Ayahuasca Death (how people died)

** Updated Feb, 2023 **

Ayahuasca deaths during ceremonies are not related to the Ayahuasca tea itself but from avoidable co-factors to the Ayahuasca ceremony. I’ll talk about what the real reasons for death were, but mainly in this article I will try to help you to think about how you can minimize your risk of death from taking Ayahuasca.

Table of contents:

• Can Ayahuasca cause death?
  • Can Ayahuasca cause permanent damage?
• How many people die on Ayahuasca per year?
• How tourists died in South America?
• What are the dangers of an Ayahuasca ceremony and how to avoid them?
  • The Ayahuasca Tea itself
  • Other plant medicines
  • Pharmaceuticals
  • Contraindicated medications with Ayahuasca
  • Ayahuasca Diet
  • Ayahuasca Retreat
  • Supervision
  • Other participants
  • Do you have an alternative plan?
• High profile Ayahuasca death stories
  • Blue Morpho Ayahuasca death
• Some other resources you might find useful

Can Ayahuasca cause death?

You can’t die from drinking Ayahuasca Tea itself but its possible there can be co-factors that lead to Ayahuasca deaths. Let’s explore this idea a little more.

NOTE: In psychedelic communities ‘ego death’ or ‘ayahuasca spiritual death‘ is a phrase used often but is not meant to mean a physical death. In this article we will be talking about a ‘physical death’ not spiritual death which is actually considered a good thing.

First of all let’s talk about how people do not die from taking Ayahuasca. Ayahuasca is both the name given to the brew you drink in a ceremony and one of the plant ingredients of that concoction. Specifically, that plant is known as Banisteriopsis Caapi or the Ayahuasca Vine.

So, how can people die from drinking the Ayahuasca Brew? Well the causes of death seem to be multiple. I’ll talk about how to avoid these later on in the article.

1. Some Shaman add additional ingredients, which are deadly to some people, to the Ayahuasca Brew. Each Shaman at each retreat will have a different recipe for brewing Ayahuasca. Some Shaman only add the Ayahuasca Vine, the Chacruna plant, and water to the brew but some add other ingredients. I’ve heard of Tobacco and Toe being added but there are probably others as well.
2. It’s also possible to die from Tobacco Cleanses which are also offered at many Ayahuasca Retreats. Ayahuasca is but just one of many plant medicines derived from the Amazon. Many Shaman are experienced in multiple plants. A Tobacco cleanse involves you drinking a Tobacco based drink which makes you purge. This is very high in Tobacco and for some people this can be at a level that is deadly.
3. Some people who take Ayahuasca are also taking pharmaceutical medications at the same time which can interact with the Ayahuasca Brew with deadly results. I did more research on this in another article which explains the possible interaction between some pharmaceutical drugs and the Ayahuasca Tea.
   • In short it’s important to know this is possible and make sure you taper off these medications in time for your ceremony.
   • Some of these medications can stay in your system for weeks after you stop physically taking the pills so you need to understand exactly how long they stay in your system. Each of them vary so you may need to consult a doctor if you are taking any of them.
   • In the article above I also point to a MAPS (Multidisciplinary Association for Psychedelic Studies) article which outlines which pharmaceuticals to avoid.
   • Note: It’s a good idea to avoid all pharmaceuticals if you can, even if they aren’t on the list.
4. Still others die from improper care or lack of supervision from Shamans while under the influence of the Ayahuasca Brew.
   • For example, people are allowed to wander off during the ceremony where they may fall from a height or otherwise injure themselves.
   • Or they have complications with the medication as per the above points and/or are improperly cared for.
     • An example of this might be, if you had a reaction to Tobacco inside of an Ayahuasca Brew . The people at the retreat don’t know first aid and then wait several hours to take you to hospital. When they do, it may be several hours away, and as happened in one report, on the way to the hospital the staff panicked and the person in need of care got injured further which eventually lead to their death. You can start to see how the situation starts to get very complicated very quickly.
5. It’s important to note that there may also be Ayahuasca deaths which, and I seem to have found some which I’ll discuss more below, are not able to be attributed to any of the above. I would guess that perhaps these occur from Ayahuasca interacting with your diet and or existing health issues.

Can Ayahuasca cause permanent damage?

In some cases Ayahuasca can cause permanent damage if,

• you take anti-depression (and possible other kinds of medications) drugs at the same time as drinking Ayahuasca leading to Serotonin Syndrome,
• if you or your immediate family have a history of psychosis or schizophrenia then by drinking Ayahuasca you can make these psychological illnesses worse,
• some people state that they have had depression after Ayahuasca also but by the same token it also has shown the ability to cure or help depression and anxiety. The later has been shown in clinical studies but anecdotally on Reddit Ayahuasca Forum some people say they feel more depressed after drinking Ayahuasca,
• it’s also possible that a stroke could be caused if you were to drink Ayahuasca when in combination with certain foods. A normal preparation for Ayahuasca would include a ‘dieta’ which excludes these kinds of foods. See below for more information on this.

How many people die on Ayahuasca per year?

It’s hard to tell exactly, but it seems to be low according to my research. Here is what I found.

• I could find 8 reports of Ayahuasca tourists killed in South America from 2012 to 2019 on touristkilled.com.
• A further 12 reports from 2001 – 2015 were mentioned in this https://erowid.org/chemicals/ayahuasca/ayahuasca_death.shtml thread I found.
• Some of these are possibly double ups but for the sake of argument let’s say it’s 18 in recent times.
• ** I found no extra Ayahuasca Deaths to speak of in 2020**

How tourists died in South America?

I thought it might be interesting to understand how most tourists die in countries where Ayahuasca tourism is popular as a way to see where it rated in terms of frequent causes of death for tourists.

Note: While this info is definitely not easy to get in a way which I can directly relate it to all tourists, I did find a website which lists the cause of deaths for American Tourists since October 2002 and is searchable by country. While only a segment of the people visiting Peru it’s as good as I can do.

I did a search for Peru from October 2002 – December 2018 (the most recent date available at the time of writing this – April 2019) and found that,

• 93 Americans died during this time
• Most are from transport accidents( ie air, bus and car accidents) or other accidents which are not specifically defined.
• Drowning and suicide also seem to be common.
• Only 2 are mentioned as ‘drug related’ which I assume would be logical to include as an Ayahuasca death although it could be other drugs as well.

In summary, I think we can see that in places where Ayahuasca Tourism is common, such as Peru, a tourist is in quite a bit more danger from traffic accidents than Ayahuasca.

**2020 update: These stats could be updated this year but, I think the point still remains the same given that there are no new Ayahuasca deaths I can find – you are more at risk from traffic accidents than Ayahuasca.

What are the dangers of an Ayahuasca ceremony and how to avoid them?

Mainly the dangers of ayahuasca can come from

• the tea itself if not brewed correctly,
• pharmaceuticals you take in conjunction with drinking Ayahuasca,
• the retreat organizers themselves if they mis-manage a situation
• and/or other retreat participants.

Let’s look at the dangers of these aspects and more as well as how you can avoid them in your own travels.

The Ayahuasca Tea itself:

So, I mentioned above that it’s possible that some Shaman use potentially dangerous additives to their Ayahuasca Brew like Toe and Tobacco. The solution here is to ask your retreat center or Shaman what goes into the mixture. If there is anything but Ayahuasca Vine, Chacruna and water then at the least beware or at worst avoid this place.

In my experience, if you ask the retreat or shaman you are planning on drinking with, and they have a vague answer about what is in the brew or brush you off I’d air on the side of caution.

Other plant medicines:

Ayahuasca Retreats offer more than just Ayahuasca sometimes. Tobacco cleanses are common and are possibly deadly to some people due to tobacco poisoning. Simple solution is don’t take Tobacco or anything else you aren’t prepared for or have researched.

I would say that you should not do a Tobacco cleanse unless you know of some particular reason why it can be helpful to you. If you show up to a retreat and they offer it to you and everyone else then I would suspect that its more of a gimmick to make you fee like you are getting your moneys worth than anything else however, if you spoke to a shaman(a) and after hearing your issues they mentioned a tobacco cleanse might be useful then that may be a case worth considering. If it was me, and I hadn’t done the research I might err on the side of caution on this one.

Pharmaceuticals:

**I updated this section in March, 2020 given my better understanding and perspective on it at this point**

Some pharmaceuticals mix poorly and are potentially deadly with Ayahuasca. In general, you shouldn’t take any pharmaceutical medications when preparing for Ayahuasca – even when it is only made of Chacruna, Ayahuasca Vine and Water.

Understanding which pharmaceuticals to avoid and which are OK is a complex game when you start to look into the details. The best answers will come from doctors who are experienced with the area of psychedelics however, there are a couple of laymen methods to get a basic understanding. Note: None of the below suggestions is meant to replace seeing a doctor for their expert advice.

• The first is to avoid all medications – even if you have done the research and you believe they do not act dangerously with Ayahuasca. Mother Ayahuasca is best done with zero pharmaceuticals in your body.
• That being said, some of you will have a situation whereby you can’t or would really prefer not to stop taking your medications. In this scenario, you can get a basic idea of whether or not the medication you are taking is contraindicated (ie bad to combine with) with Ayahuasca by looking up your medication in webmd.com and then looking at the ‘interactions’ section. Inside of this section if there is mention of this medication being contraindicated with MAOI’s then this means it is considered dangerous for it to be in your system while drinking Ayahuasca. This is because the Ayahuasca brew itself is an MAOI. NOTE: This is not a replacement for seeing your doctor.

Contraindicated medications with Ayahuasca:

• It’s important to know which medications are contraindicated with Ayahuasca but, also to understand how long before drinking Ayahuasca you should stop taking them. Pharmaceutical medications often stay in your system for weeks.
• Some common medications which are contraindicated with Ayahuasca:
  • Medications for depression and anxiety of anything that works on the Serotonin receptors in your brain. The famous Serotonin Syndrome can occur because both Ayahuasca Brew and the depression medications work on the Serotonin receptors in your brain. In this situation the brain experiences an overdose of Serotonin, so to speak, leading to possible stroke. This is applicable for any medications which work on the Serotonin System.
  • Altitude sickness medications. If you are drinking in Peru, for example, then you will often be recommended these by western doctors. Peruvians however, don’t bother with these and instead use Muna Tea (found in restaurants and hotels in many places in Peru) as a neutural remedy. You could also try this option as opposed to pharmaceutical options.
  • Malarial Medications. Not all of them are contraindicated but some are. Check with your doctor. Depending on where you are going the risk of Malaria will vary. For example, Iquitos in Peru, is considered high risk however Pucallpa and Cusco areas are much less.
    • Check out this Malarial Map of Peru to understand which locations are more at risk.
    • Note: You will get bit at some point if you are going to the jungle. If you are not on Malarial meds then use a natural (DEET not recommended) repellent and cover up as much skin as possible and you will be doing much of what you need to in order to minimize bites. Obviously a mosquito net is invaluable as well.

Ayahuasca Diet:

It’s possible that mixing certain types of foods with Ayahuasca can also lead to death. Some foods when combined with an MAOI, of which the Ayahuasca Vine is, can lead to hypertension and then a stroke which could potentially be fatal.

The solution is to go on an Ayahuasca Diet (also referred to as a ‘dieta’ which is different in that it involves more than what is traditionally thought of as a diet in western cultures) in preparation for taking Ayahuasca. Depending on who you listen to this can be between 3 days and 4 weeks and is similar to an Alkaline Diet in terms of what you can eat when preparing for Ayahuasca. You should be doing something like this for your preparation.

Ayahuasca retreat – remote location:

Ayahuasca Retreats are often in far flung areas of the Amazon Rainforest and therefore not close to a medical facility if you need one. It could be hours or a day before you could get to a hospital. Too long for some medical emergencies.

Easy solution. If you are expecting medical complications or are fearful of them then there are retreats that are close to medical facilities and even ones which say they have doctors on site. Do your research and find one that suits you.

Supervision:

Some retreats are OK with you wandering off during a ceremony un-supervised and or if a problem does arise aren’t prepared for caring for someone experiencing problems.

For my first time on Ayahuasca I paid my guide (who was an experienced Ayahuasca drinker and knew the Shaman at the retreat well) to stay a day or so longer with me in order to be with me in ceremony. Just to make sure all was well.

Other participants:

Some retreats take bookings from various people at the same time which means you are likely to be in ceremony with people who may or may not be fit to take Ayahuasca with you.

I would think that the retreat should be ‘vetting’ the participants for, among other things, psychiatric history. If they didn’t ask you about these things before you booked then they likely haven’t asked anyone else either. If participants aren’t being vetted to at least a minimum degree then I would not feel safe there and you should possibly not go to this place.

Do you have a plan if something goes wrong with you or your friends?

I’m probably a little OCD, but what if, despite all the safe guards you thought were appropriate, something goes wrong? I would suggest,

1. Getting some basic medical training. A beginners course is more or less just CPR. On top of that get a medical kit and learn how to use it.
2. Have an idea about how you can get back to civilization by yourself. That probably means having some basic Spanish, knowing how to get back to the nearest town and having an idea of transport to the nearest hospital. Of course that all depends on where you are, but it doesn’t hurt to ask the question. If you’re not comfortable with the answer then you know you probably need to find a different place.
3. It sounds dramatic until all of a sudden, however unlikely, you need it. Doing some basic thinking on this before you arrive will at least mean you aren’t completely taken by surprise. Who knows you might save someones life.

High profile ayahuasca death stories

‘Blue Morpho’ Ayahuasca death

Blue Morpho’s (an Ayahuasca retreat in Peru) head shaman and general manager, Malcolm Rossiter, committed suicide in 2018. It’s not clear what the reasons were specifically for this although depression was suspected. According to a reddit post about the suicide he was a well respected person in the Ayahuasca community and helped many people. RIP.

Some other resources you might find useful:

I wrote some articles about preparing for Ayahuasca which you can check out below,

• How to prepare for Ayahuasca (there is more than just a diet).
• Ayahuasca Diet recipes and general advice for what to eat.
• How to create intentions for your Ayahuasca Experience.
• Ayahuasca and Ego Death.
• What are the after effects of Ayahuasca?
• 8 risks and rewards of Ayahuasca

This article has been written according to ayahuascaeasy.com editorial policy.