In the heart of the Amazon, women travel by boat to the wild town of Iquitos before driving deep into the jungle.

Inside thatched huts, the symphony of frogs and insects builds to a crescendo and the jungle seems to come in through the netted walls, expanding like sacred geometry. By candlelight, shamans sing while pouring the ayahuasca, a foul-tasting brew that will provoke "la purga" — vomiting and diarrhoea.

Its effects — psychedelic visions — are claimed to be profoundly healing for some. But it carries risks, from psychosis to sexual assault. Several people have died through ayahuasca tourism, largely from other plant-based brews prepared by shamans.

But in an era where experiences and "bucket lists" are prioritised over savings and mortgages, psychedelic tours to the Amazon are sprouting like ferns in the jungle. In Peru, where taking ayahuasca is legal, there are up to 100 retreats in the Iquitos region alone.

Shipibo Ayahuasca healers at Temple of The Way of Light. ( Cosmic Sister: Tracey Eller )

Women the new psychedelic explorers?

Ayahuasca is regarded by indigenous communities as a sacred feminine plant, so it's ironic that female exploration of the medicine tends to be framed as a wellness fad, as though serious self-discovery is only for men.

What is ayahuasca? Amazonian hallucinogenic brew combining psychotria viridis shrub and banisteriopsis caapi vine

Amazonian hallucinogenic brew combining psychotria viridis shrub and banisteriopsis caapi vine Shrub contains psychedelic compound dimethyltryptamine (DMT)

Shrub contains psychedelic compound dimethyltryptamine (DMT) Vine is a monoamine oxidase inhibitor (MAOI) preventing stomach enzymes from eliminating DMT too quickly

Vine is a monoamine oxidase inhibitor (MAOI) preventing stomach enzymes from eliminating DMT too quickly Strong serotonergic effects can increase feelings of wellbeing

It's not helped by the fact that underground ceremonies have raged through yoga salons from Williamsburg to Topanga Canyon, while celebrity "aya seekers" include Chelsea Handler (who drinks the brew in her Netflix series Chelsea Does), Susan Sarandon, Tori Amos, Trudie Styler and Lindsay Lohan — who credits it with helping her cope with a miscarriage and "the wreckage" of her life.

Then there are the high-end retreats offering spas, laundry service and Wi-Fi, for about $5000 for 10 days, not including flights.

Writing in The New Yorker, Ariel Levy surmised: "If cocaine expressed and amplified the speedy, greedy ethos of the 1980s, ayahuasca reflects our present moment — what we might call the Age of Kale."

That description infuriates Zoe Helene, who runs the educational advocacy group Cosmic Sister. Formerly a performing artist, she grew up in New Zealand and now lives west of Boston, where her life's work is promoting "psychedelic feminism"— women's empowerment and healing through psychedelic plants.

Zoe Helene with an ayahuasca vine. ( Cosmic Sister: Tracey Eller )

"This is not tourism," she says emphatically. "You don't say, 'Hey, we'd like to buy tickets to that island with the monkeys and take selfies.'"

"It's also not a psychedelic festival where you dress in sexy costumes and dance until sunrise."

Cosmic Sister has developed three psychedelic feminism educational grants to support women in the field of psychedelics. The most recent, announced this July, is aimed at women tackling sexism, racism, wellness and sustainability through their psychedelic work. Then there's the Plant Spirit Grant, for women who want to participate in ceremonies with Shipibo shamans. Previous recipients include an academic, a social worker and a physician.

Physician Selma Holden received one of Cosmic Sister's grants in 2016. ( Cosmic Sister: Tracey Eller )

'Psychedelic feminism'

Jennifer Owens was 27 when she visited the village of Písac. The rope access technician from Wollongong has a history of depression and credits the ayahuasca with treating her panic attacks.

As it took effect, she believed herself to be communicating with the ayahuasca herself.

Jennifer Owens travelled to Peru to try ayahuasca. ( Supplied )

"She zoomed into my brain, showing me all the synapses and pathways lighting up. There was a pathway that needed redirection, and she dragged it to go in a different way. I asked her about the fate of this world and she took me out to space. She said, 'It's fine! I'll show you.' Time sped up and the world slowly decayed, and then was reborn bright and beautiful."

Meg Horan had turned 40 and finished up working for a record label in Australia. Before she started a new life in Iceland, she took a trip to the jungle.

"Other people there had very specific intentions. I just wanted to begin to be kinder to myself," she says.

She had long conversations with her critical voice; it was hard work and required maintenance out of the jungle, including meditation and mindfulness.

"You can't just trip your balls off and expect everything to be better," she warns.

"It's a constant journey of self-improvement, not an instant cure-all."

Meg Horan on the boat trip to her ayahuasca retreat. ( Supplied )

The dark side of 'aya seeking'

Ayahuasca has also found itself in the news for all the wrong reasons. While pure DMT has very low toxicity, some of the other brews involved in similar ceremonies can be deadly for the inexperienced. In 2015, Canadian Jennifer Logan died from a pulmonary edema and Kiwi Matthew Dawson-Clarke had a heart attack after drinking a tobacco-based "purge" medicine believed to rid the body of toxins and anxiety.

"The danger is not knowing what the shaman's methods are," says Dr Bright. "They may add angel's trumpet plants or tobacco. They have been drinking these brews since childhood — we haven't."

Avoiding danger Ayahuasca can be dangerous when consumed with medications that raise serotonin levels, including SSRI antidepressants, some antipsychotics and tramadol

Ayahuasca can be dangerous when consumed with medications that raise serotonin levels, including SSRI antidepressants, some antipsychotics and tramadol Tobacco and other non-ayahuasca brews can be harmful

Tobacco and other non-ayahuasca brews can be harmful Reputable retreats with first-aid training and good reviews are safer

Reputable retreats with first-aid training and good reviews are safer Travelling with a friend is better than going alone

Another risk is those with a family history of psychotic disorders may find drinking ayahuasca provokes an episode.

Then there are the reports of sexual assault. Taking a powerful psychedelic under the guidance of an unfamiliar man of influence is a risk for women.

"There are many recorded cases of shamans who intentionally seek out sexual relations with participants," anthropologist Daniela Peluso wrote in the book Ayahuasca Shamanism in the Amazon and Beyond.

"For these particular men, sex with participants is premeditated and part of a routine."

Lily Ross, a writer and educator in sexual violence resistance, spent nearly a month at a village in central Ecuador in 2012, where she was given brugmansia, which kept her in a fog of confusion. She says the shaman was persistent that their sexual bond was the will of god, and that he isolated and raped her repeatedly.

She says those working in the ayahuasca community must "out" abusers and put preventative measures in place.

Ayahuasca ceremonies are conducted across the Amazon, not just in Peru. ( Reuters: Lunae Parracho )

Ayahuasca as therapy?

There have long been clinical trials exploring the use of psychedelics in therapeutic settings. If all approvals go to plan, MDMA will be used in PTSD treatment in the next few years, while US trials have tested LSD for anxiety. But trials using ayahuasca are harder to get off the ground.

"Ethics committees have an issue with administering plant-based medicines because it's much more quantifiable to say, 'This is 99.9 per cent human-grade LSD'," says Dr Stephen Bright, senior lecturer in addiction at Edith Cowan University and co-founder of Australia's Psychedelic Research in Science & Medicine (PRISM).

In 1995, a Brazilian religious society called Uniao do Vegetal, which uses ayahuasca for spiritual development, held an international conference to present their research. People who had regularly been drinking ayahuasca reported better psychological functioning and that the medicine had changed their lives, be they men who were engaging in domestic violence, or people who were alcohol-dependent.

Indigenous communities have used ayahuasca as a medicine for generations. ( Cosmic Sister: Tracey Eller )

'Spiritual tourism' white-washing the Amazon?

Traditional villages have often been battered by extractive industries. Could ayahuasca tourism be further obliterating indigenous culture?

Certainly, retreats bring money into impoverished communities, although to different degrees. Some are staffed almost exclusively by westerners. Others employ locals and establish permaculture projects with neighbouring villages.

Vidal Jaquehua, a Quechua native, told Vice that ayahuasca tourism is changing his home. As a result, his own tour company, Adios Adventure Travel, doesn't include ayahuasca retreats.

"We don't offer those trips because we respect our people, the costumes, traditions, and believe there are rituals that need to be understood and respected."

His philosophy is to "let the people practise it and don't make a business out of it."

Ms Helene believes it's possible to support cultural preservation through mutually respectful cultural exchange. "The conversation should be about defending the rights of indigenous people while supporting them to champion the environment they steward," she says.

Through Cosmic Sister she supports local women such as Kleylli Vargas Urquia, a Shipibo forestry student who received a grant; Estella Pangosa Sinacay, a shaman who runs the Aya Madre Healing Center; and local textile artists, whose work she promotes.

Estella Pangosa Sinacay runs the Aya Madre Healing Center. ( Cosmic Sister: Tracey Eller )

Ayahuasca on home turf

Perhaps drinking ayahuasca in Australia would carry fewer risks — and there are local plants with the same active ingredients. But DMT is a prohibited substance in Australia, so making a brew is drug manufacture and serving to others is supply.

Dr Bright believes the safest option would be for the Therapeutic Goods Administration to regulate ayahuasca, though those wheels are not in motion.

"Without any regulation you're playing Russian roulette," he says. "You're trusting word of mouth or what you've read on Reddit," he says.

The Department of Health said in a statement:

"Deaths have occurred when taking ayahuasca. Some deaths are attributable to erratic behaviour responding to hallucinations. People have also been robbed and sexually assaulted when incapacitated under the influence of ayahuasca. In addition, the interaction of MAOIs with other drugs may present significant drug-drug interactions."

Jenny Valentish is a freelance journalist and author of Woman of Substances: a journey into addiction and treatment.