Project

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Toxic drug or herbal remedy? The tobacco plant in Amazonian medicine and innovative treatments for psychosomatic health and chronic pain

Applicant Berlowitz Ilana
Number 190428
Funding scheme Spark
Research institution Département de Psychologie Université de Fribourg
Institution of higher education University of Fribourg - FR
Main discipline Psychology
Start/End 01.12.2019 - 30.11.2020
Approved amount 100'002.00
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All Disciplines (2)

Discipline
Psychology
Mental Disorders, Psychosomatic Diseases

Keywords (8)

tobacco; Amazonian medicine; alternative treatment; mental health; psychosomatic; traditional medicine; complementary medicine; chronic pain

Lay Summary (German)

Lead
Tabak wird weltweit als gesundheitsschädliche suchterzeugende Genussdroge verstanden. Im peruanischen Amazonasgebiet hingegen, der geographischen Region aus der die Pflanze ursprünglich stammt, wird Tabak als Medizinalpflanze verstanden und verwendet. Sie spielt in der traditionellen amazonischen Heilkunde eine zentrale Rolle, kommt dabei u.a. in Flüssigform und insbesondere bei psychosomatischen Problemen therapeutisch zum Einsatz.
Lay summary

2. Inhalt und Ziele des Forschungsprojekts

Das Projekt geht dieser aussergewöhnlichen Verwendung von Tabak mittels multimodaler, naturalistischer Pilotstudie auf den Grund, unter Zusammenarbeit mit einem auf Tabak spezialisierten amazonischen Heiler (Peru, Loreto Provinz). Untersucht wird dabei einerseits, wie die Tabakpflanze in der amazonischen Medizin verstanden und eingesetzt wird (Indikationen, Kontraindikationen, Wirkungen, Risiken, etc.). Zum anderen werden erste klinische Daten bei einer Patientenstichprobe, die mit flüssigem Tabak behandelt wird, naturalistisch erfasst (Schwerpunkt psychosomatische Symptome, Schmerzen). Das Projekt wird von einem transdisziplinären Beratergremium begleitet.

3. Wissenschaftlicher und gesellschaftlicher Kontext des Projekts

Traditionelle Heilsysteme haben heute insbesondere in der Behandlung psychosomatischer Erkrankungen immer mehr Bedeutung. Klinische Forschung um die amazonische Medizin im Speziellen hat in den letzten Jahren ausserdem durch die erhebliche internationale Popularisierung von Ayahuasca zugenommen. Der Gebrauch der Tabakpflanze wurde dabei allerdings bislang vernachlässigt - obgleich Tabak, laut ethnographischer Darstellung, in diesem Medizinsystem besonders zentral ist. Erkenntnisse aus dem Projekt könnten längerfristig zu neuen Therapiemöglichkeiten sowie zur Entwicklung nachhaltiger Verwendungsalternativen der kontroversen Pflanze führen.

Direct link to Lay Summary Last update: 26.11.2019

Responsible applicant and co-applicants

Abstract

Tobacco (Nicotiana spp.) is generally conceived of as an addictive drug. In many countries including Switzerland, it is a leading risk factor for non-communicable diseases and, with 1.1 billion smokers in the world, a public health problem of global concern. Yet in the Peruvian Amazon, the geographical region believed to be tobacco's historical birthplace, this plant is associated with a strikingly different usage and repute: During our field research in this area we unexpectedly discovered that tobacco is widely used as a medicinal plant there, applied topically or via ingestion for psychological and somatic symptoms. Yet, to our knowledge, no clinical research has so far examined these uses, in spite of their ubiquity in Amazonian medicine and despite the global scientific interest in ayahuasca (which is part of the same medical system). The current project investigates an out-of-the-box perspective on tobacco and a highly innovative therapeutic approach. We propose an exploratory clinical pilot study with 4 work packages (WPs). The project will be accompanied by a transdisciplinary advisory board involving partners from science (clinical psychology, medicine, anthropology, ethnobotany) and practice (Amazonian traditional healer, public health consultant). The research questions are (i) How is the tobacco plant used in Amazonian medicine for psychosomatic conditions and pain? (ii) What are the self-reported short-term effects of a brief Amazonian intervention involving liquid tobacco? (iii) What are the basic clinical and socio-demographic profiles of patients seeking Amazonian tobacco-based treatment? The study is conducted in the Peruvian Loreto Province at the health practice of a distinguished Amazonian healer who is an expert in tobacco-based medicines (a so called "Maestro Tabaquero"). WP1 collects in-depth qualitative data by means of key informant interviews with this expert (semi-structured), to document how tobacco is used in the Amazonian medical system in terms of modes of preparation and application, indications, counter-indications, effects, risks, adverse effects, etc. WP2 quantitatively assesses clinical and socio-demographic patient profiles and motives for treatment-seeking at the study site during 60 consecutive days, using a test battery of validated psychological measures. WP3 conducts an exploratory clinical pilot using a naturalistic pre-post design to assess self-reported short-term effects of a weeklong Amazonian intervention involving liquid tobacco in a patient sample treated at the study site (N=15-20). Validated psychological state measures (e.g., pain symptoms, anxiety, depression, etc.) are administered before and after the treatment and statistically compared. WP4 involves the scientific dissemination of findings from this work. The pioneering status, unconventionality, and direct societal relevance of this project is associated with high potential for innovation and impact: This work could in the long-term (a) open new therapeutic avenues for psychosomatic problems and (b) lead to the development of sustainable alternative uses of the tobacco plant. This is significant for the worldwide mental health treatment gap as it could increase the accessibility, affordability, and pertinence of psychosomatic treatment options by integrating effective means from traditional medicine. This work is relevant for tobacco-producing developing countries that economically rely on commerce with this plant, as it could open sustainable pathways to use existing resources. This highly original research is associated with potential for controversy, as it focuses on scientifically unstudied uses of a plant that in global modern society is used detrimentally to public health. Our rationale is however in line with basic toxicology principles and with current scientific advances around other contentious plants, now widely studied for their therapeutic potentials. We expect findings from this work to be met with exceptional scientific interest and provide the basis for future controlled studies.
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