Ayahuasca-Assisted Therapy for Problematic Substance Use, PTSD, and Depression: Findings and Insights

Research Acknowledgement: we acknowledge the work, skill, and discipline of Maestro Ricardo Amaringo for his expertise & mastery in the Shipibo tradition and as a provider of his ancestral medicine and master plants including ayahuasca for this study to be possible, we give thanks to Nihue Rao Centro Espiritual for supporting these patients in the rehabilitation from toxic drugs and this research will continue to serve as evidence for our governments and those curious understand that ayahuasca assisted therapy can be a safely provided therapy and pathway to long term abstinence from problematic substance use & support behavioural changes and to acknowledge that Maestro Ricardo Amaringo is both professional & cultural provider of traditional amazonian plant medicine with shared lived experience in recovery from his own years of problematic substance use. We would also like to thank Dr. Joe Tafur & Markus Drassl for their support and contributions to our collective work. Special thanks to Dr. Megan Cooper and Dr. Glen Wolfe.

Introduction to Ayahuasca-Assisted Therapy

Ayahuasca-assisted therapy integrates the ceremonial use of ayahuasca, a psychoactive brew traditionally used by Indigenous communities of the Amazon basin. The brew contains:

1. Banisteriopsis caapi – a vine containing harmala alkaloids, which act as MAO inhibitors. (Ayahuasca or Oni Nishi in Shipibo)
2. Psychotria viridis or – plant containing N, N-Dimethyltryptamine (DMT), a powerful psychedelic. (Chacruna or Kawa in Shipibo)

When used within a structured therapeutic setting, ayahuasca helps participants engage in deep emotional processing, psychological insight, and behavioral transformation, making it a promising approach for addressing problematic substance use, PTSD, and depression.

Therapeutic Support Measures

Ayahuasca-assisted therapy at Sacred Rebels Recovery is integrated with a comprehensive set of therapeutic practices designed to support healing and sustainable change. These include:

1. Somatic Experiencing: This body-oriented approach helps participants process and release trauma stored in the body. By reconnecting with physical sensations, participants can discharge stress responses and restore a sense of safety and balance.
2. Whole Foods Diet: A nutrient-dense, anti-inflammatory diet supports physical and mental health. Proper nutrition aids in stabilizing mood, enhancing cognitive function, and promoting overall well-being.
3. Meditation: Regular meditation practices help participants cultivate mindfulness, emotional regulation, and resilience. This supports the integration of insights gained during ayahuasca ceremonies.
4. Recovery Dharma: This peer-led practice uses Buddhist principles and meditation to support recovery. Through ethical and mindful living, participants develop tools for managing cravings, emotions, and relationships.
5. Group and Individual Meetings: Regular group discussions and one-on-one sessions provide a safe space for sharing experiences, receiving feedback, and processing challenges. This fosters accountability, community, and personal growth.
6. Physical exercise, with a focus on functional fitness and mobility training, plays a key role in the program outcomes. Exercise in the Amazon and Canada gives participants an outlet for overall health, strength, and cardiovascular conditioning in between Ayahuasca-assisted therapy sessions and general integrative therapeutic practices.

Mechanisms of Therapeutic Action

1. Neuroplasticity: Ayahuasca promotes the production of brain-derived neurotrophic factor (BDNF), enhancing the brain’s ability to form new neural connections. This is essential for breaking entrenched patterns related to substance use, PTSD, and depression.
2. Disruption of the Default Mode Network (DMN): By reducing DMN activity, ayahuasca helps interrupt rigid thought patterns and maladaptive behaviors, allowing for more adaptive and flexible responses.
3. Emotional Processing and Insight: Ayahuasca facilitates the surfacing of repressed traumas and unhealthy thought patterns, enabling emotional release, personal insight, and a renewed sense of purpose.

Findings from Sacred Rebels Recovery Programs

Over a 3-year period, we conducted inpatient ayahuasca-assisted rehabilitation programs for 22 participants in the Amazon and Canada. These programs combined ayahuasca ceremonies with somatic experiencing, dietary support, meditation, Recovery Dharma, and regular group and individual meetings. The outcomes varied based on program length and engagement.

Key Insights

1. Longer Programs Yield Greater Success:

• Participants who engaged in 90-day or longer inpatient programs demonstrated the most sustainable improvements.
• Extended programs supported neuroplasticity and allowed for the deprogramming of unhealthy behavioral patterns and the reinforcement of new, healthier habits through consistent practice and peer-led support.
• The immersive nature of these programs provided the time needed to fully integrate emotional and cognitive shifts, leading to more enduring outcomes.

2. Shorter Programs Show Mixed Results:

• Participants in shorter programs of 2 to 5 weeks often experienced initial improvements but faced challenges sustaining these changes.
• Two individuals resumed the use of their prescribed stimulants or benzodiazepines after completing shorter programs. However, they reported feeling a reduced psychological reliance on these substances. Both later re-engaged with somatic practices, meditation, and Recovery Dharma, finding their way back to healthier behavioral patterns within a few months.

3. Sustained Improvements in Long-Term Participants:

• Among the 22 participants, 8 individuals maintained healthier patterns and abstained from substances such as cocaine, alcohol, prescribed opioids, illicit fentanyl, and methamphetamines for over 12 months.
• 5 participants exceeded 18 months of continued improvement, reporting enhanced emotional stability, stronger relationships, and greater overall well-being.

4. Ongoing Study:

• There are currently 6 participants in the program whose outcomes are still being monitored, with results to be evaluated in the near future.

The Importance of 90-Day and Longer Programs

1. Neuroplasticity and Behavioral Change: Longer programs provide the necessary time to reinforce new neural pathways and dismantle maladaptive behaviors. Repetition of healthy practices over 90 days helps anchor sustainable change.
2. Integration and Consistency: The combination of ayahuasca therapy, somatic experiencing, a whole foods diet, meditation, and regular group and individual meetings creates a consistent and holistic framework for recovery.
3. Peer-Led Immersion: Being immersed in a supportive community fosters trust, accountability, and shared healing, which are critical for long-term success.

Conclusion

Ayahuasca-assisted therapy, when combined with somatic experiencing, holistic health practices, and peer-supported integration, held in a combination of traditional indigenous & modern conventional rehabilitation framework offers a powerful approach to addressing problematic substance use, PTSD, and depression. Our findings demonstrate that 90-day and longer programs provide the most sustainable outcomes by supporting neuroplasticity, reinforcing new behavioral patterns, and fostering a supportive community. While shorter programs can offer valuable insights, extended, immersive experiences are key to lasting transformation.