some of the research had been deemed unethical, <a href="http://books.wwnorton.com/books/The-Search-for-the-Manchurian-Candidate/">namely mind-control experiments conducted under the auspices of the CIA</a>. Other researchers had been discredited for either unethical or self-aggrandizing use of psychedelics, or both. </p>
<p><a href="https://www.salon.com/2013/12/14/timothy_learys_liberation_and_the_cias_experiments_lsds_amazing_psychedelic_history/">Timothy Leary was perhaps the most notorious character in that regard</a>. Having been dismissed from Harvard University, he launched a recreational career as a self-appointed apostle of psychedelic living. </p>
<p>Drug regulators struggled to balance a desire for scientific research with <a href="https://academic.oup.com/jhmas/article-abstract/69/2/221/748833">a growing appetite for recreational use, and some argued abuse, of psychedelics</a>. </p>
<p>In the popular media, <a href="http://www.saynotodrugs.in/facts-about-lsd/">these drugs came to symbolize hedonism and violence</a>. In the United States, <a href="https://circulatingnow.nlm.nih.gov/2017/03/30/lsd-insight-or-insanity-1968/">the government sponsored films aimed at scaring viewers about the long-term and even deadly consequences of taking LSD</a>. Scientists were hard-pressed to maintain their credibility as popular attitudes began to shift.</p>
<p>Now that interpretation is beginning to change.</p>
<h2>A psychedelics revival</h2>
<p>In 2009, <a href="https://www.theguardian.com/politics/2009/oct/30/drugs-adviser-david-nutt-sacked">Britain’s chief drug adviser, David Nutt, reported that psychedelic drugs had been unfairly prohibited</a>. He argued that substances such as alcohol and tobacco were in fact much more dangerous to consumers than drugs like LSD, ecstasy (MDMA) and mushrooms (psilocybin). </p>
<p>He was fired from his advisory position as a result, but <a href="https://www.sciencedirect.com/science/article/pii/S0140673610614626">his published claims helped to reopen debates on the use and abuse of psychedelics</a>, both in scientific and policy circles.</p>
<p>And Nutt was not alone. Several well-established researchers began joining the chorus of support for new regulations allowing researchers to explore and reinterpret the neuroscience behind psychedelics. Studies ranged from those <a href="http://www.pnas.org/content/113/17/4853.short">looking at the mechanisms of drug reactions</a> to those <a href="https://doi.org/10.1007/s00213-017-4771-x">revisiting the role of psychedelics in psychotherapy</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/231973/original/file-20180814-2903-yn3fhf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/231973/original/file-20180814-2903-yn3fhf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=419&fit=crop&dpr=1 600w, https://images.theconversation.com/files/231973/original/file-20180814-2903-yn3fhf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=419&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/231973/original/file-20180814-2903-yn3fhf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=419&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/231973/original/file-20180814-2903-yn3fhf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=526&fit=crop&dpr=1 754w, https://images.theconversation.com/files/231973/original/file-20180814-2903-yn3fhf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=526&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/231973/original/file-20180814-2903-yn3fhf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=526&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In this April 2010 photo, one gram of psilocybin is seen on a scale at New York University, where a study investigated the effects of hallucinogenic drugs on the emotional and psychological state of advanced cancer patients.</span>
<span class="attribution"><span class="source">(AP Photo/Seth Wenig)</span></span>
</figcaption>
</figure>
<p>In 2017, Oakland, Calif., hosted the largest gathering to date of psychedelic scientists and researchers. Boasting attendance of more than 3,000 participants, <a href="http://psychedelicscience.org/">Psychedelic Science 2017</a> brought together researchers and practitioners with a diverse set of interests in reviving psychedelics — from filmmakers to neuroscientists, journalists, psychiatrists, artists, policy advisers, comedians, historians, anthropologists, Indigenous healers and patients. </p>
<p>The conference was co-hosted by the leading organizations dedicated to psychedelics — <a href="http://www.maps.org/resources/psychedelic-bibliography">including the Multidisciplinary Association for Psychedelic Studies (MAPS)</a> and <a href="http://beckleyfoundation.org">The Beckley Foundation</a> — and participants were exposed to cutting-edge research.</p>
<h2>Measuring reaction, not experience</h2>
<p>As a historian, however, I am trained to be cynical about trends that claim to be new or innovative. We learn that often we culturally tend to forget the past, or ignore the parts of the past that seem beyond our borders. </p>
<p>For that reason, I am particularly interested in understanding the so-called psychedelic renaissance and what makes it different from the psychedelic heyday of the 1950s and 1960s.</p>
<p>The historic trials were conducted at the very early stages of the pharmacological revolution, which ushered in new methods for evaluating efficacy and safety, culminating in the randomized controlled trial (RCT). Prior to standardizing that approach, however, most pharmacological experiments relied on case reports and data accumulation that did not necessarily involve blinded or comparative techniques. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/231972/original/file-20180814-2894-1mobpn5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/231972/original/file-20180814-2894-1mobpn5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=392&fit=crop&dpr=1 600w, https://images.theconversation.com/files/231972/original/file-20180814-2894-1mobpn5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=392&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/231972/original/file-20180814-2894-1mobpn5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=392&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/231972/original/file-20180814-2894-1mobpn5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=492&fit=crop&dpr=1 754w, https://images.theconversation.com/files/231972/original/file-20180814-2894-1mobpn5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=492&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/231972/original/file-20180814-2894-1mobpn5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=492&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Shaman Pablo Flores pours ayahuasca into a plastic cup during a sacred ceremony in the Peruvian Jungle in May 2018.</span>
<span class="attribution"><span class="source">(AP Photo/Martin Mejia)</span></span>
</figcaption>
</figure>
<p>Historically, scientists were keen to separate pharmacological substances from their organic cultural, spiritual and healing contexts — the RCT is a classic representation of our attempts to measure reaction rather than to interpret experience. Isolating the drug from an associated ritual might have more readily conveyed an image of progress, or a more genuine scientific approach. </p>
<p>Today, however, psychedelic investigators are beginning <a href="https://www.theglobeandmail.com/opinion/the-profound-power-of-an-amazonian-plant-and-the-respect-it-demands/article27895775/">to question the decision to excise the drug from its Indigenous or ritualized practices</a>. </p>
<p>Over the past 60 years, we have invested more in psychopharmacological research than ever before. American economists estimate <a href="http://www.dx.doi.org/10.1111/j.1468-0009.2005.00347.x">the amount of money spent on psychopharmacology research to be in the billions annually</a>. </p>
<h2>Rethinking the scientific method</h2>
<p>Modern science has focused attention on data accrual — measuring reactions, identifying neural networks and discovering neuro-chemical pathways. It has moved decidedly away from larger philosophical questions of how we think, or what is human consciousness or how human thoughts are evolving. </p>
<p>Some of <a href="http://www.mqup.ca/psychedelic-prophets-products-9780773555068.php">those questions inspired the earlier generation of researchers to embark on psychedelic studies in the first place</a>.</p>
<p>We may now have more sophisticated tools for advancing the science of psychedelics. But psychedelics have always inspired harmony between brain and behaviour, individuals and their environments, and an appreciation for western and non-western traditions mutually informing the human experience. </p>
<p>In other words, scientific pursuits need to be coupled with a humanist tradition — to highlight not just how psychedelics work, but why that matters.</p><img src="https://counter.theconversation.com/content/100579/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Erika Dyck receives funding from Social Sciences and Humanities Council (Canada).</span></em></p>Once associated with mind-control experiments and counter-cultural defiance, psychedelics now show great promise for mental health treatments and may prompt a re-evaluation of the scientific method.Erika Dyck, Professor and Canada Research Chair in the History of Medicine, University of SaskatchewanLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/988142018-06-28T10:40:02Z2018-06-28T10:40:02ZAmazonian psychedelic may ease severe depression, new study shows<figure><img src="https://images.theconversation.com/files/225161/original/file-20180627-112620-f0cios.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The vine Banisteriopsis caapi is one ingredient in ayahuasca, a psychedelic brew that Amazonian indigenous populations have long used for spiritual purposes. </span> <span class="attribution"><a class="source" href="https://flic.kr/p/JNw3ja">Apollo/flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>“Leon” is a young Brazilian man who has long struggled with depression. He keeps an <a href="https://sobredepressao.wordpress.com/">anonymous blog</a>, in Portuguese, where he describes the challenge of living with a mental illness that affects some <a href="http://www.who.int/news-room/fact-sheets/detail/depression">300 million people worldwide</a>, according to the World Health Organization. </p>
<p>Leon is among the roughly 30 percent of those patients with <a href="https://www.mayoclinic.org/diseases-conditions/depression/in-depth/treatment-resistant-depression/art-20044324">treatment-resistant depression</a>. Available antidepressant drugs like <a href="https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825">selective serotonin reuptake inhibitors</a> do not alleviate his depressed mood, fatigue, anxiety, low self-esteem and suicidal thoughts.</p>
<p>A <a href="https://www.cambridge.org/core/journals/psychological-medicine/article/rapid-antidepressant-effects-of-the-psychedelic-ayahuasca-in-treatmentresistant-depression-a-randomized-placebocontrolled-trial/E67A8A4BBE4F5F14DE8552DB9A0CBC97">new study</a> may offer hope for Leon and others like him. </p>
<p>Our team of Brazilian scientists has conducted the first randomized, placebo-controlled clinical trial of ayahuasca – a <a href="https://theconversation.com/can-ayahuasca-the-sacred-plant-of-the-amazon-help-addiction-and-depression-67764">psychedelic drink</a> made of Amazonian plants. The results, recently published in the journal <a href="https://www.cambridge.org/core/journals/psychological-medicine/article/rapid-antidepressant-effects-of-the-psychedelic-ayahuasca-in-treatmentresistant-depression-a-randomized-placebocontrolled-trial/E67A8A4BBE4F5F14DE8552DB9A0CBC97">Psychological Medicine</a>, suggest that ayahuasca can <a href="https://www1.folha.uol.com.br/internacional/en/scienceandhealth/2018/06/1971975-ayahuasca-reduces-depression-symptoms-according-to-brazilian-study.shtml">work for hard-to-treat depression</a>. </p>
<h2>The ‘vine of the spirits’</h2>
<p>Ayahuasca, a word from the indigenous Quechua language, means “the vine of the spirits.” People in the Amazonian region of Brazil, Peru, Colombia and Ecuador have for centuries used ayahuasca <a href="https://theconversation.com/can-ayahuasca-the-sacred-plant-of-the-amazon-help-addiction-and-depression-67764">for therapeutic and spiritual purposes</a>.</p>
<p>The medicinal beverage’s properties come from two plants. <em>Banisteriopsis caapi</em>, a vine that twists its way up to the treetops and across river banks of the Amazon basin, is boiled together with <em>Psychotria viridis</em>, a shrub whose leaves contain the <a href="http://www.businessinsider.com/the-research-on-the-hallucinogenic-drug-dmt-2018-3">pyschoactive molecule DMT</a>. </p>
<p>Starting in the 1930s, <a href="https://www.jstor.org/stable/3710869">Brazilian religions</a> were founded around the use of ayahuasca as a sacrament. By the 1980s, the ayahuasca ritual had spread to cities <a href="https://www.newyorker.com/magazine/2016/09/12/the-ayahuasca-boom-in-the-u-s">across Brazil and the world</a>. </p>
<p>Ayahuasca first became <a href="https://erowid.org/chemicals/ayahuasca/ayahuasca_law30.shtml">legal for religious use in Brazil</a> in 1987, after the country’s federal drug agency <a href="https://erowid.org/chemicals/ayahuasca/ayahuasca_law6.shtml">concluded</a> that “religious group members” had seen “remarkable” benefits from taking it. Some people who drink ayahuasca <a href="https://www.tandfonline.com/doi/abs/10.1080/02791072.2015.1094590">describe feeling</a> at peace with themselves, God and the universe. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/225162/original/file-20180627-112641-jkh5qz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/225162/original/file-20180627-112641-jkh5qz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=440&fit=crop&dpr=1 600w, https://images.theconversation.com/files/225162/original/file-20180627-112641-jkh5qz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=440&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/225162/original/file-20180627-112641-jkh5qz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=440&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/225162/original/file-20180627-112641-jkh5qz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=553&fit=crop&dpr=1 754w, https://images.theconversation.com/files/225162/original/file-20180627-112641-jkh5qz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=553&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/225162/original/file-20180627-112641-jkh5qz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=553&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ayahuasca tourism is growing in countries with traditional indigenous or religious uses of the plant, like Peru, Colombia and Brazil.</span>
<span class="attribution"><span class="source">AP Photo/Martin Mejia</span></span>
</figcaption>
</figure>
<p>For our study, which took place at Brazil’s Federal University of Rio Grande do Norte, researchers recruited 218 patients with depression. Twenty-nine of them were selected to participate because they had treatment-resistant depression and no history of psychotic disorders like schizophrenia, which <a href="http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832017000400103">ayahuasca use may aggravate</a>. </p>
<p>These 29 people were randomly assigned to undergo a single treatment session, in which they were given either ayahuasca or a placebo substance to drink. The placebo was a brownish liquid, bitter and sour to the taste, made of water, yeast, citric acid and caramel colorant. Zinc sulphate mimicked two well-known side effects of ayahuasca, nausea and vomiting.</p>
<p>The sessions took place in a <a href="http://www.ebserh.gov.br/web/huol-ufrn">hospital</a>, though we designed the space like a quiet and comfortable living room. </p>
<p>The acute effects of ayahuasca – which include dream-like visions, vomiting and intense introspection – last for about four hours. During this period, participants listened to two curated playlists, one featuring <a href="https://open.spotify.com/user/lftofoli/playlist/5wAyiC2RvBpbZUZeLMERza">instrumental music</a> and another with <a href="https://open.spotify.com/user/lftofoli/playlist/6sRsIxM4oNEpCPSFDQxAJB">songs sung in Portuguese</a>.</p>
<p>Patients were monitored by two team members, who provided assistance to those experiencing anxiety during this intense emotional and physical experience.</p>
<p>One day after the treatment session, we observed significant improvements in 50 percent of all patients, including reduced anxiety and improved mood. </p>
<p>A week later, 64 percent of the patients who had received ayahuasca still felt that their depression had eased. Just 27 percent of those in the placebo group showed such effects. </p>
<h2>Building on past evidence</h2>
<p>Our findings support a 2015 Brazilian clinical trial on the potential of ayahuasca as an antidepressant. </p>
<p>That study, led by Dr. Jaime Hallak of the University of São Paulo, likewise found that <a href="https://www.nature.com/news/ayahuasca-psychedelic-tested-for-depression-1.17252">a single ayahuasca session had a fast-onset antidepressant effect</a>. All 17 participants reported that depression symptoms diminished in the first hours after ayahuasca ingestion. The effect lasted 21 days.</p>
<p>This study received <a href="https://www.nature.com/news/ayahuasca-psychedelic-tested-for-depression-1.17252">significant attention from scientists</a>. Its promising conclusions were limited, however, because there was no control group of patients who received a placebo drug.</p>
<p>In clinical trials for depression, up to 45 percent of patients who take a placebo may report significant benefits. The placebo effect for depression is so strong that some scientists have questioned <a href="https://www.theguardian.com/science/2018/feb/21/the-drugs-do-work-antidepressants-are-effective-study-shows">whether antidepressants really work</a>.</p>
<p>Dr. Hallak and other researchers from the 2015 University of São Paulo study were part of our follow-up clinical trial.</p>
<h2>Religion turned science</h2>
<p>These two studies, while preliminary, contribute to a growing body of evidence that psychedelic drugs like <a href="https://www.newyorker.com/magazine/2015/02/09/trip-treatment">ayahuasca, LSD and mushrooms</a> can help people with difficult-to-treat depression.</p>
<p>But because these substances are illegal in many countries, <a href="https://www.maps.org/news/media/6680-cbs-san-francisco-bay-area-psychedelic-drug-banned-in-the-u-s-may-help-battle-addiction">including the United States</a>, their therapeutic value has been difficult to test. Even in Brazil, using ayahuasca as an antidepressant remains a fringe, informal enterprise. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/225212/original/file-20180627-112620-plhx3n.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/225212/original/file-20180627-112620-plhx3n.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=902&fit=crop&dpr=1 600w, https://images.theconversation.com/files/225212/original/file-20180627-112620-plhx3n.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=902&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/225212/original/file-20180627-112620-plhx3n.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=902&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/225212/original/file-20180627-112620-plhx3n.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1134&fit=crop&dpr=1 754w, https://images.theconversation.com/files/225212/original/file-20180627-112620-plhx3n.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1134&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/225212/original/file-20180627-112620-plhx3n.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1134&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ayahuasca being brewed in a nonclinical setting.</span>
<span class="attribution"><span class="source">L. Tófoli</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Leon, the Brazilian blogger, discovered the drug doing internet research. “Desperate” to find solutions for his intractable condition, Leon decided to take part in an ayahuasca ceremony at a <a href="http://www.santodaime.org">Santo Daime church in Rio de Janeiro</a>, one of several Brazilian religions that use ayahuasca as a sacrament. </p>
<p>The church does not track its membership, but the União do Vegetal, a similar faith, has approximately <a href="http://udv.org.br/en/about-us/">19,000 members</a> worldwide. </p>
<p>These religious organizations are among many groups across the Americas that harvest indigenous traditions around natural psychedelics. They believe psychoactive plants like ayahuasca, peyote or <a href="https://www.nytimes.com/2018/06/08/books/review/michael-pollan-how-to-change-your-mind-interview.html">psilocybin</a> open people’s minds to metaphysical realms and deeply meaningful experiences. </p>
<p>This spiritual knowledge is now being translated into the language of science, as researchers in Brazil, the <a href="https://www.maps.org/research/articles/133-participate-in-research-2/auxiliary-studies-not-sponsored-by-maps/5886-johns-hopkins-survey-psychedelic-use-and-addiction">United States</a>, <a href="https://www.cbc.ca/news/canada/british-columbia/robust-public-funding-needed-for-psychedelic-drug-research-say-researchers-1.4305592">Canada</a> and beyond begin rigorous medical evaluations of these substances. </p>
<h2>The healing power of the psychedelic experience</h2>
<p>Leon’s blog provides an <a href="https://sobredepressao.wordpress.com/2016/07/01/santo-daime-e-depressao/">excellent description of his ayahuasca experience</a>. </p>
<p>At times, he conjured visions – dream-like scenarios that offered rare insight into the relationships in his life. At other times, Leon experienced “a feeling of ecstasy and a deep sensation of a manifesting inner spirituality.”</p>
<p>We believe that these effects are critical to why ayahuasca works.</p>
<p>Participants in our study responded to the <a href="https://www.ncbi.nlm.nih.gov/pubmed/11295326">Hallucinogen Rating Scale</a>, which helps translate these ineffable experiences into numbers. Participants who took ayahuasca scored significantly higher on that questionnaire than those who drank a placebo. </p>
<p>Those who described the most abundant visual, auditory and physical effects during their ayahuasca trip had the most prominent depression reduction benefits seven days later.</p>
<p>Ayahuasca is not a panacea. Such experiences may prove too physically and emotionally challenging for some people to use it regularly as treatment. We have also observed regular ayahuasca users who still suffer from depression.</p>
<p>But, as our study demonstrates, this Amazonian sacred plant has the potential to be used safely and effectively to treat even the hardest to treat depression.</p><img src="https://counter.theconversation.com/content/98814/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Luís Fernando Tófoli is on the advisory board of the Brazilian Platform for Drug Policy. </span></em></p><p class="fine-print"><em><span>Dráulio Barros de Araújo receives funding from the Brazilian National Council for Scientific and Technological Development and from the CAPES Foundation, a grant-making entity within the Ministry of Education.</span></em></p><p class="fine-print"><em><span>Fernanda Palhano-Fontes received funding from the Brazilian National Council for Scientific and Technological Development and from the CAPES Foundation, a grant-making entity within the Ministry of Education.</span></em></p>Ayahuasca has long been used for indigenous healing and spiritual rituals. Now, a Brazilian clinical trial has confirmed that this psychoactive drink can help those with even severe depression.Luís Fernando Tófoli, Professor of Psychiatry, Universidade Estadual de Campinas (Unicamp)Dráulio Barros de Araújo, Professor, Brain Institute, Universidade Federal do Rio Grande do Norte (UFRN)Fernanda Palhano-Fontes, Universidade Federal do Rio Grande do Norte (UFRN)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/677642016-11-11T07:25:22Z2016-11-11T07:25:22ZCan Ayahuasca, the ‘sacred plant’ of the Amazon, help addiction and depression?<p>Ayahuasca goes by many names: <em>Daime</em>, <em>Vegetal</em>, <em>Hoasca</em>, <em>Kamarampi</em>, <em>Huni</em> … whatever you call it, this plant-based psychoactive decoction, which has been used by indigenous Amazonians for centuries to contact the spiritual world, has suddenly burst into global consciousness. </p>
<p>As a recent New Yorker <a href="http://www.newyorker.com/magazine/2016/09/12/the-ayahuasca-boom-in-the-u-s">article</a> put it, ayahuasca is “the drug of choice for the age of kale”. </p>
<p>The article, which positioned ayahuasca as a hipster trend in a tone of mockery mixed with mystification, nevertheless belies the growing interest of Western scientists and rich urbanites in its medicinal and therapeutic potential, which include antidepressant, anti-anxiety and anti-addiction elements. </p>
<p>Does the science support the hype? As part of a small cohort of Brazilian scientists undertaking the world’s first clinical trials on ayahuasca and treatment-resistant major depressive disorder, I’m here to say: maybe, but it’s too soon to tell.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"792038067637026816"}"></div></p>
<h2>Sacred plant, sacred medicine</h2>
<p>First, some background, which is key to understanding how ayahuasca is perceived as both a sacred plant and medicine. </p>
<p>This idea is shared by indigenous groups, <em>vegetalistas</em> (healers that use plants to treat disease), and Brazilian religions such as the <em><a href="http://www.santodaime.org">Santo Daime</a></em> and the <em><a href="http://udvusa.org">União do Vegetal</a></em>, which blend Catholic, indigenous, and Afro-Brazilian beliefs. </p>
<p>In the indigenous context, ayahuasca is used to contact the supernatural world, the realm of the <a href="http://trnres.com/ebook/uploads/contentrafael/T_14049711361%20Rafael.pdf">jungle spirits</a>, who are called on to bring peace, happiness, and good health – or harm and disease. </p>
<p>During ayahuasca ceremonies, shamans invoke specific spirits either to heal their patients, or to harm their enemies. For them, ayahuasca is a powerful and dangerous plant used with great caution, and only by individuals who’ve undergone a prolonged <a href="http://trnres.com/ebook/uploads/contentrafael/T_14049711361%20Rafael.pdf">initiation</a> process that usually involves abstaining from sex and certain foods, along with periods of isolation in the jungle. </p>
<p>Ayahuasca is also used therapeutically by the rural, poor and <em>mestizo</em>, or mixed-race, populations of Amazonian nations, including Colombia, Peru, Brazil, and Ecuador, who have limited access to hospitals and physicians but extensive training in ayahuasca.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/144076/original/image-20161101-14771-1ivklqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/144076/original/image-20161101-14771-1ivklqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/144076/original/image-20161101-14771-1ivklqm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/144076/original/image-20161101-14771-1ivklqm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/144076/original/image-20161101-14771-1ivklqm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/144076/original/image-20161101-14771-1ivklqm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/144076/original/image-20161101-14771-1ivklqm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">One of two jungle plants whose leaves are used in the preparation of ayahuasca.</span>
<span class="attribution"><span class="source">Rafael Guimarães dos Santos</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>The spiritual is medical</h2>
<p>The effects of ayahuasca start 30 to 40 minutes after oral intake, with a peak occurring one to two hours later. Most people describe a pleasant (although not always easy) <a href="http://jop.sagepub.com/content/early/2016/06/09/0269881116652578.abstract">experience</a>, which may include changes in perception (mostly visual), deep introspection, revival of seemingly forgotten autobiographical memories, and <a href="https://authors.elsevier.com/a/1T-qnY3M3EgCI">mood boost</a>. The trip lasts four to six hours.</p>
<p>A limited number of studies have suggested that those psychoactive effects could play a therapeutic role for humans. </p>
<p>Ayahuasca is made by combining the leaves of <em>Psychotria viridis</em> or <em>Diplopterys cabrerana</em> (which contain the hallucinogen DMT), with the jungle vine <em>Banisteriopsis caapi</em>, which is rich in a group of alkaloids called beta-carbolines (harmine, tetrahydroharmine, and harmaline). </p>
<p><a href="http://dx.doi.org/10.1590/1516-4446-2015-1701">Studies</a> in <a href="http://www.tandfonline.com/doi/full/10.1080/02791072.2016.1188225">animals</a>, <a href="http://www.ipjp.org/index.php?option=com_jdownloads&view=download&id=233:an-account-of-healing-depression-using-ayahuasca-plant-teacher-medicine-in-a-santo-daime-ritual-by-jean-francois-sobiecki&catid=53&Itemid=318">case reports</a> and <a href="http://jop.sagepub.com/content/early/2016/06/09/0269881116652578.abstract">observational studies</a> of long-term users suggest that ayahuasca and its alkaloids may have anti-anxiety, antidepressant, and anti-addictive properties. </p>
<p>Observational studies have also indicated that long-term members of Brazilian ayahuasca religions have apparently <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0042421">recovered</a> from depression, anxiety, and drug dependence (especially alcohol and cocaine).</p>
<p>Recent preliminary, <a href="http://www.accordclinical.com/clinical-study/types-of-clinical-trials/">open-label studies</a>, or non placebo-controlled trials, on patients diagnosed with treatment-resistant major depressive disorder have been promising.</p>
<p>These studies, led by Jaime Hallak from the University of São Paulo medical school in <a href="http://rnc.fmrp.usp.br/">Ribeirão Preto</a>, where I work, and by Draulio de Araujo, from the <a href="http://www.neuro.ufrn.br/">Federal University of Rio Grande do Norte</a>, in Natal, showed that a single ayahuasca dose was <a href="http://dx.doi.org/10.1590/1516-4446-2014-1496">associated</a> with significant, fast-acting, and enduring <a href="http://journals.lww.com/psychopharmacology/pages/articleviewer.aspx?year=2016&issue=02000&article=00013&type=abstract">antidepressant and anti-anxiety effects</a>. </p>
<p>These positive results started in the first hours after ayahuasca intake and remained significant 21 days later. </p>
<h2>Out of the jungle, into the cities</h2>
<p>In the early 20th century, during the exploration of natural rubber, a small number of religious organisations that centred their sacred rituals on ayahuasca as a sacrament began to emerge in the Brazilian state of Acre. These groups blended Catholic beliefs with Amazonian shamanism, European esoteric philosophies, and Afro-Brazilian tradition.</p>
<p>In the late 1970s and early 1980s, these religions organisations began to expand from the North of Brazil to other Brazilian capitals. In the early 1990s, some – in particular the <em>União do Vegetal</em> and <em>Santo Daime</em> – started to create groups in Europe and in the US. Today they are among the main forces collaborating to <a href="http://www.ijdp.org/article/S0955-3959(11)00128-9/abstract">extend</a> ayahuasca’s use beyond the Amazon. </p>
<p>In recent years, healers called <em>vegetalistas</em> or <em>maestros</em> (“those who know”) have started to practice rituals in big cities, including Bogota, New York, and other urban centres. In these places, their patients are more likely to be wealthy white people seeking healing from anxiety, mood disorders, drug dependence and other mental health issues. </p>
<p>As more Westerners come to South American countries for healing ayahuasca trips and more healers travel to the US and Europe to perform their rituals, the <a href="http://www.ijdp.org/article/S0955-3959(11)00128-9/abstract">idea</a> that ayahuasca has powerful therapeutic potential has spread worldwide. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/144106/original/image-20161101-11940-1154xi0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/144106/original/image-20161101-11940-1154xi0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/144106/original/image-20161101-11940-1154xi0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/144106/original/image-20161101-11940-1154xi0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/144106/original/image-20161101-11940-1154xi0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/144106/original/image-20161101-11940-1154xi0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/144106/original/image-20161101-11940-1154xi0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ayahuasca in the making.</span>
<span class="attribution"><span class="source">Rafael Guimarães dos Santos</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Indeed, in the aforementioned <a href="http://www.newyorker.com/magazine/2016/09/12/the-ayahuasca-boom-in-the-u-s">New Yorker article</a>, one American researcher is quoted as saying that “on any given night in Manhattan, there are a hundred ayahuasca ‘circles’ going on.”</p>
<p>This interest is also illustrated by a recent conference held in Acre and organised by the International Center for Ethnobotanical Education, Research & Service, which put together more than 700 participants from around the word, including <a href="http://www.ayaconference.com/">dozens of indigenous participants</a>.</p>
<p>In the past year or so, many other major international news outlets have covered ayahausca, including the <a href="http://www.nytimes.com/2014/06/15/fashion/ayahuasca-a-strong-cup-of-tea.html?_r=0">New York Times</a>, <a href="http://motherboard.vice.com/read/ayahuascas-medical-power-is-well-known-now-science-can-back-it-up">Vice</a> and <a href="http://www.nature.com/news/ayahuasca-psychedelic-tested-for-depression-1.17252">Nature</a>. Their pieces tend to portray the plant as a potential “cure” for addiction and depression. </p>
<h2>Too early to tell</h2>
<p>Media hype and promising medical results aside, I must highlight critical limitations of the few studies that have inspired this enthusiasm for ayahuasca. </p>
<p>First, the small sample size (only 17 individuals) and their non-controlled (no placebo) design makes the <a href="http://dx.doi.org/10.1590/1516-4446-2014-1496;">results unsound</a> from a <a href="http://journals.lww.com/psychopharmacology/pages/articleviewer.aspx?year=2016&issue=02000&article=00013&type=abstract">scientific perspective</a>. Indeed, the placebo effect <a href="http://peh-med.biomedcentral.com/articles/10.1186/1747-5341-3-14">can be very significant</a> in <a href="http://jop.sagepub.com/content/25/10/1277.abstract">antidepressant studies</a>. </p>
<p>Therefore, it is not currently possible to conclude that the observed effects were really caused by ayahuasca, or that ayahuasca can “cure” depression. </p>
<p>My Brazilian colleagues, supervisors and I are now trying to replicate these observations in the lab with improved methodology. A <a href="https://sistemas.ufrn.br/portal/PT/;jsessionid=9E9259F9F3FAFDFF4667DA640A20F4BC.sistemas2bi1">bigger study</a> assessing the antidepressant potentials of ayahuasca with 80 patients, using a double-blind, placebo-controlled <a href="http://www.nature.com/news/ayahuasca-psychedelic-tested-for-depression-1.17252">design</a>, is currently underway. And we at the <a href="http://www.fmrp.usp.br/?lang=en">Ribeirão Preto Medical School</a> are in the middle of a research project on the impacts of ayahuasca treatment on socially anxious individuals. </p>
<p>Ayahuasca has captured the imagination of scientists and hipsters alike. By helping us find the sacred within us, its psychoactive power seems to hold therapeutic potential as an alternative way to address common disorders that modern medicine has thus far found difficult to treat. </p>
<p>So is this sacred Amazonian medicine a potential treatment for everything from anxiety disorders to drug dependence, as both healers and patients avow? We’ll have to wait and see what the science says.</p><img src="https://counter.theconversation.com/content/67764/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rafael Guimarães dos Santos receives funding from the Brazilian National Postdoctoral Program, from the Brazilian Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior (PNPD-CAPES). He is also on the Advisory Board of the International Center for Ethnobotanical Education, Research & Service (ICEERS).</span></em></p>Western science is “discovering” the medical potential of ayahuasca, which Amazonian indigenous groups have used ritualistically for centuries.Rafael Guimarães dos Santos, Postdoctoral Fellow, Ribeirão Preto Medical School, Universidade de São Paulo (USP)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/528362016-01-22T12:32:26Z2016-01-22T12:32:26ZAyahuasca: the shamanic brew that produces out-of-body experiences<figure><img src="https://images.theconversation.com/files/107427/original/image-20160106-14966-gvt1i8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Aya-what-sca?</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/hgcharing/7070522273/in/photolist-bLNgWr-6pGMuy-axvRmr-dz8qHn-d88dT7-dCS1Na-nWT44g-aCsko9-9FoRvn-e1zRtY-7pJvPF-9FrhXN-aJaauF-9FoRFF-9FrNt3-9FoR28-9FokFc-9Fokv8-9Foknk-9Frhcu-9FoSac-9FrNFo-9FoQTP-2YCYmm-2YrckT-995RMr-amcB2a-bySFPv-77RF7x-bzyEk8-9aT964-2YqvJH-9Fxzv6-9FrNKQ-9Frh3o-f6Yrch-2YqXsc-eYKCqh-eWjjsA-9FoScc-9FrPaA-eWjdpw-eW7PnF-eWj8WN-9FoRVk-eWjiWq-eW7Uce-eWjgkq-eW7R9t-eW7Qma">Howard G Charing</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>Ayahuasca, known by various names by different indigenous groups in South America, is a generic term commonly associated with preparations of the mildly psychoactive vine <em>Banisteriopsis caapi</em>. Ayahuasca literally translates from the Quechua language of the North Andes as “soul vine” or “vine of the dead” and has traditionally been consumed by indigenous communities such as the Aruák, Chocó, Jívaro, Pano, and Tukano across the upper reaches of the Amazon River system in Bolivia, Brazil, Colombia, Ecuador, and Peru.</p>
<p>Ayahuasca is most commonly consumed by indigenous communities in liquid form as part of shamanic rituals designed to communicate with celestial supernatural forces or the spirits of the forest. The psychotropic effects of the drink are caused by three beta-carboline alkaloids: harmine, harmoline and tetrahydroharmine. Owing to their ability to intensify and prolong this psychotropic effect, other natural substances such as tree barks and coca or tobacco leaves can also be combined with the vine.</p>
<p>People outside of indigenous groups may come across ayahuasca through a variety of more or less formal contexts such as new religious movements, enlightenment retreats, neo-shamanic workshops, self-discovery weekends and eco-lodges specialising in spiritual tourism. As with <a href="http://www.bbc.co.uk/news/uk-35133580">the recent death of Unais Gomes</a>, who was killed while taking part in a shamanic ceremony in the Iquitos region of Peru, most of the fatalities linked with consuming ayahuasca occur in the unregulated and frequently ad hoc rituals of these latter scenarios.</p>
<p>Use of ayahuasca began to spread beyond traditional indigenous groups in <a href="https://www.erowid.org/chemicals/ayahuasca/ayahuasca_timeline.php">the latter part of the 19th century</a> due to inter-marriage and contact with non-indigenous people working in the region.</p>
<p>The most common form in which ayahuasca passed from indigenous to non-indigenous use was the combination of the vine <em>Banisteriopsis caapi</em> with the leaves of the shrub <em>Psychotria viridis</em>. The foliage of the <em>P. viridis</em> shrub contains the psychoactive agent N,N-Dimethyltryptamine, or DMT, which intensifies and prolongs the psychotropic effects of ayahuasca consumption. The chemical structure of DMT resembles that of <a href="https://theconversation.com/magic-mushrooms-expand-your-mind-and-amplify-your-brains-dreaming-areas-heres-how-28754">psilocybin</a>, the compound found in psychedelic mushrooms.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/107643/original/image-20160108-3337-3idg4e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/107643/original/image-20160108-3337-3idg4e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/107643/original/image-20160108-3337-3idg4e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/107643/original/image-20160108-3337-3idg4e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/107643/original/image-20160108-3337-3idg4e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/107643/original/image-20160108-3337-3idg4e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/107643/original/image-20160108-3337-3idg4e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A Santo Daime ceremony.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/visionshare/2343098667/in/photolist-4z3ZAT-4z8fSs-4z3Ze6-4xASCM-HyVdg-HpdCt-4xEVeS-4xETZN-4xAHxv-4z42HV-4z8hhm-4z3ZJP-4xEUdb-4zfu8X-4z8jwu-4z3YNR-4xEXRA-4z43Wx-4xAP9i-4zfpAi-4z45cD-4xEZU1-4xCD9W-4xEZZm-4xANNi-4xEYdd-4xASRx-4zjGKQ-4zfqGi-4z45Fz-4z8m8q-4xEXXy-4z8kgS-4xETcW-4xAFFV-4zfqZ2-4z8kRb-4zjLeu-4xEXUy-4xF3tQ-4z8eUj-4xF1Uw-4z44yH-4xEYY5-4zjFfW-4xAQTZ-4z424T-4xALH6-4z8iM7-4z42ZH">Lou Gold</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>Beyond the indigenous communities of the Upper Amazon Basin, ayahuasca is most popularly consumed in two kinds of ritual practices. The first is within the Brazilian “ayahuasca religions” of Barquinha, Santo Daime and A União do Vegetal. These religions have many of the formal attributes associated with mainstream traditional religions such as Christianity, Islam and Judaism – for example the inclusion of prayers, songs and ritual disciplines.</p>
<p>Ayahuasca is also consumed within a variety of more or less formal contexts such as new religious movements, enlightenment retreats, neo-shamanic workshops, self-discovery weekends and eco-lodges specialising in spiritual tourism. As with <a href="http://www.bbc.co.uk/news/uk-35133580">the recent death of Unais Gomes</a> in the Iquitos region of Peru, most of the fatalities linked with ayahuasca consumption occur in the unregulated and frequently ad hoc rituals of these latter contexts.</p>
<h2>The effects of the brew</h2>
<p>In its most common form, ayahuasca is a strong smelling brown liquid with a bitter taste. In addition to the age, quality, and type of plants used, the psychoactive potency of ayahuasca differs relative to the environmental conditions in which they are grown, the ratio of their combination and the amount of processing they undergo. The size of dose and frequency of consumption varies from one ritual context to another. Depending upon individual physiology, ayahuasca begins to make itself felt 20 or 30 minutes after first being consumed, with subsequent doses increasing its psychotropic effects.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/107543/original/image-20160107-13988-si9aph.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/107543/original/image-20160107-13988-si9aph.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=494&fit=crop&dpr=1 600w, https://images.theconversation.com/files/107543/original/image-20160107-13988-si9aph.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=494&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/107543/original/image-20160107-13988-si9aph.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=494&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/107543/original/image-20160107-13988-si9aph.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=621&fit=crop&dpr=1 754w, https://images.theconversation.com/files/107543/original/image-20160107-13988-si9aph.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=621&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/107543/original/image-20160107-13988-si9aph.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=621&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Aya cooking.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Ayahuasca#/media/File:Aya-cooking.jpg">Xichael</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Most renowned for the visual imagery it produces, ayahuasca may also generate auditory and olfactory sensations. The earliest effects of the liquid tend to be a warming of the stomach followed by a spreading feeling of physical relaxation and mental calm. There is, though, no loss of vigour or alertness.</p>
<p>Weaker doses of ayahuasca produce a mild detachment from one’s body and surroundings which allows a mental objectification and critical examination of the smallest of details, feelings and thoughts. Stronger forms of the liquid promote the visual apprehension of irregular shapes, recurring and colourful geometric patterns, distorted and fleeting images, and out-of-body experiences or dream-like visions populated by the familiar and the fanciful. </p>
<p>Sounds may also be heard as distortions of external stimuli or self-contained auditory experiences. Likewise, smell and taste may be affected to a more or less pleasant degree. Given its emetic qualities, ayahuasca consumption often induces vomiting and may also result in the involuntary evacuation of the bowels. While these effects may be moderated by practice and dietary restrictions, their purgative nature is positively construed as an external physical manifestation of inner spiritual cleansing. </p>
<p>DMT is a proscribed substance in various parts of the world; for example it is categorised as a “<a href="http://www.legislation.gov.uk/ukpga/1971/38/schedule/2">Class A</a>” drug in the UK and a Schedule I drug under UN conventions. Ayahuasca is frequently subject to many of the same restrictions and sanctions as narcotics such as heroin and cocaine. Nevertheless, the powerful forces of globalisation are spreading ayahuasca consumption beyond its traditional geographical heartlands and this, in turn, is resulting in the legalisation or decriminalisation of ritual use (but not production) in a growing number of countries (incuding Holland, Italy, Spain, and the United States).</p>
<p>Ayahuasca is a psychoactive substance to be used with care and, like other psychotropics, should not be consumed by individuals <a href="https://www.erowid.org/chemicals/ayahuasca/ayahuasca_death.shtml">with certain physical or psychological conditions</a>.</p><img src="https://counter.theconversation.com/content/52836/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Research by Andrew Dawson has been funded by the Arts and Humanities Research Council (AHRC), British Academy, Leverhulme Trust, and Lancaster University.</span></em></p>Indigenous groups, religious movements and spiritual tourists use the psychoactive substance to communicate with forces and purge the soul.Andrew Dawson, Professor of Modern Religion, Lancaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/173442013-08-28T20:20:20Z2013-08-28T20:20:20ZShroom to grow: Australia’s missing psychedelic science<figure><img src="https://images.theconversation.com/files/30058/original/x57jszyd-1377649069.jpg?ixlib=rb-1.1.0&rect=2%2C1%2C952%2C997&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Recent studies show psychedelics can have a positive effect on a range of mental health issues.</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>A recent <a href="http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0063972">Norwegian study</a> on psychedelic drugs and psychological well-being not only highlighted fewer mental health issues among users of these drugs but also underscored the reinvigoration of scientific research in a field maligned since the moral panic of the 1960s. </p>
<p>Psychedelics are a broad category of drugs that profoundly alter perception. Examples include LSD (Lysergic acid diethylamide), mescaline (found in some cacti), psilocybin (found in some mushrooms), dimethyltryptamine (found in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0042421">ayahuasca</a>) as well as ketamine and methylenedioxymethamphetamine (MDMA). </p>
<p>Plant-based psychedelics have been integral to healing practices for thousands of years in a number of cultures, including <a href="http://nativeamericanchurches.org/spirituality/">native Americans</a>, the <a href="http://www.bbc.co.uk/tribe/tribes/babongo/index.shtml">African Bwiti</a> and the Mazatecs. </p>
<p>Western research into the therapeutic potential of psychedelics commenced in the middle of the 20th century, but quickly became conflated with the counter-cultural movement in the United States, Europe and Australasia. </p>
<p>A moral panic ensued, leading to the prohibition of psychedelics and cessation of research. But psychedelic science is now re-emerging as a mature and credible discipline. </p>
<p>In addition to the Norwegian research, a number of other studies have recently demonstrated the powerful positive effects of psychedelics, including <a href="http://jop.sagepub.com/content/25/11/1453.short">personality changes</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/20819978">reduced anxiety and depression</a> associated with end-of-life cancer and long-term relief from <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573678/">post-traumatic stress disorder (PTSD)</a>. </p>
<p>Overseas, psychedelic research programs are increasing exponentially and can be found at prominent institutions such as <a href="http://www.bpru.org/cancer-studies/">Johns Hopkins School of Medicine</a>, <a href="http://www.nyucanceranxiety.org/">New York University</a> and <a href="http://www.harboruclapsych.com/charles-s-grob-m-d/">UCLA</a>. </p>
<p>But there’s a surprising absence of any such activity in Australia. </p>
<h2>Australian research programs?</h2>
<p>There’s a general reluctance among Australian researchers to explore the therapeutic potential of psychedelics. This might be partly attributed to the illicit status of the drugs, which, some suggest, has created a <a href="http://theconversation.com/psychedelic-drug-use-linked-to-fewer-mental-health-problems-17295">bureaucratic impediment to medical progress</a>. </p>
<p>The illegal status of psychedelics is ostensibly based on their potential to cause harm. But these drugs are not addictive and have been consistently ranked by experts <a href="http://www.sg.unimaas.nl/_OLD/oudelezingen/dddsd.pdf">as being low risk</a>. </p>
<p>Rather than remaining prohibited because they are harmful, the perception of psychedelics as harmful is maintained in order to justify their prohibition. </p>
<p>An <a href="http://informahealthcare.com/doi/pdfplus/10.1080/16066350701794972">analysis of Australian discourse</a> about psychoactive substance use explains this process in terms of the <a href="http://www.sciencedirect.com/science/article/pii/S0955395912001971">dominant pathogenic narrative of drugs</a>, which limits discussion to their harm. </p>
<p>Since Australian government funding is directed towards research that seeks to provide evidence of drug-related harm, the pathogenic narrative is self-reinforcing.</p>
<h2>The pathogenic narrative</h2>
<p>Without funding, it’s difficult for researchers to establish programs that seek to examine the positive benefits of banned drugs. And there’s little financial incentive for the private sector to invest in such research as psychedelics are not patentable because they aren’t “novel”, or because they’re derived from natural sources.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/30063/original/sky5dn53-1377649683.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/30063/original/sky5dn53-1377649683.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/30063/original/sky5dn53-1377649683.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/30063/original/sky5dn53-1377649683.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/30063/original/sky5dn53-1377649683.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=506&fit=crop&dpr=1 754w, https://images.theconversation.com/files/30063/original/sky5dn53-1377649683.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=506&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/30063/original/sky5dn53-1377649683.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=506&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Australia shoulders a heavy burden of psychological disease, particularly stress, anxiety and trauma.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>The financial incentive to demonstrate drug harm also often leads to bad science. Researchers reporting on the harms of MDMA, for instance, often use the terms <a href="http://www.ncbi.nlm.nih.gov/pubmed/22831704">MDMA and ecstasy interchangeably</a>. </p>
<p>But there are distinct differences between pharmaceutical-grade MDMA and street ecstasy pills, which usually have a range of chemicals <a href="http://www.ecstasydata.org/">mixed with MDMA</a>, or have no MDMA in them at all. </p>
<p>Observational studies are limited in furthering our <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3053129/">understanding of MDMA’s pharmacology</a> because poly-drug use (using many drugs at the same time), and the environments in which they are used, might contribute to many of the observed harms. </p>
<p>When MDMA has been administered in <a href="http://www.maps.org/research/mdma/MDMA_FINAL%20_IB-edition-7_1Aug13.pdf">clinical settings</a>, the adverse effects reported in the aforementioned research haven’t been observed. </p>
<p>The <a href="http://theconversation.com/psychedelic-drug-use-linked-to-fewer-mental-health-problems-17295">recent Norwegian finding</a> that psychedelic use is associated with decreased incidence of mental health problems provides further support for “the safety of clinical research and treatments using psychedelics”.</p>
<h2>Why it’s time to get on board</h2>
<p>Like many other countries, the Australian community is facing unprecedented levels of psychological disease, notably stress, anxiety and trauma. Their cumulative financial costs have been estimated at around <a href="https://www.medibankhealth.com.au/files/editor_upload/File/Mental%20Health%20Exec%20Report.pdf">A$28.6 billion</a>. </p>
<p>Mental illness also has a significant social cost, including its <a href="http://www.wesleymission.org.au/releases/120514.asp">impact on families</a>.</p>
<p>Current medical responses are effective in many, but not all, cases. Alternative approaches, including psychedelic therapy, offer hope to many who are resistant to current treatments.</p>
<p>Unlike conventional pharmacotherapies (antidepressants or mood stabilisers) that typically require ongoing and sometimes lifelong administration, the therapeutic use of psychedelics generally involves one or two doses of the drug under the supervision of trained therapists. </p>
<p>Most psychedelics also have large margins for safety, and the duration of their actions and contraindications are largely well understood. </p>
<p>This has clear benefits in terms of cost, safety and tolerability, as well as mitigating the risk of scheduled drugs being diverted into the community. But psychedelic psychotherapy requires the training of therapists in psychedelic treatments, which could take time and resources.</p>
<p>Global research into psychedelic therapy is gathering pace, notably in the United States. A significant player is the <a href="http://www.maps.org">Multidisciplinary Association for Psychedelic Studies</a> (MAPS), which is supporting clinical trials of MDMA-assisted psychotherapy for PTSD in the <a href="http://www.maps.org/research/mdma/">US, Switzerland, Israel, Canada</a> and the <a href="http://www.theguardian.com/science/2011/sep/30/ecstasy-trial-ptsd-sufferers">United Kingdom</a>. MAPS is very supportive of a similar clinical trial in Australia.</p>
<p>Globally, the re-emergence of psychedelic therapy is still in its early stages. It’s widely acknowledged that clinical research is required to establish the safety and optimise the efficacy of these promising approaches. </p>
<p>Australia has a pressing need to explore a range of options to deal with mounting challenges to mental health and general well-being. We believe that it’s imperative for the country to join the psychedelic renaissance, and initiate well-planned and adequately-funded, formal psychedelic research.</p><img src="https://counter.theconversation.com/content/17344/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephen Bright is vice-president of PRISM, a not-for-profit organisation that facilitates psychedelic research in Australia (<a href="http://prism.org.au">http://prism.org.au</a>)</span></em></p><p class="fine-print"><em><span>Martin Williams is president of PRISM, a not-for-profit organisation that facilitates psychedelic research in Australia (<a href="http://prism.org.au">http://prism.org.au</a>)</span></em></p>A recent Norwegian study on psychedelic drugs and psychological well-being not only highlighted fewer mental health issues among users of these drugs but also underscored the reinvigoration of scientific…Stephen Bright, Registered psychologist and sessional academic, Curtin UniversityMartin Williams, Postdoctoral Research Fellow, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.