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Personal anecdotes overwhelm cautionary details in WSJ story on ayahuasca, a Peruvian hallucinogenic concoction

Is Peru’s Psychedelic Potion a Cure or a Curse?

Our Review Summary

An ayahuasca ceremony in Peru. Credit: Flickr user brindle95.

An ayahuasca ceremony in Peru. Credit: Flickr user brindle95.

This story describes a growing industry of foreigners traveling to Peru’s Amazonian jungle to drink ayahuasca, a psychedelic brew of local plants that proponents claim can open up the mind and relieve such ailments as depression and addiction. The story includes anecdotes from people who have tried the substance and say it helped them as well as comments from clinical professionals and other users who do provide some caution about adverse effects.

But, the story could have done a better job by attempting to verify users’ claims that the substance helped their mental disorders, and by tapping more independent sources to back up the assertion that there’s “growing interest” in ayahuasca in the scientific community. We also think the six positive patient anecdotes overwhelm the details on the (very real and significant) potential harms. At least one personal account of the harms would have brought the story into better balance.

 

Why This Matters

A wave of overwhelmingly positive media coverage of ayahuasca has stoked a booming unregulated industry of ayahuasca tourism in Peru that may be putting travelers at risk. In 2013 LA Weekly declared it “exceedingly trendy,” running a cover story and a list of 10 celebrity users. In a television interview last year, actress Lindsay Lohan claimed that ayahuasca helped her addiction issues. We highlighted an 8-minute segment on Fox News last year in which a book author was allowed to hype ayahuasca use unchallenged.

While the coverage hasn’t all been glowing, the attention could lend legitimacy to a substance that has not been proven safe or effective for treating any condition. The active ingredient in ayahuasca is N,N-Dimethyltryptamine, or DMT, which is listed as a Schedule 1 drug under the U.S. Controlled Substances Act, meaning it is illegal to possess, like heroin or LSD. Schedule 1 drugs are considered the most dangerous class of drugs with a high potential for abuse and no accepted medical use. 

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story says foreigners are “paying up to $2,500 a week to drink the elixir,” though it does not say whether this is typical. The story could have elaborated by describing the costs of travel and living expenses while taking the substance, too. There are hidden costs to think about, too, such as treating the negative adverse effects of the drug

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

Without research studies to quantify the benefits of ayahuasca, the story relies on anecdotes. “Proponents say that it can provide users with spiritual and personal guidance. Others report that it has allowed them to overcome traumas that conventional therapy and antidepressants haven’t cured,” the story says.

The story mentions more several patients who’ve tried it successfully, including a Chicago man who said ayahuasca “eased his depression,” a Texas woman who said it “helped to cure her debilitating migraines, which she thinks were tied to childhood abuse,” and an Oklahoma woman who said the substance help her “overcome the trauma” of her first husband’s death. There’s no indication that the reporter attempted to contact clinical professionals who could comment on these claims.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

Potential harms are called out clearly starting with the headline, which reads: “Is Peru’s Psychedelic Potion a Cure or a Curse? Foreigners are flocking to try a traditional brew called ayahuasca that some say eases psychological distress — but it has dangers, too.”

The story mentions vomiting as a common reaction in the third paragraph. More serious risks are addressed in paragraph nine, which says “some scientists — and users — warn that ayahuasca can be dangerous. It can be fatal when mixed with other drugs, such as antidepressants, and should be avoided by those who are bipolar or schizophrenic, since it has been known to trigger psychotic episodes.”

The story also tells of purported deaths related to ayahuasca use, but these incidents are not flushed out in detail, leaving the reader to wonder about their significance. It paraphrases comments from a U.S. Navy official who says DMT can cause seizures, comas and respiratory arrests and lead to hallucinations that “can be so traumatic that they can worsen medical conditions such as PTSD.” Another user mentions “nightmarish hallucinations.”

However, there are no firsthand accounts of these known harms, unlike the many accounts of positive experiences.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story lacks objective sources who could reconcile the glowing claims of some users with a lack of medical evidence. The second paragraph states that “some Western scientists think (ayahuasca) can help to heal psychological traumas.” But the reader never gets much evidence of that. One researcher says it “might help to treat addiction,” and another that it “may help ease depression.” But the story does not explain the basis for those statements or describe what type of work the scientists do.

Further along, the story asserts that “surreal” stories from ayahuasca users “have prompted growing interest by Western researchers, amid a wider revival of studies into the therapeutic use of psychedelics.” But the story offers no strong evidence that ayahuasca is becoming a topic of more research. It mentions plans for a study in Peru of people with post-traumatic stress disorder, supported by a California-based advocacy group called the Multidisciplinary Association for Psychedelic Studies (MAPS), but offers no information on the study’s funding, methods or purpose.

The story says the association also “hopes to get FDA approval for a study in the U.S.,” but does not explain how it might overcome the funding and regulatory hurdles that such a study of a controlled substance would entail. The story needs perspective from independent mental health experts who could assess the potential of ayahuasca as a possible therapy.

Does the story commit disease-mongering?

Satisfactory

There’s no evidence of disease mongering.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

Aside from the Navy official, the story lacks input from independent mental health experts and patient advocacy groups. However, his inclusion in the story is sufficient to rate Satisfactory.

We do want to point out that the California-based advocacy group that’s mentioned as wanting to seek funding for studies (the Multidisciplinary Association for Psychedelic Studies) states on its website that it has created a subsidiary that may generate profits in the sale of legal MDMA (“ecstasy” or “molly”) if and when it gains FDA approval. So beyond selling newspapers, there may be other financial incentives for the promotion of hallucinogens-as-therapy.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story could have done a better job of explaining what treatments users of ayahuasca tried before taking the extreme step of traveling to the Amazon. The lead describes one U.S. Army vet who “tried antidepressant drugs and therapy to overcome depression and bouts of anger. Nothing worked.”  But there’s no indication that the reporter attempted to contact a clinician who treated the vet, or one who treats vets with similar conditions, to find out what specific therapies are used and their rate of efficacy.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story describes numerous “ayahuasca centers” that have cropped up around the city of Iquitos in Peru’s northeastern Amazon.

Does the story establish the true novelty of the approach?

Satisfactory

The story calls ayahuasca “a centuries-old, sacred indigenous brew.”

Does the story appear to rely solely or largely on a news release?

Satisfactory

This story does not rely on a news release.

Total Score: 7 of 10 Satisfactory

Comments (2)

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Christopher Daniels

May 6, 2016 at 3:27 am

I find it interesting that “Why This Matters” mentions “Schedule 1 drugs are considered the most dangerous class of drugs with a high potential for abuse and no accepted medical use,” – without any challenges. Is it a legitimate stance on DMT, which, by the way, is naturally produced in all mammalian brains? Maybe there should have been more ayahuasca skepticism, but then there would also have to be exploration of the criminalization of this substance.

Reply

Emily Sinclair

May 8, 2016 at 6:06 am

Have you considered the reason there is no personal account about the harms of ayahuasca is because nobody they interviewed or came across had any personal experience of the apparent harms ayahuasca can do? I work with ayahuasca in Peru and can tell you it would be difficult to find ayahuasca tourists who talk negatively about ayahuasca, although possible. To find someone who could actually give you a personal account of harm caused by ayahuasca is pretty much impossible. Any harm caused to aya tourists that I know of was not caused by the substance itself. It is interesting that you speak of ‘(very real and significant) potential harms’ but do not outline any. The only ‘evidence’ you present to suggest ayahuasca is harmful are drug laws, which are not evidence based themselves but widely refuted as completely unrelated to scientific evidence about harm risk to users.

Reply