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Adverse effects of ayahuasca: Results from the Global Ayahuasca Survey.

José Carlos Bouso, Óscar Andión, Jerome Sarris, Milan Scheidegger, Luís Fernando Tófoli, Emérita Sátiro Opaleye, Violeta Schubert, Daniel Perkins

PLOS global public health 2022 DOI: 10.1371/journal.pgph.0000438 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional survey Peer reviewed
Sample size 10,836
Population Ayahuasca users from more than 50 countries who completed an online survey
Intervention Ayahuasca
Topics Ayahuasca
Keywords Psychedelics Mental health Spiritual experiences Adverse effects
Citations 115
Key findings Acute physical adverse effects were reported by 69.9% of ayahuasca users, and mental health adverse effects by 55.9%, but most users considered these effects part of a positive growth process and continued attending ceremonies.

Abstract

Ayahuasca is a plant-based decoction native to Amazonia, where it has a long history of use in traditional medicine. Contemporary ritual use of ayahuasca has been expanding throughout the world for mental health purposes, and for spiritual and personal growth. Although researchers have been conducting clinical trials and observational studies reporting medical and psychological benefits, most of these do not report ayahuasca's immediate or medium-term adverse effects, so these are underrepresented in the literature. With the expansion of ayahuasca ceremonies from their traditional contexts to countries around the world, there is an important public health question regarding the risk/benefit balance of its use. We used data from an online Global Ayahuasca Survey (n = 10,836) collected between 2017 and 2019 involving participants from more than 50 countries. Principal component analysis was performed to assess group effects. Logistic regression analysis was performed to test for adverse effects associated with history of ayahuasca use, clinical, context of use and spiritual effect variables. Acute physical health adverse effects (primarily vomiting) were reported by 69.9% of the sample, with 2.3% reporting the need for subsequent medical attention. Adverse mental health effects in the weeks or months following consumption were reported by 55.9% of the sample, however, around 88% considered such mental health effects as part of a positive process of growth or integration. Around 12% sought professional support for these effects. Physical adverse effects were related to older age at initial use of ayahuasca, having a physical health condition, higher lifetime and last year ayahuasca use, having a previous substance use disorder diagnosis, and taking ayahuasca in a non-supervised context. Mental health adverse effects were positively associated with anxiety disorders; physical health conditions; and the strength of the acute spiritual experience; and negatively associated with consumption in religious settings. While there is a high rate of adverse physical effects and challenging psychological effects from using ayahuasca, they are not generally severe, and most ayahuasca ceremony attendees continue to attend ceremonies, suggesting they perceive the benefits as outweighing any adverse effects. Knowing what variables might predict eventual adverse effects may serve in screening of, or providing additional support for, vulnerable subjects. Improved understanding of the ayahuasca risk/benefit balance can also assist policy makers in decisions regarding potential regulation and public health responses.

Comparable studies

Other cross-sectional and survey studies on ayahuasca, most cited first.

Study Year Design Participants
Survey of subjective "God encounter experiences": Comparisons among naturally occurring experiences and those occasioned by the classic psychedelics psilocybin, LSD, ayahuasca, or DMT Adults reporting a single most memorable God encounter experience, either nondrug or... 2019 Cross-sectional survey n = 4,285
Ayahuasca in adolescence: a preliminary psychiatric assessment. Adolescents from a Brazilian ayahuasca sect and matched controls 2005 Controlled cross-sectional study n = 80
Psychological and neuropsychological assessment of regular hoasca users. Regular hoasca users from a U.S. branch of União do Vegetal and matched non-user controls 2016 Cross-sectional study n = 57
Indoleamine Hallucinogens in Cluster Headache: Results of the Clusterbusters Medication Use Survey People with cluster headache 2015 Cross-sectional survey n = 496
Assessment of Alcohol and Tobacco Use Disorders Among Religious Users of Ayahuasca Brazilian members of União do Vegetal (UDV) aged 18 and older 2018 Observational cross-sectional study with normative comparison n = 1,947

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