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One might conclude that alternative medicine is not the predominant or prevalent approach to addiction medicine, but the mainstream treatment approach to addiction in the U.S. is “alternative,” based in a fundamental reliance upon Alcoholics Anonymous.  A paradoxical situation exists in the fundamental role of spirituality in Alcoholics Anonymous (AA), and the acceptance of the AA approach by biomedicine.  The only program that the American Medical Association and boards of medical examiners recognize as providing adequate therapy and support to meet its requirements for treatment of physicians suffering from addictions is the AA.  Alcoholics Anonymous (AA), an avowedly religious and spiritual approach to overcoming addictions, is the treatment of choice for what medicine tells us is a physiological disease.

The apparent contradiction between the biomedical definition of addiction as a biological process and the predominant treatment processes based upon a spiritual healing has a resolution in understanding spirituality in neurological terms.  “Neurotheology” links spirituality with biologically based altered states of consciousness (ASC) and the physiological dynamics of addiction.  Research on spiritual ASC illustrate that they produce physiological changes in brain responses that are similar to the dynamics of addiction, enabling spirituality to affect the biological dynamics of addiction.

The incorporation of non-drug practices to deliberately induce altered states of consciousness is one of these areas in which cross-cultural perspectives can enhance addiction medicine.  Psychobiological perspectives on shamanistic healing and other forms of natural ASC indicate that they are useful both as a prophylactic against drug abuse, as well as a potential treatment for addiction.  These ASC can provide an alternative source of transcendence to the drugs of addiction, facilitating a smoother transition to the path of recovery.  Many of the forms of ASC--drumming groups, shamanic circles, meditation centers, and others--also provide a social support group and a set of activities to occupy the addict and their time and energies.  All of these aspects can facilitate recovery, easing the physical longing and mental anguish of abstinence, providing productive and supportive activities to occupy the addict’s time, and creating a social reference group to change affect and sense of self central to the self-transformations underlying recovery.

Dr. Winkelman’s Publications on Drugs and the Therapeutic Properties of Psychointegrators

2005    Drugs and Modernization. A Companion to Psychological Anthropology: Modernity and Psychocultural Change, Conerly Casey and Robert Edgerton, eds. Blackwell  In., (with Keith Bletzer).  pp. 337-357

2005    Drug Tourism or Spiritual Healing? Ayahuasca Seekers in Amazonia J. Psychoactive Drugs 37(2):209-218

2004    Spirituality and the Healing of Addictions:  A Shamanic Drumming Approach.   In: Religion and Healing in America, Edited by Linda L. Barnes and Susan S. Sered.  New York: Oxford University Press. Pp. 455-470

2003  Psychointegration: The Physiological Effects of Entheogens.  Sidestreet Electronic Journal

2003  Complementary Therapy for Addiction: “Drumming Out Drugs” American Journal of Public Health 93(4): 647-651

2003    Psychointegration: The Physiological Effects of Entheogens.  Entheos 2(1):51-61

2001    Psychointegrators: Multidisciplinary Perspectives on the Therapeutic Effects of Hallucinogens.  Complementary Health Practice Review 6(3): 219-237,

2001    Alternative and Traditional Medicine Approaches for Substance Abuse Programs: a Shamanic Perspective.  International Journal of Drug Policy 12:337-351

For Additional Resources on Shamanic Approaches to Addiction:

Alexander, C., P. Robinson, & M. Rainforth. 1994. Treating and Preventing Alcohol, Nicotine, and Drug Abuse Through Transcendental Meditation: A Review and Statistical Meta-Analysis. Alcoholism Treatment Quarterly. 11(1/2): 13-87. Reprinted in Self-Recovery: Treating Addictions Using Transcendental Meditation and Maharishi Ayur-Veda. D. O’Connell and C. Alexander, eds. New York: Haworth Press.

Booth, J. and J. E. Martin. 1998. Spiritual and Religious Factors in Substance Use, Dependence, and Recovery. In Handbook of Religion and Mental Health. Harold G. Koenig, ed. San Diego: Academic Press.

Eshowsky, M. 1993. Practicing Shamanism in a Community Health Center. Shamanism. 5(4): 4-9.

Eshowsky, M. 1998. Community Shamanism: Youth, Violence, and Healing. Shamanism. 11(1): 3-9.

Eshowsky, M. 1999. Behind These Walls Where Spirit Dwells. Shamanism. 12(1): 9-15.

Gelderloos, P., K. Walton, D. Orme-Johnson, and C. Alexander. 1991. Effectiveness of the Transcendental Meditation Program in Preventing and Treating Substance Misuse: A Review”. International Journal of the Addictions. 26: 293-325.

Green, L., M. Fullilove, & R. Fullilove. 1998. Stories of spiritual awakening the nature of spirituality in recovery. Journal of Substance Abuse Treatment. 15(4): 325-331.

Heggenhougen, C. 1997. Reaching New Highs: Alternative Therapies for Drug Addicts. Northvale, N.J.: Jason Aronson.

Jilek, W. G. 1994. Traditional Healing in the Prevention and Treatment of Alcohol and Drug Abuse. Transcultural Psychiatric Research Review, 31: 219-258.

Johnson, L. 1990. Creative Therapies in the Treatment of Addictions: The Art of Transforming Shame. The Arts in Psychotherapy. 17: 299-308.

McPeake, J.D., B.P. Kennedy, and S. M. Gordon. 1991. Altered States of Consciousness Therapy: A Missing Component in Alcohol and Drug Rehabilitation Treatment. Journal of Substance Abuse Treatment. 8: 75-82.

Metzner, R. 1994. Addiction and Transcendence as Altered States of Consciousness. The Journal of Transpersonal Psychology. 26(1): 1-17.

Miller, W. R. 1998a. Researching the Spiritual Dimensions of Alcohol and Other Drug Problems. Addiction. 93(7): 979-990.

O'Connell, D. 1991. The Use of Transcendental Meditation in Relapse Prevention Counseling. Alcoholism Treatment Quarterly. 8(1): 53-69.

O'Connell D., and C. Alexander (eds.). 1994. Self-Recovery: Treating Addictions Using Transcendental Meditation and Maharishi Ayur-Veda. New York: Hayworth Press.

Rioux, D. 1996. Shamanic Healing Techniques: Toward Holistic Addiction Counseling. Alcoholism Treatment Quarterly. 14(1): 59-69

Singer, M. and M. Borrego. 1984. Indigenous Treatment for Alcoholism: The Case for Puerto Rican Spiritism. Medical Anthropology. 8(4): 246-272.

Smith, D. 2000. Shamanism and Addiction. Spirit Talk. 11: 8-12.

Smith, E. 1999. Evolution, Substance Abuse, and Addiction. In Evolutionary Medicine. W. Trevathan, E. Smith, and J. McKenna, eds. New York: Oxford, 375-405.

Walton, K., and D. Levitsky. 1994. A Neuroendocrine Mechanism for the Reduction of Drug Use and Addictions by Transcendental Meditation. In Self-Recovery: Treating Addictions Using Transcendental Meditation and Maharishi Ayur-Veda. D. O'Connell and C. Alexander, eds. New York: Hayworth Press.

Wilshire, B. 1998. Wild Hunger. Lanham, Md: Rowman and Littelfield.

Winkelman, M. 2000. Shamanism: The Neural Ecology of Consciousness and Healing. Westport, Conn.: Bergin and Garvey.