Ayahuasca Detox Guide

For centuries, humans have bought into the collective delusion that natural substances are generally safe for consumption—an idea that couldn’t be any further from the truth. Ayuahuasca, a potent psychoactive substance native to the amazon, is quickly gaining popularity as a hallucinogenic beverage.  Its glamorized reputation is rooted in a rich history of shamanism and folk medicine that appeals to trendy drug epicenters like Brooklyn and Silicon Valley.

The drug, which is associated with alternate states of consciousness and derived from a plant that is technically legal, contains DMT (dimethyltryptamine)—an illicit Schedule 1 substance. The unpredictable, psychedelic effects of ayahuasca are considered extremely dangerous and represent an emerging public health threat. Although the drug is purported to be effective in treating various substance abuse disorders (SUDs), unsubstantiated evidence of its benefits is overshadowed by its well-documented dangers.    

AYAHUASCA WITHDRAWAL SYMPTOMS

The physical and psychological changes associated with chronic ayahuasca use vary dramatically, as do the accompanying withdrawal symptoms. Like other psychoactive substances, ayahuasca alters neurotransmitter levels in the brain and central nervous system (CNS). Once a user crosses the invisible threshold from experimentation to full-blown ayahuasca addiction, greater quantities of the drug are needed in more frequent doses in order to maintain the same psychedelic effect.  

Although aspects of ayahuasca addiction and its exact effects on the human body remain shrouded in mist, a variety of clinical tools and objective measurements can be used when assessing the severity of withdrawal symptoms upon admission into a detox program. These assessments help form the basis of subsequent medical treatment and clinical intervention.

AYAHUASCA WITHDRAWAL TIMELINE

The severity of ayahuasca withdrawal symptoms and exact length of time involved in the withdrawal process depends upon a variety of factors including age, gender, height, weight, overall mental and physical health. Intensity of dosage and frequency of use also combine to shape the process. As a general guideline, ayauasca withdrawal is typically broken down into the following four stages that mirror those of other mind-altering drugs:

• Stage one—for the majority of clients, the initial three to five days following cessation of use are the most difficult. This intense period may characterized by restlessness, cravings, paranoia, hallucinations, and exhaustion, with the brain kicked into overdrive as it adjusts to the absence of DMT in the system.  Irritability and depression are also extremely common during stage one.
• Stage two—after seven days, the severity of withdrawal symptoms typically diminishes, although cravings may persist. Although clients may continue to experience rebound hallucinations and a wide range of other physical and psychological symptoms, the nightmare of stage one is over.
• Stage three—following the first two weeks, the withdrawal process is characterized by enhanced psychological symptoms including insomnia and disturbing dreams. During this stage, physical processes continue to stabilize despite lingering moods and cravings.

• Stage four—after approximately one month, the majority of ayahuasca withdrawal symptoms begin to subside as the drug completely exits the system; however, occasional cravings may still arise. At this point, a longer, protracted withdrawal process known as post-acute withdrawal syndrome (PAWS) takes hold as mental and physical processes further stabilize. Depending upon the severity of ayahuasca addiction or polysubstance abuse, PAWS can linger for months or even years.

INPATIENT TREATMENT FOR AYAHUASCA

Addiction to ayahuasca requires quality clinical care in a medically managed setting in order to ensure optimal treatment outcomes and minimize the risk of relapse. Following successful completion of initial detox, many clients choose to enroll in treatment at a designated residential facility. This industry-preferred treatment method—known as inpatient treatment—provides a number of advantages including 24/7 client monitoring, a high staff-to-client ratio, heightened security, and a team of highly experienced clinicians and licensed medical professionals. Inpatient treatment programs offer a safe, supportive environment in which recovery remains the highest priority and environmental risks and triggers are strategically minimized, usually for a period of between 30 and 90 days.

MEDICATION-ASSISTED TREATMENT

MAT is an integral part of ayahuasca detox that combines evidence-based medications with behavioral and psychotherapy. This holistic process allows the body and mind time to gradually return to equilibrium while minimizing the adverse effects associated with the drug. After careful evaluation and assessment by a physician, Food and Drug Administration (FDA) approved pharmacological interventions are implemented, and clients begin therapy. Depending upon individual client needs, the following therapies may be included in the MAT protocol in addition to whatever medications are deemed appropriate:

• Cognitive behavioral therapy (CBT)
• Dialectical behavioral therapy (DBT)
• Motivational interviewing (MI)
• Trauma-informed therapy
• Family therapy (if needed)
• Additional creative or expressive therapies

DUAL DIAGNOSIS TREATMENT

Frequently, untreated anxiety and depression-related disorders are the driving force behind ayahuasca addiction—especially major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD). Untreated, these disorders create an ongoing psychological and physiological imbalance that users seek to self-medicate—a process that ultimately leads to addiction. The treatment of “co-occurring” disorders is a key ingredient of successful detox for many clients. Supplemental medications such as gabapentin, pregabalin, and buspirone may be included in the treatment protocol depending upon individual client needs, and are prescribed only after careful evaluation and assessment by a team of licensed medical professionals. 

OUTPATIENT TREATMENT FOR AYAHUASCA

Outpatient treatment is another popular option that involves a less intensive level of care. In outpatient facilities—available in a wide variety of public and private settings—clients do not live on the premise; however, similar treatment methods are employed. One of the primary benefits of outpatient treatment is the flexibility it offers certain clients based upon their demanding personal and/or professional schedules. Outpatient treatment is also optimal for clients successfully transitioning from inpatient detox and requiring longer-term, more casual maintenance therapy.

CAN AYAHUASCA DETOX BE DONE AT HOME

Self-guided, at-home ayahuasca detox is extremely dangerous and never recommended. The physiological and psychological changes that accompany chronic use—and especially abuse— are capable of triggering a multitude of volatile withdrawal symptoms, none of which can be effectively managed without professional intervention.  Licensed medical assistance and clinical expertise are critical to ensuring optimal treatment outcomes and preventing future relapse. Even in cases involving mild recreational use, self-detox in a home setting leads to less than favorable treatment outcomes and adds to the sense of isolation and disconnectedness  frequently responsible for fueling ayahuasca addiction.

TAPERED VS COLD TURKEY

Like self-guided treatment, quitting ayahuasca cold turkey is extremely dangerous and can lead to dire consequences. It can also trigger precipitated withdrawal, a process in which withdrawal symptoms are accelerated and magnified to debilitating effect. Although not usually deadly, precipitated withdrawal triggered by abruptly stopping ayahuasca is a major cause of relapse and failure to achieve optimal treatment outcomes.  Tapering is a more commonly utilized—yet still controversial—method of detox based on gradually weaning a user off ayahuasca in diminishing doses, known as a “tapering schedule.” It is generally considered a far safer and more effective detox option than quitting cold turkey and leads to favorable treatment outcomes.

CONSIDERATIONS/HOW TO DECIDE WHAT IS RIGHT FOR YOU

The decision to seek professional treatment for ayahuasca addiction deserves serious and careful consideration. For the majority of clients, the decision is based largely upon financial feasibility and program location. Although choosing a location close to home becomes a critical factor for some, many industry renowned treatment centers require out-of-state travel. Fortunately, an abundance of treatment centers exist to serve individual needs, and certain industry renowned programs feature an impressively diverse range of treatment options and therapeutic modalities. 

Reputable facilities have trained admissions staff available to help answer questions regarding insurance coverage and address cost-related (or other) concerns for those seeking treatment. Many programs are also willing to assist those of limited financial means with the possibility of private scholarships, federal grants, flexible payment plans, or other alternative arrangements. Although many clients have limited financial means, cost alone should never be the only factor when considering where to seek professional help. The following considerations should also be factored into any well-informed decision:

• Program reputation—locally and nationally
• Addition of amenities, aftercare services and on-site benefits
• Use of state-of-the-art technology and treatment options
• Proximity to major recreational attractions (ocean, mountains, etc.)
• Accessibility from major airports

RECOVERY SUCCESS AND AFTERCARE SERVICES FOR AYAHUASCA

Simply completing medically managed detox is not sufficient to ensure long-term recovery success following ayahuasca addiction. A key component of relapse-prevention involves planning and strictly following a multi-pronged approach. Reputable inpatient facilities can help with strategizing and planning an optimal post-treatment regimen that should include:

• Involvement in AA or NA
• Ongoing medication management
• One-on-one and group therapy
• Life and job skills coaching (if necessary)
• Regular physical activity
• A healthy, nutritious diet and lifestyle decisions
• Random drug testing
• Continual sober peer support
• Community involvement and working a spiritual program

WHO NEEDS AYAHUASCA DETOX

Like other mind-altering substances, ayahuasca is a potent drug that inspires addiction and abuse. Its addictive potential is not exclusively reserved for those with a known family history of substance abuse or genetic proclivity. Anyone, at any time, can find themselves addicted to ayahuasca and in need of professional help.  

For more information about addiction and recovery, check out these related articles:

• “Relapse and the Path to Recovery”
• “What Does a Day in Rehab Look Like?”
• “Are All Detox Programs the Same?”
• “What Are the Cost Benefits of Going to Rehab?”

Sources:

• Psychological Medicine. Rapid antidepressant effects of the psychedelic ayahuasca in the treatment of resistant depression: a randomized placebo-controlled trial.  June, 2018.
• The International Journal on Drug Policy. Ayahuasca’s entwined efficacy: An ethnographic study of ritual healing from ‘addiction.’  June, 2017.
• Brain Research Bulletin. Ayahuasca: Pharmacology, neuroscience and therapeutic potential. Sept, 2016.
• Journal of Psychopharmacology. The current state of research on ayahuasca: A systematic review of human studies assessing psychiatric symptoms, neuropsychological function, and neuroimaging. June, 2016.