Western medicine should create bridges with traditional knowledge holders, researchers say

Over thousands of years, Indigenous communities have cultivated relationships with and accumulated knowledge on psychedelics such as psilocybin mushrooms, the Amazonian botanical brew ayahuasca, and the West African shrub iboga.

More recently, psychedelics have exploded onto the stage of Western science. Clinical trials of these substances in the past 15 years have produced remarkable results in the treatment of depression, addiction, post-traumatic stress disorder, and end-of-life anxiety. Media buzz has generated a rush to legalize their therapeutic use, catapulting the global psychedelic drugs market from $3.8 billion in 2020 to an estimated $11.82 billion by 2029. But both Native and non-Native critics say the industry is ignoring the emotional, cultural, and ecological harms it is causing the Indigenous peoples who originated psychedelic medicine.

One of those critics is Yuria Celidwen, a senior fellow at the Othering & Belonging Institute at the University of California, Berkeley. She was born in Mexico into a Nahua and Maya family of healers who work with traditional plant medicine. When Celidwen moved to the United States to do research and humanitarian work, she saw no representation of Indigenous peoples in her field. Then, as Western interest in psychedelics grew, “I was seeing all these white people … pretending to know our ways,” she observes. She was struck by how much Western facilitators were profiting compared with Indigenous medicine practitioners.

So, Celidwen convened a group of Indigenous researchers, traditional medicine practitioners, and human rights activists. Together, they created a first-of-its-kind paper published this month in The Lancet Regional Health-Americas that presents ethical guidelines for engaging with Indigenous peoples in psychedelic research and practice.

Many Indigenous Nations are concerned they are being excluded from psychedelic spaces that extract their knowledge, threaten what they see as their intellectual property, and detach their medicines from their spiritual contexts, the paper finds. In addition, international demand is driving people to unsustainably harvest iboga, the plants used to make ayahuasca, and the hallucinogenic cactus peyote. Meanwhile, burgeoning retreat centers that offer psychedelic therapy often charge thousands of dollars for experiences that culturally appropriate Indigenous traditions yet share few benefits with these often impoverished communities.

The paper describes eight principles for addressing these impacts and honoring Indigenous perspectives in psychedelic research and therapy. Science spoke with Celidwen and co-author Nicole Redvers, a member of the Deninu K’ue First Nation and an associate professor at Western University, to learn more. The interviews have been combined and edited for brevity and clarity.

Q: Your paper recommends referencing reverence for Mother Nature and relationality with the natural world in psychedelic-assisted therapy. Western scientists may be wary of such paradigms that typically exist outside their vision of science. How would you respond?

Yuria Celidwen: Western science is one lens of understanding the world. We Indigenous peoples also have a science that is another way of understanding the world. We need to start expanding the definition of science to bring in different ways of addressing the challenges we’re seeing today. Each of us has a piece of the puzzle, so it is about coming together. By reaching consensus, we come to possibilities that benefit everyone.

Q: How are Indigenous peoples harmed by being excluded from psychedelic research and therapy?

Nicole Redvers: This issue is not exclusive to the psychedelic space, but it’s amplified because these medicines are so sacred to our communities. They are family members. When a medicine relative is taken from a community and used in a way it wasn’t meant for, it creates a deep hurt. It not only disrespects the community, it also disrespects these relatives of that community. That is layered onto historical and contemporary traumas that continue to be put on Indigenous communities.

Q: Your paper offers guidelines for building respectful relationships between Indigenous peoples and Western researchers or practitioners. How does that process begin?

N.R.: Lakota physician Dr. Donald Warne says, “To get to equity, we have to walk through truth.” A good first step is to walk through that truth on your own instead of expecting Indigenous people to teach you. Establish an understanding of the harms of colonization and its impacts from Indigenous viewpoints. That takes the burden off Indigenous communities, and it will lead to more successful relations.

Then it’s about questioning the motives behind establishing that relationship. There’s this idea that if you involve an Indigenous person, it gives credence or consent to the work. That’s false. It’s about a collective community determining the appropriateness of a process involving a medicine family member.

Q: Relationship building takes time. Are there ways to simultaneously reduce the harms happening now in psychedelic-assisted therapy?

N.R.: One step is to host a series of Indigenous-run discussions at community levels in different places asking this question, because the answer should come from communities. Because there’s such a diversity among Indigenous peoples worldwide, one of the dangers of saying “do this or that” is that it’s not attuned to [local] contextual factors.

We need to have open dialogues about intellectual property rights, benefit sharing, and cultural appropriation. How those conversations go will determine the next steps for the implementation of research projects and clinical trials.

Q: Are the relationship-building discussions you describe in your paper happening already? If so, what has been learned?

Y.C.: I’ve started dialogues with the Othering & Belonging Institute between Indigenous elders and researchers doing psychedelic research and training for psychedelic-assisted therapies. We need to come to these dialogues in a very careful and open way, giving Indigenous people the power to decide how we want to converse. Then we can see each other as the same authorities whose knowledge can complement each other.

N.R.: I find it’s more successful when folks engage in these conversations with Indigenous people who are used to working with Western systems. In addition to [Celidwen], Ariel Clark, an Odawa Anishinaabe attorney with the Psychedelic Bar Association in California, is hosting these discussions about ethics, intellectual property, and reparation. The conversations need to be Indigenous-led, and it’s incredibly important for people from the homes of these medicines to have a voice.