From Venerable Cultural Practices to Modern Psychological Solutions: Enter Entheogens into Mainstream Medicine

Abstract

Entheogens, a class of psychoactive substances with profound cultural and religious significance, have been utilized for centuries across diverse traditions for healing, spiritual exploration, and communication with the divine. Their historical usage spans continents, from the pre-Columbian Americas to traditional African practices and Ayurvedic medicine in India. While entheogens offer potential therapeutic benefits, their use entails inherent risks, including physiological and psychological adverse effects. Recent research has increasingly focused on elucidating the mechanisms of action and therapeutic potential of entheogens such as psilocybin, N,N-dimethyltryptamine (DMT), mescaline, lysergic acid diethylamide (LSD), ayahuasca, ibogaine, and Salvia divinorum. These substances exhibit diverse pharmacological profiles, acting primarily on serotonin receptors and other neurotransmitter systems, resulting in alterations in perception, mood, and cognition. Clinical studies have demonstrated promising results for entheogens in the treatment of psychiatric disorders, including depression, anxiety, addiction, and post-traumatic stress disorder (PTSD), and, to a lesser extent, pain management and cluster headaches. However, regulatory constraints, limited participant numbers, and ethical considerations hinder comprehensive research. Safety considerations are paramount in administering entheogens, necessitating proper dosing, individual risk assessment, supportive set and setting, and medical supervision. Adherence to rigorous clinical trial standards and transparent methodologies is essential for advancing research and harnessing the therapeutic potential of entheogens. Despite obstacles, continued investigation into entheogens is imperative for unlocking their therapeutic potential and developing safe and effective mental health treatments. Key research avenues include elucidating mechanisms of action, standardizing administration protocols, determining optimal dosages, and assessing long-term effects and associated risks. While cannabis is commonly recognized as an entheogen, it was not encompassed in this review. The authors omitted it due to its unique status, ongoing discourse, and the need for a separate dedicated analysis.