La funcionalidad política de la ciencia prohibicionista: El caso del cannabis y los psicodélicos / The political uses of prohibitionist science: The case of cannabis and psychedelics

Se analiza, desde una perspectiva externalista, el uso de la ciencia como herramienta política por parte de la lógica prohibicionista. El prohibicionismo trabaja para que sus preceptos político-morales sean considerados científicos, es decir, como el resultado de un proceso de investigación neutro a nivel ideológico. El artículo analiza el caso del cannabis y de los psicodélicos para mostrar cómo el prohibicionismo solo ha recurrido a la "ciencia" para ocultar su agenda político-moral, mientras ha ignorado todos los resultados de las investigaciones científicas que no se ajustaban a sus apriorismos. Finalmente planteamos que las políticas de drogas deben fundamentarse en la evidencia científica y en ciertos valores básicos -defensa de la salud pública, de la cohesión social, de los Derechos Humanos-, por lo que un análisis en términos de relaciones de poder permitiría entender mejor las contradictorias relaciones entre ciencia y políticas de drogas.

This article analyzes the use of science as a political tool in prohibitionist logic, adopting an externalist perspective. Prohibitionism strives to have its political-moral precepts be considered scientific, that is, the result of an ideologically neutral research process. The article analyzes the case of cannabis and psychedelics to show how prohibitionism has only resorted to "science" to hide its political-moral agenda, while ignoring the results of scientific research that did not fit its apriorisms. Finally, we argue that drug policies should be based on scientific evidence and on certain basic values - the defense of public health, social cohesion, Human Rights - such that an analysis in terms of power relations would allow us to better understand the contradictory relationships between science and drug policies.

Long-term effects of ayahuasca in patients with recurrent depression: a 5-year qualitative follow-up

Background Ayahuasca is a botanical hallucinogenic preparation traditionally used by indigenous populations of Northwestern Amazonian countries for ritual and therapeutic purposes. It is rich in β-carboline alkaloids and N,N-dimethyltryptamine (DMT). Preclinical, observational, and experimental studies suggest that ayahuasca and its alkaloids have anxiolytic and antidepressive effects. We recently reported in an open-label trial that ayahuasca administration was associated with significant decreases in depression symptoms for 2-3 weeks after the experimental session in 17 patients with treatment-resistant major depressive disorder. Objectives To investigate if the experiment had any long-lasting effects on patients Methods Eight patients were interviewed 4 to 7 years after ayahuasca intake. Results Our results suggest that ayahuasca was well tolerated and that symptom reductions were limited to a few weeks. Importantly, most patients believed that the experience was among the most important of their lives, even 4-7 years later. Discussion To the best of our knowledge, this is the first long-term follow-up of a clinical sample that participated in an ayahuasca trial. Further studies with different and repeated dosing should be designed to further explore the antidepressive and anxiolytic effects of ayahuasca.

Ayahuasca: what mental health professionals need to know

Abstract Background Ayahuasca is a psychoactive ethnobotanical concoction that has been used for decades by indigenous groups of the Northwestern Amazon and by syncretic religious organizations for ritual and therapeutic purposes. In the last two decades, it is being used worldwide in evolving practices. Ayahuasca seem to therapeutic effects, but controlled studies are lacking. Moreover, its safety and toxicity are not completely understood. Objectives To present an overview of the effects of ayahuasca based on the most recent human studies. Methods Narrative review. Results Ayahuasca administration in controlled settings appears to be safe from a subjective and physiological perspective, with few adverse reactions being reported. More frequent adverse reactions occur in non-controlled settings. Prolonged psychotic reactions are rare and seem to occur especially in susceptible individuals. Ayahuasca showed antidepressive, anxiolytic, and antiaddictive effects in animal models, observational studies, and in open-label and controlled studies. Discussion Ayahuasca administration in controlled settings appear to be safe. Moreover, ayahuasca seem to have therapeutic effects for treatment-resistant psychiatric disorders that should be further investigated in randomized controlled clinical trials. However, medical complications and cases of prolonged psychotic reactions have been reported, and people with personal or family history of psychotic disorders should avoid ayahuasca intake.

Factores relacionados con el consumo de sustancias psicoactivas en una institución educativa de Jamundí Valle, Colombia / Factors Related With Psychoactive Substance Use in an Educational Institution in Jamundí Valle, Colombia

Objetivo: Estimar la prevalencia del consumo de sustancias psicoactivas (SPA) entre los jóvenes de una institución educativa de Jamundí y sus posibles factores relacionados. Método: Estudio transversal con enfoque analítico que simula casos y controles. Se midió una institución educativa de Jamundí-Valle. Conformaron la muestra 146 estudiantes escogidos por muestreo probabilístico aleatorio simple sin reemplazo. Los participantes diligenciaron individual y anónimamente un cuestionario para identificar el consumo de SPA y sus factores asociados, incluyendo la escala de Apgar para medir el funcionamiento familiar. Una vez diligenciados los cuestionarios, los datos se ingresaron en una matriz en Microsoft Excel y se procesaron en los programas EpiInfo versión 5.0 y Stata. Se realizó análisis descriptivo bivariable y multivariable mediante regresión logística no condicionada. Resultados: Se halló consumo actual de SPA en el 35% de la muestra; la edad de inicio del consumo fue entre los 10 y los 13 años; la prevalencia de consumo de SPA por sexo es del 34% de las mujeres y el 37% de los hombres; la sustancia legal más consumida es el alcohol (34%), y el consumo de las ilegales es del 3%. Las asociaciones más significativas con el consumo de SPA son: tener disfunción familiar grave (odds ratio [OR] = 7,32; intervalo de confianza del 95% [IC95%], 1,74-30,76), cursar el grado 11 (OR = 14,6; IC95%, 2,37-89,74) y tener amigos que consumen (OR = 3,12; IC95%, 2,49-10,38). Conclusiones: Los resultados obtenidos en este estudio muestran un alto porcentaje de consumo de SPA, con mayor prevalencia en el sexo masculino; en esta población, la sustancia legal más consumida es el alcohol. La disfunción familiar y el grado escolar se asocian de manera significativa con el consumo de SPA.

Objective: To estimate the prevalence of psychoactive substances (SPA) use in young people in an educational institution in Jamundí and possible related factors. Methods: Cross-sectional study, analytical approach that simulates cases and controls, was conducted in an educational institution in Jamundí-Valley. The sample was composed of 146 students selected through simple random probability sampling without replacement. Participants individually and anonymously completed a questionnaire to identify SPA consumption and associated factors, including APGAR scale to measure family functioning. The data extracted from the questionnaires were entered into a matrix in Microsoft Excel and processed in Epilnfo version 5.0 and Stata. Descriptive analysis was performed, and a multivariate analysis was performed using unconditional logistic regression. Results: Current consumption of SPA, 35%; age of first use was 10 to 13 years; the prevalence of drug misuse by gender was 34% for girls and 37% in boys. The most consumed legal substance was alcohol 34%, and illegal 3%. The most significant associations with the use of psychoactive substances was; having severe family dysfunction (OR=7.32; 95%CI, 1.7430.76), being enrolled in the 11th grade (OR = 14.6; 95%CI, 2.37-89.74), and having friends who use (OR = 3.12; 95%CI, 2.49-10.38). Conclusions: The results obtained in this study show a high percentage of SPA consumption, with a higher prevalence in males. In this population, the most commonly used legal substance is alcohol. Family dysfunction and school grade were significantly associated with drug misuse.

Las propiedades farmacocinéticas del ayahuasca / The pharmacological properties of ayahuasca

Se describe las características químicas y los efectos del consumo del ayahuasca para conocer el estado actual de los descubrimientos existentes hasta la fecha sobre sus propiedades farmacocinéticas. Se realizó una revisión bibliográfica sobre estudios del ayahuasca hasta el año 2013 en inglés, español y portugués en las bases de datos de PubMed, PsycINFO, Psyke, Psicodoc y Redalyc, así como en capítulos de libros y bibliografía relacionada obtenida de investigaciones afines. Se concluye que uno de los componentes del ayahuasca, la harmina, puede ser utilizada para tratar diferentes patologías.

It describes the chemical characteristics and the effects of Ayahuasca consumption, in order to know the current status of the discoveries to date regarding their pharmacological properties. A literature review was performed on studies of ayahuasca until 2013 in English, Spanish, and Portuguese in the databases of PubMed, PsycINFO, Psyke, Psicodoc, and Redalyc; as well as chapters in books and literature obtained from related research. It is concluded that one of the components of ayahuasca û harmina û can be used to treat different pathologies.

Neurociencias y aplicaciones psicoterapéuticas en el renacimiento de la investigación con psicodélicos / Neurosciences and psycotherapeutic applications in the psychedelic research renaissaince

The main scope of this review is to expose the main advances regarding recent research of psychedelic substances in the neurociences and their potential psychotherapeutic applications. Psilocybin, a 5-HT2A receptor agonist has been associated with reduced activity in the Default-Mode Network (commonly activated during introspection and self-reflection), enhanced access to biographical memories, positive emotional attentional bias and a reduction on anxiety and mood symptoms. The administration of 3,4-methylenedioxy-N-methylamphetamine (MDMA) could significantly aid the psychotherapeutic process in patients with Post-Traumatic Stress Disorder by strengthening the therapeutic alliance through the release of oxytocin, as well as facilitating emotional regulation from frontal areas to the amygdala during the recollection of traumatic memories. Furthermore, the administration of ayahuasca (an amazonic beverage containing dimethyltryptamine, which binds with the 5-HT2A receptor) and ketamine (a NMDA receptor agonist) in pilot studies has resulted in reduced problematic use of cocaine, heroine, alcohol and tobacco, as well as reported reduction in craving in addiction. While modern research with substances containing psychedelic properties is still young, initial findings suggest the need of expanding the number of studies in order to further clarify their potential risks, benefits and action mechanisms associated to their administration.

El objetivo de esta revisión consiste en exponer los principales avances en la investigación reciente con sustancias psicodélicas en las neurociencias y sus aplicaciones psioterapéuticas. La acción de la psilocibina, un agonista del receptor 5-HT2A, ha sido asociada a una desactivación en la Default Mode Network (activada durante la introspección y pensamientos auto-referentes), un mayor acceso a la memoria autobiográfica, un sesgo atencional emocionalmente positivo y a reducciones en la sintomatología de trastornos de ansiedad y de ánimo. Se ha planteado que la 3,4-metilendioximetanfetamina (MDMA) podría asistir de forma significativa el proceso terapéutico en casos con Trastorno por Estrés Postraumático al fortalecer la alianza terapéutica y permitir una reelaboración de recuerdos traumáticos con menores conductas de evitación. Sus mecanismos terapéuticos se han asociado a la liberación de oxitocina y a una mayor regulación desde áreas frontales hacia la amígdala. Adicionalmente, la administración de ayahuasca (brebaje de origen amazónico que contiene dimetiltriptamina, la cual actúa sobre el receptor 5-HT2A) y ketamina (agonista de receptores NMDA) en estudios iniciales ha resultado en reducción de uso problemático de cocaína, heroína, alcohol, tabaco como también en el "craving" asociado a su consumo. Si bien la investigación moderna de substancias con propiedades psicodélicas es reciente, resultados iniciales fomentan un mayor número de investigaciones para dilucidar los potenciales riesgos, beneficios y mecanismos de acción asociados a su administración.

Hallucinogen Rating Scale (HRS) - Versão brasileira: tradução e adaptação transcultural / Hallucinogen Rating Scale (HRS) - A Brazilian version: translation and cross-cultural adaptation

CONTEXTO: Existe um crescente interesse científico pelos efeitos de alucinógenos em geral e, particularmente, pelo uso religioso da bebida psicoativa ayahuasca no Brasil. Todavia, não há no Brasil um instrumento padronizado para avaliar os efeitos de alucinógenos. A Hallucinogen Rating Scale (HRS) é um questionário amplamente usado nos Estados Unidos e na Europa para avaliar os efeitos de diversas substâncias psicoativas, incluindo as alucinógenas. OBJETIVO: Traduzir e adaptar a HRS para o português brasileiro. MÉTODO: A adaptação foi realizada em três etapas: 1) os autores do artigo traduziram a HRS para o português, visando à elaboração de uma versão-síntese inicial; 2) foi feita retrotradução dessa versão para o inglês por dois tradutores independentes; 3) foi elaborada uma versão final em português brasileiro por um comitê de revisão. Esta versão final foi desenvolvida pela comparação entre as traduções iniciais e as retrotraduções, por um processo dialógico com o autor do instrumento. RESULTADOS: Produção da versão final da HRS em português. Observaram-se as diretrizes para equivalência semântica e conceitual entre o português e inglês na descrição de estados subjetivos induzidos por alucinógenos. CONCLUSÃO: Uma versão brasileira da HRS - instrumento largamente empregado em todo o mundo para quantificar os efeitos de psicoativos - fornece um instrumento sensível para a avaliação de efeitos de substâncias alucinógenas no Brasil.

BACKGROUND: There is a growing scientific interest in the effects of hallucinogens in general and the religious use of psychoactive brew ayahuasca in Brazil in particular. However, there is not yet a standard instrument used in Brazil to evaluate the effects of hallucinogens. The Hallucinogen Rating Scale (HRS) is a questionnaire widely used in the U.S. and Europe to evaluate the effects of several psychoactive substances, including hallucinogens. OBJECTIVE: To translate and adapt the HRS to Brazilian Portuguese. METHOD: We followed three steps: 1) the authors of the article translated the HRS into Portuguese, in order to establish an initial version; 2) two independent translators back-translated this version into English; 3) a revision committee produced a final version of the Brazilian Portuguese version. This final version was developed comparing the initial translations and back-translations, through a dialogic process with the author of the instrument. RESULTS: A final Portuguese version of the HRS, following the guidelines for semantic and conceptual equivalence between English and Portuguese to describe hallucinogen-induced subjective states. DISCUSSION: A Brazilian version of the HRS - an instrument widely used throughout the world to quantify effects of psychoactive drugs - provides a sensitive instrument for evaluation of the effects of hallucinogenic substances in Brazil.

A Farmacologia da Ayahuasca: uma revisão / The phamacology of ayahuasca: a review

Ayahuasca é uma bebida psicoativa, alucinógena, utilizada por grupos indígenas e não-indígenas com objetivos mágicos, rituais, religiosos, terapêuticos e políticos. O objetivo desta revisão é o de descrever as principais propriedades farmacológicas da ayahuasca. Os potenciais benefícios e riscos do consumo da ayahuasca também serãoabordados.

Ayahuasca is an Amazonian psychoactive, hallucinogenic brew used by indigenous and non-indigenous groups for magical, ritual, religious, therapeutic and political goals. The objective of this review is to describe the main pharmacological properties of ayahuasca. The potential benefits and risks of ayahuasca consumption will also be reviewed.

Ayahuasca: uma revisão dos aspectos farmacológicos e toxicológicos / Ayahuasca: a review of pharmacological and toxicological aspects

A ayahuasca é uma bebida psicoativa originariamente utilizada em rituais de tribos indígenas da região amazônica. Esta bebida é preparada pela infusão de caules da Banisteriopsis caapi Morton, que contém Beta-carbolinas que são inibidoras da monoaminoxidase (MAO), e de folhas da Psychotria viridis Ruiz & Pavón, que contém o alucinógeno N,N-dimetiltriptamina (DMT). A enzima MAO degrada a DMT no fígado e intestino. No Brasil, a ayahuasca tem sido incorporada em rituais de grupos sincréticos religiosos e seu uso dentro do contexto religioso é amparado por lei federal. Atualmente, esses grupos têm se espalhado na Europa e Estados Unidos, chamando a atenção de pesquisadores internacionais quanto aos efeitos da ayahuasca. Estudos têm indicado que a ayahuasca poderia ter aplicações terapêuticas como no tratamento da farmacodependência e até sugerem seu uso seguro por adultos sadios. Entretanto, poucos estudos têm sido conduzidos para melhor avaliação de suas propriedades. O objetivo do artigo é mostrar uma revisão geral da história até as recentes descobertas envolvendo a farmacologia e a toxicologia da ayahuasca.

Ayahuasca (or caapi in Brazil) is a psychoactive plant beverage initially used by shamans in religious rituals practiced by indigenous peoples in the Amazon region. It is prepared by infusing the pounded stems of Banisteriopsis caapi Morton, a liana which contains beta-carbolines, alkaloids that are potent monoamine oxidase (MAO) inhibitors, together with the leaves of Psychotria viridis Ruiz & Pavón, which contains the psychedelic agent N,N-dimethyltryptamine (DMT). The enzyme MAO normally degrades DMT in the liver and gut. In Brazil, the use of ayahuasca within religious ceremonies is protected by law and it has been incorporated into rituals of syncretic religious groups. Some of these groups have established themselves in the United States and European countries, attracting international research interest in the effects of ayahuasca. Studies suggest that it may have therapeutic applications, such as in the treatment of drug addiction, and that it can be used safely by healthy adults. However, too few studies have been performed for a good assessment of its properties to be made. The aim of this article is to present a review of the history of ayahuasca, up to the recent discoveries concerning its pharmacology and toxicology.