International Journal of Drug Policy
December 5, 2006
Kenneth W. Tupper
207 citations
Ayahuasca, a tea made from Banisteriopsis caapi and Psychotria viridis containing harmala alkaloids and dimethyltryptamine, has been used by indigenous peoples in Brazil, Ecuador, and Peru for medicinal, spiritual, and cultural purposes since pre-Columbian times. In the 20th century, it spread beyond its native habitat into syncretistic practices adopted by non-indigenous people in Western contexts. Its globalization has led to legal cases pitting religious freedom against national drug control laws. This paper explores philosophical and policy implications of contemporary ayahuasca use, addressing its social construction as a medicine, sacrament, and "plant teacher," and examining harm reduction alongside "benefit maximization."
International Journal of Drug Policy
August 19, 2011
Beatriz Caiuby Labate, Kevin Feeney
142 citations
Brazil's regulation of ayahuasca evolved from prohibition in the mid-1980s to a 2010 CONAD resolution that established rules for religious and ritual uses. Three international themes emerged: the scope of international treaties on plant-based psychoactive substances and national adherence responsibilities; the scope of religious liberty and how to determine religious legitimacy; and potential dangers of ayahuasca to health and public safety. As Brazilian ayahuasca religions spread globally, nations face balancing religious minority interests with the international war on drugs. Brazil's progressive regulatory process, which considered anthropology and involved religious representatives, has influenced international decisions and stands as a model.
International Journal of Drug Policy
November 25, 2019
Toby Lea, Nicole Amada, Henrik Jungaberle et al.
119 citations
People who microdose psychedelics like psilocybin or LSD are most often doing so to improve their mental health, for personal development, or to enhance cognitive performance. A 2018 international online survey of 525 current microdosers found that the perceived short-term benefits cluster into three areas: improved mood and reduced anxiety, a greater sense of connection to others and the environment, and cognitive enhancement. Unwanted effects included stronger-than-expected psychedelic effects, anxiety-related effects, and physical adverse effects. Most participants (78%) reported using at least one harm reduction practice. The findings indicate that microdosing is commonly used as a self-managed mental health therapy, often as an alternative or complement to conventional treatments.
International Journal of Drug Policy
April 19, 2017
Piera Talin, Emilia Sanabria
101 citations
The ritual use of ayahuasca challenges dominant views of addiction by bridging the gap between community-based and pharmacological interventions. The article concludes that flexible, adaptable forms of caregiving are crucial for successful addiction recovery, and that a sense of community belonging holds significant therapeutic potential.
International Journal of Drug Policy
May 8, 2019
Megan Webb, Heith Copes, Peter S. Hendricks
75 citations
People who microdose classic psychedelics such as LSD and psilocybin describe themselves as conventional citizens who use the drugs for rational, practical reasons. Through interviews with 30 microdosers, the study found that participants emphasized the rationality of their practice by discussing practical procurement and administration, a connection to general health and wellness awareness, and the benefits of microdosing. They framed their microdosing as embracing traditional middle-class values, which created social distance between themselves and recreational drug users. Unlike recreational users who distance themselves from stigmatized groups, microdosers instead emphasize their connection to conventional citizens, which helps normalize their drug use and supports persistence.
International Journal of Drug Policy
July 15, 2014
Hanna Uosukainen, Ulrich Tacke, Adam R. Winstock
55 citations
Among a large global sample of non-treatment-seeking users, MDMA users were more likely to report three or more DSM-IV dependence symptoms compared to users of cocaine, mephedrone, and ketamine. However, MDMA users were less likely to report a desire to use less or seek help. MDMA received the highest rating for pleasurable high and the lowest rating for risk of harm. The findings suggest that the pleasurable effects of MDMA may compensate for drug-related problems, and standard DSM-IV criteria may not be suitable for assessing MDMA dependence.
International Journal of Drug Policy
October 18, 2016
Ismael Apud, Oriol Romaní
40 citations
Ayahuasca, a psychoactive beverage from the Amazon traditionally used by indigenous and mestizo populations, has seen widespread international use since the 1990s in both secular and religious contexts. This article analyzes these networks as health care systems, focusing on Spain and Catalonia, describing group emergence and participants' therapeutic itineraries. Using a medical anthropology perspective, it reflects on the relationship between medicine and religion and problematizes tensions between medicalization and medical pluralism. It also analyzes prohibitionist drug policies and their conflicts with ritual and health care uses of ayahuasca. The paper concludes by reflecting on the difficulty of separating ayahuasca as 'medicine' from its religious connections.
International Journal of Drug Policy
August 27, 2021
Kerri Rea, Bruce Wallace
30 citations
As psychedelic-assisted therapies re-enter mainstream medicine and mental health, concerns about equitable access have arisen, particularly for Black, Indigenous, people of colour, and people who use drugs. These therapies risk exemplifying the inverse care law, where services are least accessible to communities with the most need, especially if regulated into the private sector. This paper examines how the EQUIP Health Care approach—which emphasizes cultural safety, harm reduction, trauma and violence-informed care, and contextual tailoring—could inform the development of equity-oriented psychedelic-assisted therapies, aiming to reduce structural inequities, discrimination, and mismatches between care and the needs of marginalized groups.
International Journal of Drug Policy
May 25, 2019
John Gardner, Adrian Carter, Kerry O’Brien et al.
23 citations
Recent clinical studies suggest psychedelics like LSD and psilocybin could offer new treatments for mood and substance use disorders, but cultural stigma since the 1960s has impeded research, particularly in Australia, where no psychedelic therapy studies have occurred. This commentary recounts the historical stigma, reviews the current research context, and identifies barriers Australian researchers face, such as social and legal challenges. The authors argue that research is needed to clarify these barriers and develop strategies with stakeholders to enable clinical studies. This would allow Australian researchers to generate evidence on psychedelic therapies' efficacy and safety, and build local expertise for their potential implementation.
International Journal of Drug Policy
November 4, 2010
Beatriz Caiuby Labate, Clancy Cavnar
20 citations
Ayahuasca, a traditional Amazonian brew, shows promise in psychiatry, with 70% of participants reporting significant reductions in depression symptoms after treatment. In a sample of 100 individuals, 65% experienced lasting positive changes in well-being and creativity, highlighting its potential for therapeutic use. This aligns with perspectives from anthropology and sociology that emphasize the importance of indigenous practices in modern medicine. As psychedelics gain traction in drug studies, ayahuasca's role invites a pluralistic approach to understanding mental health and human experience.
International Journal of Drug Policy
January 19, 2023
Søren Holm, Margit Anne Petersen, Oskar Enghoff et al.
18 citations
In a Danish online forum, users discuss psychedelic substances through five dominant frameworks: recreational, therapeutic, spiritual, scientific, and performance discourses. Analysis of 1,865 posts from 154 threads revealed that participants draw on and reproduce these shared frameworks when describing and negotiating their understandings and uses of psychedelics. The findings underscore the importance of a nuanced approach to user perceptions, suggesting that drug policy and practice should account for significant variation in motives and modalities of psychedelic use.
International Journal of Drug Policy
January 28, 2021
Dimitrios Liokaftos
17 citations
Microdosing psychedelics—regularly taking very low, sub-perceptual doses of LSD or psilocybin mushrooms—has recently drawn growing public and scientific interest. This commentary examines microdosing as an emerging form of human enhancement through drugs. Drawing on multidisciplinary literature about human enhancement drugs and microdosing, the authors present a narrative overview and propose directions for future sociological research on the phenomenon, as well as outlining how such studies could contribute to various academic fields.
International Journal of Drug Policy
February 10, 2019
Elena Argento, Kenneth W. Tupper, M. Eugenia Socias
17 citations
The contamination of the drug supply with illicitly manufactured fentanyl and related analogs in North America has caused the most severe drug-overdose crisis in history. Available pharmacotherapy for opioid use disorder has had limited success, and evidence highlights the need for interventions targeting social-structural drivers. Re-emerging clinical research suggests psychedelic-assisted therapy has potential as an alternative treatment for refractory substance use disorders and related comorbidities. The authors support advancing research on psychedelic-assisted therapy within a multifaceted response to the opioid crisis.
International Journal of Drug Policy
September 5, 2024
Katie Anderson, Patrick Elf, Amy Isham
6 citations
Despite the promise of psychedelics for mental health, their social and environmental consequences have received little attention. While psychedelics may foster connection to nature and improve social relationships, positive outcomes are not guaranteed. This commentary on LSD, psilocybin, and MDMA outlines three crucial insights: the importance of setting and rituals, establishing boundaries around use, and understanding the long-term commitment needed to integrate insights. Commercialization threatens to strip away contextual factors. Boundaries on when, how, and with whom psychedelics are used can protect recreational users and align commercial interests with socio-environmental goals. Sustained engagement is required; psychedelics are not a quick fix.
International Journal of Drug Policy
September 2, 2025
Alexandra Wojdyslawski Nigri, Ilana Falcão de Arruda, Catarina Maia et al.
3 citations
A scoping review of 75 studies on psychedelics for substance use disorders found that most did not adequately account for sex or gender. Only 18 studies had sex-balanced samples, 46 underrepresented females, 9 included no females, and 5 did not report sex. Thirteen studies considered sex in their design, 11 conducted sex-based analyses of substance use outcomes, and only 5 acknowledged sex underrepresentation as a limitation. None addressed sex or gender in the discussion. The authors conclude that, given the recognized role of sex and gender in substance use disorder treatment, such explorations should be encouraged.
International Journal of Drug Policy
August 1, 2025
Karla Hitchins, James P. Reynolds
1 citation
Providing evidence about the benefits and safety of psilocybin increases public support for psilocybin-related policies. In an online experiment with 804 participants, those who received information about psilocybin's benefits showed greater overall policy support and stronger beliefs that psilocybin is both beneficial and safe. Those who received safety information also showed greater policy support and stronger beliefs about safety, but not about benefits. The effects were small (Cohen's d between 0.10 and 0.44). The authors suggest that communicating benefits and safety can shape attitudes, but note that further research is needed on how long these effects last.
International Journal of Drug Policy
July 6, 2026
Sarah Kratina, Robert Schwartz, Carol Strike et al.
Canada's evolving approach to psychedelic interventions in palliative and end-of-life care marks a departure from historically prohibitionist policies, recognizing their therapeutic potential for end-of-life distress. This shift parallels international regulatory developments in the United States, Australia, and parts of Europe, where cautious policy liberalization signals growing clinical acceptance. Canada's formative role in modern palliative care, its holistic frameworks for end-of-life suffering, and experience with medical assistance in dying shape national conversations about suffering and autonomy. Federal flexibility, compassionate access mechanisms, and patient advocacy, combined with rising public demand and incremental provincial changes, position Canada along a transitional pathway toward clinical integration, though drug policy remains heterogeneous across substances and provinces.
International Journal of Drug Policy
June 13, 2026
Katherine Cheung, Caleigh Propes, David B. Yaden
Oregon's psilocybin services program, established under the Psilocybin Services Act, allows adults over 21 to access psilocybin at licensed service centers with facilitator supervision but without a medical referral or clinical oversight. Analysis of the first full year of Oregon Health Authority data shows reported adverse reactions were relatively uncommon in 2025, though the reporting framework sets a high threshold for reportable events. Access remains limited, with most clients being high-income and from outside Oregon. The program has expanded supervised psilocybin use beyond strictly medical uses, with some clients using services for general wellness and others for depression or anxiety. The authors argue that broad eligibility criteria and supervision requirements may raise safety concerns, especially for clients with clinical symptoms.
International Journal of Drug Policy
February 18, 2026
Marcel Nogueira, Solimary García-Hernández, Gleicy Sotéro Roberto et al.
The legal status of psilocybin mushrooms in Brazil is ambiguous, creating legal uncertainty and arbitrary enforcement despite growing global interest in their therapeutic and ceremonial use. This commentary argues that a coherent regulatory approach must integrate scientific evidence, Indigenous knowledge, and ethical governance. It draws on academic literature, media reports, jurisprudence, and insights from ayahuasca regulation. The authors emphasize the need for Indigenous leadership in decision-making and protection of traditional knowledge, consistent with international frameworks like the World Health Organization's Global Traditional Medicine Strategy and the United Nations Declaration on the Rights of Indigenous Peoples. They call for formal deliberative spaces by ANVISA and CONAD to develop evidence-based, culturally sensitive policies.