Chapter Seven - Excerpt from The Psychedelic Renaissance - 3rd Edition
An early draft of the next chapter from my forthcoming textbook on psychedelics. To be published by Aeon Books in September 2025. Enjoy!
CHAPTER 7
Modern Uses of Natural Plant and Fungi Psychedelics
If we are to progress, we must break away from our restrictive Western view of what functions and what doesn’t when it comes to improving our individual and societal health. The apparently instinctive model of unbridled greed simply does not work, and it will kill us pretty soon, unless we experience a global transcendence of our current level of consciousness — not necessarily spiritually but, certainly, socially and behaviourally, as Daniel Pinchbeck describes in his 2017 book, How Soon is Now?1. This need to go beyond current attitudes to health, politics and the organisation of society is no longer a fringe point of view held by the bearded and beaded, but, in recent years, has rather become the talk of mainstream politics2. Our exponential destruction of the world’s ecosystems, since the advent of agriculture, and particularly through industrialization in the last 150, is shooting us in our Nike Air clad feet, when what we really need to do is re-learn how to slip off our sandals and start feeling the earth between our toes again.
We know for certain that the sacramental use of psychedelic mushrooms has been going strong in the last 5,000 years of recorded human history and there is no reason to believe it hasn’t played an equally central role in human life since the dawn of humans themselves. Indeed, if the graph is extrapolated backwards from 5,000 years ago, there is plenty of evidence to suggest sacrificial mushroom consumption was more, rather than less, widespread the further back one goes.
Wasson All the Fuss About?
Perhaps an even more influential event than Huxley’s 1953 excursion into his ‘archipelagos of the mind’ on mescaline is Gordon Wasson’s 1957 excursion to Mexico in search of the psilocybin mushroom. Wasson’s trip, which subsequently piqued Timothy Leary’s interest in mushrooms, truly deserves a large part of the credit for kick-starting the massive cultural changes of the 1960s.
The American Robert Gordon Wasson was, believe it or not, yet another character from psychedelic history with a wide range of esoteric interests. And, like many others in the field, once the subject of psychedelic drugs seduced him, they changed the direction of his life thereafter. He was initially a banker, the vice president of J. P. Morgan & Co., no less, who developed a sideline interest in mushrooms through his Russian wife, who was, incidentally, a child psychiatrist.
In 1955 the pair travelled to Mexico to carry out field research on the cultural use of fungi and discovered the locals using what Wasson referred to as ‘magic mushrooms’ (Psilocybe mexicana) as part of their spiritual practice (not to be confused with P. semilanceata). Wasson became the first known Western outsider to participate in a psilocybin mushroom ceremony when he was given the sacrament by the Mazatec curandera (local shaman) Maria Sabina. When Wasson returned to the USA and published his results for Life magazine in 1957, along with pictures taken by the photographer Allan Richardson, the event became the first wide-scale mention of psychedelic drugs to occur in contemporary Western consciousness and it led to a wide interest in the subject4.
Picture HERE:
Wasson’s feature in Life Magazine in 1957 brought ‘magic mushrooms’ into the living rooms of the Western world for the first time.
Wasson went on to collect many other specimens of different mushrooms, and also psychedelic plants such as Salvia divinorum. It was Wasson’s mushroom specimens that Albert Hofmann used to first identify and synthesize the active psychedelic compound psilocybin. In Wasson’s wake many others besides Timothy Leary followed his path to Mexico, and, by 1967, when the psychedelic revolution in the West was in full swing, Maria Sabina had reluctantly become something of a local celebratory. Visitors included Bob Dylan and Mick Jagger, travelling to meet Sabina and pay their respects. Albert Hofmann also visited Maria Sabina and gave her some of the newly developed Sandoz psilocybin pills to see what she thought of the synthetic alternative. She admitted that the little yellow pills did indeed appear to contain some of the spirit of the mushroom. But Sabina later came to regret allowing herself to be thrust into the limelight, saying that the foreign visitors, coming in their droves, had ruined the power of her holy sacrament. She also felt betrayed by Wasson, who had promised not to reveal her identity, but in doing so not only opened the doors to unwanted drug tourism, but also brought great stress upon Sabina and her family5.
Wasson’s continued interest in the subject led to him making claims that mushroom cults were widespread throughout all parts of the world and that the Amanita muscaria (fly agaric) mushroom was the source of the mysterious Vedic soma — a belief that has been supported by many in the psychedelic community until very recently, though there are now some notable challenges to his ideas.
Mazatec Magic Mushroom Morning Mayhem
There is reliable archaeological evidence that the indigenous people of South and Central America have used psilocybin mushrooms for thousands of years. Mushroom shaped statues and paintings have been discovered in ancient tombs, which supports the view that the use of the mushroom for religious purposes is older than the Spanish conquistadors that tried so hard to eradicate it.
In Guatemala, mushroom-shaped stones have been discovered, which point towards a sacramental use by the ancient Mayans. As I student I travelled with two friends to Guatemala and, after sneaking past the nonchalant pot-smoking guards, we spent the night on the top of the tallest temple of Tikal after everyone else had left. At dawn we had the place to ourselves, looking down from our position above the canopy of the trees. We marvelled as the sky lit up the jungle and surrounded us with coloured birds — only to have our solitude destroyed by a busload of tourists shipped in like a colonial invasion, hoping to be the first people on the temple to enjoy the daybreak after having had a nice night’s sleep in their hotels. What they thought when they climbed the steps to find three straggly hippies already there sitting strumming their guitars I do not know.
Psychedelic mushrooms are ubiquitous throughout Central and South America, and were well known to the Aztecs at the time of the Spanish offensive. The ancient pagan practices were viewed as deeply blasphemous and well worth eradicating by the wise and knowledgeable Christians, who did not share the Aztec’s enthusiasm for a fungal based approach to altered states of consciousness as a channel to communicate with the divine.
In 1656, Dr. Francisco Hernandez had this to say of the hallucinogenic mushrooms: ‘When eaten they cause a madness of which the symptom is uncontrollable laughter and all kinds of visions, such as wars and demons’. This grated with the European version of spirituality, in which the orthodox Christian approach to religion does not allow for followers to actually experience God first hand. Rather, that privilege is only for the priests, whose job it is to then transmit the message to the flock. In stark contrast, in the shamanic use of communal psychedelic ceremonies, the whole group of worshippers take part in the ritual and directly experience their gods.
Despite the efforts of the conquistadors, the practice of mushroom ceremonies was not eradicated entirely. Rather it was pushed into secrecy, surviving only in the most remote mountainous parts of the continent. Over time, in certain places Christian beliefs were embraced, adopted and incorporated into the mushroom ceremonies until we begin to see a peculiar crossover between pagan religion and Christianity. And where the practice of spiritual Mexican mushroom use persists today, we still see this hybrid Christian-pagan ceremony. Some of the cults today believe their mushrooms were a gift from the Christian God, and that the mushrooms grew from the earth in the spots where Christ’s tears fell as he hung on the cross:
We wait for our father, we wait for our Father,
We wait for Christ.
With calmness, with care,
Man of breast milk, man of dew,
Fresh man, tender man,
And there I give account, the mushroom says,
Face to face, before Your glory, the mushroom says,
Yes, Jesus Christ says, there I have an answer.6
Over Fields we go, Laughing all the Way . . .
We will now travel, astrally, from the steamy rainforests of Central America to the frozen wastes of Siberia. During the winter solstice, here we find a fascinating seasonal character, dressed in red with white plumage, a magical being with the power to fly. No, it’s not Santa, it’s the Amanita muscaria mushroom. Or are they in fact the same thing?
The role of the Amanita muscaria mushroom — or ‘fly agaric’, so called for its capacity to attract flies (it is used as a bait/insecticide in many countries) — has become the classic symbol of psychedelia, folklore and fantasy alike. It is the fat, bright red, spotted white toadstool that appears in children’s stories. It also has psychedelic qualities as a result of the active components muscimol and ibotenic acid, which can cause nausea, drowsiness and low blood pressure as a result of its cholinergic effects. Despite its vivid ‘warning’ colour, the toxicity, as well as the psychedelic effects of amanita, are not too much to write home about. Certainly, though it can cause harm if not used correctly (as can staplers and chilli peppers), reported fatalities are rare indeed. Drying or boiling the mushroom can reduce the toxicity, as can drinking the urine of someone who has eaten it, in comparison to eating the raw mushroom.
Picture HERE:
The Amanita muscaria (Fly Agaric) mushroom has become the prototypical image of magical psychedelic fungus. The red with white spots mushroom can be found in all kinds of objects, symbolizing a playful magical character.
Use of A. muscaria for spiritual purposes is well known throughout northern Europe, and noted by many scholars, particularly James Arthur, whose book Mushrooms and Mankind: The Impact of Mushrooms on Human Consciousness and Religion, is well worth a read7. Siberia is particularly famed for its use of A. muscaria. There is a rich shamanistic tradition attached to the use of the mushroom, which still endures today. The Siberian shamans go out in search of their deity dressed in red and white to pay homage to their hunted prize, filling their sacks with the fruits when they find them growing at the base of pine, spruce, fir, birch and cedar trees. Siberian shamans believe these trees point upwards into the heavens, towards the Pole Star, and that eating the flesh of the Amanita muscaria mushroom is equivalent to climbing the trees to their summit and reaching the sky gods beyond the stars.
Reindeers feature heavily in the lives of these Siberians, which further ties in with the Santa analogies. The reindeer themselves also enjoy spontaneously searching for and eating the spotted mushroom, drinking each other’s or even the human urine of those who have consumed the fruit8. Muscimol, the more psychoactive and also the safest of the two active ingredients, is excreted virtually unchanged in the urine and so effective is it at attracting reindeer that Siberian tribesmen will sometimes bottle post-mushroom human or reindeer urine and use it to attract back those beasts that have strayed from the vicinity.
Flying through the sky in a chariot pulled by reindeers, dressed in red, following a star that sits on top of an evergreen tree. It seems that when Coca Cola ‘invented’ Christmas in their 20th century advertising campaign, they knew more than a little about the shamans of Siberia.
Objections to the Mushroom Cult
R. Gordon Wasson made much of the Siberian mushroom stories, as well as believing the Amanita muscaria mushroom was the legendary soma of the pre-Hindu texts. He described a worldwide ancient mushroom cult and his ideas gained great popularity in the 1960s. But, more recently, scholars have begun to come up with opposing views. Certainly, in terms of A. muscaria being the mythical product soma, it seems an unlikely candidate simply because it is not strong enough as a psychedelic drug to produce the kind of mental states described in the Rig Vedas — unless (and this is quite possible, of course) those ancient Aryans knew of some tremendous purification techniques which have since been lost in the midst of time.
The British academic Andy Letcher goes a step further, challenging the view (long held, since the sixties) about the widespread use of magic mushrooms in the United Kingdom. The sixties gave birth to a myriad of stories about pixies, druids and pagans from these isles, including many theories about the role mushrooms played in the building of and worshipping at Stonehenge and other ancient monuments. Despite the wishful thinking of many people, Andy Letcher argues very persuasively in his book Shroom that there is no evidence — either archeologically or, more importantly, culturally — to support the idea that magic mushrooms played any part whatsoever in British history until very recently9. Even as recently as Victorian times, the mention of liberty caps was rare, with most mushrooms being understood simply as either edible or poisonous. Some conspiracy theorists would argue that this is because of the Christian anti-psychedelic propaganda of the Middle Ages and beyond, to effectively erase such data from the collective knowledge. But, as Letcher says, this has not been the case in South America, where, despite the extreme efforts of the conquistadors, the mushroom cults survived and continued. Letcher’s argument about the informal cultural recording of such information is strong. We British are fantastic at preserving our cultural heritage through folk songs and stories, even in the face of powerful political or dogmatic religious forces that try and oppress such traditions. Yet there is no mention of magic mushrooms anywhere in a rich back catalogue of folk songs, drama and art from this country. Nothing, not a single psychedelic sausage. Shakespeare doesn’t touch on it and nor does anyone else. Personally, I am inclined to share Letcher’s opinion that this cultural omission from British history would be unfeasible if mushrooms were out there and people were indeed taking them.
On the other hand, (and I put this to Letcher when we invited him to talk at the Breaking Convention conference in 2011), how on earth did so many generations of Welsh hill walkers possibly miss the liberty cap mushrooms? It is impossible to walk more than 20 feet across the countryside in October and November without crushing them underfoot. Letcher wonders whether in fact the liberty cap mushroom is a relatively recent addition to our natural habitat, relying, as they do, on a particular climate and lots of rich grassland that has only been available in abundance since the 17th century tradition of large scale deforestation, both for the practice of farming and in order to build fleets of wooden ships to defeat Spanish armadas10.
Whenever the mushrooms arrived in Britain, what is certain is that since the sixties it has been very difficult to convince the psychedelic community of any point of view other than one that assumes the whole world revolves around psychedelic drugs.
The Long-standing Use of Peyote Cacti
We now look back across to the other side of the world to meet a small green cactus about which there is no dispute regarding the role it has played in the cultural development of southern Texas and Mexico. The peyote cactus is a slow-growing, spineless green button that peppers the desert scrub. Archaeological finds of the cactus, at least 5,000 years old, have confirmed that the native people of America — particularly the Huichol of Mexico — have used this plant as a tool for spiritual worship just as long as any other recorded psychedelic on the planet — despite its incredibly bitter taste!11
The cactus’ active component, mescaline, produces a long-lasting and intensely sustained psychedelic experience accompanied by rich visual phenomena that encourage spiritual searching. It provides a deep connectivity to the Earth for those that use it as part of their ceremonial worship, and it is a powerful unifying force for the community. Not only does it cause no demonstrable problems for the community, but recent evidence demonstrates that those tribes that use peyote have better general mental health than those that do not use the cactus. In particular, peyote-using tribes have reduced rates of alcohol dependency, which fits with our knowledge about the important role to be played by psychedelics as psychopharmacological tools to combat addictions. No doubt the anti-alcohol effect is partly attributable to the intense cohesive effect of the traditional cactus-taking ceremonies, which help the native users to resist the tide of Western trappings, of which alcohol is one of the more destructive elements12.
As in South and Central America’s traditional pagan use of the psilocybin mushrooms, peyote ceremonies have also now developed to incorporate aspects of Christian tradition alongside the ancient beliefs. This is exemplified by this quote from Quanah Parker: ‘The white man goes into his church and talks about Jesus. The Indian goes into his tepee and talks with Jesus.’13
Parker, born in 1852, was an important figure in the history of the Native American people as he was arguably the most successful at demonstrating an ability to adapt to the changing face of white persecution. For many Native Americans, this means he sold out, but, nevertheless, he remains respected by both sides. Parker was a firm believer in the traditional use of peyote after it was used to heal his wounds when a bull gored him. He was a founder of the Native American Church, which combined Christian and ancient religious elements and kept peyote at the centre of the worship. While mescaline is a Schedule-One controlled substance in the USA and elsewhere, even today Native American members of the church can legally use peyote as part of their practice.
Ibogaine: Nature’s Anti-addiction Plant
In the West African countries of the Democratic Republic of Congo and Gabon, many people follow the Bwiti spiritual practice. It is a form of religion in which the root bark of the Tabernanthe iboga plant is consumed for spiritual purposes14. The plant contains the drug ibogaine, which produces an intense psychedelic high with an accompanying strong dissociative effect, so users typically report visual hallucinations as well as out of body experiences. This mixed bag of psychoactive effects arises from the complex psychopharmacological profile of ibogaine.
The drug behaves as a partial 5-HT2A agonist — as does LSD, DMT and psilocybin — which explains its classical psychedelic effects. But it also acts to some extent as an NMDA-antagonist (like ketamine) and a kappa-opioid agonist (like Salvia divinorum), which explains its dissociative effects. The Bwiti incorporates the subsequent extremely dreamlike qualities of the experience into their functional use of the plant.
Picture HERE:
The West African use of ibogaine produces a trance state in which users meet with their spiritual ancestors.
Used as part of a community ceremony led by an N’ganga, who occupies a shamanistic role of priest and respected village elder, the ceremonies have an ostensibly healing purpose in which individuals may seek to communicate with the dead, ask questions of the spirits of ancestors or seek the answers to meaningful personal questions about their health or future. The root bark is chewed or eaten in large quantities and the experience happens at night, accompanied by elaborate and colourful rituals of drumming, designed to enhance the altered state of consciousness. Many users also experience vomiting and nausea.
The Bwiti use the ibogaine ceremonies as an important rite of passage and it is a hugely significant moment when young men take the plant for the first time. As with other non-Western psychedelic shamanistic ceremonies, in many Bwiti tribes there is a mixture of Christian and more archaic spiritual practice woven into the ceremony.
What makes ibogaine stand out as a therapeutic tool, one that has attracted the attention of the West, is its capacity for treating addictions. It is uncertain how long the West Africans have been using ibogaine as a sacramental tool for their religious purposes, but the anti-addiction qualities have been known to the Western world for around 150 years. The drug appears to be effective at not only relieving the subjective unpleasant effects of withdrawal from dependent drugs such as alcohol and opiates, but also for producing a reduction in the long-term craving and reducing habitual, repetitive and obsessional behaviours that often accompany substance dependence. There is good anecdotal and epidemiological evidence for this, supported by the low rates of alcohol dependence by the Bwiti tribe people. Formal clinical trials are underway and will be described in the next chapter. For a vivid and personal account of ibogaine therapy used to treat a person with opiate dependence, see the work of film maker David Graham Scott15,16.
Using ibogaine has been of tremendous importance in improving and sustaining community cohesion for the Bwiti. Its use has been credited as having helped Gabon and the Democratic Republic of Congo resist external Western influences such as widespread drug and alcohol use and consumerism. This has got to be a good thing, if only we in the West could recognise it.
At the turn of the 21st century, the FDA approved phase 1 studies in humans, which is the first step on the log road to seeing ibogaine becoming an approved medicine to treat addictions17. Since then, there has been a plethora of research with ibogaine, including two randomized, double-blind, controlled clinical trials, one double-blind controlled clinical trial, 17 open-label studies or case series (including observational or retrospective studies), three case reports, and one retrospective survey. This research is excellently summarised in a systematic review by Köck et al (2022)18, who concluded that in respect of ibogaine:
“Treatment of substance use disorders (SUDs) and persisting comorbidities requires innovative treatment approaches. Rapid-onset therapies such as the application of ibogaine may offer novel treatment opportunities for specific individuals. Rigorous study designs within medical settings are necessary to warrant safe application, monitoring, and, possibly, medical intervention.”
The Eerie Effects of the Diviner’s Sage: Salvia Divinorum
Those who know Salvia divinorum always refer to it in the female form, so I shall pay the plant the same respect. She grows in the forests of Oaxaca, Mexico, where she has been used for thousands of years by the Mazatec people as a tool for spiritual worship; and still is today19.
She exerts her effects via the compound Salvinorin A, a potent kappa-opioid agonist, that, like ibogaine, causes dissociative states of altered consciousness. She is very low in physiological toxicity and very high amounts can be consumed. In her native country of use, she is almost always eaten or drunk, either by making a tea from the crushed and infused leaves (about 50 are required) or chewed in great rolled up bundles of leaves like a massive green cigar such that the psychoactive effects come on slowly and build insidiously over time. But when consumed in the West (bought most often by teenage hedonists on the internet), kids usually choose to smoke a purified extract of the plant through a bong, which produces an immediate and intense high.
Salvia is held in high esteem by the Mazatec shamans, who believe she is an incarnation of the Virgin Mary (more of that ubiquitous Christian influence creeping in here). The psychoactive effect is often trance-like. Some describe it as eerie or spooky, with peculiar visual distortions. She is used in order to produce a visionary state which may be useful for healing of specific ailments or as a tool to help the user gain a greater insight into whatever personal questions they choose to ask her when they start on their journey to the realms of insight opened up by consuming the plant.
A particularly well-known effect is the graceful afterglow that users experience after the more intense psychedelic effects have worn off, which has led some researchers to postulate whether salvia might have uses as an antidepressant — a clinical application that has also been explored for the dissociative psychedelic ketamine. More about this in coming chapters.
Alongside salvia’s psychedelic effects, the Mazatecan people also use the salvia plant for healing many physical conditions, including menstrual cramps, insect bites, and eczema20. And recent biochemical research has explored salvia’s role as an analgesic21 and anti-inflammatory22 agent at the cellular and molecular level. Whilst many people enjoy and benefit from the psychedelic drug effects of salvia, there are also efforts being focused on discovering a new analogue of salvia that will induce analgesia and reduce inflammation but without the psychedelic23. This could greatly increase the accessibility of salvia’s potential to a broader population of patients who could benefit. But not everyone agrees with the concept of removing the psychoactivity from psychedelic drugs. This somewhat divisive issue will be discussed in greater detail later in the book.
Picture HERE:
Katherine Harrison, who has done a lot of good work in the field to bring Salvia Divinorum’s indigenous uses to the world’s attention. Pictured here in Greenwich, London, when she came to speak at the Breaking Convention gathering in 2015
The Sacred Vine: Ayahuasca
Interest in this mysterious South American brew, which is found throughout the Amazonian basin in Columbia, Peru and Brazil, has grown exponentially, like a jungle vine, in the last thirty years. The use of it now represents a major subject of research for university departments throughout the world. Ayahuasca studies encompass elements from chemistry, shamanism, sociology and ecology, medicine and legal issues. At our Breaking Convention psychedelic research conference in 2011, we dedicated an entire day’s parallel track presentations to the subject, knowing how popular the subject had become. All the talks on ayahuasca were packed to the rafters, with delegates spilling out of the rooms and sitting in the corridors, such was the demand to learn more about this vine.
Picture HERE:
Ayahuasca brewing in its natural habitat. A specified mixture of MAOI and DMT containing plants; combined in a recipe, which the curandero’s were handed-down to the curanderos by the plant spirits themselves.
Interest in ayahuasca continues to grow, with publications on the subject weaving like a jungle through the academic and popular press. In recent years, there has been a significant industry of tourism to these countries for those soul-searching psychonauts inclined to taste its glories in its natural habitat. There are passionate opinions on both sides of the debate about whether such drug tourism is a good or bad thing. Many notable Hollywood celebrities have trekked to the jungles of South America (accompanied, no doubt, by large crews of bearers to carry their Louis Vuitton bags) and returned to tweet their experiences to the masses. Indeed, ‘Ayahuascaphilia’ has now reached such a jungle fever peak that there is something of a split occurring within the psychedelic community — much like the one that occurred when LSD entered the popular scene in the mid-1960s. Back then the question on the lips of anyone who was anyone was Are You Experienced or Not? There are those who have taken ayahuasca and rave about it, like born-again enlightenment bunnies, and those who (because they have not yet had the experience) don’t. The issue is becoming somewhat divisive. Then when one throws in the growing negative mainstream media reports — which must only be taken with a hefty pinch of shamanic snuff — about spiritually-absent drug tourists steam-rolling into the Amazon and leaving their physical and psychological litter behind, whilst unscrupulous pseudo-shamans take liberties with, at best your girlfriend and your money or, at worst, your life, we have ourselves a heady mix of controversy.
These conflicts are not new to psychedelia, of course. In the sixties stories abound about how “if only all the world leaders could just take LSD, there would be no more wars” For the 90s substitute ‘Ecstasy’ and for the early decades of the 21st century we can now say ‘Ayahuasca’. There has always been a vying for spiritual authenticity when it comes to mass psychedelic use; one guru is kosher and another is a fraud. And there will always be the ‘early pioneers’ who so keenly pronounce that their acid back then was better than it is now and how their trip to San Francisco / the Amazon / Esalen / India was the real deal; whilst lamenting how sad they feel to see so many people flocking there now. Let’s not forget that when it comes to being the first to trample through Amazonian jungles, whose magic is defined by their isolation from Western influence, such trail blazers are, by that very definition, also culture crushers.
One must not judge too harshly the rights or wrongs of global ayahuasca experiences and the growing commercialization that is emerging. One person’s Western exploitation is another person’s livelihood, after all. And there is a now a significant body of knowledge – with a recent large scale metanalyses review of research - that ayahuasca, for many people, provides a positive experience and could be of great benefit to people’s mental and physical health24. What is clear, however, is that safety and, something I feel passionately about, giving psychedelic users a good name, is paramount to the wider issue of how these chemicals and plants are going to be assimilated into the generations of the future. There is much good in ayahuasca and its potential for healing — both societal and clinical.
But What is It All About?
Ayahuasca (which means variously ‘vine of the soul’ or ‘vine of the spirit’) is the name for a psychedelic brew made from several key ingredients, the main constituents being at least one plant containing DMT and at least one plant containing the essential monoamine oxidase inhibitors (MAOI) required to allow the DMT to become psychoactive when consumed orally25.
Usually, the MAOI plant is that of the Banisteriopsis caapi vine, which contains, among other chemicals, harmine and harmaline. The DMT commonly comes from the Psychotria viridis (or chacruna) plant, although a number of alternative plant sources of DMT may be used, including Diplopterys cabrerana (or chaliponga).
Traditionally, the plants are chopped and ground, then boiled together by a shaman with intimate knowledge of the local jungle flora. Icaros are sung by the people processing the plants, and over the boiling mixture. There is wide variation in the exact ingredients. The leaves, flowers and bark of many other plants may be added to the brew, each with their own idiosyncratic and purposeful intent to provide particular effects. Contemporary scientists marvel at how the traditional shaman could have possibly known which of the many thousands of species of plants combine to produce the specific desired effects of the brew. The shamans say the spirits themselves told them how to make the brew. It seems there are many such revelations arising from traditional cultures that could teach us in the West a lot, if only we could open our eyes to the fact that just because it does not come from ‘big pharma’ doesn’t mean it isn’t important.
The Ayahuasca Ceremony
Ayahuasca is traditionally taken as part of a religious ceremony. The rite is led by the shaman, who sings songs periodically to enhance and guide the travellers on their inner journeys during which the consumer will engage with aspects of their personal, collective and communal spiritual awareness and pass through different dimensions of a spiritual reality. The intensity of the psychedelic experience is described by many as ‘simply colossal’, something that is no doubt influenced by the set and setting engendered by a necessary visit to a strange foreign country and a trek through the rainforest to where it takes place.
Ceremonies often involve several separate sittings, in which the drug is taken over the course of many days, and they also incorporate many non-drug rituals as part of the process. There is a strong element of purging — both mentally and physically — and users routinely spend many hours vomiting or passing diarrhoea in the early stages of the intoxication with the drug, all of which contributes to the overall intensity of the experience26.
The purging component is worthy of a closer look. Of course, many ayahuasca users see the purging as an essential part of the experience, and it has taken on the significance of ‘letting go of negative energy’ through diarrhoea and vomiting. Or could it simply be seen as an irritating side effect, an emetic aspect of the drugs being taken, that, ideally, one would prefer not to have? Could the global acceptance of purging even be seen as an example of cultural appropriation? If the traditional ayahuasca shaman had the psychopharmacological knowledge to remove the sickness and diarrhoea component from the experience, would they not have done so? Or, similarly, if you – as a Westerner being offered ayahuasca – were provided with the choice of ‘vomit-inducing’ or ‘vomit-free’ ayahuasca, which would you choose? True, some people would opt to keep the vomiting in there, as this chimes with their belief that to vomit copiously is to remove negative energy. But many others (most, I would postulate), faced with a non-emetic alternative, would say: “Oh, vomit-free please!” In my opinion, we need to be careful when accepting all aspects of indigenous uses of psychedelics are right and perfect. It could be that all cultures could learn from one another a few useful tips.
Participants will frequently encounter entities (a phenomenon also seen when DMT is smoked or injected), often in the form of jungle animals representing spiritual ancestors, who provide messages and instructions for the journeyer.
Ayahuasca Through the Ages
Ayahuasca was first brought to the attention of the Western world in the 1950s by the explorer and botanist Richard Evan Shultes, who is also credited as being the father of modern ethnobotany for his adventures with psychedelic plants and fungi amongst indigenous populations of the world.
The traditional practice of ayahuasca ceremonies amongst Amazonians has most likely been taking place for thousands of years. It was certainly known to the conquistadors of the 16th century who, just as they did with the mushroom ceremonies, dismissed and tried to eradicate the practice of ayahuasca use, believing the excited psychedelic states induced by the brew were akin to fornicating with the devil. Such was the skewed wisdom of those culturally pure Catholic liberators of old.
William S. Burroughs famously travelled to South America in the 1950s in search of the plant, immortalised in The Yage Letters27. Similarly, it was the search for the magical properties of the sacred vine that set Terence McKenna on his pathway to psychedelic notoriety in the mid-1970s when he tracked through the jungle with his brother Dennis, resulting in his book True Hallucination28. Dennis also describes those jungle moments in his own more recent book, Brotherhood of the Screaming Abyss: My Life with Terence McKenna29. Those South American experiences with ayahuasca and psilocybin mushrooms led Terence to discover his ‘novelty theory’, which holds that many connected strands of the universe converge together towards an epoch ‘eventually reaching a singularity of infinite complexity on the winter solstice in 2012, at which point anything and everything imaginable will occur simultaneously’.
Picture HERE:
Walking in, early morning, to present our lectures at the Beyond Psychedelics conference, Prague, September 2016. I shared a house with Dave Luke, Robin-Carhart-Harris, Rick Doblin and Dennis McKenna. Plus, a spare room for the entities.
When the first edition of the Psychedelic Renaissance was published in early 2012, it remained to be seen whether McKenna was right, and humanity and the multiverse were going to melt into a vortex of psychedelic apocalypse on 21st December 2012. But here we are in 2025 and, as far as I can tell, that hasn’t happened yet. Some (of the more hardcore believers) in the psychedelic community might still maintain that McKenna was correct, and that some vitally important event did indeed happen that day, about which we are yet to experience the manifestation of its meaning. Whatever.
Ayahuasca in Modern Times
As described earlier, many Westerners have well and truly latched on to the idea that ayahuasca represents yet another vital mind-tool worthy of exploring, and are now flocking into the Amazon basin, such is the righteous boredom with our modern TV living. But the growth of interest in ayahuasca has also blossomed amongst indigenous people in the Amazonian regions. And as with the Native American church’s claim to use peyote in their ceremonies as an example of the right for religious freedom, several ayahuasca-using churches have emerged.
The Brazilian Santo Daime church was founded in the 1930s in the Amazonian state of Acre by Raimundo Irineu Serra. Serra first drank ayahuasca (or Daime) in the 1920s when he was working in the forest as a rubber tapper. He began conducting ceremonies for local people; using sung hymns alongside the ayahuasca medicine to provide a healing ceremony for sick people who could not otherwise access other medical treatments. The traditional Santo Daime ceremony — just like that of the contemporary Mazatec mushroom ceremonies — uses elements of Christianity, alongside more pagan imagery worshipping the natural elements and environment. The Santo Daime church has undergone several changes in the last 80 years, with different factions emerging and continuing alongside the original version.
Another religious organisation centred around the use of ayahuasca is the União do Vegetal (UDV), which translates as ‘union of the plants’. Founded in Brazil in 1961 by José Gabriel da Costa, it has since spread throughout the world with around 20,000 members. Both the Santo Daime church and UDV have been subject to legal battles with authorities over their entitlement to use ayahuasca legally as part of their religious practice. In 2006 the UDV, quite rightly, gained approval from the US courts to practice their religious use of ayahuasca, under the Religious Freedom Restoration Act. Both the UDV and the Santo Daime church continue to fight legal battles throughout the world regarding the legal status of ayahuasca, which has become an interesting subject of its own.
In the last ten years, numerous organisations and individuals have sprung up, not affiliated with either Santo Daime church or the UDV, providing ayahuasca experiences for people on every continent on the planet. And the global network of ayahuasca interest now has a fine home in the World Ayahuasca Conference, which met in 2014 in Ibiza, Brazil in 2016 and Spain in 2019. Organised by the ICEERS Foundatio30, these gatherings have provided the ayahuasca research and experiential community with a wonderful opportunity for multidisciplinary exploration of their work. Some exciting modern clinical projects with ayahuasca will be discussed later in the book.
DMT itself, in its pure form, is universally classified as a Class A and Schedule One substance. But, like the debate that continues to rage about psilocybin mushrooms, there remains considerable lack of clarity about whether plants that contain DMT are themselves illegal. After all, if they are that makes the waterways of the UK hotbeds of illegal drug cultivation, as Reed Canary Grass and the gardeners’ favourite Ribbon Grass both contain high concentrations of DMT, as do the brains of many mammals (including humans). In short, the concept that vessels that contain DMT can be outlawed is surreally self-defeating. Nevertheless, the law generally stands that, as with mushrooms, as soon as one makes efforts to prepare the DMT-containing plants in some way — for example, by drying or boiling them — one is seen to be heading towards an interest in DMT, and one gets busted.
In 2011 in the UK, we had a sad situation in which a modern-day shaman from the west of England, Peter Aziz, was jailed for possessing and supplying DMT. He was offering ayahuasca to his clients as part of his well-established 35-year practice and got caught foul of the law when importing plant products from South America. Inevitably, the authorities (and the media) took issue with his atypical (meaning non-industry-sanctioned) approach to pharmacology. Many others, me included, wrote in his support at the time, but to no avail31. His legal defence was that of religious freedom, but this rarely satisfies the judge. It seems Christianity’s cultural devouring of all in its path is not a phenomenon confined only to the 16th century.
Another of (the many) notable psychedelic pioneers who have become stuck on the wrong end of the law for their pursuits is the LSD chemist Leonard Pickard, who received two life sentences in year 2000 for his part in the production of tens of millions of hits of LSD. Leonard’s remarkable story will be discussed in greater detail later in the book.
Picture HERE:
Leonard Pickard in conversation with Rick Doblin, with Matt Johnson and others looking on. At the Vermont Psychedelic Society gathering in June 2022. More about Len later in the book.
Name and Shaman
We have already touched on the shady issue of cultural appropriation in respect of ‘false shamans’. In recent years, there has been an alarming increase in reports of such unscrupulous pseudo-shamans, whose practices are unsound, unethical and unsafe32,33. Some high-profile deaths have occurred and there are some stories of sexual assaults occurring in the context of ayahuasca ceremonies, around which participants are, by the very nature of the experience, at times highly vulnerable.
The worldwide ayahuasca communities are, in my opinion, working hard to organise themselves into a network of support to tackle these problems. It is essential that they do this if the practice, which, as I said earlier could be an important force for good in the world, is to be recognised predominantly for its merits rather than its pitfalls. All psychedelic drugs are powerful, but ayahuasca particularly so — especially when it is delivered in far-off places with little opportunity for visitors to seek redress or access support. Basic checks and measures, such as appropriate psychological and physical screening to identify vulnerable users, and greater safeguards (given the disposition of some shamans — who, like any other group, are wide ranging in their personal ethics), must be established. A deeper discussion about the importance of safeguarding in the psychedelic community will follow later in this book. For now, we are going to take a brief departure away from psychedelics and look into getting stoned instead.
The Weed: The Risks, Benefits, Culture and (brief) Chemistry of Cannabis
Moving away from ayahuasca and on to another popular substance: cannabis. This subject is vast and mostly beyond the scope of this book. But given how popular cannabis is, and how widely it is associated with the psychedelic drug using community, I felt it was worth a brief mention.
Pictures HERE:
Let’s not forget that the Western world’s demonization of cannabis is a relatively recent phenomenon. For thousands of years up until the early 20th century it was globally recognised as a valuable medicine.
The subject of cannabis encompasses so many strands of human developmental culture, from science and sociology to botany, law and medicine, that I will not begin to try and cover it all here. There are many other books I could recommend for the interested reader; going back as far as the mid-19th century for The Hasheesh Eater, some extremely psychedelic writing from Fitz Hugh Ludlow34, countless books from the 1960s and 1970s and a detailed and sensitive revisiting in the early 1990s by Harvard’s Lester Grinspoon and James Bakalar35. Another excellent contemporary tome about the green stuff is Julie Holland’s Pot36. Holland is a learned and wise researcher of all things psychedelic, but particularly cannabis and MDMA (she also edited a great book called Ecstasy: The Complete Guide a few years ago37. And there are even books about what a prohibition-free future in which cannabis is legally available through a regulated market in the UK might look like, from the talented Steve Rolles, of Bristol’s Transform drug policy activism group38.
However, despite so many changes to cannabis prohibition strategies around the world in recent years39 – especially in the USA, Germany, Malta, Canada, Portugal, Spain and elsewhere – our politicians in the UK remain steadfastly fixed on the rigid idea that ‘We will never be soft on drugs’, with no meaningful relaxation of UK domestic laws on cannabis possession. One can easily lose oneself in the smoky vapours of cannabis writings. Perhaps one ought to.
But is cannabis a psychedelic drug? My answer, of course, is… it can be sometimes psychedelic-like, for sure. However, when used at low doses (with high CBD and low THC) the psychedelic high is obviously far slighter than drugs like LSD, psilocybin or DMT. But at high doses (with high THC and low CBD) — as one tends to see with the many hydroponic strains of cannabis (‘skunk’) that most people in the West now smoke — the effects can be extremely strong, bordering on the same sense of altered state intensity induced by the classical psychedelics. Try an intravenous injection of pure THC and tell me that isn’t ‘psychedelic’. It is!
Cannabis’ link with humanity is an old as the hills. Queen Victoria was a big fan. She used the drug throughout her life to treat everything from labour pains to anxiety and epilepsy. Our knowledge of the medicinal uses for cannabis continues to grow every year40. With the tremendous revolution in medicinal cannabis research in the United States in the last fifteen years — with accompanied promising shifts in prohibition — the drug is increasingly carving a place in the pharmacopeia of modern clinical practice41. As with research on compounds like LSD and MDMA, research into cannabis has been difficult up until now because of restrictions on its use by doctors and scientists. Much of the research on its potential use in psychiatry revolves around the different constitutional chemicals found in the cannabis plant. There are many hundreds of active components in cannabis but two stand out as important. The first is delta-9 tetrahydrocannabinol, or THC, and the second is cannabidiol, or CBD. THC is generally considered to be the principal chemical that produces the psychoactive, more psychedelic, alerting and trippy effect of the high; and the CBD is the chemical that produces the more relaxed, bodily dreamy effect. Furthermore, whilst THC is illegal (in most places), CBD is legally available (in most places).
In the field of psychiatry, THC is generally thought to be a psychotogenic drug; that is, it can induce psychosis in people who have a genetic predisposition to the condition, and it ought to be avoided by those people with schizophrenia. I can say this with relative authority as I, like all psychiatrists, have seen many patienys with schizophrenia coming back into hospital as a direct result of relapse secondary to heavy cannabis use. This does not mean that I believe cannabis will cause schizophrenia in people who don’t have that genetic predisposition — if that were the case then we would see a great many more cases of schizophrenia than we do! After all, at least 10% of the population smokes the drug regularly and rates of enduring psychosis (schizophrenia) have remained relatively stable at around 1% all over the world since records began.
So, cannabis does not cause the condition to arise de novo, but it can certainly trigger an episode in those who already have it. In such cases, the most likely cause of the psychotic effects is the THC content of the plant. The cannabidiol on the other hand is another story. There is a general acceptance that CBD may have an antipsychotic effect42. Its presence in the natural form of cannabis (not the hydroponically grown and selectively bred strains of skunk weed, which are abnormally high in THC and low in CBD, but the pure ‘grass’, as grows in the ground of those countries where it is a native species) acts to balance the psychedelic effects of the THC and provide a calming effect. There are many researchers investigating whether CBD in its pure form can act as an anticonvulsant43, an antidepressant44 an antipsychotic45 or an anxiolytic drug46.This is an area that deserves a great deal more research.
In recent years we have seen an explosion of CBD products. What started online only, has now progressed to CBD being available in just about every pharmacy, supermarket and corner shop. The drug is being added to all sorts of products, from tablets and gummies and chewing gum to tinctures, ointments and oils47. I even saw some CBD dog shampoo for sale recently. In my opinion – and that of many others in the field – the majority of these products are a rip off, with little or no meaningful psychoactive component in the low dose low potency CBD products offered over the counter in the UK48. However, a lot of people swear by them, and with other good examples of a positive placebo effect, if it floats your boat, does little harm, and makes you feel better: Be my guest.
In the meantime, as a psychiatrist, and this is what I tell my patients who have decided to continue to smoke, I would say avoid skunk and move on to unadulterated weed or low-grade hashish, which would naturally have a higher CBD content, provide a more balanced smoke and have possible positive neuro-protective factors. But, as mentioned, if there is any personal or family history of psychosis it is best to avoid this drug altogether. Furthermore, in my experience clinically, most my patients with any degree of psychotic fragility usually do not need much reminding not to use cannabis; they readily state that weed scares the hell out of them at the best of times.
I am all-too-rapidly summarizing a vast amount of research and knowledge here, so do forgive me. Nevertheless, we shall briefly consider a few other aspects of cannabis in its context as a non-Western contemporary religious sacrament.
Indian Cannabis
Where does cannabis grow? The simple answer to this is that cannabis grows just about anywhere on the planet. It is one of the hardiest plants we know, which is why in the form of hemp it makes such good rope — and canvas, of course — from which the name derives. But cannabis is strongest, from a psychoactive point of view, in the hottest climates. It thrives throughout Asia: Thailand, Cambodia, India, Afghanistan, Pakistan, Nepal, Tibet, Mongolia, China, and so forth. It is also particularly strong in Africa, especially Malawi, where I went for my medical elective, just before graduating from med school in 1997, spending six weeks delivering babies in an isolated rural and badly resourced obstetric hospital. But that’s another story.
It is well known that the ancient Chinese shamans used cannabis as a vehicle to communicate with the other worlds, and its use by the Greek, Roman and Norse societies is also well documented. But it was particularly central to the development of the Indian culture. The 4,000-year-old Vedas describe the Hindus use of cannabis very clearly, unlike their vaguer descriptions of the sacramental substance soma, which may have been a variety of different compounds — including cannabis. Cannabis was clearly a ‘food of the gods’ and was also venerated by the early Sikhs as a powerful ally in battle. Like the Chinese, who documented the medicinal properties of the plant meticulously, cannabis has always played its part both as a healer of the sick in this world and as a sacramental substance for religious purposes.
Picture HERE:
The author sitting inside a wild cannabis bush playing the guitar in Nepal in 1990.
Cannabis is at the heart of Vedic India49. Modern Hindu holy people, sadhus, still take their cannabis traditionally in the form of charas — a handmade resin, sometimes mixed with datura leaves, which they smoke in a tall clay pipe called a chillum. Their presence all over India is abundant. Millions of people chose this lifestyle (including people from professional business backgrounds), that of a solitary wandering monk without possessions or home, on the final leg of the Hindu journey towards moksha (liberation).
Picture HERE:
Hindu tradition describes how the churning of the oceans created the elixir of life, which Shiva then purified with cannabis, which he created from his own body. Sounds like a positive endorsement to me.
One cannot turn a corner in India without seeing one of these old men (and sometimes women) adorned usually in rags, their skin smeared in white ash, contorted in impossible yoga poses and smoking a tall chillum. Smoking cannabis is a sign of devotion to Shiva for these Hindu holy people as they wander barefoot through their magnificent country from one holy site to another on their final pilgrimage (they get free travel on buses and trains), which ends at the banks of the Ganges in Varanasi. Their final opportunity to break the chain of reincarnation, if they haven’t achieved moksha through their lifetime of devotion, is to be burned in a funeral pyre and floated down the river. India is truly a country out of this world. I can highly recommend a long visit with no set date or ticket for return, as I did for seven months as a young man. I believe I may have left various parts of my consciousness there. One day I might return to find them.
East African and Jamaican Rastafarian Religion and Cannabis
The Rastafarian way of life arose in Jamaica in the 1930s, but has its roots in East Africa and particularly Ethiopia. The Jamaican political activist Marcus Garvey did much to propagate the cohesion of Jamaican fervour for collective organisation and is venerated by the Rastafarian religion, as is the late Emperor of Ethiopia, Haile Selassie I, whose previous name before becoming royalty, Ras Tafari, after which the movement was named50.
The hair is traditionally worn long in dreadlocks, and smoking cannabis is a powerful way of demonstrating dedication to god, or Jah. Cannabis is central to the life of Rastafarians, who are found all over the world. Whilst I was in northern Kenya a Rastafarian funeral was taking place, in which hundreds of devotees followed the procession and gathered at the graveside to smoke copious amounts of cannabis before throwing an eternity’s supply of joints and growing plants into the grave for their brother to use in the afterlife’s appreciation of Jah.
Picture HERE:
It is fabulous that in 2015 after many decades of lobbying, those practicing the Rastafarian religion in Jamaica were finally granted permission to legally use the plant as part of their sacramental practice.
Like other psychedelic drug ceremonies mentioned earlier, there is a mixture of Christianity and traditional African religions in the Rastafari religion. Parts of the Bible are quoted by Rastafarians to validate the spiritual acts of smoking cannabis:
Genesis: 3:18 ‘Thou shalt eat the herb of the field.’Proverbs: 15:17 ‘Better is a dinner of herb where love is, than a stalled ox and hatred therewith.’
It is fantastic news that Jamaica have recently – finally – decriminalised cannabis51.
The Weed is Here to Stay
With whatever lens one chooses to look at the influence of cannabis through the years, there is no getting away from its universally abundant presence. It always has been, and probably always will be, the gateway drug of choice for generations of young people. This is not because it has some unique pharmacological trait that makes it lead on to harder things (as the politicians who wish to maintain its prohibition may tell us) but, rather, because it carries the mantle of being such a mild, safe and harmless prohibited substance, it’s very prohibition naturally makes questioning teenagers ask: ‘What’s so bad about this stuff? The government made out that if I smoked this, I’d be out murdering my granny next week in order to sell her wedding ring for my next fix. What a load of rubbish! I’ve been lied to. Well, if they are lying to me about cannabis then they are probably lying about ecstasy and cocaine . . . and heroin . . . so I may as well try those too!’
This prevalent reaction against current drug laws, which is well documented, is worrying indeed. If the laws are seen to be so unfit for purpose that they encourage young people to try harder drugs, then surely it is time to review them. There will be more commentary on the issue of the illegalisation of cannabis later in the book.
This is What I tell My Teenage Patients About Cannabis
By far the most dangerous aspect of weed is that it is illegal and to be caught with it can ruin your life. The next riskiest element is that it causes a degree of chilled relaxedness, or viewed another way, demotivation and apathy — that is, after all, its raison d’être and why people take it. So, forget trying to pass your exams if you’re smoking a spliff on the way to school each day. Another important risk factor regarding cannabis is its potential to impair normal brain development in young people. Between the ages of around 12 years and 20 years old adolescents’ brains undergo an important process of ‘neuronal pruning’, in which many of the myriad connections between neurons (called dendrites) that formed during earlier childhood are selectively ‘cut back’ until the brain is left in its most high-functioning adult state. This is a vital process for healthy adult mental health and intellectual functioning. There is reasonable evidence that heavy and persistent cannabis use between 12 years and 18 years old can impair this process of pruning, which has been shown to result in potentially life-long intellectual impairments52. However, some studies dispute the significance of long-term cognitive impairment from cannabis use53. Because of the potential risk I sometimes find myself telling my child or teenage patients that if they insist on being lifelong heavy cannabis smokers (something I would advise against; chronic daily use of any drug is bound to be destabilizing over time, not to mention boring), then I recommend they at the very least give up for a few years in their adolescence and wait until they are in their 20s before recommencing their use. They will then give themselves the best possible adult brain to later expose at their will.
So, cannabis is certainly not entirely without its risks — whatever the pro-cannabis lobby might tell you. But for most adults, moderate to low dose cannabis use is generally relatively harmless. Indeed, it is the smoking aspect of cannabis consumption that can be the most harmful for heavy users. Respiratory disease is bound to occur eventually if one frequently drags the smoke of burning plant material into the body’s most sensitive and fragile tissue — the lungs. But this is the 21st century; there are now many excellent vaporisation options for cannabis consumption. Inhaling smoke is sooo last century, man. Pharmacology delivery methods have come a long way since the Middle Ages. Vape, man.
However, there are more serious risks for a small number of unfortunate people who use cannabis. For around 1% of people cannabis, like many other drugs, is a poison. That 1% is the same 1% that already have, or may be susceptible to developing, schizophrenia. For these people, it is best avoided. It is well recognized that cannabis use can trigger a psychotic episode in those unfortunate souls who carry the genetic and environmental risk factors for schizophrenia. The genetic risk factors are unavoidable; simply having a family member with a history of psychosis is all it takes. Environmental risk factors, such as stress induced by relationships, are multifarious and not at all specific to schizophrenia. Drug use is the most important of the non-genetic risk factors.
So, whilst cannabis is clearly a risk factor for acute psychoses in vulnerable people, (a phenomenon well-established in large systematic reviews)54 does cannabis cause schizophrenia in people who don’t have that pre-existing genetic vulnerability? As mentioned, it would seem not, or we would see especially high rates of schizophrenia amongst the Jamaicans in Jamaica, the Africans in Africa and the Asians in Asia — not to mention in the West — where cannabis is smoked copiously by large proportions of those populations. We do, incidentally, see increased rates of schizophrenia in black populations living in cities in the UK and other Western countries, but that is different, and due to the stress of social exclusion, poverty and frank racism — both from the wider community and from the medical profession who misconstrue their idiosyncratic and culturally-bound presentation as psychosis55. Hopefully, in future categorical manuals for psychiatric diagnoses we will include the category ‘spiritual emergency’, which will allow for certain people to behave in a fashion as befits their culture without having to pathologize them further. In the meantime, we remain restricted to the medical model, with all its shortcomings and gross prejudices.
Genetic vulnerability — in combination with environmental risk factors, including cannabis — remains the primary most likely cause of chronic schizophrenia56. Incidentally, some interesting findings from a recent study suggest that schizophrenia and increased use of cannabis may have a shared genetic aetiology; meaning people with a predisposition to use cannabis heavily also have an increased genetic risk of developing schizophrenia anyway57.
Medical Cannabis Developments in the U.K. in Recent Years
In November 2018 something positive and progressive finally occurred in respect of U.K. cannabis laws58. This was a welcome change, after so many decades of a wholly prohibitive stance from successive UK governments. On 20th June 2018, the then Health Secretary Jeremy Hunt supported the medical use of cannabis and started a review to study changes to the law. Then on 26th July 2018, the new (then) Home Secretary Sajid Javid announced that cannabis products would be made legal for patients with an "exceptional clinical need", and that cannabis would be moved from a Schedule 1 classification to Schedule 2, which acknowledged that it has potential clinical value. Medical cannabis would finally be allowed for patients in the UK! It was a great step forward at last.
It is interesting to understand how the Conversative government made this move, and it is a frustrating chain of events. Despite decades of people like me and David repeatedly calling for the UK governments (of all ruling political parties) to look at the scientific data regarding the evidence-based safety and efficacy of medical cannabis, all requests always fell on deaf ears. No government was willing to listen.
So, why did the change come about? Sadly, it was nothing to do with science, but (not unexpectedly) the Conservative government caved in eventually in 2018 as a PR stunt. The sad cases of two children with intractable epilepsy made the front pages of the tabloid newspapers59. The families of the two children, Billy Caldwell, 12, and Alfie Dingley, 6, both described how their children experienced significant improvement in their conditions after they began using cannabis, and they publicly stated their dissatisfaction with UK governments blocking their access to legal medical cannabis. There was a subsequent public outcry, and this led to the government making the changes to the law. Whilst the outcome was undoubtedly a great one – for the two children in question, and for the millions of other sufferers in the UK who could benefit from medical cannabis – the scheme of events highlights the frustration that it took the tabloid papers to shame the politicians before they moved on this important issue. If only governments could have listened to the scientists many decades earlier…But that’s politics for you, I suppose.
Prior to November 2018, the only licensed cannabis products available were Epidiolex (cannabidiol), Cesamet (nabilone) and Sativex (nabixomols)60. Epidiolex is a CBD oral solution used in addition to clobazam for children (from the age of two) and adults with epilepsy. Epidiolex can also be prescribed for patients with Lennox-Gastaut syndrome and Dravet syndrome. Cesamet (nabilone) is a capsule containing synthetic THC and is prescribed for chemotherapy-induced nausea and vomiting. Sativex (nabixomols) is an oromucosal spray containing both THC and CBD, in a 1:1 ratio. It is licensed in the UK for people with MS-related muscle spasticity that is resistant to other treatments.
Picture HERE:
There are only three fully licensed cannabis-based products on the UK market approved as medicines. All other UK medical cannabis prescribing is ‘off license’.
With the changes to the law in 2018, suddenly many other medical cannabis products became available, in the form of oils and flower (weed) formulations. There were strict guidelines released by the Royal College of Psychiatrists61, the NHS and the MHRA62. In order to prescribe the new CBD and THC products, the patient has to meet off-licence prescribing criteria which includes:
• Patient has unsuccessfully tried at least 2 first line medications for that specific condition.
• Patient accepts and understands they are taking an unlicenced medication.
• Cannabis must be prescribed by a GMC registered specialist in the relevant field.
• Patient has provided clear documented evidence that the diagnosis is accurate. This means you need written documented proof of the patient's medical history.
General Rules for Prescribing Medical Cannabis Products in the UK
There was – and still is – a certain amount of ‘grey area’ in prescribing medical cannabis in the UK, because the new CBD and THC oil and flower products are not officially ‘approved medicines’, but rather, they are tolerated, as long as specific guidelines (below) are followed. Medical cannabis is then able to be prescribed in an ‘off-license’ fashion. It can be used for a wide range of psychiatric conditions, including depression, anxiety, insomnia, PTSD and ADHD. Current UK doctors are still largely unaware of, or overly cautious about medical cannabis, and they require a lot of education to bring them up to the standards required to safely prescribe medical cannabis products for their patients. I wrote and delivered several teaching modules for my medical colleagues through the newly emerging excellent medical cannabis company, Medisonal63.
In general, CBD and THC oils are preferred over flower products, as they provide the patient with 24-hour coverage of their psychiatric symptoms. This is sometimes a problem for many patients, who have been used to smoking herbal, flower cannabis for years. They find the switch over to oils a challenge. Nut once settled on oils, most patients report a better management of symptoms. So it is important to tell them to persist with the switch. Cannabis flower (vaped) is also good for breakthrough symptoms, to be used on top of the regular oils, when extra symptom coverage is required acutely.
When starting a new patient on medical cannabis - If naïve to cannabis – it is always a good idea to start with a CBD product first, then cautiously add THC products after reviewing the patient. The basic rule is ‘Start low, go slow!’ Other general rules for prescribing include the doctor providing a thorough initial assessment to check for eligibility and to clarify whatever psychiatric diagnosis is the target for medical cannabis. There are some major exclusion factors that would make certain patients ineligible for medical cannabis, including a history of schizophrenia or other psychoses, certain physical health conditions (e.g. cardiovascular disease, severe liver/renal impairment), pregnancy or breastfeeding, or a history of adverse events associated with cannabis - including a past history of cannabis dependance. Once eligibility has been established, the patient assessment is then sent for further review by other cannabis doctors. And if approved, the prescriber can then discuss with the patient whatever cannabis product type is the best choice for them. The decision around what THC:CBD ratio is strongly influenced by the patient's past cannabis experience. There are broadly four different types of ‘cannabis experience’ patients that one sees in a medical cannabis clinic:
• The patient has never smoked cannabis recreationally at any point: The doctor is therefore not sure how they might tolerate THC. In which case, start with pure CBD product and cautiously add THC to see how they respond.
• The patient has smoked cannabis in the past and had an adverse reaction, but not psychosis: In this group, it is best to start with a CBD dominant product and cautiously add THC to see the response. Be more cautious patient may be more susceptible to adverse effects of THC.
• The patient has used cannabis in the past, tolerated it well but hasn’t used it in years: Best advice is to consider starting on a balanced THC:CBD product, then monitor carefully.
• The patient is already a heavy daily user of illicit cannabis, and they tolerate high doses, and reports beneficial management of symptoms: Given that we know this type of patient tolerates high THC, they will likely need a high THC product from the start – and it would be shortchanging them to recommend CBD-only products.
After choosing the starting product, the prescriber recommends the patient to titrate the new THC/CBD product slowly over 2-weeks according to the product information leaflet. The doctor must then review the patient after 4-weeks and change the product or dose or add further products as required. Then they are reviewed again after another 4-weeks. Once stable on the medical cannabis product or products, they need only be reviewed every 3-months thereafter.
Using the guidelines described above, I became one of the first doctors in the UK to prescribe medical cannabis products to patients with psychiatric disorders. Over the course of two years I subsequently wrote over 500 cannabis prescriptions.
The Growth of UK-Based Cannabis Clinics
There was a rapid emergence of UK cannabis clinics. Even though our domestic cannabis clinic operations are relatively small compared to other countries, the UK is the world's biggest producer and exporter of legal cannabis for medical and scientific purposes64. Globally there is a rising trend in the legal production and use of cannabis for medical and scientific purposes. At present there are around 25 private medical cannabis clinics in this country. Some of the better-known ones are: ReLeaf, Cantourage, Leva, My Access Clinics, CB1 Medical, Wellford Mecical Clinics, Treat It, Jorja, Medisonal, Lyphe Clinic, Integro, Curaleaf, Mamedica and Elios Clinics. The important thing to remember about these clinics is that there are almost all exclusively private clinics. Medical cannabis products (other than Epidyolex (cannabidiol), Cesamet (nabilone) and Sativex (nabixomols) mentioned above, are not yet available on the NHS. This means private patients can find themselves paying expensive fees for their assessments and review meetings. But by far the greatest costs to patients is the cost of the medicines themselves. Each THC/CBD oil product costs around £200/month, and if a patient is on more than one product, then monthly costs quickly spiral. This puts private medical cannabis treatments beyond the reach of most patients and leaves potentially millions of UK patients who could benefit from cannabis medicine having to go without – or be forced towards illicit cannabis sources for their much-needed medicines.
Efforts to get Medical Cannabis onto the NHS – Project Twenty-21
Professor David Nutt has been a proud supporter of medical cannabis for decades. Through his organisation Drug Science65 (which he set up in 2010 after being sacked by the then government for insisting on politics-free drug policy discussions), he started Project Twenty-2166. I was proud and excited to be the first UK psychiatrist to prescribe medical cannabis for the initial patients on the beta-testing component of Project Twenty-21, assisted by Dr Chloe Sakal, another Bristol-based psychiatrist. The aim of Project Twenty-21 at the time was to see 20,000 patients on medical cannabis by the end of 2021. At present there are around 30,000 people on legal medical cannabis scripts in the UK, and Drug Science puts our regular bulletins on the progress of the project. But virtually all of the people on medical cannabis in the UK are paying privately for their medicines. Nutt’s vision is to set up a largescale database of all UK medical cannabis patients, to demonstrate to the government using ‘real world data’ that medical cannabis is both safe and efficacious for a variety of physical and mental health conditions. The concept of using real world data (as opposed to data from much more expensive randomised-placebo-controlled trials), and its potential role in driving forward drug policy and drug development changes, will be discussed in greater detail in coming chapters when I discuss the current amazing activities going on with MDMA and psilocybin in Australia. The hope is that the UK government will see sense and formally approve medical cannabis products, so we can start to develop a proper, nationwide NHS-funded cannabis service in the UK for the many people who could benefit.
She Who Controls the Spice…
In recent years, we have seen a worrying emergence of synthetic cannabinoids — called various names recreationally but generally lumped together under the term ‘Spice’. These are drugs that are potent specific CB-1 and CB-2 agonists. Until the 2016 Psychoactive Substances Bill they could be bought legally in head shops or online and have rapidly become the scourge of healthcare, social and criminal justice services. Although they were initially sold as legal alternatives to cannabis, the effects of Spice are far different from weed.
When Spice first entered the market, its psychoactive properties were something of a mystery, because the herbs themselves were advertised as blends of benign plants such as Coastal Jack-bean, Blue Egyptian water lily, dwarf skullcap, lion's tail, lotus and honeyweed — all with little or no known psychoactivity. It then became apparent that these herbs were merely a vehicle for the sprayed-on potent synthetic cannabinoid chemicals.
There is a large range of synthetic cannabinoids. Some of the most popular forms of spice contain the naphthoylindoles JWH-018 and JWH-073, which act as a full agonist at both the CB-1 and CB-2 cannabinoid receptors. Like most research chemicals most of the new synthetic cannabinoids have not undergone any toxicity testing. And more arrived on the market every week to stay ahead of the legal restrictions.
The JWH novel cannabinoids were first synthesised by John William Huffman, professor emeritus of organic chemistry at Clemson University, South Carolina. Huffman himself, who says of the current misuse of Spice, “It bothers me that people are so stupid as to use this stuff", embarked on his research of synthetic cannabinoids to develop drugs to target multiple sclerosis and HIV/AIDS67. He therefore must not be blamed for any subsequent misuse of his discoveries; just as Shulgin and Nichols cannot be blamed for their role in developing so many new chemicals that have since been used irresponsibly by some people.
Spice in herbal form is added to a spliff or smoked in a pipe in the same way as traditional cannabis. The intoxication tends to be very extreme; with users describing high levels of paranoid psychosis, physical ailments including muscular pains, cramps, diarrhoea and — ironically, given that natural cannabis is an antiemetic — vomiting, which can then be associated with seizures. Spice is also highly addictive; with regular users rapidly progressing to daily use in large quantities to avoid frightening and painful physical withdrawal symptoms.
Significant numbers of psychiatric admissions are now associated with the use of Spice, with some researchers dubbing the condition “Spiceophrenia”68. And the drug has also seen a proliferation in prisons, as the drug is currently not easily detected in bodily fluids using standardized drug testing kits, prompting Public Health England to publish an ‘NPS Toolkit’ in 2015 for staff to use when dealing with prisoners using Spice, among other NPSs69. In a potentially even more worrying recent development, users are now able to buy a liquid or powder form of CB-1 and CB-2 drugs, bypassing the herbal medium, which presents a whole new host of risks including injectable forms of Spice.
I am far from the sort of person to hold a restrictive or draconian view about drug use or dissemination; believing that for most drugs there exists a possibility of safe — even beneficial — use, that can be separated from examples of misuse. But I — and my colleagues in the field of addictions — am concerned about Spice. The therapeutic window between recreational and addictive use is narrow and Spice appears to become problematic very quickly for most habitual users. Nevertheless, this does not mean that I believe a blanket banning of the substance is the answer. Spice is arguably the main target in the sites of the new Psychoactive Substances Act, which, as I have already stated, will not work to reduce the usage or harms of the drug. What is clear, however, is that the very existence of Spice is the greatest example of the utter failure of the War on Drugs. The fact that, when it first emerged, it could be bought legally resulted in some people preferring to risk their health with harmful Spice rather than take the risk of breaking the law and use the tried and tested, low toxicity natural cannabis that has been taken safely taken for thousands of years. Thankfully, in recent years the prevalence of spice use has reduced in the UK. But it continues to be considered a significant public health concern70. What a startling illustration of the folly of drug prohibition laws.
Being a ‘Psychedelic Consultant’ for MTV
In 2008 a producer at MTV contacted me. She needed a doctor with knowledge and experience of psychedelic drugs for insurance purposes, to consult on a new show she was planning. Dirty Sanchez entailed a group of young Welsh chaps travelling the world quaffing local psychoactive plants. It was a less culturally highbrow version of the Bruce Parry programme The Tribe that was quite popular at the time. From what I knew of Dirty Sanchez (and I’ll leave the reader to look up what that name means), the Welsh fellows in question were famed for their brashness. I was wary of getting involved and spent some time stressing to the producer that if the presenters were planning on meeting shamans and partaking in spiritual ceremonies, they must pay attention to the local customs and behave with respectful deference and humility. I happened to know they had a habit of nailing their scrota to planks of wood in the past.
I was sent their travel itinerary and a list of the substances they had in mind. With assured safeguards in place they set off and I responded to the updates as they came in from distant shores; providing trans-Pacific and trans-Atlantic psychedelic consultation. The producer told me what country they were visiting next and drawing references from Stafford’s Psychedelics Encyclopedia71 and Hofmann and Schultes’ Plants of the Gods72, I suggested which indigenous psychedelic flora were worth sampling. Some of my notes to the producer are reproduced below.o
If in South Africa, One Must Try Sceletium
Sceletium tortuosum and Sceletium expansum — also known as mesembryanthemum, kanna or channa — have been used for millennia by Hottentots as a vision-enhancing hallucinogen. Smoked, chewed or absorbed through the mucous membrane of the mouth, the plant contains the psychoactive alkaloid components mesembrine and mesembrenine. The main effect is a mild simulative intoxication not unlike cocaine, with elevated mood, and energy. In higher doses the user enters a prolonged state of sedation.
When in Australia You May Wish to Consider Cane Toad Licking?
The toads were introduced to Australia in the 20th century to eradicate pests in sugar cane crops. The most popularly used variety by Australian hippies is the Colorado River toad, Bufo alvarious and the active components are 5-MeO-DMT and bufotenin. The toads are not actually licked. Rather, the venom from the parotid gland behind the toad’s ear can be gently ‘milked’, then dried and smoked in a glass pipe. The toad’s store of venom replenishes within a month so there is no need to kill it. But sometimes the toad is killed, dried and eaten, smoked or boiled into a foul-tasting tea and drunk. The effects of smoking the venom come on quickly and may be strong — similar to psilocybin or LSD.
There are no mentions of indigenous use of cane toad venom as a sacrament. But there is a history of indigenous sacramental use of 5-MeO-DMT sourced from plants in the Amazon. Amazonian shamans have used psychedelic snuff made from virola bark resin, which may also may be a trace constituent of ayahuasca, when plants such as Diplopterys cabrerana are used as part of the ayahuasca brew73. And in another interesting piece of 5-MeO-DMT history, between 1971 and the late 1980s, a chap called John Mann ran the Church of the Tree of Life in California, and declared the use of 5-MeO-DMT to be a sacrament, for use by the church’s members74. The Church of the Tree of Life has since ceased to be. It is not to be confused with the Tree of Life Church, which is still an ongoing Christian institution!
If in Tonga, Check Out the Kava
Kava (Piper methysticum) is an evergreen shrub with large heart-shaped leaves and woody stems. The mashed-up roots make an intoxicating drink with active ingredients called kavalactones. The effects last for up to eight hours, with mouth numbness, nausea and a lot of falling over. It produces reduced social inhibitions, much like drinking alcohol. Popular in Pacific Polynesia, it is enjoyed in the evenings as part of a communal activity. (The MTV producer wanted her boys to snort their kava. I warned her that unless they were using a concentrated extract they would need to snort so much material they could get serious sinus problems). There is no historical tradition of snorting kava. Though it’s probably superior, as a recreational high, than nailing one’s scrotum to a plank.
Next Stop India: for Indian Snakeroot
Also called serpent wood or rauwolfia, this evergreen shrub found in forests in springtime is peppered with white and pink flowers. It is not especially psychedelic. The alkaloid reserpine produces a sedative and depressant effect and has been used in Ayurvedic medicine for thousands of years to treat everything from poisonous reptile bites to insanity.
Calamus! Calamus! Will You Do the Fandango?
Calamus — also known as sweet flag, sweet sedge, sweet root and myrtle grass — grows in wetlands as leafy stems bearing yellow-brown flowers. The chewed stems taste horrible and contain the active components, alpha and beta-asarone, which increase energy, reduce hunger and provide a calming sensation. It has been compared to LSD by some; but those familiar with the effects of LSD may disagree.
If You Stop in South East Asia, Be Sure to Ask for Kratom
In Southeast Asia, Kratom is called mambog. It can be found throughout Thailand, Malaysia, Borneo and New Guinea. The dried leaves are smoked or chewed and contain many indole alkaloids, including mitragenine, which can be simultaneously stimulating, like cocaine, and soothing, like morphine. It has been used as an opium substitute to cure opiate addiction and has become popular in the West in recent years, with many internet-based suppliers. One of the best being Kratom Frog.
Nonda Mushrooms
Boletus manicus and Boletus kumeus, Papua New Guinea’s Nonda mushrooms, are famed for causing what psychiatrists call Lilliputian hallucinations; visions of miniature people and animals. Natives claims the mushrooms cause violent rages and sometimes take them before planning to kill another person. Not one for Glastonbury Festival or Burning Man then.
The ‘Rubbish’ Bird
Also from New Guinea, the pitohui bird is referred to as ‘rubbish’ by locals because of its foul taste if eaten. Pitohuis produce a defensive endotoxin, homobatrachotoxin, that comes from their diet of choresine beetles. The taste is extremely bitter. There are no reports of it being psychedelic (except to look at; beautiful plumage) but some 16th century Aztec documents mention a bird that “induced visions”. This could be the pitohui bird, at a stretch.
New Guinea’s Fierce Agara
The colossal Galbulimima belgraveana tree grows up to 90-feet tall. When the bark and leaves are boiled together with another plant, ereriba, over twenty alkaloids combine to produce a deep, vision filled slumber. The people of the Okapa region use Agara leaves to make men fierce against the malevolent power of a variety of illnesses.
The Visionary Plants of Africa
Africa is splendidly mystical; oozing with spirituality just as much as, though less overtly, perhaps, than India. Every rock, tree and river in Africa breathes a spiritual history. My travels there have been more contemplative than the screeching rancour of the East, but certainly no less spiritual. The concept of African ‘witch doctors’ is well known and Western doctors struggle with the idea of people practicing medicine without the proper evidence-based methods. Time will tell who offers the best therapeutic interventions for full holistic well-being.
Ubulawu is the Zulu word for visionary plants; the hundreds of barks, bulbs, vines, pods, roots, leaves, seeds and flowers that are chopped to make the white frothy mixture. Plants incorporated in ubulawu are often those growing near to rivers and include African dream root (Heimia salicifolia), Acacia xanthophloea and Dianthus mooiensus. Unlike the South American ayahuasca, ubulawu’s effects are wildly idiosyncratic. Dreams are enhanced and certainly full-blown psychedelic experiences are possible. African shamans use the medicine as a divine tool:
Ubulawu belongs to the ancestors. It opens your brain to work. It is used to induce or clarify dreams of ancestral spirits and opens minds to receive the messages of the ancestors.
(Of note: In 1997 when I was working in Malawi I was getting a lot of arthritic pain from my distant childhood fractures, so was recommended to visit a local shaman for treatment. Adorned in animal skins, he shuffled about his hut, fussing over plastic pots, bits of tangled defunct electrical equipment and animals that wandered in and out during the afternoon session. I was not aware that he had given me any visionary plants (but he may well have been on something or other himself). Rather, he held my ankle tightly, murmured, tossed runes and bothered the ashes in the fire, creating billowing sparks. When we left I asked my Malawian guide to translate what the man had said about my foot. Although he had been talking to me constantly for over two hours during the session, all she said, with a smile was, ‘He says when you die, you will still have both your legs’. Very reassuring.)
The Zulu’s Strawflower Smoke
Strawflower is tall, being of the sunflower family, and it produces clusters of golden-yellow flowers. It grows in Africa and the Zulu traditionally smoke the dried herb. Although native doctors use it to induce trances, the active ingredients, coumarins and diterpenes, are not known to have any psychedelic effects.
Jenkem
Jenkem is allegedly fermented human faecal matter and urine. The active ingredients are methane and ethanol, which, when inhaled, is like a mild version of sniffing glue. Some people say that the whole concept of jenkem is a hoax designed to humiliate drug tourists. Perfect.
Pandanus Nuts
Screw Pine grows along the coast in salt marshes. Huge quantities of these pine nuts, which contain dimethyltryptamine (DMT), must be eaten to get any psychedelic effect whatsoever. Used in folk medicine and for ceremonial purposes, Pandanus nuts are attributed to outbreaks of ‘irrational behaviour’ called Karuka madness.
Whatever Happened to the Dirty Sanchez Boys?
The producer never sent me a DVD of the series, and I had no idea how to watch it on terrestrial TV. But several years later, I inadvertently stumbled upon a late-night program featuring two Welsh boys sitting respectfully in meditation with a shaman. I was impressed to see they were displaying appropriate reverence to the local customs. Then, sure enough, at the end I realized it was Dirty Sanchez and there I was in the credits: ‘Psychedelic Consultant — Dr. Ben Sessa’. Job well done.
Contemporary Psychedelic Plant Medicine Retreats
To finish this chapter on the global uses of plant medicines, one has to explore the mushrooming (Lol) industry of psychedelic retreats. These institutions have become a huge part of the psychedelic landscape in recent years. Often tightrope walking along a thin edge of legality, with a great lack of parity and much confusion around the world about different territories legal status of the drugs they offer. Many advertise themselves not as ‘clinics’ (as most of the compounds on offer at such retreats are not yet considered licensed medicines), but rather as ‘wellbeing centres’, for personal growth and development. With the explosion of interest in all things psychedelic in today’s renaissance, people in their droves are packing up their psychedelic garb and heading off to distant – and not so distant – lands for their fix of enlightenment and bliss.
There are now so many retreat options that it would not be possible to list them all in this book – and nor would I want to give the spotlight to just a randomly chosen few. Rather, I would direct the reader towards one of the many useful websites that list the availability of current retreats. One such site that I have discovered is Retreat Guru75. It lists the details of over 2000 retreat centres from all over the world, for a variety of different compounds, including psilocybin, mescaline, kambo, ayahuasca, 5-MeO-DMT, across over 24 different countries in Europe and the Americas.
Different retreats provide different levels of luxury accommodation, differing numbers of preparation sessions, psychedelic sessions and integration sessions. All sorts of alternative well-being interventions are also offered by most places, including include breath work, massage, hypnosis, yoga, and gourmet food. And whilst some of the options on offer start as £200, there are some – particularly in Costa Rica and Jamaica - that provide such a high level of luxury glamour that they are coming in at closer to £8000 for a short course of psychedelic experience toe-dipping.
There is no questioning that many of these retreats are financially out of the question for that huge population of people who really need psychedelics – psychiatric patients – but rather are best considered a plaything for fortunate wealthy Westerners who are able to meet the high price tag76. The high-end retreats are now advertised in places like Vogue77 and high finance websites78. There has been considerable criticism of this situation in recent years – ranging from people complaining about the inaccessible costs for most people, to more sinister concerns about frank sexual abuse going on in some establishments79. It’s all a long cry away from those early days of buying (or more likely being simply given) a bag of mushrooms or a piece of blotter from a dodgy geezer down the pub.
It is worth mentioning here that there are some excellent examples of wellness centres, providing holistic approaches to healing. The Silva Wellness Centre in London, UK, has found the perfect formula to combine esoteric alternative therapies such as sound baths, aromatherapy, Reiki and breathwork – together with sublingual ketamine treatments80. Run by Lucy da Silva and her partner, the centre also provides a conduit to indigenous uses of psychedelics and encourages clients to focus on mind, body and spirit. I wish them the best of luck for the grand opening in Autumn 2024!
Whatever one’s opinion or criticisms, it is arguable that overall, the rise of opportunities for more people to experience a guided psychedelic experience in a safe and secure setting, with trained therapists / guides and known compounds, has got to be better than the ‘pot luck’ approach of past generations. The difficulty lies in sourcing the right retreat option, that provides the security and certainty one is looking for – and at an affordable price. I hope that what has started out as a plaything for the rich will gradually filter down to an industry that is more widespread and commonplace for everyday people. We must strive for greater transparency, customer services and scrutiny of such places, so people can make informed choice and be assured of their safety. In my opinion, the whole rise of the luxury psychedelic wellness industry is simply a distraction from the real work that needs to be done; which is getting these essential compounds licensed as approved medicines, so we can roll them out across healthcare systems around the world, free for everyone that needs them. In the meantime, good luck to those wealthy folk who want to spend $7000 a week for something that grows for nothing all over Wales every October.