Medicine Man

Beyond the circle of lantern light, the darkness is absolute. Daniel Mattin (not his real name), sitting cross-legged in a small hut, listens to the freakishly loud chorus of tropical birds and trees rustling in the night breeze. A shaman wearing a jumble of necklaces and emblems chants icaros, or songs, to summon the "spirit of the plant"--in this case an ayahuasca, a species native to the Peruvian Amazon and purported to evoke mystical experiences. Minutes after Mattin imbibes ayahuasca-infused brew, the "spirit" catches him. He sees elephants adorned with jewels and crowns, and a dwarf performing magic tricks. Some of the hallucinations are harmless enough, but others, like the image of women's rotting genitals, are terrifying. Mattin, though, interprets them as healing messages. "Yes, you touch your dark side," he says. "But you have to in order to get to the light." Eventually, Mattin finds what he believes he had been looking for all along: Jesus Christ and the Virgin Mary appear before him, as palpable as anybody he'd ever met.

Until that moment, Mattin, 21, didn't know what he was looking for. That had always been part of his problem. At 13, he acquired an addiction to cocaine. By his last year of high school, he was getting high at least five days a week--bingeing on cocaine or barbiturates, and dabbling in heroin. "I thought I was nobody without drugs," he says. A psychiatrist prescribed an antidepressant, which may have hastened his downward spiral. When he hit rock bottom, he enrolled at Takiwasi, a drug treatment center on the edge of the Peruvian Amazon. Mattin's religious awakening came during the course of dozens of treatments over 10 months ending in May. It was a turning point in his life--at least he's convinced it was. Mattin has gone a year without illegal drugs, and in August his psychiatrist stopped the antidepressants.

Mattin credits his recovery to Jacques Mabit, a French physician who founded the Takiwasi clinic 10 years ago near the remote town of Tarapoto in Peru. Since then, he claims to have successfully treated scores of former addicts with ritual fasting, psychotherapy and hallucinogenic-drug trips. Nearly all his patients undergo a mystical or religious awakening.

The notion of using hallucinogenic drugs sounds like a relic of the 1960s, but recently scientists have taken a fresh look. Research on ecstasy, psilocybin and other drugs is ongoing in dozens of universities in the United States and Europe. Scientists believe that psychotropic drugs may yield therapeutic benefits for drug addicts and those suffering from chronic depression, and that studying their effects may yield insight into how personality is constructed in the brain. "There is tremendous potential there in terms of future research," says Charles Grob, a psychiatrist at UCLA.

Depending on your point of view, Mabit is either at the forefront of this research or he's careering dangerously ahead of it. Research on psychotropic drugs is many years from clinical trials, but Mabit isn't waiting for the tests: he's already using hallucinogens on live patients. The practice is controversial, to say the least. Critics contend that he's endangering the lives of his patients without any good science to back up his claims. Back in France, where Mabit gets many of his referrals, he's been suspected of being involved in a "sect." Mabit says he's simply picking up where conventional medicine has failed. Is he a visionary who's anticipating where medical science is headed? Or is he, as critics charge, a danger to the desperate and vulnerable young adults he lures to his treatment center in the jungle?

Mabit, a portly 47-year-old who speaks reassuringly like a country doctor, first went to Peru in the 1980s with the French group Doctors Without Borders. Native healers told him about how they used plants to cure rheumatism and mental illness. They would talk about how the plants "taught" them how to heal, or "told" them what a particular patient needed. "They told me that if I really wanted to understand how the plants worked, I would have to try them," says Mabit. During several months, Mabit underwent several ayahuasca sessions with local ayahuasceros, or healers. During one session, he saw himself treating drug addicts with the plants. "It was the last thing I wanted to do," Mabit says. "I knew that working with addicts was supposed to be very frustrating. They were always falling back into abuse." But he took the vision to heart.

Since opening Takiwasi in 1992, about 500 patients--three quarters of them from Peru and the rest from Europe, the United States and elsewhere--have gone through the program, most referred by sympathetic doctors. Mabit typically admits 15 to 20 patients at a time, and puts them through periods of fasting and psychotherapy in addition to the drug ceremonies. Addiction, Mabit believes, requires a kind of spiritual healing that comes from deep introspection--for which ayahuasca acts as a catalyst.

The ayahuasca that Mabit gives out to his patients is actually a brew that includes two active ingredients. The bark of Banisteriopsis ca-api, the ayahuasca plant, contains the chemical harmine, which acts like an antidepressant drug, increasing levels of the neurotransmitter serotonin in the brain. The jungle plant Psychotria viridis contains DMT, a common hallucinogen. When taken with harmine, DMT lasts longer than usual in the body, yielding the kind of sustained visions that Mabit says are compatible with spiritual awakenings. When patients are properly guided through the experience, they have direct and visceral access to their unconscious thoughts. It's as though they were having intense dreams while still awake, but unlike conventional dream analysis, the patients experience the images while fully conscious and can discuss them afterward in therapy sessions. "You can free yourself of your anger, or actually see your father and forgive him," says Mabit. "That's healing."

Mabit's ideas have generated some interest among specialists in mental illness and drug addiction, but few outside a small coterie of scientists are convinced. When a lawyer in the French town of Pau heard that a psychotherapist had persuaded his daughter to attend Takiwasi, he called the cops and accused Mabit of running a "sect," a criminal offense in France. In June, the police detained the psychotherapist and a psychiatrist, both of whom have referred patients to Mabit. Police also searched the offices of an association that represents Takiwasi in France. The investigation is ongoing.

Even scientists who conduct research on hallucinogens express concern over Mabit's treatments. Safety is a big issue: hallucinogens can induce psychosis. Mabit says he is careful to screen prospective patients for signs of schizophrenia, which the plants would exacerbate, and he lays down elaborate rules designed to avoid bad side effects. Scientists also question whether the treatment works over the long term. "It's one thing to go down to the jungle," says Grob. "It's quite another thing to go back to your home community and keep it up." Says Benny Shannon, a cognitive psychologist at Hebrew University in Jerusalem, and author of the first book on ayahuasca from a psychological perspective: "To think ayahuasca is a one-time solution to drug addiction is both naive and dangerous."

In 10 years of data collecting, Mabit has failed to build an airtight case. In a typical drug-addiction program, only about 30 percent of patients manage to kick the habit entirely; the other 70 percent suffer relapses. Mabit claims that only a third of his patients go back to taking drugs. On the other hand, he admits that only a third manage to stay completely clean. The remainder show "significant improvement"--they may continue to abuse drugs, but not as egregiously as before. In which category belong those who, like Mattin, keep going back to Takiwasi for more ayahuasca? "I come back here every chance I get," Mattin says. "But I'm not addicted to the plants. I know what addiction is. I come here to get in touch with nature, because that's what keeps me healthy; that's why I don't need drugs anymore." The data wouldn't show whether Mabit's program helps those who couldn't be helped any other way. And that, in the end, may be the true virtue of the ayahuasca cure.