Report on psychoactive drug use among adolescents using ayahuasca within a religious context

Ayahuasca is a hallucinogenic botanical brew used ceremonially in Brazilian syncretic churches such as União do Vegetal (UDV) and Santo Daime. Rituals typically last about four hours, are held roughly twice a month, and are often attended by multigenerational families; adolescents are frequently invited to join ceremonies with their parents. While some view ritualised ayahuasca use as posing little risk to young people when administered in a controlled religious setting, early exposure to psychoactive substances is generally considered a potential risk factor for later drug misuse, and empirical data on adolescent patterns of other substance use in this context have been lacking. Doering-Silveira and colleagues set out to describe patterns of psychoactive substance use in adolescents who consume ayahuasca within a religious setting, comparing them with a matched group of adolescents who had never used ayahuasca. The study aimed to clarify whether systematic ritual exposure to ayahuasca is associated with higher rates of use of alcohol, tobacco, cannabis, stimulants, or other drugs, or whether religious affiliation might exert a protective effect.

This was a cross-sectional, comparative study conducted in 2001 in two Brazilian cities. The sample comprised 84 adolescents aged 15 to 19 years: 41 adolescents who had consumed ayahuasca in a ritual context at least twice a month during the two years prior to assessment, and 43 comparison adolescents who reported never having used ayahuasca. The ayahuasca users were randomly selected from participants at three UDV churches, and the control group was randomly selected and paired on sex, age and educational level. Both groups lived in the same communities and thus shared environmental influences. Adolescents and their parents provided informed consent, and trained psychiatrists conducted the interviews. Substance use was assessed using World Health Organization criteria applied to three timeframes: lifetime use (ever), last year use (at least once during the prior 12 months) and recent use (at least once during the prior 30 days). Analyses were descriptive and group comparisons for categorical outcomes were tested with chi-square. The extracted text does not report additional inclusion or exclusion criteria beyond the age range and the ayahuasca-use requirement for the exposed group, nor does it provide the content of a referenced table summarising substance-specific frequencies.

Sample characteristics were similar between groups. In the ayahuasca group (n = 41) 56.1% were male and 43.9% female, with a mean age of 16.49 ± 1.34 years; 75.6% described themselves as White and 92.5% lived with their parents. In the comparison group (n = 43) 53.5% were male and 46.5% female, mean age 16.65 ± 1.0 years; 81.4% described themselves as White and 97.5% lived with their parents. Among ayahuasca users, 25 adolescents (60%) began drinking systematically before age 13, while 15 (40%) began after age 13 (one case missing). The mean duration of systematic use (at least monthly) was 4.05 ± 2.28 years, and at assessment the mean abstinence period from ayahuasca was 41.16 ± 15.55 days. Lifetime use: No statistically significant differences between groups were detected for lifetime frequencies of most substances. The extracted text reports higher proportions of lifetime cocaine use among UDV adolescents (10.3% vs 2.4% in controls) and higher lifetime tobacco experimentation in UDV members (52.5% vs 34.9%), but these differences were not reported as statistically significant. Last year use: A significant difference emerged for alcohol: 74.4% of controls reported alcohol use during the prior 12 months compared with 46.3% of UDV adolescents (p < 0.05). For other substances (amphetamines, cannabis, cocaine, hallucinogens, solvents) the control group showed higher last-year use proportions, but these contrasts did not reach statistical significance. Tobacco, anabolic steroids and tranquilisers were reported slightly more often by UDV members, without statistical significance. The text refers to a table for detailed frequencies that is not included in the extracted content. Recent (30-day) use: Recent alcohol use was significantly more frequent in the comparison group (65.1%) than among UDV adolescents (32.5%) (p < 0.01). The authors note a reported trend of higher recent amphetamine use among controls and state a p value of 0.87 for this comparison. For most other substances, recent use prevalence among UDV members was below 10%, with exceptions for alcohol (32.5%), minor stimulants such as guarana and coffee (26.3%), tobacco (21.1%), and cannabis (10.8%).

The investigators frame early access to psychoactive substances as a known risk factor for later misuse and emphasise psychosocial vulnerabilities in adolescence, such as incomplete coping skills and peer influence. They acknowledge two competing hypotheses: systematic exposure to ayahuasca could increase the likelihood of subsequent substance use, or religious affiliation associated with ritual use could serve as a protective factor. Interpreting their findings, the researchers report that adolescents who consumed ayahuasca within the UDV were overall comparable to matched controls in substance use profiles, but had a substantially lower prevalence of alcohol use in both the prior year and the prior 30 days. The authors attribute the lower alcohol use to religious teachings that encourage alcohol abstinence and to a broader sense of belonging to a structured community, which may function as a protective factor. They also note that higher use of minor stimulants among UDV adolescents may reflect social substitution of beverages such as guarana and coffee for alcohol. Earlier work in adult UDV members is cited by the authors as having reported remission of severe psychiatric disorders, including substance abuse, after religious involvement, but they acknowledge the methodological limits of that research and the present cross-sectional design. The discussion mentions suggestibility during hallucinogenic experiences as an underreported effect that could influence behaviour. Limitations explicitly acknowledged include the modest sample size, which constrained exploration of dimensions of religiousness, and the absence of longitudinal data, which prevents causal inference. The authors further note that some lifetime cocaine or crack use reported among UDV adolescents was not reflected in recent use, suggesting discontinuation in some cases. Finally, they call for further rigorous research to examine ayahuasca's potential role in treating addictive disorders and other psychiatric conditions, while noting that religious members consider ayahuasca relatively safe and potentially medicinal.