Ayahuasca: Coming to a Clinic Near You?

Oh, how the times they are a changin’. Twenty years ago, traveling from the U.S. to the jungle to take ayahuasca was mostly reserved for the wildly adventurous, the earthy hippie, or those on a quest with a purpose.

Today, going to the jungle to take the “medicine” is a featured “dream trip” in luxury travel magazines like Afar.

Which means, of course, there is work being done in the U.S. to take the jungle and the travel out of the equation (as a sign of the times, not by causation).

For example, Jessica Nielson, a research faculty member at University of California-San Francisco, and a neurobiologist and trauma researcher by training, is devoted to making ayahuasca available in the U.S. as medicine. Inspired after she received her PhD, she went to Peru where she saw first hand the use of the tea to treat post-traumatic stress disorder on U.S. veterans. She’s been working to fold ayahuasca research in to her post doc ever since, especially work on developing a protocol to get ayahuasca research moved forward to reschedule it—ayahuasca is considered Schedule I, with no recognized therapeutic value and considered at high risk for abuse—the same Federal class of drug as marijuana and LSD.

Nielson says the ayahuasca concoction, a tea made of the two common Amazon jungle plants Banisteriopsis caapi and Psychotria viridis, does, in fact, have increasingly recognized therapeutic value. “There are indications out of Brazil it is useful [for treating] depression, and out of Canada for drug addiction, and [there’s] research out of UCLA on alcoholism.” She says there is also evidence that the tea is useful in treating cognitive decline and diabetes.

What makes the research into ayahuasca unique is that the scientific research is actually taking place using the plants, unlike, for example, psychedelic mushrooms, where research is being conducted on synthetic psilocybin.

With mushrooms, “even though you might have a certain weight, you don’t know how much psilocybin is there.” Consistency in dosage is key. “But with ayahuasca tea, you can determine the concentration of the tea.”

“In Brazil, they’re [researching] the tea, where they cut the two plants, boil them together, and get a tea they administer,” she explains. “They can standardize that, so you know the actual concentrations.”

Other researchers are producing a freeze-dried pill version of ayahuasca, of which Nielson says there is “some debate if it’s ayahuasca,” as it is possible the body metabolizes it differently in pill form.

Peter Gorman, an investigative journalist and someone who has spent more than 30 years working with plant medicines in South America, says the plants are key. “Ayahuasca is a part of the jungle experience, not apart from it.”

“I’m a scientist, but I’m a spiritual person,” says Nielson. “The shamans have a deep connection to the plant and the spirit world. They can communicate to figure out how to make ayahuasca and how to administer it. It’s been a deep-seated tradition they’ve had for a long time. As a western white researcher, I don’t want to step on the toes of all this tradition. There’s things these communities have been doing for a long time that work.”

Nielson stresses the safety of the concoction, when proper protocol is followed, referencing a tragic case of a young man from Sebastopol, California, who died during an ayahuasca experience.

“People don’t die of ayahuasca, they die of improper support,” she says. Something happened and they hit their head, she says, or sometimes a purgative taken before hand can poison them. Or, “somebody has underlying psychosis, and someone stabbed someone else in the ceremony. They’re not ODing—something about the set or the setting caused the fatality.”

“If done with the appropriate support and preparation in place, it’s incredibly safe,” she says, pointing out there’s also a risk in taking antibiotics. “It’s a matter of taking appropriate precautions.”

Nielson, along with the Multidisciplinary Association for Psychedelic Studies (MAPS), has a Phase 1 clinical trial protocol to test first in healthy volunteers, and then plans to follow that with a Phase 2. Among other approvals, they will need both the FDA and the DEA to give the thumbs up for their study. If all goes well, they will likely begin their ayahuasca research in 2018. The study will be on the tea itself—via the FDA’s botanical division. “We don’t want to discount what’s in its natural form. Right now, we’d like to see it move through the pipeline in its natural form.”

While MDMA might be available by 2021 in the U.S. in dedicated facilities, to be administered by trained MDMA therapists, Nielson says she is also considering how to have an ayahuasca facility in a more natural, yet still clinical, setting. “A lot of these experiences are intense and you need someone to guide the patient to it.”

In the jungle, she says, “that’s how you do it—you’re with a shaman. It’s getting to that state, but have someone to help you navigate the difficult things that come up.”

Certainly there are good reasons to administer ayahuasca in a clinical setting with trained therapists. But as Gorman notes, “if you didn’t know what you were missing, you wouldn’t miss anything,” But, “if you knew what you’re missing, you’re missing quite a lot. It’s not wrong,” Gorman stresses. “It’s just different.”

“To me, plants are sentient,” he continues, comparing ayahuasca’s preparation by a curandero to that of a good chef: Say you have six cooks using the same equipment and ingredients. The carrot has to give up itself, he says, and “as a sentient being, it does not have to give up its spirit. But if the chef invokes, talks to, coaxes those plants to give the extra juices, it’ll be juicier.”

“If you go to a traditional setting, it’s going to take you out of where you are in the world. It slows you down, and allows your body to forget the nonsense of your life. In the more traditional setting, you get quiet enough to see … and get rid of those bags of potatoes around your neck. If your brain is full of nonsense, how are you going to hear the spirits if they happen to whisper?”

Ayahuasca, he says, “doesn’t solve the problem. It gives you hints on how to solve your own problems.”

And if all goes well for Nielson and MAPS, although still a lot of work and approvals and money away, those hints might be coming to a clinic near you in the foreseeable future.


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