The study was intended to generate empirically based hypotheses on the therapeutic mechanisms of ayahuasca in substance dependency treatment. As outlined in this paper, ayahuascaassisted treatment can trigger various types of psycho-spiritual processes that are valued in other therapeutic approaches for substance dependency. Further clinical investigation is still warranted to assess the efficacy of ayahuasca for substance dependency treatment in comparison to current best treatment practices. It seems, however, based on preliminary research that ayahuasca interventions for substance abuse treatment are, in some cases, very effective and that they can be integrated into multidisciplinary multicultural addiction treatment programs.