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A Note on the Safety of Peyote when Used Religiously.

by Matthew J. Baggot


Note: this essay was originally posted to the alt.drugs newsgroup as part of an informal discussion on past mescaline research. Although it has been reorganized and expanded by the author for its inclusion in the Council on Spiritual Practices web site (www.csp.org), it is still meant as an informal note rather than an exhaustive literature survey.

Among the psychedelic drugs, mescaline is perhaps the best understood. It was the first psychedelic to be isolated and synthesized by scientists. Its metabolism and biochemistry have been extensively studied in human and non-human animals. As the main psychoactive component in the cactus peyote (Lophophora williamsii), mescaline has a long history of religious use that continues to this day. This gives us a rare opportunity to study the effects of a psychedelic in a controlled, traditional, and (relatively) Westernized setting. Unfortunately, this opportunity has too often been ignored, perhaps because of the political unpalatability of any positive model of psychedelic use. Those studies which have been conducted have tended to focus on the pathology-related issues where Western medicine excels (such as mutagenicity, teratogenicity, and adverse psychological reactions).

Peyote's long tradition of use has been used to examine whether it might be mutagenic. At one point there was concern that some psychedelics, in particular LSD but also mescaline, might cause chromosomal disorders. A comprehensive review of the evidence concerning LSD eventually concluded that there was no significant risk (Long 1972). It appears that the type of chromosome breakage that occurs with psychedelics can be induced by many different substances and causes no real harm to users or their offspring (Henderson and Glass 1994). Nonetheless, several studies have addressed this issue in Native American populations. For example, Oscar Janiger M.D. and his colleagues published a study on the effect of peyote on human chromosomes among the Huichols, who have used peyote for approximately 1600 years, and found no abnormalities (Dorrance, Janiger, and Teplitz 1975). They estimated that the people they tested took peyote up to 35 times a year and had been doing so for essentially all of their lives. Another study, among the Yanomano Indians of Venezuela, found no difference in chromosomal damage between males and females despite the fact that only males ingested peyote (Bloom et al 1970).

A more interesting type of study investigates the psychological safety of religious peyote use. It would appear that, when used in a controlled religious setting, peyote can be used with very few adverse reactions. This conclusion is reached in "Navajo Peyote Use: Its Apparent Safety" by Robert Bergman M.D. (Bergman 1971). While working with the mental health program of the Indian Health Service, Bergman tracked every report of a peyote-linked psychiatric episode in Navajoland over four years. At the time, the Indian Health Service provided almost all medical services in the area and consultation to many community organizations, including the Native American Church. This put the program in a good position to document adverse psychological reactions to peyote.

However, they saw "almost no acute or chronic emotional disturbance arising from peyote use (p. 697)." Of the approximately 40 to 50 reports of adverse reactions over the four year period, there was only one "relatively clear-cut case of acute psychosis and four cases that are difficult to interpret (p. 697)." The other reports were either heresay or were traceable to physicians blindly assuming that mental problems among the Navajo people were due to peyote.

This low number of cases allowed Bergman to make some estimates about the actual incidence of adverse reactions to peyote: ...The Native American Church of Navajoland estimates its membership at 40,000. This estimate may be high and there may be inactive members, so we will use a population base of 30,000. Our informants report attending meetings with an average frequency of about twice a month. Since this may be exaggerated, we will assume an average attendance of only once every two months. This would result in a total of 180,000 ingestions of peyote per year by the population we serve. Assuming that all five of our cases represent true reactions to peyote and that we hear about only half of the cases occurring, the resulting (probably overestimated) rate would be approximately one bad reaction per 70,000 ingestions. (p. 697) As you can see from this estimate, the incidence of negative reactions among peyote users is very low when the substance is taken under controlled circumstances. We should note that there may be a sampling bias in the estimate since people who experience repeated or severe problems after using psychedelics probably drop out of the Church and wouldn't be represented in the '70,000 ingestions.'

The 5 case reports which the article mentions involve:

  • One man who, against rules, had been drinking alcohol and experienced a paranoid panic attack after taking peyote; he recovered in 24 hrs but quit attending the ceremonies;
  • An acute schizophrenic episode which began at the time of the meeting and became worse over the next few days but improved after inpatient treatment and didn't prevent attendance at further meetings;
  • A man who had attended ceremonies at the insistence of his wife, despite the objections of his family, and who reported feelings of anxiety and depersonalization until he quit attending meetings and worked out some of his feelings about his marriage; and
  • Two chronic schizophrenic patients who became anxious during meetings but who continued to attend them without untoward effects.
This is too small a sample of cases to allow us to draw any sweeping conclusions, but it is interesting to note that at least some diagnosed schizophrenics are generally able to comfortably ingest peyote. This suggests that mescaline and probably other psychedelics do not cause schizophrenic episodes directly but at best trigger episodes in people with latent schizophrenia through some other (possibly stress-related) mechanism. After all, if psychedelics directly interacted in a negative manner with whatever neurosystems are affected in schizophrenia, then we would expect psychedelic use to acutely increase the symptoms of these disorders.

This argument is consistent with a survey of the literature on adverse reactions to psychedelics by Rick Strassman M.D. (Strassman 1984). Among other things, Strassman discusses the data comparing those patients with "schizophrenia-like" disorders who had used LSD with those who had not. He concludes that "these data, taken as a whole, limited as they are in terms of comparing subgroups ... of 'schizophrenia-like' disorders, point toward, at most, a possible precipitatory role in the development of these disorders, in a nonspecific and not etiologically related manner" (p. 585).

The 'comfortable' religious use of peyote by the schizophrenics Bergman described stands in contrast to the situation when schizophrenics are given psychedelics in a psychiatric setting. In psychiatric settings, LSD --the psychedelic most often clinically administered-- is often received with "displeasure" by patients and few are receptive to subsequent administrations (Fink et al 1966). This is despite the fact that patients showing typical schizophrenic symptoms are generally able to "tolerate" LSD well, possibly due to their experience handling other 'altered states' (Glass 1973) or because their brain already produces psychedelic-like substances as part of their illness (Strassman 1984). Of course, there may also be some differences in severity of symptoms between schizophrenics participating in Native American Church ceremonies and those who were psychiatric inpatients which allowed the first group to ingest peyote more easily. Finally, the differences in attitude between someone intentionally ingesting a religious sacrament and someone taking an experimental medicine should affect their willingness to tolerate some of the drug'sside effects.

In addition to these differences, the social environment and structure of the peyote ceremony doubtlessly also plays some role in minimizing adverse reactions. This becomes clear when we examine theories concerning the development of adverse reactions. Fink et al (1966) concluded that the hazard of LSD (and presumably other psychedelic) administration "appears not to be in the precipitation of a schizophrenic-like state but rather in decreasing emotional and affective controls... (p. 453)." Using more psychiatric terminology, Glass (1973) hypothesized that a psychedelic drug can cause the ego to lose control, especially in patients predisposed to this:

The drug effect is a stress and, while dose-related, may be awesome for the borderline individual whose tenuous control over both the environment and his own intrapsychic state makes normal functioning difficult. He may not be able to reintegrate rapidly the distorted perception, rapidly changing emotions, and loosened ego boundaries after the actual drug effect has begun to wane. (p. 235) If we understand the potential dangers of psychedelics in this way, it makes sense that a group ceremony which is focused on praying for specific purposes would reduce the stress of psychedelic use. Occurring in a socially sanctioned setting, loosened ego boundaries might not appear threatening but instead might allow the individual to identify with the larger social group.

Bergman made similar observations in his study and argued that usually repressed emotions are made available by peyote in the religious meetings. Although these emotions might normally cause panic or psychosis, the structure of the meetings carefully channels the emotions into ego-strengthening directions. Bergman identified and explained several factors through which he believed this channeling is carried out:

...Some of the crucial factors are a positive expectation held by the Peyotists, an emphasis on the real interpersonal world rather than the world within the individual, emphasis on communion rather than withdrawal during the drug experience, emphasis on adherence to the standards of society rather than on the freeing of impulses, and certain practices during the meetings.

Peyotists regard peyote as a powerful and beneficial medicine. Meetings are held for curative or other beneficial purposes, and the road man is regarded as curer as well as priest. Much of the time in meetings is spent praying for and talking about expected benefits from the drug. As in psychotherapy or any other curative ritual, this expectation seems to be an important influence.

...The whole spirit of the religion seems best characterized as communion --with God and with other men. Meetings are experienced as a time of being close and growing closer to one another. It is acceptable and expected that if someone in a meeting expresses a strong feeling, the others present feel it with him and tell him so. If there is a tendency to lose old features of one's identity, there is an equally strong tendency to acquire stronger identity as a member of the group. As a member of the church, each person is assured of his own significance and of group support for his own needs to be self-assertive in the outside world.

Meetings are conducted in a strict and organized way. Distortions in time sense are counteracted by the various events of the service that take place at precisely defined times of the night. Almost everything is done in a ritualized way that requires attention to the detail of one's movements and speech. The drum, ceremonial tobacco, and other important objects are passed only in a certain way. In moving about the hogan or tepee, one walks only in a certain direction. All these details are invested with considerable emotion, and some Peyotists say that this keeps them "thinking in the right way." The ceremony is experienced as beautiful, but much of the beauty is the beauty of orderliness.

Road men are trained to look after people who become excessively withdrawn. If a participant begins to stare fixedly into the fire and seems unaware of the others, the road man will speak to him and, if necessary, go to him and pray with him. In the process of praying with him, the road man may fan him with an eagle feather fan, splash drops of water on him, and fan cedar incense over him. All of these processes are regarded as sacred and helpful, and they seem to provide stimulation in several sense modalities to draw one back into the interpersonal world. Another safeguard is the custom that no one is to leave the meeting early. Considerable effort is made to prevent someone who has been eating peyote from going off alone into the night. This factor is probably important too, in the customary activities of the morning after the meeting. Everyone stays together and socializes until well after the drug effect is over. (p. 698)

From the point of view of an anthropologist, Bergman's explanations probably lack ethnographic sophistication. Nonetheless, he still provides some excellent observations about how the larger social context can help structure an individual's drug experience. Although it is now generally recognized that this can occur (see, for example, Falk and Feingold 1987), there is too little research into the exact mechanisms of this interaction. This may be because such research would span disciplines and would not easily be replicated in a laboratory.

Despite these potential difficulties, research of this sort is important. It could not only help us to manage and prevent 'bad trips' but would also have potential in making non-psychedelic medical drug use safer and more effective. Set and setting influence the effects of many drugs; the influence is simply most obvious with psychedelics.

Finally, religious use of peyote deserves close study because it is the only non-experimental psychedelic use allowed by the U.S. government. This is largely due to peyote's long history of religious use by Native Americans. Ultimately, however, the U.S. government's position on psychedelics will need to be rationalized. In other words, we will need to understand what factors make the Native American Church's use of peyote safe (and apparently beneficial) so that we can rationally distinguish between responsible and reckless psychedelic use.

Matthew J. Baggott, April 1996,mbagg@itsa.ucsf.edu

REFERENCES
  • Bergman RL (1971). ""Navajo peyote use: its apparent safety," Amer J Psychiat 128(6):695-699[51-55].
  • Bloom AD; Neel JV; Choi KW; Iida S; Chagnon N (1970). "Chromosome aberrations among the yanomamma indians." Proc Natl Acad Sci USA 66(3):920-927.
  • Cohen S (1960). "Lysergic acid diethylamide: side effects and complications." J Nerv Ment Dis 130:30-40.
  • Cohen S; Ditman KS (1963). "Prolonged adverse reactions to lysergic acid diethylamide." Arch Gen Psychiatry 8:475-480.
  • Dorrance; Janiger; and Teplitz (1975), "Effect of peyote on human chromosomes: cytogenic study of the huichol indians of northern mexico." JAMA 234:299-302.
  • Eisner BG; Cohen S (1958). "Psychotherapy with lysergic acid diethylamide." J Nerv Ment Dis 127:528-539.
  • Falk JL and Feingold, DA (1987). "Environmental and cultural factors in the behavioral action of drugs" in (ed Meltzer, HY) Psychopharmacology: the third generation of progress, Raven Press, New York, p. 1503-1510.
  • Fink, M; Simeon, J; Haque, W; and Itil T (1966). "Prolonged adverse reactions to LSD in psychotic subjects." Arch Gen Psychiatry 15:450-454.
  • Glass GS (1973). "Psychedelic drugs, stress, and the ego: the differential diagnosis of psychosis associated with psychotomimetic drug use" J Nerv Ment Dis 156: 232-241.
  • Henderson LA and Glass WJ (1994). LSD: still with us after all these years, Lexington Books, New York.
  • Long SY (1972). "Does LSD induce chromosome damage and malformations? a review of the literature" Teratology 6:75-90.
  • Strassman RJ (1984) "Adverse reactions to psychedelic drugs: a review of the literature." J Nerv Ment Dis 172(10):577-595.

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