Exploring ayahuasca-assisted therapy for addiction: A qualitative analysis of preliminary findings among an Indigenous community in Canada

Indigenous populations in Canada experience disproportionately high rates of mental health and substance use problems linked to historical and ongoing colonial harms, social marginalisation and disrupted cultural continuity. Conventional addiction treatments have achieved limited success in many Indigenous settings, prompting interest in alternative, culturally congruent approaches. Ayahuasca, an Amazonian plant brew, has been used ceremonially and is increasingly investigated in clinical and non-clinical contexts for its potential to reduce problematic substance use and improve psychological well-being. Prior work by the study team included an observational evaluation of ayahuasca-assisted retreats in a rural Coast Salish community that found statistically significant reductions in self-reported cocaine use and improvements in well-being; however, the mechanisms and lived experience underlying those quantitative changes remained unclear. This paper aims to explore participants’ lived experiences of the ayahuasca-assisted ‘Working with Addiction and Stress’ ceremonial retreats to better understand how the intervention affected substance use, cravings and psychosocial well-being. By analysing semistructured interviews conducted at six-month follow up, Argento and colleagues sought to elucidate processes—such as changes in connectedness, self-understanding and relationships—that might explain reductions in problematic substance use reported in their earlier observational study.

The qualitative study was added to a previously reported observational evaluation of community retreats. Retreats were conducted for members of a single First Nations band in rural southwestern British Columbia; participants were Indigenous members of the same Coast Salish community, most residing in a small, isolated community of about 10 000 people. Eligibility for the retreats and parent study included being over 18, English-speaking, no prior ayahuasca experience, no current selective serotonin reuptake inhibitor use and no current or recent psychosis. The extracted text notes that detailed methods for the parent observational study are reported elsewhere. Each retreat ran over four days and incorporated two nocturnal ayahuasca ceremonies (approximately 21:00–03:00) guided by a Shipibo master ayahuasquero supported by three Canadian apprentice ayahuasqueros. Ceremonies were held in the community longhouse, prepared according to Coast Salish tradition. Participants followed a traditional Shipibo diet during the retreat (abstaining from meat, sugar, alcohol, salt and strong seasonings). Small glasses (50–100 mL) of ayahuasca were offered and traditional songs (icaros) were sung in Shipibo, Quechua or Spanish. Daytime activities included group talk therapy, breathing and meditation exercises led by a Canadian physician with addiction expertise, with opportunities for sharing intentions prior to ceremonies and debriefing afterwards. For the qualitative component, the research team obtained ethics approval to add a short semistructured interview at the six-month follow up of the quantitative study. Eleven of the 12 retreat participants joined the qualitative interviews. The three interview questions asked whether the retreat impacted the participant’s life, asked them to rate the impact on a 1–10 scale, and invited description of effects on substance use, relationships, sense of self and connection with nature/spirit. Interviews were audio recorded (in person or by phone), transcribed and analysed using thematic analysis. Two researchers (EA and RC) independently coded transcripts and the team reached consensus on six central themes reported in the Results. The extracted text does not report additional analytic details such as the software used or inter-rater reliability metrics.

Eleven participants (six men, five women) aged 19–56 years (mean age = 38) took part in the qualitative interviews; one of the 12 original retreat participants declined the second-night ayahuasca dose but otherwise all drank in both ceremonies. Every participant reported that the retreat had an impact on their life. On the 1–10 impact scale, eight participants rated the experience 8 or higher; the mean score was 7.95 (range 5–10). Nausea and vomiting (the expected ‘purge’) occurred for some participants. A primary and consistent theme was marked reductions in substance use and cravings. All participants described positive changes in substance use following the retreats. Eight reported complete cessation of at least one substance by follow up; the remaining three reported reduced or less problematic use (two quit temporarily then resumed less problematically, one said they ‘still party—but think about what (I am) doing more’). Reported changes covered tobacco, alcohol, pharmaceutical painkillers and crack/cocaine. Several participants attributed cessation or reduced cravings to emotional release and confronting trauma, with vivid accounts such as: “I felt free of my addiction… I stopped completely. I had no desire to use” (P5, 19-year-old female). Two participants described a visceral bodily rejection of substances after the retreat, including nausea on trying to smoke, which they interpreted as aiding cessation. Participants contrasted the retreats favourably with prior conventional treatments. Many had previous unsuccessful treatment attempts; narratives suggested other programmes often ‘scraped the surface’ whereas the ayahuasca ceremonies enabled more direct engagement with underlying trauma and deeper psychological material. Several participants reported rapid, sustained gains that prior interventions had not produced. Enhanced connectedness to spirit and nature emerged as a central theme. Most participants described an intensified or renewed sense of spirituality, gratitude and appreciation for the natural world after the retreats; one participant reported having had little spirituality prior but opened up afterwards. Heightened connection with a sense of self was also reported: participants spoke of encountering a ‘higher self’, increased self-acceptance, emotional release, reduced stress and improved clarity. These intrapersonal shifts were linked by participants to reductions in substance use and improved capacity to carry out psychological work. Transformations in interpersonal relationships were described, including mended family ties, greater openness and reduced judgment, and new friendships among retreat participants that increased community connection. Overall impressions were predominantly positive; participants expressed gratitude, said they would recommend the retreats and some wished for broader access to ayahuasca-assisted therapy. A minority noted caveats: one participant felt negatively influenced by other attendees’ distress, one chose not to participate in the second ceremony because the first was overwhelming, and one said they would not do ayahuasca again despite recognising benefits.

Argento and colleagues interpret the narratives as showing that ayahuasca-assisted therapy delivered within a supportive, community-based retreat can facilitate recovery from addiction among members of an Indigenous community, including individuals with traumatic histories and prior failed treatment attempts. The authors emphasise that enhanced connectedness—to self, others and nature/spirit—was described by participants as a pivotal factor linked to reductions in substance use and cravings. These qualitative findings corroborate and extend the team’s earlier quantitative observations of reduced problematic use of cocaine, alcohol and tobacco in this setting. The authors place their results within the broader resurgence of research on psychedelics, noting parallel findings from studies of psilocybin, LSD and recent randomised trials of ayahuasca for depression. They highlight hypothesised mechanisms discussed in the literature, including psychological integration, shifts in cognitive biases and neural pathways suggested by nascent neuroimaging work, and the role of awe- or mystical-type experiences in imparting meaning and purpose. The paper also links the results to Indigenous perspectives that frame healing in terms of interconnected dimensions of psyche, spirit and community; the authors argue that a connection-focused approach, which integrates cultural and spiritual elements, may be particularly relevant in Indigenous contexts. Key limitations acknowledged by the authors are that the sample was small and a convenience sample, introducing self-selection bias and limiting generalisability to other Indigenous populations or settings. The study design does not permit causal inference: the authors did not disentangle the specific contributions of group therapy, other retreat elements or the pharmacology of ayahuasca, nor did they monitor concurrent treatments received by participants. Variability in the concentration or composition of ayahuasca cannot be ruled out, although the reported phenomenology did not raise concerns about potency. Given these constraints, the authors call for further mixed-methods and controlled research to clarify mechanisms, and emphasise the need for culturally appropriate, community-driven interventions. They argue that any clinical application of psychedelic-assisted therapy in Indigenous or marginalised populations should be integrated within multi-faceted, community-led structural approaches.

This qualitative analysis expands on prior quantitative findings and offers experiential insights into how ayahuasca-assisted therapy may facilitate recovery from addiction among members of an Indigenous community. Participants reported reductions in substance use and cravings alongside enhanced connectedness with self, others and nature/spirit, improved relationships and greater psychological clarity. Given limitations of conventional treatments and the study’s methodological constraints, the authors recommend further research into ayahuasca and other psychedelic-assisted therapies—particularly mixed-methods and culturally grounded approaches—to investigate whether enhancing connectedness and related factors can support sustainable recovery from substance use disorders.