Well-being, problematic alcohol consumption and acute subjective drug effects in past-year ayahuasca users: a large, international, self- selecting online survey. Lawn, W., Hallak, J., E., Crippa, J., A., Santos, R., D., Porffy, L., Barratt, M., J., Ferris, J., A., Winstock, A., R., & Morgan, C., J., A.
Well-being, problematic alcohol consumption and acute subjective drug effects in past-year ayahuasca users: a large, international, self- selecting online survey [pdf]Paper  Well-being, problematic alcohol consumption and acute subjective drug effects in past-year ayahuasca users: a large, international, self- selecting online survey [link]Website  abstract   bibtex   
Ayahuasca is a natural psychedelic brew, which contains dimethyltryptamine (DMT). Its potential as a psychiatric medicine has recently been demonstrated and its non-medical use around the world appears to be growing. We aimed to investigate well-being and problematic alcohol use in ayahuasca users, and ayahuasca's subjective effects. An online, self-selecting, global survey examining patterns of drug use was conducted in 2015 and 2016 (n = 96,901). Questions were asked about: use of ayahuasca, lysergic acid diethylamide (LSD) and magic mushrooms; demographics, current well-being and past-year problematic alcohol use of past-year ayahuasca users and comparison drug users; and subjective effects of ayahuasca and comparison drugs. Ayahuasca users (n = 527) reported greater well-being than both classic psychedelic users (n = 18,138) and non-psychedelic drug-using respondents (n = 78,236). Ayahuasca users reported less problematic drinking than classic psychedelic users, although both groups reported greater problematic drinking than the other respondents. Ayahuasca's acute subjective effects usually lasted for six hours and were most strongly felt one hour after consumption. Within our online, self-selecting survey, ayahuasca users reported better well-being than comparison groups and less problematic drinking than classic psychedelic users. Future longitudinal studies of international samples and randomised controlled trials are needed to dissect the effects of ayahuasca on these outcomes. Ayahuasca ('the vine of the soul') is a powerfully psychoactive brew which is thought to have been used for several hundred years by indigenous people in the Amazon 1 . It is usually prepared by boiling the leaves of the Psychotria viridis bush, which contains N,N-dimethyltryptamine (DMT), and combining with the stems of the Banisteriopsis caapi vine, which contains the β-carboline alkaloids harmine, harmaline, and tetrahydroharmine, to create a thick brown liquid 2 . DMT is a tryptamine hallucinogen which is thought to act primarily at 5-HT 2A receptors but also at 5-HT 2C and 5-HT 1A 3 . DMT is orally inactive due to its breakdown by monoamine oxidase activity in the gastrointestinal tract. The β-carboline alkaloids in the Banisteriopsis caapi vine are monoamine oxidase inhibitors (MAO-I) and therefore render orally administered DMT psychoactive 4 . Ayahuasca is used by both indigenous tribes and by members of modern syncretic religious groups in and around the Amazon, including the Santo Daime and Uniao do Vegetal 2 . However, use is not confined to the Amazon, and there has been suggestion of a recent global increase in use of the drug 5 , particularly amongst tourists travelling to South America. Use is also suggested to have increased in Europe and the US amongst Western 'neoShamans' 6 . The psychedelic state induced by ayahuasca often makes users reflect on personal con-cerns and memories 7 and produces intense emotions 8 . These effects are highly valued by ayahuasca users who characterize the drug experience as similar to a psychotherapeutic intervention 7 . Emerging scientific evidence complements the users' view of ayahuasca as therapeutic: a small, uncontrolled pilot study found that symptoms of depression reduced following consumption of the brew 9 . There is further suggestion of its use in the treatment of addiction 10–12 . If the drug is to represent an important treatment, however, it is critical that its short and long-term effects are investigated and safety well established. Several observational studies have examined the long-term effects of regular ayahuasca use in the religious context. In this work, long-term ayahuasca use has not been found to impact on cognitive ability, produce addiction or worsen mental health problems 10,13–16

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