BARCELONA (SPAIN) NEWSPAPER “LA VANGUARDIA” PUBLISHES ARTICLE ON SCIENTIFIC RESEARCH ABOUT AYAHUASCA.
Jordi Riba is a pharmacologist who investigates psychoactive substances and has just been included in Rolling Stone magazine’s list of the 25 people who will mark the future of science.
It is said that no one is a prophet in their own land. And it’s usually true. It is something that Jordi Riba, a Catalan pharmacologist who has just been included in the American magazine Rolling Stone’s list of the 25 most influential people in the future of science, knows very well. Riba (Barcelona, 1968) enjoys recognition abroad. “I give an average of 10/12 conferences a year throughout Europe and the United States,” he says. But here his research, for the moment, has not had such an impact. Maybe it’s because of the substances he studies, which are rather exotic. This scientist dedicates himself to the pharmacology of the central nervous system and neuroscience in general. He has studied psychoactive substances that produce changes in perception and cognition, such as Ayahuasca, a kind of concoction that indigenous peoples of the Amazon have consumed since time immemorial. Thanks to his research, Riba, head of the Neuropsychopharmacology group at the Hospital Research Institute of Sant Pau, has revealed part of the potential that this brew conceals, and has wanted to share it with La Vanguardia.
How does one feel when they are chosen as one of the 25 most influential people in the future of science.
Well totally surprised and dumbfounded. It makes me happy to think that there are people who recognise the work that we are doing. I have been working in an unorthodox area for 20 years, which has been growing a lot in recent years, especially abroad. Precisely, one of the things that I am happy to have been included in this list is that it entails, perhaps, is that the area that I work in become better known here. I have to say that in the world of science there are people a millions times better than I [laughs]. I take it as recognition without creating delusional thoughts about my abilities.
What a responsibility, is not it?
No, you have to shield yourself a little from that. When I arrived here 20 years ago [at the Hospital de la Santa Creu i Sant Pau] and I proposed starting studying psychoactive substances to the then head of pharmacology at the time, Dr. Manel Barbanoj, he thought it interesting. He was a person with a very open mind. But the reactions I perceived around me were rather more sceptical.
I followed my path, despite scepticism, because I understood that what I wanted to investigate was interesting enough to put my attention to it.
Your studies are somewhat exotic…
Yes, it is a very exotic area. If you pursue something that is not within a project that is already financed, that rolls along by itself, it will mean that the effort you need to make will be a hundred times more. I followed my path, despite scepticism, doubts, possible criticisms and various obstacles, because I understood that what I wanted to investigate was interesting enough to put my attention to. Still, it is also a commitment to myself. I do not feel a special responsibility for being included in that list.
How did you come across Ayahuasca?
I’ve always been interested in brain biochemistry. I got to know the work of anthropologists who had gone to study Ayahuasca to South America. I read some of the stories and made contact with one of them. Later, in the middle of the 90’s and by coincidences of life, I met some of the people who were starting to organise Ayahuasca sessions in Catalonia, especially around Barcelona, which involved a series of practices, rituals, that came from Brazil and that involved taking a drink that had psychoactive properties.
In the 90’s there were already groups here that organised sessions…
There was another group in the Balearics, another in Madrid … I was struck by the motivations of those people to take that substance. I was hoping to find a more playful use of psychoactive substances, but I ran into the opposite.
What did you find?
These people met every fortnight. They explained to me, that through their subjective experience with Ayahuasca, that they entered a state of introspection in which they experienced a whole series of sensations. Recovery of emotional memories above all. That was very important to them. I saw that these memories, which sometimes appeared in the form of visions similar to dreams, helped them to revisit some aspects of their personal biography, and all this without losing awareness at any moment that this was produced by what they had taken.
They said that it helped them to overcome some conflictive situations, traumas, that they had lived throughout their lives.
Curious.
They said that it helped them to overcome some conflictive situations, traumas, that they had lived throughout their lives. Twenty years later, Ayahuasca has become extremely popular. Now, some of the people who approach this ritual are people who are suffering from post-traumatic stress, such as ex-combatants from the US in Afghanistan or Iraq, for whom nothing at all worked. They continue to have intrusive memories and a whole series of disabling symptoms. This is the most recent movement.
You’ve talked to me about the mid 90’s and today. But in the meantime, what kind of people consumed this drink?
People who had serious addiction problems to cocaine and heroin and who were able to quit this type of consumption after a period in which they would drink Ayahuasca perhaps six to ten times. After that, they decided to leave that self-destructive path they had gone down completely .
People who had serious problems with cocaine addiction were able to overcome them after drinking Ayahuasca
Sounds surprising.
When I listen to these stories, I think that it seems that what I do can help someone. If I try to understand what the mechanism of action behind all this is, I can warn the scientific community that perhaps they should pay attention to this question. When I started, little attention was paid to these substances, something that made them attractive to me as it was non-ventured territory. This is what you like to do if you have the spirit of a researcher,.
Is the interest greater now?
The doors are opening in other countries, like in England and the United States. Highly prestigious universities and research centres are studying similar substances. In my case I study Ayahuasca, of which the active principle that produces visions is called dimethyltryptamine (DMT). But there are other studies that have been done with psilocybin, and also with MDMA, the active principle of ecstasy. It is being seen that there are a whole series of substances, which had very bad reputations, that if used in a suitable context – with a concrete purpose and with a well-chosen population of patients – can have beneficial effects.
And where do you locate the tipping point?
In the discovery, about ten years ago, of an aesthetic called ketamine, which at sub-anaesthetic doses produces very intense perceptual modifications, a group of US psychiatrists saw that, given at certain doses, it was a potent antidepressant that acted very quickly. And now there is a boom in research of this type of antidepressants, which act quickly through mechanisms that are very different from those used in traditional drugs.
I understand.
With traditional antidepressants, it takes about three to four weeks before symptoms begin to improve. With Ayahuasca, in a study we did in Brazil, improvements in symptomatology were observed within a few hours of a single dose, and the effect was maintained for three weeks.
We see that something that was stigmatised as a drug that was consumed at ‘raves’ works with some patients.
Surprising.
These results have been achieved systematically with ketamine, and this has opened many people’s minds. We see that something that was stigmatised as a drug that was consumed at ‘raves’ works in some patients. What happens with depression is that there is a very important percentage of patients that do not respond to any drugs. We are talking about patients for whom electroconvulsive therapy, electroshocks, has not worked.
And how does it act at the brain level?
It is a rather complex preparation. It is an infusion, a tea, which is mainly obtained from a vine called Ayahuasca and that gives its name to the drink. It grows in the high Amazonia (Bolivia, Venezuela, the westernmost part of Brazil, Peru and Ecuador). This vine contains a number of active principles that we have now seen have very interesting effects on the central nervous system and are not responsible for the visions. The procedure consists of crushing the vine and making an infusion with the leaves of another plant. In these leaves there is a compound, DMT, which is very structurally similar to psilocybin, which is another psycholytic.
It is a rather complex preparation that is mainly obtained from a vine
I follow.
Psilocybin can be taken orally as it is not degraded and it is absorbed. But DMT, if taken alone, even grams of it, degrades completely and does not reach the blood, so it has no effect. The curious thing is that the active principles of the vine block the degradation of DMT. And you wonder how it could be that the inhabitants of this part of the planet, a place with more vegetable biodiversity than one can imagine, decided to combine this vine with the leaves of another plant.
Exciting.
The vine is very robust, it is like a log. Breaking it, crushing it and making the infusion is a huge job, not something done by chance. No one knows how they came to the conclusion that the combination worked. What has come to Europe and the United States is this combination, but there are other groups that add other plants that contain other psychoactive substances and that their consumption could pose a greater risk to health.
You have to be careful.
Many people who want to experiment with Ayahuasca travel to the Peruvian Amazon. They go with the first person who tells them that they are a shaman and they drink what they offer them without knowing what they are drinking. There may be, for example, scopolamine (popularly known as burundanga), which is a substance that can endanger your life.
Let’s go back to your investigations…
We have done neuroimaging studies, and what we have seen is that under the effects of Ayahuasca, what happens is an activation of the areas of the brain that are involved with the processing of emotions, memory and areas that are on the border between cognitive and emotional aspects. There is also some activation of the visual areas, although it is not very striking, so we are not sure that this phenomenon is responsible for the visions.
Many people who want to experiment with Ayahuasca travel to the Peruvian Amazon. They go with the first person who tells them that they are a shaman and they drink what they offer them without knowing what they are drinking.
I understand.
The end result is that the person is recovering, very abruptly, visions that usually contain important emotional burdens. There are people who, for example, relive a relationship with someone who was important in their life. The experience is quite intense and can become overwhelming. If you look at a session from the outside, you see the person with their eyes closed sitting on a chair. But suddenly, after a while, they can start crying.
How long can the effect last?
Typically, after taking a dose the effects start after about 45 minutes. It takes quite a while. From there, there is a gradual onset, reaching a maximum effect at around an hour and a half or two hours. Then it starts to decrease and the effects have completely disappeared after four or six hours after the session. It also depends on how much is ingested.
The experience is quite intense and can become overwhelming
In general, is there a responsible consumption of Ayahuasca?
It is a little dizzying to see how it is being trivialised. You see people organising Ayahuasca sessions everywhere, how it appears in the New York Times as a fashionable experience… I understand that there are people who go to these sessions thinking that they will have a pleasant, playful time, but it is not recreational. After the experience, people say ‘wow, wow, wow!’.
It leaves an imprint…
I have been evaluating people who have consumed it and they explain to me that they believe that after their experiences, they have acquired a knowledge that is useful for their life, but that sometimes they are in session about to drink the tea and think ‘what am I doing here knowing what is coming!’. They all point out to you that it is not a recreational drug, quite to the contrary. If you are trying to escape your problems, drinking Ayahuasca is the last thing you should do, because it puts them in front of your eyes and you experience them again, often in a painful way.
If you are trying to run away from your problems, drinking Ayahuasca is the last thing you should do
Not a recreational drug at all, in other words
It has a series of drawbacks that make it unpleasant. In its usual form, it has a horrible taste. It also smells bad. It produces a burning sensation in the stomach and nausea at the moment of drinking it which is almost immediate. In addition, it is quite common for the person to vomit soon after having drunk it. It’s not recreational at all. If you add to this that the experiences can be emotional and painful … This for me is a security barrier.
In what sense?
I do studies with patients who have addiction problems, and the people who work with them say to me: ‘Are you telling me that you want to experiment with someone who has addiction problems by giving them something that contains a potent psychotropic that might have potential for abuse?’. I assure you that no one will take Ayahuasca for pleasure, 100% guaranteed.
I assure you that no one will take Ayahuasca for pleasure, 100% guaranteed
This is good news…
One thing we have recently found is that in the vine’s compounds, which were believed to only help DMT not to degrade, have rather interesting biological effects. In the adult mammalian brain, there are a number of stem cell niches that produce new neurons. This phenomenon has not been given much attention because the production rate is frankly low. Now, we have seen that two of the compounds that are present in the vine, the beta-carbolines, have very powerful neurogenic effects.
Do they help to generate neurons?
They stimulate the proliferation of the number of these stem cells and their migration to integrate into pre-existing brain circuits where they are transformed into functional neurons. These three processes are stimulated by these two compounds of the vine. This refers to the conclusions of an article that we just published and that has left everyone quite surprised, myself being the first.
Sounds hopeful.
When I explain that there are people, who from the consumption of Ayahuasca, have changed their lives, people who were immersed in depressions or addictions and have been able to redirect, and describe the subjective experience they relate, I find many sceptical faces. But when you are biologically testing these compounds and you notice that they are acting in the same way as clinically functioning antidepressants, you have data that is more easily communicable and can be better received and accepted by the community that engages in study of neurosciences.
It seems that Ayahuasca has a lot of potential.
It is very clear that it produces an effect at the biological level. We have also seen, by doing functional magnetic resonance imaging studies (i.e. looking at brain structure and brain function), that 24 hours after consumption of Ayahuasca there is a decreased activity of one area of the brain, the medial area of the lobe parietal, which is directly associated with what would be the intimate perception of your own self. In pathological situations, where there may be depressive symptoms, this area is in a state of hyperactivity, and this hyperactivity is directly related to obsessive and negative thoughts.
I find many faces of scepticism
I understand.
If we compare ourselves with other great apes (gorillas, chimpanzees, bonobos) one of the things that sets us apart from them is a great expansion of this medial area of the parietal lobe. There is increasing evidence that this part of the brain is possibly associated with processes of self-consciousness. A particular state of this area appears to correlate with negative thoughts. We have seen that once the acute effects of Ayahuasca have disappeared, there is a deactivation of this zone.
Interesting.
At the psychological level, we have observed that after the acute effects of Ayahuasca, there is a decrease in the constant harmful critical evaluation of oneself that certain people make. This is a deficit that my colleagues in the department of psychiatry see in many patients regardless of their diagnosis.
It is clear that it produces an effect at the biological level
I see that this substance has many uses.
Speaking to colleagues who treat people with addiction problems, they tell me that for the treatment of, for example, cocaine addiction there currently isn’t anything. Not that there isn’t anything that works, just that they have nothing to give them. Everything is symptomatic: if the patient is anxious because they give benzodiazepines, if they have psychotic symptoms because they give them antipsychotics. They also give them drugs that balance the sudden variations of the mood … We did a study with people who were diagnosed exclusively with addiction to cocaine and we saw changes in their brain structure.
Of what kind?
The connection and the volume of areas of the brain that are constantly seeking gratification had been strengthened and, at the same time, we observed that areas of the brain that help you assess a situation and warn you of potential hazards were disabled. It does not surprise me, seeing what we detect, that these people find it extremely difficult to give up their addiction, and that there are structural changes, they have reconnected their entire brain.
We have seen that after the acute effects of Ayahuasca there is a decrease in the harmful critical evaluation of oneself that certain people make
Astonishing.
These are very problematic situations. But I see, in parallel, that there are people who, thanks to Ayahuasca, tell me they have managed to quit their addictions. Despite the stigma of being a substance that indigenous people use, the stigma that it is psychoactive, psychedelic, hippie, etc., I feel the obligation to investigate it, because if I don’t, I am failing in my obligation as a researcher. The path I started was rather lonely from 1996 to 2005, but then studies with psilocybin began to appear in the US, no less than in the best medical school in the country, Johns Hopkins.
It is a very prestigious centre.
There is another psychiatrist doing the same at the University of California in Los Angeles (UCLA). The FDA, the US drug agency, has given MDMA a priority therapy designation to treat post-traumatic stress disorder, a huge problem in the US. And there is another group at Imperial College London conducting this type of study. The US was also where the first investigations were made with ketamine for therapeutic use. When sacred institutions like these start doing this type of research, you get more people to pay attention than when you talk about it.
When I see that there are people who thanks to Ayahuasca have managed to quit their addictions, I feel the obligation to investigate.
Earlier you commented that some vine compounds have the property of generating neurons. Could it have its practical application in diseases like Alzheimer’s?
We are far away from that. We are very cautious. The speed at which new niches are produced within the adult mammalian brain is low. You can stimulate it, but there has always been doubt as to whether and if this stimulation could counteract the neuronal loss associated with a neurodegenerative disease. We still do not have the answer for this. The next step we want to take is to test it on animal models. We want to see if we could prevent or reverse cognitive deficits.
If all this research you have done does not end up having a therapeutic translation someday, how will you feel?
I began to study all this because I was very intrigued in its mechanism of action. I am not a clinician. I am very interested in how the brain works and how it was possible that very simple a priori substances could so profoundly alter our capacity to perceive and think about our emotions, as well as the perception of our self and our role in the world. That was my main interest. I was the number one sceptic that these investigations could have therapeutic application someday. It was not my goal. But others have come to see that they could have, and have almost had to convince me. In this case, I think the risk-benefit relationship would be totally justified.
What is the use of knowing how a substance acts in the brain if it does not have a therapeutic translation?
Newton’s laws belong to the seventeenth century and were not applied to reach the Moon until 1969. Possibly Newton never considered this, he did it for the pleasure of understanding how gravity worked.
You research for the simple pleasure of knowing…
Yes, I basically do it for the simple pleasure of knowing. You spend long periods of time in emotional misery, but on the day you get results, that day you feel satisfied.
For a neophyte in the field it is difficult to understand that something is not investigated for a practical purpose.
Then you look for it. This is the great mistake that is being made regarding science’s approach. When you ask for resources for a project, you are asked about the transferable capacity that it will have in the form of benefit for society. It’s a vision you can apply to engineering, but none of the great medical findings has come through a pre-established goal. It is often wrongly said that something has been discovered by chance.
None of the great medical findings have come through a pre-established goal
Serendipity.
Fleming was with his bacterial cultures and one day, by chance, they became contaminated with a fungus. He could have picked up that slide and said, ‘It has been contaminated, it’s bad, I’ll clean it and continue with the experiment’. But instead he stopped and saw how there were no bacteria around the mushroom that had grown. And he asked himself, ‘Is this fungus blocking the growth of bacteria?’ But if Fleming had been locked up for 10 years of his life and told ‘you must find the antibiotic’ he wouldn’t have found anything.
I understand.
Now, the factual powers do not understand this, and they want you to find the application already. But that’s when you ask yourself: ‘Where are the most powerful pharmaceutical companies from?. Well, from Germany and Switzerland. And when did they start producing drugs? At the beginning of the 20th century’. I started studying organic chemistry, and all the names of the reactions had, and have, German names. Why? Because they were experimenting with chemistry that was useless throughout the nineteenth century. They spent a hundred years discovering that this along with the other reacted in such a way and could get such a thing and then in the twentieth century became pharmaceutical powers. But they were breaking rocks for a century.
If Fleming had been locked up for 10 years of his life and told ‘you must find the antibiotic’ he wouldn’t have found anything.
Something we do not do here.
In Spain we want to skip all this, and already want the application. You’re killing the possibility of discovering things. What are we seeing now? That many directed investigations have not led to anything. And many pharmaceutical companies are abandoning the central nervous system sector because they have spent millions on targeted research and have found nothing.
It is not the way to go.
Surely, the guy who thought ‘I’ll give ketamine to depressed people’ had to fight a stigma. ‘If that’s what party people take at ‘ raves’. You want to give people a drug,’ they would say. But now this man appears in ‘Nature’ as a great star. If I had listened to some of the disgusted faces I saw around me when I got here, I wouldn’t have done anything. But you do it because there is something that motivates you to follow that path.
After 20 years studying it, Ayahuasca is still surprising me.
If you had to define what Ayahuasca is in a few sentences , how would you do it?
A deep well of therapeutic potential that we should research further. I would also say that I wish I had more resources to research because 20 years after having started its study, it is still surprising me. It is the opportunity to possibly develop drugs that can help people who right now have nothing that solves their problems.
ORIGINAL ARTICLE FROM NEWSPAPER “LA VANGUARDIA”
http://www.lavanguardia.com/vida/20171219/433742427184/jordi-riba-huir-problemas-tomar-ayahuasca-ultimo-debes-hacer.html
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