Skip to main content

Advertisement

Log in

Ayahuasca Exposure: Descriptive Analysis of Calls to US Poison Control Centers from 2005 to 2015

  • Original Article
  • Published:
Journal of Medical Toxicology Aims and scope Submit manuscript

Abstract

Background

Ayahuasca is a hallucinogenic plant preparation which usually contains the vine Banisteriopsis caapi and the shrub Psychotria viridis. This tea originates from the Amazon Basin where it is used in religious ceremonies. Because interest in these religious groups spreading as well as awareness of use of ayahuasca for therapeutic and recreational purposes, its use is increasing. Banisteriopsis caapi is rich in β-carbolines, especially harmine, tetrahydroharmine and harmaline, which have monoamine oxidase inhibiting (MAOI) activity. Psychotria viridis contains the 5HT2A/2C/1A receptor agonist hallucinogen N,N-dimethyltryptamine (DMT). Usual desired effects include hallucination, dissociation, mood alteration and perception change. Undesired findings previously reported are nausea, vomiting, hypertension, and tachycardia.

Methods

All human exposure calls reported to the American Association of Poison Controls Centers' (AAPCC) National Poison Data System (NPDS) between September 1, 2005 and September 1, 2015 were reviewed. Cases were filtered for specific plant derived ayahuasca-related product codes. Abstracted data included the following: case age and gender, exposure reason, exposure route, clinical manifestations, treatments given, medical outcomes and fatality.

Results

Five hundred and thirty-eight exposures to ayahuasca botanical products were reported. The majority of the calls to poison control centers came from healthcare facilities (83%). The most common route of exposure was ingestion. Most cases were men (437, 81%, 95% CI 77.7% - 84.3%). The median age was 21 (IQR 18-29). Most exposures were acute. Three hundred thirty-seven (63%) were reported to have a major or moderate clinical effect. The most common clinical manifestations reported were hallucinations (35%), tachycardia (34%), agitation (34%), hypertension (16%), mydriasis (13%) and vomiting (6%). Benzodiazepines were commonly given (30%). There were 28 cases in the series who required endotracheal intubation (5%). Four cases were reported to have had a cardiac arrest and 7 a respiratory arrest. Twelve cases had a seizure. Reports of exposures called to poison centers appeared to increase during this period based on annual estimates. Three fatalities were reported.

Conclusions

Ayahuasca use appears to be rising in the United States based on calls to poison control centers. While most use is reported to be safe and well tolerated, with possible beneficial effects, serious and life threatening adverse manifestations are possible. Most of the exposures reported to poison control centers were young people, more likely to be men and already in a healthcare facility. Further research, which includes comprehensive drug testing, will be needed to better identify the risks and effects of ayahuasca use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. United States Supreme Court case 2005. Accessible at: http://www.supremecourt.gov/opinions/05pdf/04-1084.pdf

  2. Riba J, Valle M, Urbano G, Yritia M, Morte A, Barbanoj MJ. Human pharmacology of ayahuasca: subjective and cardiovascular effects, monoamine metabolite excretion, and pharmacokinetics. J Pharmacol Exp Ther. 2003;306(1):73–83.

    Article  CAS  PubMed  Google Scholar 

  3. Buckholtz NS, Boggan WO. Monoamine oxidase inhibition in brain and liver produced by β-carbolines: structure-activity relationships and substrate specificity. Biochem Pharmacol. 1977;26(21):1991–6.

    Article  CAS  PubMed  Google Scholar 

  4. Samoylenko V, Rahman MM, Tekwani BL, Tripathi LM, Wang YH, Khan SI, Khan IA, Miller LS, Joshi VC, Muhammad I. Banisteriopsis caapi, a unique combination of MAO inhibitory and antioxidative constituents for the activities relevant to neurodegenerative disorders and Parkinson’s disease. J Ethnopharmacol. 2010;127(2):357–67.

    Article  CAS  PubMed  Google Scholar 

  5. Pierce PA, Peroutka SJ. Hallucinogenic drug interactions with neurotransmitter receptor binding sites in human cortex. Psychopharmacology. 1989;97(1):118–22.

    Article  CAS  PubMed  Google Scholar 

  6. Smith RL, Canton H, Barrett RJ, Sanders-Bush E. Agonist properties of N, N-dimethyltryptamine at serotonin 5-HT 2A and 5-HT 2C receptors. Pharmacol Biochem Behav. 1998;61(3):323–30.

    Article  CAS  PubMed  Google Scholar 

  7. Mowry JB, Spyker DA, Brooks DE, McMillan N, Schauben JL. 2014 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 32nd annual report. Clin Toxicol. 2015;53(10):962–1147.

    Article  CAS  Google Scholar 

  8. Palamar JJ, Martins SS, Su MK, Ompad DC. Self-reported use of novel psychoactive substances in a US nationally representative survey: prevalence, correlates, and a call for new survey methods to prevent underreporting. Drug Alcohol Depend. 2015;156:112–9.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sklerov J, Levine B, Moore KA, King T, Fowler D. A fatal intoxication following the ingestion of 5-methoxy-N, N-dimethyltryptamine in an ayahuasca preparation. J Anal Toxicol. 2005;29(8):838–41.

    Article  CAS  PubMed  Google Scholar 

  10. Callaway JC, Grob CS, McKenna DJ, Nichols DE, Shulgins A, Tupper KW. A demand for clarity regarding a case report on the ingestion of 5-methoxy-N, N-dimethyltryptamine (5-MeO-DMT) in an ayahuasca preparation. J Anal Toxicol. 2006;30(6):406–7.

    Article  CAS  PubMed  Google Scholar 

  11. Alatrash G, Majhail NS, Pile JC. Rhabdomyolysis after ingestion of “foxy,” a hallucinogenic tryptamine derivative. In: Mayo clinic proceedings 2006 Apr 30 (Vol. 81, No. 4, pp. 550–551). Elsevier.

  12. Smolinske SC, Rastogi R, Schenkel S. Foxy methoxy: a new drug of abuse. Journal of medical toxicology. 2005;1(1):23–5.

    Article  PubMed Central  Google Scholar 

  13. Osório FD, Sanches RF, Macedo LR, dos Santos RG, Maia-de-Oliveira JP, Wichert-Ana L, de Araujo DB, Riba J, Crippa JA, Hallak JE. Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report. Rev Bras Psiquiatr. 2015;37(1):13–20.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. William Heise.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Sources of Funding

No funding was used for this project.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Heise, C.W., Brooks, D.E. Ayahuasca Exposure: Descriptive Analysis of Calls to US Poison Control Centers from 2005 to 2015. J. Med. Toxicol. 13, 245–248 (2017). https://doi.org/10.1007/s13181-016-0593-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13181-016-0593-1

Keywords

Navigation