Contents
What ayahuasca is
Ayahuasca is a brew from the Amazon, usually made from two plants: the vine Banisteriopsis caapi and the leaves of a plant that contains DMT, most often Psychotria viridis (chacruna).
DMT taken by mouth is normally broken down in the gut and liver by an enzyme called monoamine oxidase A (MAO-A). The vine contains harmala alkaloids, such as harmine and harmaline, that temporarily block this enzyme. Only the combination makes the brew psychoactive. The same mechanism is behind its most important risks, explained below under safety.
The effects usually begin within an hour and last around four to six hours. Nausea, vomiting and diarrhoea are common, as are intense emotions, visions and memories. The experience is often demanding rather than pleasant.
Ayahuasca has a long history in Indigenous and mestizo traditions of the Amazon, and is used as a sacrament by Brazilian churches such as Santo Daime and the União do Vegetal. In Belgium it is mostly encountered in neo-shamanic ceremonies and retreats. The strength and contents of the brew vary widely, and some providers add other plants that carry their own dangers.
The legal situation in Belgium
The legal position is not settled. DMT is a controlled substance in Belgium, but neither the plants nor the brew itself are listed by name. Because the law also covers preparations that contain a controlled substance, some legal interpretations treat the brew as illegal. Judges and law enforcement do not agree on this.
Few cases have reached court. In one, a practitioner who held ceremonies in Flanders was charged with importing and possessing ayahuasca and with incitement to its use, after a search in 2010 and a seizure at Brussels Airport in 2011.
In practice, shipments and luggage containing ayahuasca or its plants can be seized by customs, and organising ceremonies carries legal risk. In the Netherlands, DMT is on List I of the Opium Act, and courts have upheld the ban on importing ayahuasca, even for a church that uses it as a sacrament.
This site takes no position on what the law should be. This is general information, not legal advice, and laws change.
Safety: what to take into account
For healthy people, ayahuasca's physical toxicity is considered low, and it is not known to be addictive. Most serious problems are linked to factors you can check in advance: certain medications, some health conditions and the care taken by the people around you.
The most important thing to check is your medication. Because ayahuasca blocks MAO-A, combining it with drugs that raise serotonin can cause serotonin syndrome, a serious and sometimes life-threatening reaction. Researchers warned about this combination with SSRI antidepressants as early as 1998.
Medicines and substances that can interact dangerously include:
- antidepressants, especially SSRIs (such as fluoxetine, sertraline, paroxetine, citalopram and escitalopram), SNRIs (such as venlafaxine and duloxetine), tricyclics and other MAO inhibitors
- the painkiller tramadol and the cough suppressant dextromethorphan
- certain migraine medicines (triptans)
- St John's wort
- MDMA, amphetamines, cocaine and other stimulants
This list is not complete. Tell any provider about every medicine and supplement you take, and discuss it with your doctor or pharmacist.
Never stop prescribed medication on your own to make a ceremony possible. Stopping antidepressants suddenly has its own risks, and some take weeks to leave the body. Talk to the doctor who prescribed them.
Health conditions to discuss first
- heart disease or high blood pressure
- a personal or family history of psychosis, schizophrenia or bipolar disorder
- pregnancy or breastfeeding
- a recent serious mental health crisis
The experience itself
Ayahuasca experiences can be intense. Fear, confusion or painful memories may come up. Usually they pass during the session, and many people later see these moments as meaningful. Some feel unsettled for a few days. In rare cases, mainly in people with a predisposition, a psychotic episode can occur. Vomiting and dizziness are common, so it is good to have someone nearby at all times.
In this state you are also more vulnerable, so clear agreements about touch and consent matter. You always have the right to refuse touch, and to leave.
Signs of serotonin syndrome include agitation, confusion, high temperature, heavy sweating, shivering, muscle twitching or stiffness and a racing heart. If you see these, call 112 and say what was taken. For advice on poisoning or interactions, the Belgian Poison Centre (Antigifcentrum / Centre Antipoisons) is available day and night on 070 245 245.
Questions to ask a provider
A good provider will welcome these questions and answer them openly.
- Do you ask about my medication, health and mental health history before I can take part, and can you refuse me?
- What exactly is in the brew, who prepares it, and are any other plants added?
- Who leads the ceremony, what is their training and experience, and how many participants are there per facilitator?
- What is the emergency plan? Is someone with first-aid training present, and how far away is the nearest hospital?
- What happens if someone panics or becomes unwell?
- What is your policy on physical touch and consent?
- Is there any support after the ceremony?
- What does it cost, and what happens if I change my mind?
Reasons to be cautious
- no questions about medication or health
- claims that ayahuasca cures illness or can replace medication
- pressure to drink more than you want, or to take part at all
- secrecy about what is in the brew
- facilitators who are themselves heavily under the influence
- touch without clear consent, or sexual advances
- discouraging contact with doctors or emergency services
- large groups with very few facilitators
- alcohol or other drugs offered alongside the brew
After a ceremony
The days and weeks after a ceremony matter as much as the night itself. It often helps to rest, to avoid major decisions for a while, and to talk about the experience with someone you trust. Writing down what happened can help you make sense of it later.
It is common to feel moved, raw or tired for a few days. Seek help if you notice persistent anxiety or panic, several nights without sleep, a sense of unreality that does not fade, or thoughts that frighten you. Your GP is a good first step.
In an emergency, call 112. If you have thoughts of suicide, you can talk to someone anonymously: in Dutch at the Zelfmoordlijn on 1813, in French at the Centre de Prévention du Suicide on 0800 32 123.
Frequently asked questions
Is ayahuasca legal in Belgium?
It is not clearly settled. DMT is a controlled substance, and the law also covers preparations that contain one, so the brew can be treated as illegal. The plants and the brew are not listed by name, and judges and authorities do not agree. At least one ceremony leader in Flanders has been prosecuted. See the legal situation.
Is ayahuasca dangerous?
For healthy people, ayahuasca's physical toxicity is considered low, and it is not known to be addictive. The main risks are interactions with certain medications, some heart and mental health conditions, and the quality of care during the ceremony. Most of these can be checked in advance. See safety.
Can I drink ayahuasca if I take antidepressants?
Combining ayahuasca with SSRIs, SNRIs and several other antidepressants can cause serotonin syndrome, which can be life-threatening. Never stop your medication on your own to make a ceremony possible; discuss it with the doctor who prescribed it. A responsible provider will ask about all your medication before accepting you.
How long does an ayahuasca experience last?
The effects usually start within an hour and last around four to six hours. Tiredness and emotional sensitivity can continue into the next day or longer.
Why do providers ask me to follow a diet?
Partly tradition, partly precaution. Because ayahuasca temporarily blocks MAO-A, foods rich in tyramine, such as aged cheese, cured meats and fermented products, can in theory raise blood pressure. This effect is considered smaller than with prescription MAO inhibitors, but avoiding alcohol and other drugs remains important.
What is the difference between ayahuasca and DMT?
DMT is one of the active compounds in ayahuasca. Smoked or vaporised DMT acts within seconds and lasts minutes. In ayahuasca, the vine's harmala alkaloids make DMT active when swallowed, which produces a longer experience lasting hours, and also brings the medication interactions described on this page.
What should I do if someone feels very unwell during or after a ceremony?
Stay with them, keep them safe from falls, and call 112 if they have trouble breathing, lose consciousness, have a high temperature, muscle stiffness or a racing heart, or if you are unsure. Tell the emergency services exactly what was taken. The Belgian Poison Centre (070 245 245) can advise on poisoning and interactions.
Can ayahuasca help with depression or addiction?
Research is interesting: small early studies have reported encouraging results. The evidence is still limited, however, and ayahuasca is not an approved treatment in Europe. Be cautious with anyone who promises a cure.
Sources
- ICEERS. Ayahuasca: legal status in Belgium. iceers.org
- Callaway JC, Grob CS. Ayahuasca preparations and serotonin reuptake inhibitors: a potential combination for severe adverse interactions. Journal of Psychoactive Drugs, 1998;30(4):367-369. PubMed
- Bijzonder Strafrecht. Verbod op invoer van ayahuasca-thee vs. vrijheid van godsdienst (Dutch appeal court ruling on importing ayahuasca for the Santo Daime church). bijzonderstrafrecht.nl