Incorporating the Spiritual Geography of Psychoactives in Post-Prohibition Public Health
Greetings, I am Sunil Aggarwal, a doctor and medical geographer and a member of the Sacred Garden Community. I hail from Oklahoma, a child of Indian Immigrants, and I live today in Seattle, which rests on the unceded territory of the co-Salish Duwamish People, and I am so honored to join you here in Portland, a city which rests on the traditional village sites of the Multnomah, Wasco, Cowlitz, Kathlamet, Clackamas, Bands of Chinook, Tualatin, Kalapuya, Molalla, and many others who made their homes along the Columbia River. The title of my talk is . I envision a public health system that more closely tracks with human needs for individual and collective flourishing– in which the core principles of integrative health are foundational such as universalizing respect and protection for spiritual health as well as physical and mental health. There is no way to respect public spiritual health without respecting and protecting one of humanity’s oldest methods of achieving states of awe: entheogenesis. In order to get there, it is time we rekindle the illuminating vision of drug peace in the 21st century.
What better time to envision this than now, when we are in the midst of an entheogenic reformation, in which more and more people are having spiritual and religious experiences involving consumption of highly controlled entheogenic substances such as psilocybin, DMT, MDMA, LSD, mescaline, ibogaine, THC, and others; experiences which are now and increasingly officially recognized as valid and protected free exercise of religiosity by the highest public authorities here and around the world? Shall we not leverage the transformative power of this sociocultural entheogenic reformation, wherein the “worst”, most demonized substances under our drug war laws are now legally recognized as the most good, most sacred substances for some? What better time than now to envision a reconfiguration of our way of thinking about and regulating the human relationship with psychoactive substances writ large? Consider Timothy Leary’s thoughts on this matter.
The status quo ‘drug war’, or United States federal drug control prohibitionist policies and practices, have successfully been exported to nearly all countries globally over the past century, and even though they have been demonstrably harmful to public health, they are perversely enforced under the banner of public health betterment as their raison d’etre. But they have led, over the course of several decades, to a significant amount of corruption, chaos and instability (eg., money laundering and bribery), structural violence, direct violence (eg., disputes within underground markets), morbidity (eg., untreated problematic substance use, significant spread of HIV and Hepatitis C due to needle sharing and inaccessible clean injection equipment), lost opportunities for medicinal applications of controlled substances (eg., impeded right to try access to psilocybin), mortality (eg., overdose deaths from unregulated products and lack of accessibility to harm reduction measures), lengthy mass incarceration with non-violent offenders being the majority and drug offenders held the longest, execution (including summary and extra-judicial), ecological harms (e.g., aerial spraying of herbicides), educational harms (e.g., teaching of misinformation, exaggerating rare and lurid sequelae of psychoactive substance use to frighten youth into abstinence, withholding lifesaving harm reduction knowledge), and opportunity cost globally.
At root, bans on psychoactive substances, regardless of whatever ‘hidden agendas’ may additionally be at work, undermine longstanding medicinal, cultural, and religious practices and unsuccessfully attempt to politically suppress what may well be an acquired universal human drive for psychoactivation through categorically forbidding psychoactive substances and policing populations for compliance. This policy is a low-grade, persistent, prisoner-taking war steeped in the ideology of pharmacologicalism, a moral ordering of drugs, in which some substances are allowed and encouraged for psychoactivation (e.g, tobacco, alcohol, caffeine, sucrose sugar, cacao) and others are forbidden. Since human drives must prevail for life to go on, there will always be a demand for these officially prohibited substances as long as there is information available about their effects. By creating a regulatory vacuum, substance prohibitions essentially ensure that the drive to psychoactivate will be met by and large in the most exploitative and damaging manner–maximizing harm and minimizing benefit at both the population and individual levels. An earnest attempt at public health would at the very least reduce the harms associated with the consumption of psychoactive substances by ensuring that such substances are safely self-administered, made available through safe and regulated channels with known and unadulterated compositions, and that factual, evidence-based education about their effects is shared with the public.
The latest iteration of our drug war started over 50 years ago and has become ingrained in many social institutions. Scholars have described the overzealous criminalization and demonization regime of drug prohibition as a pharmacratic inquisition. ‘Pharmacracy’ refers to a system of rule based on drugs and medicine. Our present pharmacratic rule surveills and interrogates with inquisitorial zeal whether subjects are making, have made, or will make illicit close contact with an ever-growing list of demonized drugs and substances, and punishes the accused accordingly. Another term to describe this political ideology of selective drug-associated criminalization and outcasting is ‘psychopharmacological McCarthyism’.
The pharmacratic inquisition further claims a patina of scientific order and legitimacy from a system of drug ‘scheduling’ which is actually a moral ordering of drugs, of angel drugs and demon drugs, whose moral valence can be determined once and for all and codified. This latter dogmatic ideology as mentioned before has been called pharmacologicalism. One example of this that the coiner of this term, Richard DeGrandpre, gives is our social treatment of ritalin as ‘an angel’ vs cocaine as ‘a demon’, even though both are pharmacologically equivalent (can’t be distinguished in blind experiments by humans and fMRI response is the same).
Historians have established that global drug prohibition has its modern roots in racism, colonialism, and imperialism. It has achieved such success that it has become firmly and deeply rooted in our collective psyche: the mere utterance of the word ‘drug’ or its plural ‘drugs’ immediately connotes the substances along with their contraband or semi-contraband ilicitude under the reigning pharmacratic regime.
To further highlight the urgency of the present moment, let’s acknowledge the larger socio-ecological backdrop of the drug war. This is a time of extremes, and the window to restore balance is closing. The haves have more and more and the have-nots have less and less. The ecosystem balance of the Earth’s biosphere is tilting towards ongoing global warming, driven by human industrial activities, driving global climate breakdown, and leading to many downstream effects such as sea level rise, ocean acidification, heat waves and other extreme weather events, and many others. Biodiversity hotspots are under increasing threat, and species extinction is proceeding at a rate not seen for millions of years. The massive military powers of the world continue to point thousands of megaton nuclear weapons and missiles at each other, often on hair trigger alert, creating a highly volatile omnicidal situation. Meanwhile, everyday structural violence and deprivations persist in many zones of conflict above and beyond the low-intensity, deadly conflicts of the drug war, including military occupation, colonial capitalist extraction, and authoritarian rule. A wide range of scientists, thinkers, writers, and spiritual leaders have taken a ‘spiritual ecology’ perspective on the various crises we face today and point to a personal and collective inner turmoil out of which these problems are arising and persisting. In other words, this too, like the drug war, is a problem rooted within the collective psyche.
Next, let’s illuminate the vision of achieving drug peace after dismantling the drug wars. Radical abolition of drug prohibition will require a profound transformation in the way public policy views drug use and health. One way forward is to take as our starting point the basic pan cultural human spiritual geography of entheogens. The recognition of entheogens, which include cannabis, serves as a crucial opening in a reconfiguration of our understanding of the human relationship with all psychoactive substances. They offer a deep opening to shift away from perpetual, worldwide drug prohibition to drug peace. I believe a key part of that coming policy transformation will be the integration of the human-entheogen relationship and all it represents into the human health and social sciences—most notably public health.
Okay, so what do I mean by spiritual geography, spirituality, and entheogens?
Spirituality has been de-emphasized or even ignored in contemporary public health, in part a consequence of the longstanding reductionist trend of conventional biomedicine and the confusion of spirituality with religion. We can see this as an existential matter. We are all mortal, born to die, and fundamentally we must all grapple with this existential stress. It is as core to being human as having a brain or heart or needing nutrition to survive.
My friend who is a hospital-based palliative care chaplain shared with me a wonderful definition of spirituality that functions well in spiritual care work:
- Spirituality is the existential and ontological search for truth, meaning, and being.
- Ontological questions would be: what does it mean to be human? To be born to die? To be in relationship?
- Existential questions would be: who am I? Where am I going? What am I doing here?
The key thing is that our responses to these questions are unique to each of us. The spiritual dimension of life is inherently tied-in with the concept of human dignity, or inherent self-worth of a person, which we commonly attend to in the health sector through respect for privacy, autonomy, Informed consent, and other values and practices. Respecting the dignity of a human being is an important aspect of public health because violations of dignity are perceived as safety or existential threats, which can impact the physiology of the body and psycho-spiritual well-being of the person. They are also potentially traumatic experiences because they threaten the integrity and core of the individual. The way the autonomic nervous system deals with threats of various kinds has been described well by the PolyVagal Theory by Stephen Porges.
Turning now to spiritual geography, this has to do with the layout of the intersection of human spirituality with space, place, and environment. One author has stated that humans have a need and unique ability to “legitimize the unknown through the construct of place. Place becomes the text of what it means to be human… place [is] a medium to understand human spirituality1”
A related concept in geography which helps us go beyond the separation we have carried in our language between humans and nature–nature being where entheogens were originally and continuously found–engages with what happens when we call forth and name the existence of something called “ecocultural identity.”
From the Routledge Handbook of Ecocultural Identity (xvii):
The absence of ecological palpability…has been evident in much social activism, which often has emphasized sociocultural identity formations, such as race, gender, sexuality, and class, yet largely disregarded interrelated more-than-human dimensions (environmental justice movements being among the clear exceptions.)…Indeed, all of us, each and every one, are always participants in crisscrossing sociocultural and ecological webs of life, whether consciously or not….What has largely been missing across disciplines and in the public domain, however, is a dedication to understanding identity ecologically in tandem with cultural and social modes of consideration. An ecocultural identity framework troubles this tendency to conceive of the environmental as separate from or a subsidiary of the economic, political, historical, and cultural and instead situates group and individual ecological affiliations and practices as inextricable from – and mutually constituted with – sociocultural dimensions.
Keeping this in mind, returning back to the spiritual geography of entheogens, how is this recognized in contemporary public policy and public health?
First let’s consider spiritual issues in general. In the US public health sector, spiritual issues have mostly focused on respecting select groups’ religious practices with regards to participation in state health programs. Examples include allowance for conscientious objector exemptions for members of qualified religious groups from mandatory enrollment in health coverage programs (e.g., the Amish do not have to enroll in Medicare), presumed consent to
1 https://www.prismjournal.org/uploads/1/2/5/6/125661607/v15-no1-a3.pdf
emergency medical therapy (e.g., Jehovah’s Witnesses do not have to consent to blood transfusions even in emergencies), and required licensure and underage restriction when serving sacramental psychoactive substances (e.g., Christians’ ceremonial alcohol has age and premises waivers in place). Additionally, the national Medicare hospice benefit is the only health care program that mandates the provision of spiritual care services.
Turning now to entheogens, increasingly, exemptions to federal drug abuse prevention and control public health laws are being made for religious entheogen use practices.
Let’s define ‘entheogen’. It was coined in 1979 (coincidentally, the year of my birth) by four leading scholars: an ethnobotanist, a mycologist, and ethnomycologist, and two classicists. Definitions of ‘entheogen’ include:
“a chemical substance, typically of plant origin, that is ingested to produce a non ordinary state of consciousness for religious or spiritual purposes.” – Oxford English Dictionary
“In a strict sense, only those vision-producing drugs that can be shown to have figured in shamanic or religious rites would be designated entheogens, but in a looser sense, the term could also be applied to other drugs, both natural and artificial, that induce alterations of consciousness similar to those documented for ritual ingestion of traditional entheogens.” – Ruck et al. (1979)2
I am happy to say, seventeen years after launching the neologism [entheogen] on its literary career, that the word has been accepted by the majority of experts in this field, and has appeared in print in at least eight languages. The term is not meant to specify a pharmacological class of drugs (some, for example, conceive of psychedelic as implying indole and phenethylamine drugs with an LSD- or mescaline-like effect); rather, it designates drugs which provoke ecstasy and have traditionally been used as shamanic or religious inebriants, as well as their active principles and artificial congeners. – Ott 19933
I endorse the looser, wider original definition of entheogens referring to psychoactive chemicals, plants, fungi, or animal secretions.
What is happening now is a Reformation analogous to the supposed nailing of the 95 theses on the German church door by Martin Luther in 1517 that ushered in the Protestant Reformation. Prohibitions on drug preparation, use, and exchange under the half-century-old Comprehensive Drug Abuse Prevention and Control Act have been lifted for members of select religious groups whose use of select entheogens is now protected under enacted legislation or federal court
2 Ruck, Bigwood, Staples, Ott, Wasson. 1979. “Entheogens” Journal of Psychedelic Drugs 11(1-2): 145-146. Reprinted as appendix to Ott, J. 1996. “Entheogens II: On entheology and entheobotany” Journal of Psychoactive Drugs 28(2): 205-209.
3 Ott, J. 1993. Pharmacotheon: Entheogenic Drugs, Their Plant Sources and History. Kennewick, Washington: Natural Products Co.
rulings or settlements. This includes lawful recognition of the cultivation, preparation, and use of the entheogen peyote, a mescaline-containing cactus, by the Native American Church since 1993 (which the federally funded IHS reimburses patient expenses for) and the entheogen ayahuasca by the Brazilian Unio de Vegetal and Santo Daime Churches since 2006 and by the Church of the Eagle and Condor since May 2024, the first non-Christian lineage Church to receive such protection. Despite recognized traditions in other countries (e.g., South Africa, Jamaica, and India), cannabis’ entheogenic use has not been recognized under US law (though interestingly the US State department gives Jamaica a more favorable human rights rating because of their recognition and protection of traditional cannabis use by Rastafarians.)
In sum, our strict drug policies are allowing for these select groups’ religious practices that involve entheogenic psychoactive sacraments. Where and for whom this is all happening in this legally protected manner are landmarks of a spiritual geography of entheogens in the US.
Let us dig deeper into this geography. Its existence begs the question: as a matter of public health, why make exemptions only for select groups and entheogens? Spirituality is a universal, core dimension of health, irrespective of membership in any particular religious sect (Puchalski et al. 2009). Shouldn’t respect for spiritual health and safety be universalized for all persons and all entheogen and psychoactive substance use practices? This is how the spiritual geography of entheogens would become more visibly daylighted.
Consider the observations of Norwegian scholar Petter Grahl Johnstad on the broader concept of entheogenic spirituality. In his 2016 thesis, he writes: “Entheogenic spirituality challenges our understanding of religion in an overall sense, and particularly from the perspective on the relationship between religion and power. As a largely non-institutionalized form of religion, entheogenic spirituality does not conform to an understanding of religion as involving institutions. Nevertheless, it can be understood in relation to discourse, practice, community, and experience as a form of institution-less religion. Since entheogens are apparently highly efficacious means of inducing experiences with mystical-type characteristics, furthermore, and since such characteristics may serve as a basis for claims to spiritual authority, entheogenic spirituality has the apparent capacity to challenge the authority and power of religious institutions”4.
Furthermore, consider this passage from the Washington State Constitution written in1889: “SECTION 11 RELIGIOUS FREEDOM.
Absolute freedom of conscience in all matters of religious sentiment, belief and worship, shall be guaranteed to every individual, and no one shall be molested or disturbed in person or property on account of religion; but the liberty of conscience hereby secured shall not be so construed as to excuse acts of licentiousness or justify practices inconsistent with the peace and safety of the state.”
4 Entheogenic Spirituality: Conversations with Psychonauts. Petter Grahl Johnstad Master’s Thesis, University of Bergen, 2016
https://bora.uib.no/bora-xmlui/bitstream/handle/1956/12355/144653987.pdf?sequence=1&isAllowed=y#pa ge=102
Think about the fact that when this constitution was adopted, many cultural and spiritual practices of the Native peoples of the PNW were banned under law (eg the potlach), and how do these apply to pagan, Wiccan, earth based spirituality, neoshamanistic practices, and other non Judeo-Christian spiritual and religious practices? Should not entheogenic spirituality be afforded the constitutional protection of “absolute freedom of conscience in all matters of religious sentiment, belief and worship”?
Who are we to prejudicially say that one person’s spiritual and/or religious expression can only be in a particular way and that the only psychoactive substances that can be in service of that expression are these circumscribed ones? Isn’t this the same as preconfiguring people’s understanding of God, divinity, the significant, or the sacred?
Let’s instead take the view that natural grounding of the spiritual geography of entheogens and the phenomena they help generate is that they are a part of the web of life that evolved on our biosphere, with entheogens and entheogenic experiencing being a kind of “fundamental force of nature” that humanity has co-evolved with and co-created through traditional ecological knowledge application, modified admixtures, and modern chemistry know-how. Consider the validity of the theory put forth by serious scholars of religious studies over 50 years ago5 that the fountainhead and ongoing wellspring of religion is the use of visionary or entheogenic plants.
That core assertion is that there is a fundamental, crucial, time-honored spiritual-existential relationship between human beings as a species and a variety of psychoactiving consumables in our environments. These relationships likely began through zoological observation and foraging explorations of vegetation, fungi, animal secretions or tissues, and continued on in wild and domesticated cultivated gardens, and continued further still in a different but fundamentally similar way as we began to perform chemical reactions ourselves ex vivo, in pots, cauldrons, and Erleynmeyer flasks, to “make our own” psychoactive consumables of spiritual and existential import. Crucially, these relationships always involved the wider human and more-than-human community at some level and were integrated into what have been called archaic techniques of ecstasy. They can certainly be seen as part of individual and group ecocultural identity.
Over 35 years ago, renowned scholar R. Gordon Wasson opined about the primordial experience of entheogenic ecstasy:
“At that point Religion was born. Religion pure and simple, free of Theology, free of Dogmatics, expressing itself in awe and reverence and in lowered voices, mostly at night, when people would gather together to consume the Sacred Element. The first entheogenic experience could have been the first, and an authentic, perhaps the only
5 Mary Barnard, “The God in the Flowerpot.” American Scholar 32.4 (Autumn 1963): 578-586. Reprinted in Psychedelic Review 1.2 (Fall 1963): 244-2511964 (Available at:
https://maps.org/research-archive/psychedelicreview/v1n2/012244bar.pdf)
authentic miracle. This was the beginning of the Age of the Entheogens, long, long ago.”6
Furthermore, leading evolutionary anthropologists studying hominins, which includes modern humans and all our extinct ancestors on our own branch of the evolutionary tree, have theorized, in the case of the ubiquitous natural entheogen psilocybin found in the mycelia and fruiting bodies of hundreds of species of mushrooms, an evolutionary scenario suggesting its influence in ancient hominin’s evolution of “a socio-cognitive niche, i.e., the development of a socially interdependent lifeway based on reasoning, cooperative communication, and social learning.” Specifically, it is theorized that
“the integration of psilocybin into ancient diet, communal practice, and proto-religious activity may have enhanced hominin response to the socio-cognitive niche, while also aiding in its creation. In particular, the interpersonal and prosocial effects of psilocybin may have mediated the expansion of social bonding mechanisms such as laughter, music, storytelling, and religion, imposing a systematic bias on the selective environment that favored selection for prosociality in our lineage.”7
These anthropologists are proposing that just as we integrate in community our experiences with entheogenic elements from our environment, so too do the entheogenic elements impose, through us, an integrating force that strengthens the efficacy and vitality of our community and society as a whole.
Once we accept as a given that human cultures have a core tendency to develop meaningful/ special/sacred/spiritual/religious relationships with select psychoactive substances, then I assert that any absolute criminal prohibition of people’s close nonviolent contact with any psychoactive substances in presumed service of public health fundamentally diminishes religious freedom and spiritual health and safety associated with valued psychoactivation experience and free exercise of sovereignty over one’s own consciousness—or cognitive liberty. This is true even if those substances are not psychedelic.
Take for example the entropic brain hypothesis put for by Cahart-Harris and others. They use this model to explain how the disruptions caused by ingestion of psilocybin and other psychedelics in the Default Mode Network lead to a greater state of entropy in the brain, “a shaking of the snow globe” as Michael Pollan has famously put it in plain language, which allows for creation of new pathways and new connections.
Here is the kicker – many psychoactive substances that have been studied lead to some kind of disruption or suppression of the default mode network, including coffee, SSRI and TCA
6 Wasson.R.G.; Kramrisch. S.; Ott. J. & Ruck. C.A.P. 1986. Persephone’s Quest: Entheogens and the Origins of Religion. New Haven, Connecticut: Yale University Press.
7 Rodríguez Arce JM and Winkelman MJ (2021). Psychedelics, Sociality, and Human Evolution. Front. Psychol. 12:729425. doi: 10.3389/fpsyg.2021.729425
antidepressants, atypical antipsychotics, lithium, benzodiazepines, stimulants like methylphenidate and amphetamines, and alcohol.
To me, this means that all psychoactive substances as a matter of human-environmental relationship, can offer humans different degrees of DMN relaxation and may very well become part of personally and culturally integrated meaningmaking systems. This means they could be part of authentic spirituality. In other words, that amazing chocolate you had truly might be Divine to you.
Here’s the rub: in the name of public health, would you ever want to criminalize a human being who has ingested a psychoactive substance that may have some kind of spiritual-existential import to them, to whatever degree? If not, then we must end drug prohibition all-around. This is actually the recommendation of the WHO, ASAM, and now even the conservative AMA. In case you are wondering about the concept of recreation, which is related to sport and play, do you think we might have lost sight of its sacred and spiritual dimensions? In fact, it is right there in the word “recreation”. When you look at the word roots in late Middle English and Latin for our contemporary word “recreation”, their definitions are “mental or spiritual consolation” and the opportunity to create again and renew one’s spirit. When we understand recreation like this, we can no longer relegate it to being a trite afterthought or “icing on the cake” of life. It must be appreciated and understood in all quarters what an essential role recreation plays in the universal human pursuit of meaning, purpose, and renewal in the face of existential realities of aging, morbidity, mortality, and death.
The entheogenic reformation we are amidst is growing in both religious and secular spheres and is reawakening in diverse quarters a deep respect and appreciation of the potency and import of entheogens, as ancient and still-accessible portals to gnosis and healing and what many might call a direct experience of transcendence or divine presence within one’s lifetime. As the entheogenic reformation spreads, the healing they offer will increasingly be recognized and the gnosis they offer will be understood as valued knowledge. Entheogenesis will become widely accepted as a valid pathway to transcendence and all consentual psychoactive substances use will cease to be a matter of criminal law.
Like the Protestant Reformation before it, these developments will impact wider culture, including public health, medicine, science, politics, and law.
I’ll leave you with a 3-point Drug Peace Plan. It foundationally Should:
- Respect the natural spiritual relationship formations between humans and psychoactive substances,
- Acknowledge and ameliorate the ubiquitous spaces of indignity created by the structural violence of drug prohibition, and
- Foster a culture of caring promoting safety in spaces held for diverse expressions of spirituality, religious experience, and relationship with psychoactive substances
