In a cave tucked into the rocky Andean wilderness of southwestern Bolivia, amid karst and llama feces, in 2008 anthropologists discovered a small leather bag that once belonged to a shaman from the Tiwanaku civilization—a pre-Columbian empire in the Southern Andes—more than 1.000 years ago.
Inside they found a collection of ancient drug use equipment.
It included a snuff tube, spatulas for crushing the seeds of psychoactive plants, and the remains of chemicals ranging from cocaine to psilocin, one of the active hallucinogens in magic mushrooms, and the basic ingredients for the psychoactive ayahuasca tea.
Experts believe that the shaman's bag represents a unique insight into the relationship between ancient civilizations and powerful hallucinogenic drugs.
The substances found in the bag are also of increasing interest in today's medical research.
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Psychedelics such as MDMA, LSD, psilocybin (another compound found in magic mushrooms) and ketamine are gaining increasing attention in the Western world as a possible way to combat the burgeoning mental health crisis.
Some psychedelic compounds are seen by their proponents as a potential new class of effective treatments for psychiatric disorders such as anxiety, depression and substance abuse, among others.
The compounds are believed to help change individuals' perspectives on so-called "diseases of despair," which include suicide, drug overdose, and alcohol abuse, in conjunction with therapy.
However, these treatments have also been criticized as overhyped and potentially harmful.
And while this new field of medicine is evolving, there have been twists and turns along the way (see box: No MDMA for PTSD), and discoveries such as a shaman's bag in the Bolivian Andes shed new light on the role psychedelics played in ancient societies. .
Treatment of post-traumatic stress disorder (PTSD) with the drug MDMA is not approved
Taking psychedelic drugs through the approval process to become official drugs requires a lot of research.
On August 10, the US Food and Drug Administration announced that it would not approve MDMA-assisted therapy as a new treatment for moderate to severe post-traumatic stress disorder (PTSD).
Some promising results from the Phase 3 trial were released in September 2023, but the Food and Drug Administration said there was not enough data to conclude that the drug is safe and effective as a medicine.
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And yet in those cultures, psychedelics were experienced in very different ways.
Yuria Selidven, a senior professor at the University of California, Berkeley, says that the term "psychedelics" is a very modern Western construct.
Indigenous communities across the Global South have incorporated these drugs into their own lives for centuries, calling them spiritual medicines.
"The belief in the West is that they are used to treat mental health disorders," says Selidwen, herself of Nahua and Mayan descent, who wants to use her research to reclaim, revive and pass on indigenous wisdom.
"But the essence of indigenous use is not only in rituals and ceremonies, but in everyday practice. For example, if something valuable was lost, the community would turn to the medics."
Historical documents do indicate that psychoactive substances were used for healing purposes, but this was only one small aspect of their use.
Instead, spiritual remedies played a major role in community bonding, sacred rituals, palliative care, consciousness exploration, creativity enhancement, and hedonism.
Records show that the ancient Greeks and Romans had seasonal rituals that involved taking a psychoactive drug called kikeon that contained hallucinogens similar to LSD.
But Osiris Sinuhe Gonzales Romero, a researcher at the University of Saskatchewan in Canada who documents the history of indigenous knowledge, says the use of psychedelics probably stretches much further back in human history.
Archaeologists believe that the psychoactive mushroom Amanita muscaria was first used in the Americas shortly after the first humans crossed the Bering Strait between eastern Russia and Alaska during the Ice Age about 16.500 years ago.
Mushrooms are still used today among the Ojibwa indigenous community in the Great Lakes region between Canada and the US.
"We know that sacred mushrooms with psychoactive properties have an ancient tradition in Mesoamerica," says González Romero.
"There is evidence for this based on pollen analysis, pictographic writing, ceramic sculptures, figurines holding sacred mushrooms, and even carved mushroom-shaped stones from the Maya civilization. The use of the San Pedro cactus and peyote [both of which contain the psychedelic mescaline] is believed to date back to 8.600 BC in Peru and 14.000 BC in Mexico."
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According to Gonzalez Romero, one of the earliest known written documents describing rituals with sacred mushrooms is Codex Vindobonensis.
Mexicanus 1, a picture book made by the ancient Mixtec civilizations between 1100 AD and 1521 AD
According to researchers Marten Jensen and Gabina Aurora Perez Jimenez, who studied Mesoamerican archeology and The Mexican Codex of Venice 1, one of the descriptions features the Wind God carrying a lizard with a mushroom on his back, while the participants in the ritual carry mushrooms in their hands.
Knowledge of these practices first began to spread more widely in the writings of a Franciscan friar named Bernardino de Sahagun, who spent decades studying and documenting Aztec beliefs, culture, and history after the Spanish colonization of Mexico.
Albert Garcia-Romo, a professor of psychedelics and consciousness at the Johns Hopkins University School of Medicine, says De Sahagun described Aztec rituals with psilocybin-containing mushrooms in the 1520s, after what modern practitioners might call group therapy.
"De Sahagun wrote that they would use these mushrooms in ceremonies where people would dance, sing and cry, and then, in the morning, they would talk about the visions they had," says García-Rome.
But Selidven says that in order for Western society to fully appreciate why indigenous communities have valued these ceremonies for so long and considered these substances so valuable, you have to understand the different belief systems for interacting with and interpreting the world around them.
There is growing interest within Western medicine in using psychedelics as a way to shift perspective through psychotherapy, helping people process trauma and change the introspective thought patterns that can get stuck in conditions such as anxiety and depression.
However, Selidwen says that while the use of psychedelics in the West focuses on the individual, the most common use of psychoactive substances in ancient cultures across the Americas and the Global South has always been based on interaction with the natural and spiritual world.
"In most of these traditional cultures, we don't have that sense of division between the human and the natural world," Selidwen says.
"We believe that we are always interacting with a living, active consciousness all around us, and when we use spiritual medicine, we want to communicate and restore balance with that world.
"So the context is never individual well-being or mental health, but the collective well-being of the environment as a whole," she says.
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Garcia-Romo agrees, saying that among indigenous communities in Colombia, Brazil and Mexico, psychoactive substances are used to communicate with ancestors, access other planes of existence and gain information about the world around them.
Studying Aztec medicine documents, Gonzales Romero discovered that music, especially drumming, had long played a role in psychedelic ceremonies because it reflected the heartbeat, and was thought to aid in trance-like states that could enhance creative expression.
He explains that although the word "shaman" is often used to describe the practitioners who lead these ceremonies, it is a completely colonial concept.
Instead, the direct translation of the expression used by some indigenous communities is "one who sings".
"Some alkaloids present in classically used psychedelics, such as psilocybin mushrooms or LSA in the plant Rivea corymbosa, have psychodysleptic properties, which means they cause auditory hallucinations or modifications in auditory perceptions," says Gonzales Romero.
"This means that even if you are not trained, you can create or hear music that has never been played to anyone in this world."
"Perhaps because of this, according to the Aztec view, mushrooms are seen as related to Xochipili, the god of song, music, joy and fertility," he says.
These perceptions also apply to the way indigenous cultures experience psychedelics for healing.
González Romero says the ritual could also involve fasting and celibacy for purification, depending on what the practitioner deems appropriate for the patient.
Some healing rituals would not involve music at all, but take place in complete silence during the night with domestic animals such as singers and dogs locked away to avoid any disturbance.
But if psychedelics could be used to treat anything from pain to fever, the emphasis was not so much on healing any one individual as on restoring balance to the community as a whole.
"The Viksarika people tell how the peyote cactus was used to bring their community back from anemia after a great wave of malaria decimated their population and health more than 500 years ago," says Ahau Samuel, a practitioner of the Chiquimeca tribe of Guanajuato, Mexico, who leads the Roots of the Gods herbal medicine project.
Gonzales Romero says this is because some disease outbreaks were seen as connected to sins within the community, so the gods punished people by spreading disease.
"Psychedelic rituals were a way to reclaim the soul," he says.
"The etiology of indigenous medicines is very different.
"Some diseases are seen as the result of a loss of balance between human beings and nature, for example, the lack of respect for hunters who kill more animals than they need and the overexploitation of land," he says.
Given psychedelics' long history in indigenous culture, many communities have mixed feelings about the recent boom in Western psychedelic research, spawning an industry expected to be worth $7 billion by 2027.
Last year, Selidwen and a group of other Indigenous researchers wrote a study expressing concern about cultural appropriation, the exclusion of Indigenous voices and leaders from the Western psychedelic field, and the lack of recognition that many of these substances are believed to have sacred value.
The authors of the study pointed out that although this booming industry is built on medicines and practices that have been extracted and adopted from indigenous cultures, little of the wealth made in this multi-billion dollar industry reaches the communities.
Reports indicate that while a place next to a Western-run psychedelic resort can cost several thousand dollars, indigenous practitioners earn between $2 and $150 for providing very similar services.
Others, including non-Indigenous researchers, questioned whether psychedelic drugs could achieve their stated goals of combating mental health conditions without somehow embracing the spiritual and mystical element of the psychedelic experience.
Jules Evans, a psychedelic researcher at Queen Mary University of London who runs the non-profit Challenging Psychedelic Experiences, explains that one of the reasons negative experiences can occur is that they are so foreign to our secular culture.
"Some Native American tribes have been using psychedelic plants for centuries," says Evans.
"They have maps, guides, deep knowledge of altered states of consciousness. Secular people, on the whole, don't. As a consequence, people can be stunned by the experience and not know how to fit it into their materialistic world view. This existential confusion can last for months or years, and the person who comes out on the other side can be very different from the person before," he says.
Selidven says one of the key limitations of the Western approach is that it focuses on psychedelic substances that are as pill-like as possible.
She says that if we can learn anything from thousands of years of use among ancient cultures, it's that the real power of psychedelics lies in their ability to foster connections between people and communities, as part of a collective experience.
"It's not just about the molecule, it's about the broader constellation of relationships that occur and bring about healing," Selidwen says.
"In the West, we often notice a peak of well-being immediately after the initial exposure to the drug, but it is not sustained because there is no collective context of the hallucinogenic experience.
"And because of that, you just run the risk of creating another addiction because people keep coming back to experience the same sense of magic or wonder," she says.
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