Psychedelic treatments promise relief on an unraveling planet. But how long can it last?
High in the Sierra Mazateca mountains, which skirt southern Mexico’s Pacific coast, a ruddy brown mushroom angles its cap toward a creek running through the misty rainforest. Known by Indigenous Mazatec people as Ndi shi tjo, the unassuming toadstool has shaped their community in just about every way—from the music they make to the bonds they share and even to their health.
To the world outside the cool mists of the Sierra Mazateca’s pine-oak forest, where jaguars slink through the dense shadows and salamanders slide along slippery logs, Ndi shi tjo are known as magic mushrooms. They induce hallucinations. Unfortunately for Huautla de Jimenez—the region’s densest community now urbanized by foreign commercialization—their mushroom’s psychedelic qualities are in high demand as a mental health remedy in the form of psychedelic therapies. The raid on the Mazatec’s land has left their sacred mushroom in short supply.
Fueling that raid is a confluence of crises—the turbulent aftermath of a novel pandemic, widespread social unrest, and unchecked climate devastation—that have spurred a spike in mental health issues across the globe. The hunt for new mental health remedies has led many to psychedelics. But to the Indigenous Mazatec, it makes no sense to sever a remedy from its natural web, which includes the land and community rituals that support connection and well-being. As novel as psychedelics may be to Western medicine as a treatment, many Indigenous cultures have long understood that their efficacy is inextricable from the natural world.
“It's unusual to see a medicine that would be used to treat depression, but also anxiety and different forms of addictions. But the data indicate that it is possible with some of these psychedelics,” says Albert García-Romeau, Center Director of the Center for Psychedelic & Consciousness Research at Johns Hopkins University. The dazzling results of studies with psychedelics in the past fifteen years—such as a 2021 clinical trial involving 91veterans with PTSD that found 67 percent no longer qualified for the diagnosis after treatment with MDMA—have attracted researchers from around the world. Substances such as psilocybin, DMT, MDMA, and ketamine show potential to treat conditions ranging from depression and PTSD to Alzheimer’s and even PMS.
Unsurprisingly, an increasing number of people who suffer these ailments have begun to turn to psychedelic therapies when traditional treatment has failed. But such therapies are widely unregulated and unmonitored, leaving patients with a confusing array of options. Ketamine, currently the only legal psychedelic treatment, is administered in clinics that deliver IV drips or through online programs that mail ketamine tablets to patients at home. Underground and international retreats offer spiritually focused approaches that lack clinical frameworks or training. Then there are research studies like García-Romeau’s on naturalistic psilocybin use.
Whether regulated or unregulated, where people go, money flows. Venture capitalists and pharmaceutical companies see billion-dollar opportunities, with a market valued at $8.7B by 2033, according to analysts at Spherical Insights. This worries researchers and Indigenous communities alike. “If you look at ketamine, it’s lucrative, like cocaine,” says Phil Wolfson, a pioneer of psychedelic research, now CEO of the Ketamine Research Foundation. Indigenous groups like the Mazatec, however, see a deeper issue: commercialization separates the sacred medicine from the rituals that make it effective.
“The power of the mushrooms remains so long as you don’t let go of the sacred ritual in which they are to be taken. In no way can commercialization aid in healing,” says Osiris Garcia Cerquedas at a 2021 conference. Garcia Cerquedas is a Mazatec historian and activist.
He and fellow activists in the Sierra Mazateca have seen firsthand how commercialization breaks the connective tissues of a community that support well-being. Coffee plantations established in the early 1900s razed their land, displaced traditional work, and started a cycle of poverty. Alcoholism spread like wildfire, which today afflicts Mexico’s Indigenous communities at 2.5 times the national average, fueling a legacy of domestic violence and systemic trauma. In this weakened community, the ideology of exploiting the land for profit has grown even among locals, further devastating the people and the environment that they once treated as kin.
“Mushrooms haven’t grown in Huautla for years,” says Garcia Cerquedas, referring to the commercial crops that displaced the Ndi shi tjo. “Nothing but little sticks.” Disappearing deeper into the mountains, the mushrooms can’t keep up with demand from the throngs of psychedelic tourists who descend on the region every rainy season, searching for mystical experiences that will transport them from their own disconnected lives. Will any newfound relief follow them back home?
Isolation, we saw during the pandemic, brings humanity to its knees. But sheltering in place and its alarming consequences of suicide and depression only magnified a systemic glitch: Disconnection is a hallmark of modernity—disconnection from one’s self, disconnection from community, disconnection from nature. The facets of life that Indigenous Mazatec connect with through sacred mushroom ritual are out of reach. So, while the promise of scaling psychedelics into clinical medicine grows, the lasting effects remain unclear.
Enter the concept of ‘integration’, a buzzword in the psychedelic community. Integration guides people through what they felt and thought during a psychedelic experience so they can make sense of it in their lives. Sebastian Mamani*, a US-based psychedelic guide trained in the lineage of the famous Mazatec cuarandera, María Sabina, describes the process as unfolding. In many psychedelic experiences, people relive the sense of wonder and visceral emotional states characteristic of babies. “Once you’ve gotten what that feels like,” Mamani says, “then the integration process can happen.” He coaches his clients to notice when they are far from that connected state of presence, and how they can tap back into it.
From the perspective of Psychedelic Assisted Therapy (PAT), psychedelic treatment without integration can be counterproductive. Practitioners recognize that patients are returning to disconnected, often dysfunctional lives without an opportunity to make sense of their experience.
“In a lot of settings, like IV settings, there's no one there. No one to talk about this powerful psychedelic experience, which leaves people empty and confused. Who are you going to talk to? You can't talk to your mother. You’re 18 and you just did a journey without her knowing, or you're 16, with your friends, and they don't know how to integrate it,” says Wolfson. The environment is critical. “You see someone who's going back to a violent, abusive home. The psychedelic effect is small. It depends on when you go back to your environment and what happens there.” A loving partner and a stable income for someone in an urban environment can support integration that leads to longer lasting mental health benefits. A loving community in a natural environment may enhance the benefits even more.
No one understands the importance of the environment on well-being better than the Indigenous communities who first developed relationships with plant medicines. An awareness of the sentience of the natural world has led Mazatec and Indigenous cultures such as the Ashaninka of the Peruvian Amazon to consider the plants, animals, cosmos, rivers, and all parts of the landscape as kin. With the ayahuasca vine, Ashaninka receive visions that guide their decisions, from how to treat illness to how to protect their home from commercial logging. Because of their reciprocal, embedded relationship with the natural environment, the Ashaninka—who won the United Nations Equator Prize for placing “cultural exchange and social inclusion at the heart of environmental education”—understand that their well-being depends upon the preservation of their homeland’s biodiversity.
The pivotal role that plant medicines play in Indigenous relations with nature may be driven by a phenomenon that clinical researchers like García-Romeau call ‘mind attribution’. “After people had used psilocybin,” he recalls from his study, “things like plants and rocks were later considered to have more mind or consciousness than they did before. From an ecological standpoint, these people may be more inclined to take care of plants and animals, forests, or even things like mountains, rivers, oceans.” With insight like this during a climate crisis, one might expect a flurry of research into how psychedelics can play a role in protecting the environment—as they do for the Ashaninka. So far, research into how psychedelics encourage pro-environment attitudes is spotty, as industries double down on scalable clinical treatments.
Still, the interplay between plant medicines and mental and environmental well-being is profound in Indigenous cultures and may serve as a model for Western medical practitioners. Mamani experienced this firsthand through ayahuasca ceremonies with the Ashinnanka. “The jungle really stays with me. It’s a really strong energy when you arrive, and by the next morning you feel high without taking anything. You feel this true life force.” Indigenous Amazonians teach that the sacred medicines change our energetic body. “You don’t have to do anything, it just rewires you,” he says. “And I think if you live in an Indigenous place with spaciousness, then you don’t have to do much because the jungle enables you to be held and integrate the experience.”
In the global North, where embedded cultural experiences in nature are scarce, how will psychedelic treatments make a lasting impact on well-being—of people or nature? Even Mamani, a dedicated psychedelic guide, has his doubts: “Here they take a day off to do this work, but then they have to really cultivate that space to get the insights. We’re not spending time in nature, putting our hands in the soil, sitting by the river all day.”
Wolfson also worries about the staying power of psychedelic therapy that’s extracted from nature-based cultures. “They were integrated. They didn’t have integration. It wasn't this process of, ‘What happened to you? Now can you love your mother?’ We're extracting that in our format and that doesn't represent what Indigenous People did.”
Bringing plant medicines into a system that is severed from the web of life in which they, and their human relations, thrive may bring isolated relief to some individuals. But will they bring sustainable relief—a cure—to the planet that sustains all life? Indigenous leaders such as Benki Piyãko of the Ashininka believe that there is no time to wait: “If the ecological balance breaks down, the world feels it, gives warnings, alerts. Our head is like the world and the world is like our head.” While many people in the modern world feel like they have lost their heads, others, such as Mamani have an idea of where to find them. “The medicine is connected to the earth. It just happens, the more you sit with the medicine, the more aware you become of the earth, of nature, of the climate, in a way it kind of takes you away from your ego place and reconnects you with something greater. And that’s my hope for us.” If psychedelics help to connect us to the web of life, they may just deliver the promise of well-being that their proponents seek.
____
*Name has been changed to protect privacy
List of Sources
Wolfson, Dr. Philip. Interview, Dec 5, 2024
García-Romeau, Dr. Albert. Interview, Dec 3, 2024
Mamani, Sebastian*. Interview, Dec 5, 2024
“Capitalism, the State and Sacred Mushrooms in the Sierra Mazateca” Sacred Plants II, Chacruna Institute, Apr 14, 2021. https://www.youtube.com/watch?v=TZm62eOESrY
Huang, R. “Anonymous Curanderas” Are Helping Women in Their Community Address Trauma From Domestic Violence, Double Blind, January 03, 2024. https://doubleblindmag.com/anonymous-curanderas/
INEGI. National Survey on the Dynamics of Household Relationships 2021. SNIEG. https://www.inegi.org.mx/programas/endireh/2021/#documentacion
Mitchell, J.M., Bogenschutz, M., Lilienstein, A. et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med 27, 1025–1033 (2021). https://doi.org/10.1038/s41591-021-01336-3
12/08/2024
Nayak SM, Jackson H, Sepeda ND, Mathai DS, So S, Yaffe A, Zaki H, Brasher TJ, Lowe MX, Jolly DRP, Barrett FS, Griffiths RR, Strickland JC, Johnson MW, Jackson H, Garcia-Romeu A. Naturalistic psilocybin use is associated with persisting improvements in mental health and wellbeing: results from a prospective, longitudinal survey. Front Psychiatry. 2023 Sep 19;14:1199642. doi: 10.3389/fpsyt.2023.1199642. PMID: 37795509; PMCID: PMC10545967.
Spherical Insights LLP, March 13, 2024. https://finance.yahoo.com/news/global-psychedelic-drugs-market-size-090000854.html accessed 2025 Jan 19.
United Nations Development Programme. ‘Associação Ashaninka do Rio Amônia Apiwtxa, Brazil.’ Equator Initiative Case Study Series. 2022. New York, NY. https://www.equatorinitiative.org/2017/06/28/associacao-ashaninka-do-rio-amonia-apiwt xa/
The Yorenka Tasorentsi Institute website, accessed Dec 5, 2024. https://yorenkatasorentsi.org/our-foundations/