Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives by Beatriz Caiuby Labate and Clancy Cavnar, eds. Cham, Switzerland: Springer International Publishing; 2018. Hardcover, 227 pages. ISBN: 978-3-319-76719-2. $169.99.

This book describes its aims in terms of the “intersections of three dimensions:” the history of psychedelics in healing and psychiatry; psychoactive compounds and their effects in humans; and traditional healing. It also claims a broad potential audience of healers, academics, and students. Such an expansive scope indicates lofty ambitions that proved difficult to fulfill. The reader is bound to be challenged by this text, which certainly weighs heavily toward the sociological-political-philosophical spectrum, as opposed to the botanical-pharmacological-anthropological. Its vocabulary is similarly esoteric. More than once, this reviewer had to reach for another reference to decipher terms such as “therianthrope” (a mythical shape-shifting human), “ontoseismic” (“earthquake of being,” used to describe the psychological effect of a first psychedelic experience), and “unEnglishable” — all ineffable manifestations of entheogenic (“god-within”) pharmacology and words guaranteed to challenge your competitors at your next Mensa Scrabble match.

The first chapter addresses the ever-present friction between clinical or cultural uses of mind-altering plants and drugs versus their recreational or “non-clinical” uses. The latter applications often lead to a “fall from grace” in the form of almost universal prohibition outside of indigenous refugia. The growing audiences at psychedelic symposia, coupled with renewed medical research on these agents, is said to reflect a renaissance in the status of these substances. The next chapter highlights this situation with respect to peyote (Lophophora williamsii, Cactaceae), an endangered species native to northern Mexico and the Rio Grande border, and describes a so-called “race problem:” possession of peyote is allowed for Wixárika (“Huichol”) indigenous peoples and members of the Native American Church, but it is prohibited for others.

This concept is extended in Chapter 3, which describes the contemporary situation in the Sierra Mazateca Mountains where psychonautic pilgrims gather leaves of “divine sage” (Salvia divinorum, Lamiaceae) or the “magic mushrooms” of the genus Psilocybe (Hymenogastraceae), often for uses and contexts quite different from their ritual- and faith-based antecedents in Mexico. These chapters are missing the fascinating backstories of how indigenous use of these sacraments was suppressed by the Catholic clergy, or, in the case of peyote, how it was a mainstream US medicine for a time in the 19th century, much like cannabis (Cannabis spp., Cannabaceae). (See Edward F. Anderson’s Peyote: The Divine Cactus for additional insights.¹)

Some of this ground is made up in Chapter 4, in which the traditional usage of S. divinorum is discussed in detail, along with its adoption and adaptation to countercultural use, usually by smoking of concentrates. The book’s momentum is maintained in the next chapter, which thoroughly explores the kratom (Mitragyna speciosa, Rubiaceae) phenomenon. This Southeast Asian plant harbors morphine-like alkaloids that possess analgesic properties and are claimed to be able to treat opioid addiction. The topic is of critical current interest, as the plant’s proponents tout its medical attributes while the US Drug Enforcement Administration (DEA) is now in its third year of attempts to place the kratom alkaloids in Schedule I of the Controlled Substances Act before science has had the opportunity to fully and critically appraise the plant’s pros and cons. As stated on pages 79-80: “it appeared that kratom might be one in a string of many drugs that essentially ended up in the pharmacological scrap heap of American drug regulation.”

Chapter 6 examines the curious case of ayahuasca (also known as yajé or hoasca), which traditionally is a mixture of the liana Banisteriopsis caapi (Malpighiaceae) and the leaves of Psychotria viridis (Rubiaceae). The use of this psychedelic brew by Amazonian indigenous tribes has spread to syncretic religious groups in Brazil and subsequently elsewhere, creating the strange situation in which the DEA has become an arbiter of what might constitute true religion in the application of ayahuasca sacraments. Chapter 7 examines the thorny issues of how psilocybin and mushrooms might be integrated into psychiatry, whether chemical isolates are necessary (as opposed to whole mushrooms with their “entourage effect”), and problems related to proper blinding in clinical trials.² This theme is examined in greater detail in Chapter 8, which focuses specifically on this single-chemical versus whole-plant argument. For the herbally oriented, the debate will be quite familiar, and readers may enjoy the bias of Sidarta Ribeiro, PhD, toward whole-plant preparations. He claims that synthetics are the true “snake oil” and have not fulfilled their promise.

Chapter 9 tackles the huge problems associated with placebo blinding in psychedelic studies. Placebo responses have been rising for decades, and the problem is more acute with respect to any drug with psychoactive effects, or when only subjective measures from the patient are available (e.g., with pain conditions).^3,4 Chapter 10 pertains to do-it-yourself mycology and presents an interesting history and sociology of the phenomenon surrounding Psilocybe mushrooms and their allies, blurring the lines between medicine, recreation, and activism.

Chapter 11 focuses on ayahuasca and presents the challenge of recognizing and categorizing “plant teachers” in their own terms. When Laura Dev asked plant teachers during an ayahuasca experience how humans could collaborate with them in in disseminating knowledge, their response was simple, yet profound: “We build life.” In the scheme of Amazonian cosmology and efforts to survive and thrive in an endlessly challenging environment, the message seems entirely appropriate, but does it also hold relevant lessons for modern urban dwellers?

Finally, Chapter 12 examines N,N-dimethyltryptamine (DMT), that enigmatic psychedelic lightning strike of a compound. Though it is a trace endogenous chemical in the human brain, DMT is widespread in Amazonian plants and even temperate Phalaris spp. (Poaceae) grasses. The problem remains as to how to describe to the uninitiated a phenomenon in which the DMT-affected mind is overwhelmed by whirling fractal geometries and 18 simultaneous tangential thought processes.

Plant Medicines, Healing and Psychedelic Science certainly is a worthy contribution to the sociological literature on psychotropic drugs, but it is a very expensive tome and difficult to use as a reference. Although it has a detailed introduction and chapter headings, it lacks an index that would allow for more thorough exploration of topics. People interested in this topic on botanical, historical, or pharmacological levels may find some classics available on the used book market to be more fruitful purchases, especially those of Richard Schultes^5-7 and Jonathan Ott.^8,9

—Ethan B. Russo, MD
Director of Research and Development
International Cannabis and Cannabinoids Institute
Prague, Czech Republic

References

1. Anderson EF. Peyote: The Divine Cactus. Tucson, AZ: University of Arizona Press; 1996.
2. Mechoulam R, Ben-Shabat S. From gan-zi-gun-nu to anandamide and 2-arachidonoylglycerol: The ongoing story of cannabis. Nat Prod Rep. 1999;16:131-143.
3. Tuttle AH, Tohyama S, Ramsay T, et al. Increasing placebo responses over time in U.S. clinical trials of neuropathic pain. Pain. 2015;156:2616-2626.
4. Russo EB. Current therapeutic cannabis controversies and clinical trial design issues. Front Pharmacol. 2016;7:309.
5. Schultes RE, Hofmann A. The Botany and Chemistry of Hallucinogens. Springfield, IL: Charles C. Thomas; 1980.
6. Schultes RE, Hofmann A. Plants of the Gods: Their Sacred, Healing, and Hallucinogenic Powers. Rochester, VT: Healing Arts Press; 1992.
7. Schultes RE, Smith EW. Hallucinogenic Plants. New York, NY: Golden Press; 1976.
8. Ott J. Ayahuasca Analogues: Pangæan Entheogens. Kennewick, WA: Natural Products Co.; 1994.
9. Ott J. Pharmacotheon: Entheogenic Drugs, Their Plant Sources and History. Kennewick, WA: Natural Products Co.; 1996.