Ayahuasca and Public Health II: Health Status in a Large Sample of Ayahuasca-Ceremony Participants in the Netherlands

This survey study (n=377) assessed the association regular ayahuasca ceremony participation has with a person’s health. Compared to normative Dutch data, regular participants in ayahuasca ceremonies showed better general well-being, fewer lifestyle-related diseases, more physical activity, and a more balanced diet. Ceremony attendees also used less alcohol over the course of the COVID-19 pandemic but they did use more illegal drugs than the general population.

Abstract

“Ayahuasca is a plant decoction in traditional Amazonian medicine. Its ritual use has been internationalized, leading to policy challenges that countries should address. This study evaluates the impact of regular ayahuasca ceremony participation on health by assessing the health status of 377 participants in ayahuasca ceremonies in the Netherlands using validated health indicators. A questionnaire was developed and administered to study participants. The questionnaire included several health indicators with public health relevance (e.g., BMI, diet, physical activity) and psychometrically validated questionnaires (ELS and COPE-easy). The data retrieved through health indicators was compared to normative Dutch data. Participants (50.1% women) were mostly Dutch (84.6%) with a mean age of 48.8 years (SD = 11.6). Compared to normative Dutch data, regular participants in ayahuasca ceremonies showed better general well-being, fewer chronic or lifestyle-related diseases, more physical activity, and a more balanced diet. Participants also used less alcohol during the COVID-19 pandemic, and although they used more illegal drugs than the general population, they did not report associated harms. Our findings suggest that regular participation in ayahuasca ceremonies is not linked to relevant health harms. This data could help drug policymakers to develop and implement evidence-based public policies.”

Authors: Maja Kohek, Genis Ona, Michiel van Elk, Rafael G. Dos Santos, Jamie E. C. Hallak, Miguel A. Alcazar-Corcoles & Jose C. Bouso

Summary

A self-administered questionnaire was administered to long-term ayahuasca users around Spain to assess the impact of long-term exposure to ayahuasca on public health. Results showed that long-term ayahuasca use was associated with higher positive perception of health or with a healthy lifestyle.

Ayahuasca is a decoction of the Amazonian vine Banisteriopsis caapi, which contains inhibitors of the monoamine oxidase (MAOI) enzyme. It is used in traditional contexts as a medicine, for spiritual purposes, and in communitarian ceremonies to strengthen social bonds.

Ayahuasca use is expanding internationally, while psychedelic research is gaining new recognition in the field of biomedicine. At the same time, the use of biomedicine is being questioned, and some authors suggest that psychedelic drugs may offer a solution for overcoming this crisis.

Studies comparing ritualistic peyote and ritualistic ayahuasca users with non-users have indicated that the former performed better regarding some neuropsychological and psychopathological variables, including showing less use of alcohol and illegal drugs and reporting remission from anxiety and mood disorders.

There are no studies based on public health indicators that assess the potential benefits of psychedelics when they are used in communitarian contexts. However, the globalization of some traditional medicines like ayahuasca and peyote makes it possible to assess the consequences of their integration into society.

Participants

This study involved long-term ritualistic ayahuasca users in Spain. The participants were excluded if they were under 18 years old or had a neurocognitive disorder.

Measures

A questionnaire was developed to measure eight different dimensions of health, including self-perceived health status, body mass index, presence of chronic disease, physical limitation, sleep problems, levels of cholesterol and blood pressure, medical/psychology visits, and use of prescription drugs. The Engaged Living Scale (ELS) and the General Health Questionnaire (GHQ-12) were used to measure the degree to which an individual is involved in engaged living, understood as a concept of the Acceptance and Commitment Therapy (ACT) model.

Procedure

During a six-month period, we visited various locations in the Spanish territory where ayahuasca ceremonies took place. We asked to collaborate with ayahuasca leaders to conduct this study, and participants completed questionnaires before the ceremony started.

Statistical analyses

Descriptive statistics were used to present the data, and a multivariate General Linear Model (GLM) was performed with the number of times that ayahuasca was used, type of ceremony (Santo Daime vs Neoshamanic groups), and gender as factors to determine differences between groups.

Results

The majority of participants reported having used ayahuasca between one and 10 times in their lifetime, and more than 100 times in the previous six months.

General health

The majority of ayahuasca users reported a positive perception of their health status, and 7.4% were told by a health professional that they presented a high cholesterol or blood pressure level. The majority of ayahuasca users did not visit a doctor during the previous six months, and many of those who did visited did so infrequently. Among ayahuasca users, the majority of users reported reducing their use of medical and mental health services.

Lifestyle

Almost half of the sample reported not being as physically active as they wished, and most were trying to increase their consumption of healthy foods while reducing their intake of sugars, fats, and/or alcohol.

Positive mental health

Most participants reported being happy, having vital goals to fulfill, having someone who loved them, and having personal autonomy.

Adjustment

Based on all items, 9.4% of respondents scored five, 33.3% scored four, and 52% scored three, which can be interpreted as poor general adjustment.

Social support

39.4% of the sample reported having four to six close friends or family members, 24% reported having one to three, and 22% reported having 10 or more.

Personal values

Scores of the questionnaire range from 11 to 55 on the Valued Living scale, and from 6 to 30 on the Life Fulfillment scale.

Multivariate general linear model (GLM)

Chi-square testing showed that groups based on the number of times ayahuasca was used were not matched by age, but were matched by gender. The multivariateGLM identified potential differences between groups, including being older, having an enhanced sense of Valued Living, and being Engaged Living.

Discussion

This study assessed the mental health status of a large sample of long-term ritualistic ayahuasca users using indicators from a public health perspective.

The results of this study are in disagreement with previous studies, except regarding alcohol intake, because the participants in this study were not members of an ayahuasca religion. Ayahuasca has been proposed as a treatment for drug dependence, but the results of this study do not contradict those of earlier studies, since participants seem to engage in the responsible use of other psychoactive drugs.

Our sample scored higher in terms of perceiving their health status positively, had BMIs within the normal range, and had lower levels of cholesterol and hypertension than the general Spanish population. In addition, the prevalence of chronic diseases was lower among our sample.

More than half of the sample reported reducing their use of medical and/or mental health services due to ayahuasca use, and 56% reported reducing their use of prescription drugs due to ayahuasca use. This may be preliminary evidence that psychedelics offer promise for the treatment of mental health problems.

In this study, ayahuasca users had a similar mental health status to the general Spanish population, with a daily intake of fruits and vegetables considerably higher. The prevalence of a degree of mental disturbance was very similar between ayahuasca users and the general population.

Over 85% of participants engaged in activities that had a positive effect on mental health, including yoga and meditation. Most participants had positive self-perceptions of happiness and 97% had someone who expressed affection to them.

We selected specific items from several validated rating scales to assess adjustment, coping and personal values in ayahuasca users. We found that only 5.3% of the sample obtained scores indicating poor general adjustment, 1.1% showed poor coping strategies, and high scores were obtained for the three scales.

Participants who took ayahuasca more than 100 times differed in age and personal values, but not in the number of times they visited mental health services in the previous six months.

A linear regression model was used to determine if any variables could be seen as predictors of the sample’s mental health status. Personal values were found to be highly correlated with mental health status.

This study’s main limitation is that it was self-selected, and the number of ayahuasca users in Spain cannot be known, since national surveys concerning drug use have not included ayahuasca.

This study shows that regular ayahuasca users have high levels of general, mental, and positive health, and have healthy lifestyle habits. The results do not suggest the possible effects of ayahuasca, but show how the ritualistic use of a drug considered a hallucinogen is not associated with negative consequences.