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Psychedelic plant medicines, such as psilocybin-containing mushrooms, mescaline-containing San Pedro and Peyote cacti, and N-N-dimethyltryptamine (DMT) have been used for thousands of years as ritual sacraments. Recently, there's been renewed interest in psychedelics as a treatment for psychiatric illnesses, including depression and substance use disorders

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  • Ayahuasca is used in shamanic ceremonies by indigenous peoples of the Amazon.

  • Ceremonies are conducted at night and outlast the psychedelic effects of ayahuasca by a few hours. They are led by a shaman who provides the brew for each participant to drink and spiritual support. One to 2 drinks are typically offered per evening, and rituals may be conducted a few evenings in a row. A person's baseline mindset a priori to drug ingestion as well as the physical surroundings to the drug experience are thought to be crucial to minimizing harm and maximizing potential for benefit. These parameters are described in psychedelic literature as “set and setting.”

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In ritual context, the user prepares and approaches the experience with intention along with ingesting in a supportive, supervised, and spiritual setting, which is hypothesized to augment any potential benefits. Ayahuasca drinkers are primarily seeking a vehicle of self-development or healing, including treatment of psychiatric illness.

Although the psychedelic effects of the ayahuasca attract the most attention in the literature and media, both preparation and integration phases pre- and postceremony are integral components to ritual ayahuasca use.​

N-N-dimethyltryptamine is currently a schedule I controlled substance in the United States although the right to ritual drinking of ayahuasca for members of the UDV has been upheld by the Supreme Court under the Religious Freedom Restoration Act. Consumption in native areas of the Amazon as well as nonsanctioned ritual use in the West is also growing.

The Santo Daime and União do Vegetal (UDV) are two of the largest modern-day ayahuasca churches. Church membership has expanded to every inhabited continent.

The legal status of DMT poses a considerable barrier to adequate research of ayahuasca in the treatment of psychiatric illness.

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