Anja Loizaga-Velder, Ph.D.

Anja Loizaga-Velder, Ph.D.

Anja Loizaga-Velder, PhD is clinical psychologist who has been investigating the therapeutic potential of the ritual use of psychedelic plants for twenty years. She is Director of Research and Psychotherapy at the Nierika Institute in Mexico.
Anja Loizaga-Velder, Ph.D.

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Armando Loizaga

Armando Loizaga

Armando Loizaga is president of the Nierika Institute in Mexico. His work focuses on advancing multidisciplinary clinical research protocols to evaluate therapeutic potential of psychedelic plants used in ritual contexts, preservation of indigenous psychedelic culture and drug policy reform.
Armando Loizaga

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    Addictions have become one of the most critical health issues of modern society, costing many lives and affecting countless individuals and families. We have learned a lot in the last century that helps us better understand the complexity of addictions, however it is also apparent that conventional treatments have not made much of a dent on this social epidemic; thus, finding alternative treatments that actually prove effective is both a medical and a human rights imperative.

    For mainstream addiction treatment, it may appear paradoxical to employ a mood altering psychotropic substance as a valid intervention to treat this condition.  However, there is consistent evidence that psychedelic plants, utilized within culturally bound rituals, can have very positive results for people in recovery from substance dependence and other mental health challenges. Within the ways of the Native American Church, the ceremonial use of peyote, a small cactus endemic to the Mexican desert, has been an important catalyst for positive change in the lives of many indigenous people within the US and Canada also standing out as a support in their recovery from alcoholism and drug dependence.1 2 Psilocybin, a compound found in psychoactive mushrooms and used in traditional ceremonies by Mexican indigenous people, is also currently being studied as adjunct treatment for indications such as alcoholism and nicotine dependency with promising results.3 4 5 6

    Finally, it should be noted that the traditional use of the iboga plant in African Biwiti ceremonies has inspired the now expanding ibogaine clinics around the globe as an alternative pathway to assist patients in opiate dependence interruption and other mental health conditions.7 8 Long-term results are still to be evaluated, and will likely vary, depending on treatment indications and professional structure of complementary therapeutic programs. This is true for psychedelic treatment in general.

    Ayahuasca is being used as a therapeutic resource based in traditional Amazonian medicine for the treatment of a wide range of psychological and psychosomatic ailments, and as catalyst for personal growth.9 10 Several retreat centers and addiction treatment programs that offer ayahuasca assisted treatments for dependence and other chronic mental health conditions have been developed in the Amazon Basin. One of the pioneer projects in this area is Takiwasi in Peru; a government-approved treatment center that has integrated the ceremonial use of ayahuasca within a traditional medicine and intercultural treatment model. It has treated hundreds of patients with very significant results.

    How does ayahuasca help in recovery?

    This question cannot be answered in simplistic terms. Several therapeutic mechanisms have been suggested to account for these effects. From a biological point of view, we can observe that these plant compounds interact in our neurotransmitter systems in similar places as conventional psychiatric drugs used in the treatment of depression or addictions.11 12 Additionally, they facilitate processes of psychological nature that appear to be of important therapeutic value.13 14 Many people report that sacred plants facilitate consciousness of self and restructure the meaning of life it self. Both are very important mechanisms in order to succeed in changing self-destructive behaviors and stopping an addictive cycle.

    Addiction is often described by lack of meaning and irrational impulses characterized by semi-conscious or unconscious acts resulting in frustration and feelings of emptiness and depression that feed into the addictive cycle. People can remain stuck in denial of their problem for years and complacent to the harmful consequences of their addiction. Ayahuasca, as well as other psychoactive plants in carefully structured settings, can catalyze psychological processes  such as insights, problem acceptance, healing of trauma,  and spiritual processes  that can be essential steps towards recovery. Treatment outcomes, however, can be influenced by several variables. These include  the composition of the brew and adequate dosage, the psychological readiness and preparation of the patient for the experience, the quality of guidance of the experience, the psychotherapeutic support provided for integration and aftercare, as well as adequate frequency and spacing of the ayahuasca-assisted interventions.15

    Is ayahuasca an effective treatment for addictions?

    Scientific evaluation of the efficacy of ayahuasca-assisted treatment is necessary for ayahuasca-assisted treatment to be recognized as a legitimate therapeutic approach for treating addiction and other mental health challenges..The Ayahuasca Treatment Outcome Project (ATOP), was developed in response to this need by a multidisciplinary international research team.

    Within this research project, it was important for us to consider ayahuasca-assisted treatment not as a pharmacological intervention but rather as a well-structured ritualistic psycho-therapeutic intervention, such as is found in traditional medicine. Towards this purpose, we follow a scientific approach that both complies to the rigorous evaluation of therapeutic efficacy demanded by modern medicine and respects the integrity of ayahuasca as a therapeutic tool with roots in indigenous medicine. Within ATOP, the Mexican subproject has developed a research protocol for the conduction of a randomized controlled clinical study with the objective to evaluate the therapeutic efficiency and safety of ayahuasca-based therapy in the treatment of substance abuse disorder in comparison to current best practices for substance dependency treatment provided by the public health system.

    Based on preliminary studies and research in animal models of addiction, we start from the hypothesis that ayahuasca-assisted psychotherapy will produce a significant improvement in several psychometric measures associated with recovery from substance abuse disorder. To test this hypothesis in the pilot study, patients with chronic alcohol dependency will be recruited from public addiction service centers in Mexico, whose treatment concepts are compatible with ayahuasca-assisted treatment. After screening for physical or psychological counterindications, 36 patients who are fit to receive ayahuasca will be randomly divided into an experimental group and two control groups. The experimental group will attend three ayahuasca ceremonies, complemented by group and individual psychotherapy. These ceremonies will be led and supervised by a traditional Peruvian healer, with the assistance of a female and male clinical psychologist specialized in addiction treatment, who will also prepare the patients for ayahuasca interventions and will facilitate the integrative sessions.

    The first control group will participate in three sessions of receptive music therapy of the same duration, and will receive the same group and individual psychotherapeutic care as the treatment group. Before, after and inbetween ayahuasca sessions or music therapy, both groups will receive individual and group standard psychotherapeutic care provided by a public out-patient facility. The second control group will participate in standard therapeutic care provided by a public outpatient facility. The therapeutic progress of patients in the experimental group and the two control groups will be evaluated  with psychometric assessments over 12 months; this data will be complemented  by qualitative interviews and, if financing allows, also through neurobiologic assessment (fMRI and biomarkers).  With our research, we hope to make a contribution to the recognition of ayahuasca as a legitimate intercultural therapeutic tool for the treatment of addiction and other mental health challenges.

    References

    1. Calabrese, J. D. (2013). A different medicine: Postcolonial healing in the Native American Church. New York City, NY: Oxford University Press.
    2. Feeney, K. P. (2014). Peyote as medicine: An examination of therapeutic factors that contribute to healing.  Curare,  37, 195–211.
    3. Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P. & Griffiths, R. R. (2014). Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction, Journal of psychopharmacology, 28(11), 982–982.   DOI 10.1177/0269881114548296.
    4. Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A., Wilcox, C. E., Barbosa, P., & Strassman, R. J. (2015). Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study, Journal of psychopharmacology, 29(3), 289–299.
    5. Vollenweider, F., & Kometer, M. (2010). The neurobiology of psychedelic drugs: Implications for the treatment of mood disorders. Nature Reviews Neuroscience, 11(9), 642–651.
    6. Tylš, F., Páleníček T., & Horáček J., (2014). Psilocybin: Summary of knowledge and new perspectives. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 24, 342­–356.
    7. Winkelman, M. (2014). Psychedelics as medicines for substance abuse rehabilitation: Evaluating treatments with LSD, peyote, ibogaine and ayahuasca. Curr Drug Abuse Rev., 7, 101–116.
    8. Schenberg, E. E., de Castro Comis, M. A., Chaves, B. R., &  Silveira, D. X. (2014). Treating drug dependence with the aid of ibogaine: A retrospective study., Journal of Psychopharmacology. 28(11), 993–1000.
    9. dos Santos, R.; Osório, F., Crippa, J. A.,  Riba, J.,  Zuardi, A., & Hallak, J. E. (2016). Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): A systematic review of clinical trials published in the last 25 years. Therapeutic advances in psychopharmacology, 6(3), 193–213.
    10. Sanches, R. F., de Lima Osorio, F., Dos Santos, R. G., Macedo, L. R., Maia-de-Oliveira,  J. P., Wichert-Ana L, … Hallak, J. E. (2016). Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a SPECT study. Journal of clinical psychopharmacology. 36(1), 77–81.
    11. Sanches, R. F., de Lima Osorio, F., Dos Santos, R. G., Macedo, L. R., Maia-de-Oliveira,  J. P., Wichert-Ana L, … Hallak, J. E. (2016). Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a SPECT study. Journal of clinical psychopharmacology. 36(1), 77–81.
    12. Liester, M. B., Prickett, J. I. (2012). Hypotheses regarding the mechanisms of ayahuasca in the treatment of addictions. J Psychoactive Drugs., 44(3), 200–208.
    13. Loizaga-Velder, A., & Verres, R. (2014).Therapeutic effects of ritual ayahuasca use in the treatment of substance dependence – qualitative results. Journal of Psychoactive Drugs, 46(1), 63–72.
    14. Thomas, G., Lucas, P., Capler, R., Tupper, K., & Martin, G. (2013). Ayahuasca-assisted therapy for addictions: Results from a preliminary observational study in Canada. Current Drug Abuse Reviews, 6, 30–42.
    15. Loizaga-Velder, A. & Loizaga, A. (2014). The therapeutic value of ayahuasca for addiction treatment from psychotherapeutic perspective. In B. C. Labate, & C. Cavnar (Eds.), The therapeutic use of ayahuasca (pp. 133–152 ). Heidelberg: Springer.