We can predict that the ongoing globalization of ayahuasca will take one of several different paths in the future. The plant can continue to be abused by charlatans who extract cash from unwary men and women—those hungering for spiritual experiences or psychological help for personal problems. The Peruvian, Brazilian, and Ecuadorian governments should consider a travel advisory in several languages to alert tourists to the potential of charlatanry as they are accosted on the streets of downtown Iquitos or Manaus, or at airports while they wait, with offers of ayahuasca ‘‘rituals.’’ Or, the plant can be absorbed and integrated into an enlightened medical/spiritual model, where a cost-benefit analysis carefully evaluates the ingestion of the plant with health and mental health risks. Or the plant will simply be used up and tourists will go elsewhere to meet their needs and fantasies. Shall we see these substances as malevolent agents and pathogens? Or, are they tools, as Winkelman and Tupper argue? Are they inherently dangerous, or does their alteration of consciousness provide some kind of potential benefit? Are we seeing a replay of the 1960s, when a serious medical lobby saw great potential in the use of LSD to treat intractable mental illness and alcoholism—while at the same time, the intoxicated, LSD-using daughter of a famous television personality jumped off a building to her death, believing she could fly? Using a metaphor of hallucinogen as tool, rather than malevolent agent and pathogen, any plan for future incorporation of ayahuasca into a medical model would come attached with a set of protocols. Such protocols should include the following: bona fides regarding the source of the plant; set and setting control; a mindful sitter of safety; no involvement in risky activities; screening out takers of those with psychiatric disorders; careful diet intake prior to ingestion to eliminate foods containing chemicals that prevent the action of ayahuasca from occurring, and the avoidance of certain substances like antidepressive medications. Any formal use of ayahuasca would entail some kind of screening of practitioners. This unfortunately reminds us of the many pseudoscientific certification boards that spring up like mushrooms after a rainfall in medicine and psychology, where, for a very high fee, one can be a member of a select group of specialists who supposedly meet a minimum standard of competence. This is a problem when, as Arrevalo stated to Rumrrill in an interview, almost every Shipibo house in Pucallpa, Peru has a resident shaman, now that the profit for offering the experience is so high. In earlier times, there might have been one or two specialist shamans in the community who were highly regarded. Apprenticeships have almost disappeared in recent years, as the commercialization of the ayahuasca rituals has pushed out the traditional knowledge base. In this book we have looked at the fascinating plant ayahuasca and its potential for good, as well as its dangers. We see the trajectory of its use in ancient shamanic religions of the Amazonian rain forest, the changes among indigenous South American shamans, the usurpation of ayahuasca by mestizo rural and urban river-edge peasant farmers, its incorporation into several new Brazilian religions, and its entry into religious sacraments in the United States. Finally, we see its impact on drug tourism and its European augury for do-it-yourself use. Quite a profile for a simple woody vine, threading its way through the moist tropics of the Amazon.