The brochure my friend Cass sent me had a photo of a wooden platform at dawn, mist coming off the river, and a price in US dollars that she had converted into Australian in the message underneath so I would not have to. Fourteen hundred, roughly, for nine days, not counting the flights, which were the expensive part, and not counting the two nights in Lima on the way in because the connection to Iquitos was awkward and she wanted to see the cathedral in the Plaza de Armas anyway. She had just come out of a long thing with a man who did something in logistics, and she told me the retreat was not about him, and I believed her about eighty per cent, which is the same number I land on for most things people say about why they are going to drink ayahuasca in the Amazon.

I want to be careful here, because I am not a sceptic about the medicine and I am not a believer either, and the grievance I have is narrower than either of those positions. It is this. Ayahuasca in Peru has become a product, and the product is sold with the confidence of a package holiday, and the two things — the brew and the holiday — do not sit together as comfortably as the websites want you to think they do.

What the thing actually is

Start with the plants, because most of the marketing skips them.

Ayahuasca is not a single substance. It is a brew, cooked usually for most of a day, from a vine called Banisteriopsis caapi and the leaves of a second plant, most often Psychotria viridis, which the Shipibo call chacruna. The leaf carries DMT. The vine carries compounds that stop your gut from breaking the DMT down before it can do anything. On their own, neither plant does much when you drink it. Together they do a great deal, and the fact that some people in the Amazon worked out this combination from thousands of possible plants, without a chemistry lab, is one of those facts that should stop you in your tracks and usually gets one line on the retreat’s “About the Medicine” page.

The people who traditionally prepare and serve it are curanderos, and in the region around Iquitos and Pucallpa they are very often Shipibo-Conibo. In ceremony the curandero sings — icaros, these songs are called, and they are not background music, they are understood to be the working part, the thing that shapes and directs the experience. Before the ceremonies there is usually la dieta: no salt, no sugar, no pork, no alcohol, no sex, sometimes for weeks. The diet is not health advice. It is part of how the tradition understands the plants to teach.

I lay all this out not to sound informed but because the distance between this and the Instagram version matters. On the ground it is vomiting into a bucket in the dark while a man you met four days ago sings in a language you do not speak. Cass called it, without any irony, the worst and most important night of her year.

The purge, and why nobody photographs it

They call it the purge, and the retreats mention it the way airlines mention turbulence, as a manageable feature. You will probably be sick. You may have diarrhoea. Some people shake, some cry, some lie very still for hours convinced they are dying and then are fine and hungry by breakfast. The bucket is standard equipment. This is not a side effect that the tradition apologises for; it is understood as part of the cleaning.

Here is where the product framing starts to fray. A retreat that has sold you nine days and a dawn-mist photo has a commercial interest in you having a profound experience and none at all in you having a medically complicated one. And ayahuasca is genuinely, not theoretically, dangerous in combination with certain things. The MAO-inhibiting part of the brew interacts badly with a long list of medications, antidepressants chief among them, particularly SSRIs and anything in the older MAOI class. Serotonin syndrome is a real risk and it can kill. People with certain heart conditions are taking a gamble they may not know they are taking.

A responsible operation screens for this properly, asks about your medications and your psychiatric history and means it, and turns people away. A less responsible one sends a form. I keep coming back to a thing a harm-reduction researcher said years ago, that the plant does not check your paperwork — the point being that the vine is indifferent to whether anyone did their job before you drank it. There have been deaths of foreign visitors over the years, and the reporting on them is patchy, but the pattern in several is depressingly consistent: inadequate screening, a facilitator whose training nobody could verify, and no medical anything within hours of help.

I am not telling you people die routinely. They do not. Most people come home with a story and a slightly annoying evangelism that fades by about March. But the risk is real and it is unevenly distributed across operators, and the operator you can find is not necessarily the operator who screens.

Who is actually running the ceremony

This is the part I find hardest to write about honestly, because it involves taking seriously two things that pull against each other.

The first is that the Shipibo tradition is real, deep, and not yours or mine to assess. When people say a curandero has trained for decades, that training is a genuine apprenticeship, often beginning in childhood, involving its own long diets and a relationship to the plants that does not translate cleanly into English or into a Eventbrite listing. There are curanderos in Peru of extraordinary skill and integrity.

The second is that the boom has produced the thing every boom produces, which is people who have noticed the money. Ayahuasca tourism around Iquitos is now large enough to distort the local economy, and the title “shaman” is not licensed by anyone. A facilitator can be a third-generation Shipibo healer or a Westerner who did a few ceremonies and now runs retreats, or, worst case, someone who has learned exactly enough of the aesthetics to be convincing to a foreigner who has flown for most of a day and wants to believe. There have been credible, awful accounts of sexual abuse of vulnerable participants, usually women, during or around ceremonies, where the disorientation of the state and the authority of the “healer” were used as instruments. The community that takes ayahuasca seriously talks about this openly and with shame. The marketing does not.

My colleague Deb thinks the whole industry should carry the same warnings as adventure tourism and I do not entirely disagree with her, though we have never finished the argument. It is a bit like diving. The activity can be done superbly safely and can also kill you, and the single biggest variable is who is running the boat and whether they are the person their website says they are.

What I actually think you should weigh

So here is the practical part, because grievance without anything useful attached is just complaint.

If you are going to do this, the questions that matter are not the ones the retreats want you to ask. The retreats want you to ask about the accommodation, the food after the diet, the airport transfer from Iquitos, whether there is Wi-Fi (there is usually, deliberately, not). Ask instead: who specifically is serving the medicine, what is their lineage or training, and can you verify any of it independently rather than from the retreat’s own testimonials. Ask what their medical screening actually consists of and whether they have ever turned someone away, because an operator who has never declined anyone is telling you something. Ask what happens if something goes wrong at two in the morning, how far the nearest hospital is, and whether anyone on site can do more than reassure you. Ask whether they require you to disclose medications and whether they understand the SSRI interaction, and if the person answering does not immediately know what you mean, that is your answer.

And then there is the question underneath all of it, which no operator can answer for you. What are you actually going for. Cass went, I think, to draw a line under the logistics man and to feel something large enough to reorganise a bad year around. She came back changed in ways that lasted longer than March, gentler with her mother, off the antidepressants she had tapered under her GP well before she flew, which is exactly the sort of thing that has to be done carefully and with a doctor and not improvised in the jungle.

Whether the vine did that, or whether a fortnight without her phone, without alcohol, without the man, with strangers who were kind to her and a diet that emptied her out, would have done most of it anyway — I honestly cannot tell you. I have watched this go two ways with people I know and I cannot give you the mechanism. That uncertainty is not me hedging. It is the actual state of the evidence as far as I can read it, and anyone who tells you cleaner than that is selling something, possibly the retreat.

Before you book

The thing I would say, if you have read this far and you are still half-planning it, is that the seriousness of the tradition and the seriousness of the risk point in the same direction, which is towards slowing down. The people who do this well, on both sides of the transaction, treat it as a big thing. The trouble starts wherever someone has an incentive to treat it as a small one — a weekend add-on to a Peru itinerary, a cleanse between the Sacred Valley and Machu Picchu, a thing you squeeze in.

Peru is not the problem. The vine is not the problem. The problem is the gap between how carefully this deserves to be approached and how casually it is now sold, and that gap is yours to close, because the person converting the dollars into Australian for you in the brochure is not going to.