- Symposium in Brazil Debates Psychedelics at a Political Crossroads - December 13, 2024
- Conference in Rio Defends Psychedelics in Public Health - December 11, 2024
- Santo Daime ‘Padrinho’ in Rio Faces Accusation of Sexual Harassment - November 5, 2024
Psychobiology meeting in Natal defends innovative therapy in the country’s public health system
In just a 16-day interval, two events on psychedelics in Brazil addressed the political difficulty of resuming the benefits of these substances as alternative psychotherapeutic treatments. After the 2nd Brazilian Congress on Psychedelics in Rio de Janeiro, it was the turn of the 16th Symposium on Psychobiology in Natal to raise the banner of “psychedelics in the SUS.”
The acronym “SUS” stands for Sistema Único de Saúde, the universal public health system maintained by the Brazilian government. It was established by the 1988 Constitution, inspired by Britain’s National Health Service (NHS).
The meeting attracted around 200 people to the main auditorium in the Federal University of Rio Grande do Norte (UFRN) for three days of lectures and debates on the theme “Psychedelics in Mental Health – Charting the future of innovative therapies.” Many warnings were heard about the risk of them falling back into the limbo to which they have been relegated for over 30 years, leaving out millions of patients who could, in principle, benefit from them.
“[Psychedelics in the SUS] is not a naive phrase,” said Dráulio de Araújo, from the Brain Institute at UFRN, who heads the Advanced Center for Psychedelic Medicine (CAMP) and conducts studies to treat depression with dimethyltryptamine (DMT) from jurema-preta [Mimosa tenuiflora], a compound also present in ayahuasca. “It is a motto for guidance.”
The use of psychedelics is ancient, as exemplified in the journal Scientific Reports by an article published November 13th by researchers from Italy and the US indicating the presence of Syrian rue (Peganum harmala) in an Egyptian vase from the 2nd century BC, which is still used today in tandem with jurema in Brazilian neo-shamanic circles to alter consciousness.
Ayahuasca and mushrooms of the Psilocybe genus, known as “magic shrooms”, have always been used religiously or in underground circles, especially in countries such as Peru, Brazil, and Mexico.
Ayahuasca and mushrooms of the Psilocybe genus, known as “magic shrooms”, have always been used religiously or in underground circles, especially in countries such as Peru, Brazil, and Mexico. The syncretic churches Santo Daime and União do Vegetal (UDV) have spread ayahuasca (AKA daime) throughout Brazil and the world, as have neo-shamans.
Despite these ancient and pervasive uses, when science resumed researching its psychoactive compounds for their therapeutic potential, the resurgence received the clumsy nickname of psychedelic renaissance. “What kind of renaissance is this?” —asked Fernando Beserra, from the Brazilian Psychedelic Association (APB), at the symposium, meaning that psychedelics have never left the scene, just the mainstream.
For the specter of the biomedical status quo is once again haunting the resurrected and threatening it with a triple psychotomy: of the psyche (soul, or mind) as the target for healing, while reinforcing the pharmacological model; then of psychotherapy, going back to its irrelevance in the eyes of many psychiatrists; and finally of psychedelia itself, the very subjective effect (trip) that some neuroscientists are eagerly trying to purge from future treatments.
The alarm was sounded in the last lecture by Brazilian anthropologist Beatriz Labate, from the Chacruna Institute in San Francisco: “We couldn’t make [psychedelics] fit the FDA model. That narrative didn’t work.” She was referring to the food and drug agency’s rejection in August of MDMA-assisted psychotherapy to treat post-traumatic stress disorder (PTSD). “And what is coming next could be much worse, more biomedical, more reductionist,” she warned.
“We couldn’t make [psychedelics] fit the FDA model. That narrative didn’t work … And what is coming next could be much worse, more biomedical, more reductionist.”
Beatriz Labate
For Labate, Brazilian science should stop imitating this failed model and take advantage of the experience accumulated in Latin America to make an original contribution to the clinical rehabilitation of psychedelics. One of the strengths of the traditional context of ayahuasca consumption, whether in Indigenous or syncretic rituals, is the communal use of substances that modify consciousness, such as Indigenous beverages and snuffs.
Luís Fernando Tófoli, a psychiatrist at São Paulo State University of Campinas (UNICAMP), stated that a valuable notion of Indigenous peoples is the concept of bem-viver (well-living), which does not apply only to the individual, it must also encompass the collective and harmonious coexistence with nature. In other words: mental health cannot be solved by treating each person alone.
The head of the symposium, Nicole Galvão-Coelho, was a co-author of Fernanda Palhano-Fontes (both from UFRN) in a clinical trial published in 2019 that demonstrated the efficacy of ayahuasca in mitigating drug-resistant depression. This pioneering study was the first to test a psychedelic compound against the disorder in a double-blind, placebo-controlled system.
On the second day of the event, coincidentally, Galvão-Coelho and Tófoli published, with colleagues from Australia and Spain, an article confirming the beneficial effects of the tea with 7,576 users in more than 50 countries. Many of those who responded to the questionnaire use ayahuasca in a community setting, such as religious ceremonies.
Another speaker at the symposium, physician Bruno Rasmussen Chaves, has already subjected more than 2,000 drug addicts to doses of ibogaine in Ourinhos, a town in the State of São Paulo. Rasmussen claims a response of up to 70% with the treatment. Each patient, though, has to obtain special authorization from Anvisa (Brazil’s FDA) to import the semi-synthetic version of this substance originally extracted from African plants, which makes access to treatment very expensive.
Given the various indications for their therapeutic potential, it is difficult to justify why psychedelics are not yet included in the SUS. The reason behind the paradox is that these substances are still prohibited in most countries (with exceptions such as Australia and Canada, where psilocybin and MDMA can be prescribed, and Oregon and Colorado in the US, where licensed facilitators can administer mushrooms).
It is not trivial to raise the regulatory barrier, anywhere, not to mention the stigma created by prohibitionist propaganda. The stigma, as Tófoli recalled in his speech, was never rejected by the medical establishment, which fell in love with psychiatric drugs that emerged from the 1950s to the 1980s, simultaneously with the rejection of psychedelics and psychoanalytic practices.
Something similar seems to be under way, a sort of pharmacological second coming. Companies committed to patenting and commercializing psychedelic therapies, such as psilocybin for depression, minimize the psychotherapeutic component of the treatment, reducing it to mere support—as is the case with Compass Pathways, which has a phase III clinical trial underway.
The psychotherapy component was one of the obstacles highlighted by the FDA for rejecting MDMA. The Brazilian symposium, on the other hand, reaffirmed the crucial role of therapists, as Rasmussen did when describing the wealth of content and the cathartic re-enactment of traumas under the influence of ibogaine, which is not classified as a classic psychedelic, some preferring to call it oneirogenic (dream inducing).
Students in the audience wanted to know which type of psychotherapy would be most useful in psychedelic treatment – transpersonal, cognitive-behavioral, psychoanalysis? Sophie Laborde, from the team of psychologists in the UFRN studies, downplayed the lack of standardization criticized by the FDA, saying that the important thing is for the psychologist to have the necessary skills and that these would need indeed to be required for accreditation of psychedelic therapists.
If it depended on neuroscientists like David Olson, from the University of California at Davis, it would be a waste of time. He is working to develop psychoplastogens, which this blog would prefer to call parapsychedelics: ibogaine analogues and such, incapable of triggering visions, acting solely on other neuronal receptors to induce the formation of neural connections (neuroplasticity).
On November 14th, Olson’s group published another article suggesting that the subjective psychedelic experience could be discarded as a therapeutic factor. It was published in the prestigious journal Science, indicating that the reductionist pharmacological strategy remains popular in normal science and biomedicine.
The dispute for hegemony between this soulless psychedelia and the psychosocial component … could be resolved with the contribution of Brazilian researchers, both in natural sciences and the humanities, but not without a political and social movement behind them.
The field has reached a crossroads, pointed out Beserra, from APB, and Labate, from Chacruna. The dispute for hegemony between this soulless psychedelia and the psychosocial component, as represented at the symposium in Natal, could be resolved with the contribution of Brazilian researchers, both in natural sciences and the humanities, but not without a political and social movement behind them to bring psychedelics to the SUS, comparable to the movement at the turn of the century that led religious use of ayahuasca to be legalized in the Latin American nation.
As many events in Brazil, the symposium closed with a party and a music performance of the artist Raphael Egel (@liveenlightenment), who also composed the playlist used in psychedelic trials at the UFRN.
Art by Mulinga.
Note: A Portuguese version of this story was originally published in the blog Virada Psicodélica by the newspaper Folha de S.Paulo, here.
DISCLAIMER: The author attended the symposium as a speaker and had airfare and lodging expenses paid by the organizers. The views expressed here are by Leite, and not Chacruna. Leite sits on the advisory board of Chacruna.
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