There is currently a renewed academic interest in hallucinogenic drugs such as psilocybin or ayahuasca. The clinical use of hallucinogens has been accompanied by psychotherapeutic models that address their subjective effects. The clinical approach developed in Brazil is particularly interesting, since it does not have psychotherapeutic orientations or techniques of directionality of the subjective experience. This text discusses the complex crossroads that crystallize in Brazil and that occur between the use of ayahuasca in clinical settings, its use by Indigenous communities and religions, the relationships between these communities and the general Brazilian population, and the hegemonic therapeutic models built around hallucinogens.