Reduction in comorbidity in indigenous patients attending an addiction treatment with ayahuasca in Mexico
Background: Substance use disorders and comorbid conditions disproportionately affect indigenous populations worldwide, who are also facing limited access to mental healthcare due to scarcity of services and lack of cultural adaptation of care. In the Yaqui indigenous territory of rural Mexico, this picture is compounded by the presence of drug cartels, with high prevalence of violence and high rates of methamphetamine use leading the systemic societal impact of substance use. The Yoo Joara Intercultural Medicine clinic was established in 2021 to address the critical treatment gap through an innovative blend of traditional healing practices including ayahuasca and contemporary mental health care in a community outpatient setting.
Methods: Under the Entheogenic Treatment Outcome Project (ENTOP), an international team conducted a mixed-methods observational study to evaluate the safety, efficacy, and cultural attunement of the Yoo Joara clinic's therapeutic program. A sample of 37 patients, diagnosed with substance use disorder, depression or anxiety participated in individual and group psychotherapy alongside intercultural medicine interventions with ayahuasca. Data was collected using established diagnostic scales and validated instruments in Spanish-speaking populations (BAI, BDI, IDC, MINI).
Results: Preliminary findings reveal significant reductions in depression, anxiety, and grief symptoms following ayahuasca interventions. From 15 patients diagnosed with moderate to severe depression at baseline, only 1 still met the criteria for depression after the first ayahuasca intervention. All 8 patients presenting suicide risk as assessed by the MINI at baseline presented a score of 0 risk of suicidality after one ayahuasca intervention. Despite limitations in follow-up data and response rates, the results suggest rapid and marked improvement, especially noteworthy considering the delayed treatment-seeking tendencies in the community. Safety assessments indicated only one mild adverse event, highlighting the well-tolerated nature of the interventions.
Conclusions: The study's early results suggest that ayahuasca interventions, when integrated into a community-based mental health program, show promise in swiftly alleviating symptoms in patients with diverse mental health diagnoses, thus supporting patients in recovery from substance use. While the authors acknowledge limitations regarding the sample size and lack of follow up data, these results indicate the feasability of implementing a community-based treatment programme including ayahuasca interventions in a indigenous, low ressource setting with promising results.
This approach offers a cost-effective alternative to individual psychiatric care, especially in regions with limited access to mental health services and opens a dialoge towards providing innovative and culturally relevant tools for indigenous mental health workers.
