Why have addictions and the social problems of drug abuse become one of the greatest public health concerns confronting contemporary societies? One might suppose our addictions are simply a consequence of our well-documented biological proclivities to use drugs. Substances are addictive because they mimic the effects of neurotransmitters. Humans use drugs because they enhance the ability of our nervous system and its many higher-level systems to function more effectively—to resist pain, stay up longer, be sociable, enjoy ourselves, relax and sleep, among others. Yet pre-modern people in general did not succumb to addiction; instead, such substance use provided avenues for seeking spiritual experiences and therapeutic alterations of consciousness.1 2

Why has drug addiction become a major worldwide public health problem when such problems were virtually non-existent in the pre-modern world? While some modern addictions to drugs, such as pharmaceutical opiates and cocaine, reflect the consequences of technology, many substances were used in the past without producing social problems. Andean cultures used coca for thousand of years without negative social consequences. Most Native American cultures used tobacco, but without the addiction problems associated with cigarette smoking today. African cultures regularly produced fermented beverages and consumed them without the problems associated with the consumption of alcohol today. And psychedelic drugs were used in cultures around the world in rituals for strengthening social solidarity and healing.

What is different about the use of drugs in the modern world? One can point to many factors that promote drug use and addiction, such as stress, easily available substances, and norms supporting use; but that is only part of the picture. The other part involves the loss of social institutions and practices that helped to reduce the motivations for drug use by providing natural means of altering consciousness.

While natural processes for altering consciousness, such as meditation, have become increasingly popular in Western societies in the last 50 years, they are still relatively rare. How do we alter consciousness today? In the words of Paul Simon’s song, “taking downs to get off to sleep and ups to start you on your way” has become a way of life for many, with alcohol to tranquilize us after a day that starts with coffee and other stimulants. For many, the alteration of consciousness is a drug fueled stimulant frenzy that is mellowed out with alcohol, barbiturates, and other drugs.

While stress may provoke drug use behaviors, such responses also reflect a deeper human need to experience some alteration of consciousness. My cross-cultural studies have shown that ritualized alterations of consciousness were virtually universal in pre-modern societies, which usually had institutionalized means to alter consciousness, including through ritual practices that did not involve the use of drugs.

Our Innate Need to Alter Consciousness

It appears that humans have an innate need to alter consciousness, but that, in the post-modern world, we lack generally accepted rituals for altering consciousness. Could this cultural loss be responsible for the addiction epidemic, a consequence of a mismatch between deeply embedded needs of our human nature for altering consciousness and modern cultural biases which reject such practices?

I think the answer is yes, that humanity has lost vital institutions involving communally based ritual practices that used drumming, singing, dancing, and other behaviors to provoke alterations of consciousness. A primordial form of the alteration of consciousness was the shamanic ritual, a suite of communal practices designed to produce transcendent experiences.3 4 Shamanic ritual practices and cosmology had many social functions, constituting the most important collective social events of foraging societies. These practices gathered and unified the social group, provided processes for healing, regularized relationships with animals and nature, and provided a cosmology of human relations with the powers of the universe.

The central alteration of consciousness of the shamanic ritual involved the shaman’s soul flight or out-of-body experience that enabled a projection of consciousness into other places and worlds. The community’s alterations of consciousness were also propelled by the drumming, singing, and dancing; the overnight nature of the ritual; and, in many cases, the consumption of psychoactive plants.

So, did shamanic practices provide a psychological dynamic that precluded addictive patterns of behavior? I think so. The general lack of addiction in these societies reflected the effects of their ritual practices, which also can provide help for modern people who are hopelessly addicted to drugs.

“Drumming Out Drugs”

The concept of drumming circles has been found in many cultures, and persists in modern societies in marginalized activities. I interviewed participants in drumming rehabilitation groups and participated in drumming activities to understand their effects. The participants told me how drumming can provide important support in the processes of rehabilitation5 —and perhaps in drug-resistance and harm reduction practices. Drug rehabilitation participants find a variety of benefits in community drumming, including the production of pleasurable experiences that provide a mechanism for self-expression and a sense of relaxation. Drumming was seen as a mechanism for erasing the effects of trauma and engaging processes of self-integration. There was also the benefit of creating a sense of connectedness with others, overcoming the self-isolation often characteristic of addicts.

Shamanic Treatment of Addiction

More traditional shamanic practices have also been found to have important roles in substance abuse rehabilitation, especially for cases in which the individual has repeated relapses and is considered “treatment resistant.” Many people who are addicted to drugs recognize the slippery path to recidivism, but are unable to control their behaviors. Shamanic practices provide a number of benefits for people who are lacking the personal resources to avoid the path to relapse by enhancing their contact with spirit powers who can provide psychological assistance. Shamanic practices of soul recovery, power animal recovery, and de-possession may also provide important adjunct therapies in addressing treatment-resistant addictions.

Shamanic rituals can reduce stress and produce direct experiences of a spiritual power that many consider central to the recovery process.  There is evidence that the alterations of consciousness induced by shamanic rituals may enhance the operation of the dopamine and serotonergic neurotransmitters that are compromised by prolonged drug abuse.  Drumming, singing, and dancing provide mechanisms for enhancing the release of dopamine, processes that are reinforced by the social bonding dynamics of ritual participation.

Shamanic alterations of consciousness, particularly the soul flight, provide processes for engaging a variety of psychological and emotional effects. The psychodynamics of the shamanic “journey” engage personal insight, enhance self-awareness, provoke emotional release, and induce psychological integration. Shamanic altered states of consciousness (ASC) engage natural brain processes involving the brain’s primary processing capacities, manifested in visual symbols and exemplified in the shamanic journey. These visual experiences are forms of symbolism that can reveal to the person the underlying dynamics of their troublesome addictive patterns of behavior, feeling, and thought.  Shamanic experiences can provide a clear vision of the addict’s future—a horrible death through drug-induced problems. This enhances the sense of “hitting the bottom” that many find as a necessary step towards sobriety and healing.

Alterations of consciousness generally produce an increased suggestibility, enhancing a commitment to the message of recovery. Ritual drama can provide an important mechanism for expressing feelings and soliciting support from others in the struggle against the demons of addiction. Ritual activities are particularly powerful mechanisms for addressing concerns at the affective level, and can be used as processes for social reintegration. Participation in rituals provides a supportive community context that can provide therapeutic assistance from the group, which can also provide a sense of community through the bonds created by regular ritual interaction

Shamanic ideology also provides an important framework for reconceptualizing human nature and the self. A significant feature of shamanism is the view of humans as having an animal nature, including animal allies and power animals.6 These constructs can provide useful tools for managing the emotional dynamics of addiction. Animal allies can provide assistance in resisting the drives to addiction, or in personalizing the “beast within” that out of control addicts frequently experience and attribute to the dynamics of relapse. Animal powers reflect the operation of innate brain processing modules and provide mechanisms for integrating dissociated neural dynamics. This integration enhances personal power by entraining structures of the unconscious that reflect aspects of the self and emotions, permitting the production of integrative healing states.

The consciousness-altering activities of rituals can also contribute to the processes of personal transformation and revitalization, exemplified in the classic processes of  “death and rebirth.” This involves the death or release of one sense of self in order to allow for the emergence of a higher level self that is not compromised by the dynamics of addiction. The death dynamics can provide mechanisms for the release of negative self-perception, alienation, anomie, and meaninglessness that lead to addiction, while the rebirth dynamics can produce an improved, positive self-image with new coping resources.

Shamanic Plant Medicines as Addiction Treatment

Perhaps the most powerful of all of the shamanic practices for addressing addictions are the psychedelics, known in shamanic contexts as plant medicines, doctors, and spirit entities. These substances have been repressed for almost half a century by their administrative classification as Schedule I substances, alleging no established medical uses and a high abuse potential. The evidence is to the contrary: that they have little risk of harm or abuse and are effective as tools for addictions treatment. A variety of studies have shown the therapeutic potential of LSD, psilocybin, ayahuasca, ibogaine, and peyote in addressing the dynamics of addiction (for reviews, see 7 8). Studies also reveal that these substances have a variety of different mechanisms of effectiveness, providing a nuanced approach to treating addictions. While pharmacological mechanisms are a significant part of the treatment dynamic, their ability to induce spiritual experiences must be considered a prominent feature of their overall treatment efficacy.

Our human nature contains a deeply embedded need for collective communal rituals that provide for spiritual engagement and the transcendence of ordinary consciousness. 9 Our lack of socially supported rituals for engaging in this dynamic makes us susceptible to drug-mediated experiences to achieve this sense of a dopamine-mediated connection and serotonin-enhanced integration. The rediscovery and reinvention of ritual practices for achieving these experiences and neurological states will need to be a part of a successful response to the scourge of addiction.


  1. Winkelman, M.  (2010). Shamanism: A biopsychosocial paradigm of consciousness and healing. Santa Barbara, CA: Praeger.
  2. Winkelman, M. (2014b). Evolutionary views of entheogenic consciousness. In J. H. Ellens (Ed.), Seeking the sacred with psychoactive substances: Chemical paths to spirituality and God (pp. 341–364). Santa Barbara, CA: Praeger.
  3. Winkelman, M.  (2010). Shamanism: A biopsychosocial paradigm of consciousness and healing. Santa Barbara, CA: Praeger.
  4. Winkelman, M. (2013a). Shamanism in cross-cultural perspective. International Journal of Transpersonal Studies, 31(2), 47–62.
  5. Winkelman, M.  (2003). Complementary therapy for addiction: “Drumming out drugs.” American Journal of Public Health, 93(4), 647–651.
  6.  Winkelman, M.  (2013b).  Shamanism and psychedelics: A biogenetic structuralist paradigm of ecopsychology, European Journal of Ecopsychology, 4, 90–115.
  7. Winkelman, M. (2014a). Psychedelics as medicines for substance abuse rehabilitation: Evaluating treatments with LSD, peyote, ibogaine and ayahuasca. Current Drug Abuse Reviews, 7(2), 101–116.
  8. Winkelman, M. & Roberts, T.  (Eds.). (2007). Psychedelic medicine: New evidence for hallucinogenic substances as treatments. Santa Barbara, CA: Praeger.
  9. Winkelman, M.  (2015). Shamanism as a biogenetic structural paradigm for humans’ evolved      social psychology, Psychology of Religion and Spirituality, 7(4), 267–277.