Ayahuasca and Addiction: Is It Addictive, And Can It Help You Quit?
Ayahuasca itself is not chemically addictive. It does not produce tolerance, withdrawal, or compulsive use, and the major pharmacology and harm-reduction reviews are clear on this (ICEERS, 2024). A separate question is whether the brew can help treat addiction. The evidence so far is small but unusually consistent. Observational studies of long-term ceremonial users show significantly lower rates of alcohol and tobacco use disorder (Barbosa et al., 2018), and clinical reviews report anti-addictive effects across the available trials (dos Santos et al., 2016). Ayahuasca is not a cure, it carries serious risks for people on antidepressants or with psychiatric conditions, and outcomes depend almost entirely on setting, screening, and integration.
| Question | The Honest Answer |
|---|---|
| Is ayahuasca addictive? | No physical dependence or tolerance documented. Behavioural attachment to the ceremony itself is possible (ICEERS, 2024). |
| Can it treat addiction? | Promising but small evidence base. Works through experience plus integration, not as a single-dose cure (Wong et al., 2023). |
| Biggest medical risks | SSRI/MAOI drug interactions, psychosis risk in vulnerable people, cardiovascular load, contraindicated in pregnancy (Callaway & Grob, 1998). |
| Vs. AA / rehab | A different tool, often a complement rather than a replacement. |
| Vs. ibogaine | Ayahuasca has broader anti-addictive evidence. Ibogaine has a stronger signal for opioid use disorder but higher cardiac risk (Mash et al., 2018). |
| Legal status (US) | Federally Schedule I. Religious exemptions for UDV and Santo Daime. Decriminalised for personal use in Colorado (Gonzales v. UDV, 2006). |
This piece is for the careful reader. Maybe you have failed at AA twice. Maybe you have a sibling whose drinking is killing them. Maybe you have read three sympathetic articles and one alarmed article and you still cannot tell which is closer to the truth. The honest answer is that ayahuasca occupies an unusual position in the addiction conversation. It has low addiction potential itself. It shows a real anti-addictive signal in the data. It carries real and specific dangers when mishandled. And the outcome depends more on context than on chemistry. The rest of this guide is the long version.
This article is for educational purposes only. It is not medical advice, a treatment recommendation, or a substitute for psychiatric or addiction care. Decisions about substance use disorder treatment require a qualified clinician who knows your full history. Decisions about whether ayahuasca is medically safe for you require a prescriber familiar with your psychiatric medications, cardiovascular profile, and family history. The information below reflects published research and clinical consensus and does not replace either. If you or someone you love is in crisis with substance use, the SAMHSA National Helpline (1-800-662-HELP) is free, confidential, and available 24 hours.
Is Ayahuasca Addictive? What the Evidence Actually Shows
The chemistry says one thing. The behaviour of regular drinkers says something more interesting.
Ayahuasca does not produce the chemistry of addiction. DMT, the active visionary compound, does not generate tolerance the way alcohol or opioids do. A drinker does not need a larger dose next month to feel the same effects.
The brew does not produce withdrawal. It does not light up the dopamine reward circuits the way cocaine or methamphetamine do. It is not associated with compulsive use patterns. The major safety reviews are clear on this. ICEERS, the European harm-reduction body that helped draft the safety guidance for the Catalan Department of Health, states plainly that ayahuasca does not produce dependence and does not produce tolerance at standard ceremonial doses (ICEERS, 2024).
That is the simple answer. The honest answer is more interesting.
The drinker can become attached to the experience. Some people start chasing ceremonies the way they once chased a substance. The pattern looks less like chemical dependence and more like ceremonial repetition: the certainty of insight, the relief from ordinary consciousness, the community that forms around the work.
The Global Ayahuasca Survey, the largest dataset on use patterns in the world, drew on more than 10,000 participants across more than fifty countries. It found that around 88% of people who reported challenging mental health effects in the weeks afterward viewed those challenges as part of a positive growth process rather than a problem (Bouso et al., 2022). That is a striking finding for any psychoactive substance.
It is also the kind of finding that hides a quieter pattern: the small subset for whom ceremony attendance starts to function as avoidance, not integration. Behavioural attachment is not chemical addiction. But it is real. Anyone considering long-term work with the medicine should know the difference.
What Ayahuasca Actually Is (in 90 Seconds)
Ayahuasca is a brew. Two plants are cooked together for hours over an open fire: the woody vine Banisteriopsis caapi, and the green leaves of Psychotria viridis, or in the Colombian and Ecuadorian traditions, the leaves of Diplopterys cabrerana (Callaway, Brito & Neves, 2005).
The vine contains harmala alkaloids, which are reversible MAO inhibitors. The leaves contain N,N-dimethyltryptamine, or DMT. Neither plant is psychoactive when swallowed alone. Together, they unlock each other. The MAO inhibitors stop stomach enzymes from destroying the DMT, which lets it reach the brain (Egger et al., 2024).
The combination is one of the more sophisticated pieces of pharmacological knowledge ever developed by people without laboratories. It is also the reason ayahuasca is dangerous to mix with most psychiatric medications, which we will return to.
For a fuller account of the brew, the plants, and the lineages that have used it for centuries, see our complete guide to ayahuasca. For this article, what matters is that this brew, drunk in a ceremonial setting, sometimes helps people stop using something else. The rest of the piece is about that.
Drug or Medicine? Why the Framing Matters
Set determines almost everything.
The same molecule can be a sacrament or a substance of abuse depending entirely on where it is consumed, by whom, with what preparation, and for what purpose. Ayahuasca makes this clearer than almost any other psychoactive.
Drink it alone in a hotel room and it can be a chaotic, frightening, occasionally dangerous chemical event. Drink it in a structured ceremony with a trained facilitator, after weeks of dietary preparation, with integration support afterward, and it can be the most carefully held experience a person ever has.
The Catalan harm-reduction guide commissioned in 2019 makes this point in clinical language: the most reliable predictor of a difficult outcome is an unsupervised setting (ICEERS, 2019). The Global Ayahuasca Survey reaches the same conclusion from epidemiological data (Bouso et al., 2022). The two strongest predictors of harm are unsupervised use and unscreened psychiatric vulnerability.
This is what the public conversation about ayahuasca usually misses. The substance is the same. The container is not.
A federally Schedule I drug under the Controlled Substances Act (DEA, 2024) is also a sacrament that the Supreme Court ruled the U.S. government could not prevent the União do Vegetal church from importing for ceremonial use (Gonzales v. UDV, 2006). Both are true.
For someone considering ayahuasca for addiction recovery, the framing matters. It decides whether you are asking “should I take this drug” or “should I work with this medicine in this lineage with this team for this length of time.” Those are different questions. They get different answers.
Can Ayahuasca Treat Addiction? What the Research Says
The research base is small but unusually consistent.
A systematic review of clinical trials of ayahuasca, psilocybin, and LSD published over the previous twenty-five years found beneficial antidepressant, anxiolytic, and anti-addictive effects across the available studies, with all three substances well tolerated in supervised settings (dos Santos et al., 2016).
A more recent review of serotonergic psychedelics for mental and substance use disorders looked at 77 studies and reached a similar conclusion: improved mood, reduced substance use, and improved insight across the available trials, though with low-quality evidence and a clear call for rigorous controlled studies (Wong et al., 2023).
The most striking population-level signal comes from the União do Vegetal, the Brazilian ayahuasca church. A study of nearly 2,000 long-term UDV members found rates of current alcohol and tobacco use disorder significantly lower than Brazilian national norms, with years of membership and ceremony attendance predicting the reduction (Barbosa et al., 2018).
These are observational findings, not randomised controlled trials. The people drawn to ayahuasca churches are not a random sample. The mechanisms remain partly speculative. But the direction of the evidence is unusually unanimous.
The proposed mechanisms are biological and psychological at once.
Ayahuasca acutely modulates the default mode network, the brain network associated with self-referential processing and rumination. It promotes neuroplasticity through BDNF signaling and 5-HT2A receptor agonism, the same pathway implicated in psychedelic-assisted therapy more broadly (De Vos et al., 2021). A comparative review of psychedelic pharmacology for addiction identifies these mechanisms as the likely substrate of the anti-addictive signal across the classic psychedelics (Nutt & Vamvakopoulou, 2024).
The experience itself often delivers what addiction medicine calls a quantum-change moment. A sudden reframing of self, history, and possibility that conventional therapy may take years to approach.
What ayahuasca is not is a cure. A single ceremony does not undo years of substance use, even when it delivers a dramatic experience. The clinical signal points to a tool, not a magic bullet, and one that depends almost entirely on what comes before and what happens after the brew.
Ayahuasca vs AA, 12-Step, and Conventional Rehab
Different doors open onto the same room.
Twelve-step programmes are free, geographically available almost everywhere in the world, and have helped many millions of people stay sober. The model is built on group accountability, abstinence, daily practice, and a spiritual surrender that some find liberating and others find religiously off-putting.
Conventional rehab, residential or outpatient, leans on cognitive behavioural therapy, motivational interviewing, medication-assisted treatment for opioid and alcohol disorders, and a clinical scaffolding that insurance sometimes covers. Both are well-evidenced for what they are. Both have failure rates that anyone in long-term recovery can describe in detail.
Ayahuasca-assisted recovery is something different. It is shorter in calendar time, more intense in dosed contact with the medicine, expensive, geographically scarce, almost never insurance-covered, and structurally dependent on integration support that most retreats do not provide. The pharmacology gets the headlines. The container is the variable.
| Dimension | Ayahuasca-Assisted | AA / 12-Step | Conventional Rehab |
|---|---|---|---|
| Core philosophy | Insight-led inner change with somatic and spiritual elements | Surrender, fellowship, lifelong abstinence, higher power | Behavioural change, relapse prevention, often medication-assisted |
| Active duration | Days to weeks of ceremony plus months of integration | Lifelong, daily or weekly meeting practice | 30 to 90 days inpatient; longer outpatient |
| Typical cost | Several thousand USD for a structured retreat | Free | Tens of thousands USD; insurance varies |
| Evidence base | Observational and early clinical; consistent direction | Decades of outcome data; effective for committed adherents | Strongest formal evidence base of the three |
| Abstinence model | Variable; many drinkers reduce or stop without total abstinence framework | Total abstinence required | Total abstinence typical, harm reduction in some programmes |
| Role of community | Ceremonial circle plus integration peers | Central; sponsor and meetings are the structure | Therapeutic group plus aftercare |
| Role of facilitator | Trained shaman or facilitator with lineage | Peer sponsor, no professional | Licensed clinical staff |
| Geographic access | Limited; mostly Latin America and a few legal carve-outs | Almost universal in major cities worldwide | Widely available in higher-income countries |
The table is not a verdict. It is a way of seeing that these are different tools for different situations and not necessarily competitors.
Some people who could not work the 12-step programme have found their footing through ayahuasca. Some people who found ceremony overwhelming have done well in AA. Many people end up using more than one resource. The honest version of this question is not “which is better.” It is “which is right for this person in this moment, and what does the next year look like.”
That last question is where the real difference shows up. AA gives daily structure for as long as a person wants it. Rehab gives 30 to 90 days of intensive care. Ayahuasca gives a small number of intense ceremonies, then sends a person home. What they do at home is the work.
Real Dangers and Who Should Never Take Ayahuasca
The dangerous list is short, specific, and non-negotiable.
The most common medical emergency associated with ayahuasca is serotonin syndrome from drug combinations. The harmala alkaloids in Banisteriopsis caapi are potent reversible monoamine oxidase inhibitors. Combining them with serotonin reuptake inhibitors creates a documented risk of life-threatening serotonergic crisis, first formally described in 1998 (Callaway & Grob, 1998) and confirmed across the pharmacological literature since (Ruffell et al., 2020).
The contraindicated medication list includes SSRIs (such as fluoxetine, sertraline, escitalopram), SNRIs, tricyclic antidepressants, lithium, MAOIs, trazodone, St John’s wort, triptans, dextromethorphan, linezolid, methadone, and stimulants of the amphetamine class (Malcolm & Lee, 2018). Washout periods vary by drug and must be supervised by a clinician. For the full breakdown of which antidepressants matter, why, and what supervised washout looks like, see our SSRI and MAOI interaction guide. Any retreat that does not require medication disclosure and a medical washout is unsafe.
Psychiatric history is the second non-negotiable.
Documented psychotic episodes after ayahuasca use are rare in ceremonial contexts, estimated below 0.1% of UDV servings, but they are concentrated in people with personal or family history of psychosis, mania, or schizophrenia spectrum disorders (dos Santos et al., 2017). A documented case of bipolar I mania emerged in a 30-year-old man with an undiagnosed bipolar history within two days of completing a four-day ayahuasca ritual in Brazil (Szmulewicz et al., 2015). Psychiatric screening is the most effective harm reduction available. For more on these specific risks, see our deeper guides on ayahuasca and psychosis risk and ayahuasca with bipolar disorder.
Cardiovascular load is real but typically manageable in healthy people. Ayahuasca acutely raises blood pressure and heart rate, which is a problem for people with serious uncontrolled hypertension, recent cardiac events, or active arrhythmias. For the full picture, see ayahuasca and the heart and ayahuasca and blood pressure. Pregnancy is a hard exclusion. Animal studies show developmental toxicity at doses above the human ceremonial range (White et al., 2024).
Death is uncommon but not zero.
A ten-year analysis of US poison control data reported 3 fatalities and 4 cardiac arrests across 531 ayahuasca exposure calls, with hypertension and tachycardia the most common cardiovascular effects (Heise & Brooks, 2017). The 2025 U.S. Embassy health alert in Lima noted that several U.S. citizens died or experienced severe illness following ayahuasca consumption in 2024, almost all in unscreened, unsupervised retreat settings (U.S. Embassy Lima, 2025). Standardised clinical safety protocols now exist for managing acute psychiatric and cardiovascular events in research settings, and they exist precisely because the risks are real and addressable when taken seriously (Rossi et al., 2023).
If you are taking psychiatric medication, have a personal or close family psychiatric history, or have any cardiovascular concern, ayahuasca is not a good fit until those questions are sorted with a clinician. If a retreat tells you otherwise, leave.
Ayahuasca vs Ibogaine for Addiction
Ibogaine is the other psychedelic that addiction medicine pays attention to. The two work very differently.
Ibogaine is a psychoactive alkaloid from Tabernanthe iboga, a West African shrub used ceremonially by Bwiti practitioners in Gabon. For where iboga and ibogaine sit in the wider field, see our plant medicine overview. Its appeal in addiction medicine is specific and dramatic: a single dose can substantially interrupt opioid withdrawal and cravings (Mash et al., 2018).
Observational and follow-up studies have reported sustained reductions in opioid use at 12 months in people for whom other treatments had failed (Brown & Alper, 2018; Noller et al., 2018). The current scoping-review literature treats ibogaine as a serious candidate for substance use disorder treatment, particularly opioid use disorder (Esperança et al., 2026).
The catch is cardiac. Ibogaine prolongs the QTc interval through hERG potassium channel blockade, and ibogaine-related fatalities are dominated by cardiac arrhythmia (Alper et al., 2012; Meisner et al., 2016). Pre-treatment cardiac screening, including ECG and electrolyte correction, is mandatory. Even with proper screening, ibogaine carries higher acute medical risk than ayahuasca.
| Dimension | Ayahuasca | Ibogaine |
|---|---|---|
| Origin plant | Banisteriopsis caapi + Psychotria viridis (Amazonian) | Tabernanthe iboga (West African, Bwiti tradition) |
| Strongest evidence for | Alcohol, tobacco, broad emotional and behavioural addictions | Opioid use disorder specifically |
| Mechanism | 5-HT2A agonism, BDNF-mediated neuroplasticity, default mode network modulation | Interrupts opioid receptor adaptation; SERT inhibition; metabolite noribogaine effects |
| Acute duration | 4 to 6 hours | 12 to 36 hours |
| Cardiac risk | Mild to moderate hypertension; rarely cardiac events in screened use | QTc prolongation, risk of fatal arrhythmia; ECG screening mandatory |
| Drug interaction risk | Severe with serotonergic medications; managed with washout | Significant with CYP2D6 substrates and QTc-prolonging drugs |
| Typical setting | Ceremonial retreat, multiple sessions | Medically supervised single dose; some clinical, some underground |
| Legal status (US) | Schedule I; religious exemptions for UDV and Santo Daime | Schedule I; decriminalised personal use in Colorado |
Different tools. Different conditions. Different stakes.
Ibogaine has the stronger signal for opioid use disorder specifically and is sometimes used as an interruption protocol followed by other treatment. Ayahuasca has a broader signal across alcohol, tobacco, stimulants, and emotional dependencies, and it works through a longer arc of insight and integration rather than acute receptor reset. Some clinics offer both, sequenced. Most offer one or the other.
For most people considering psychedelic-assisted addiction work for something other than opioid dependence, ayahuasca has the better safety profile, the better evidence base outside of OUD, and the better global access to trained facilitators. For opioid use disorder specifically, ibogaine deserves a serious conversation with a clinician who knows the field.
Choosing a Treatment Setting (and Avoiding the Bad Ones)
The retreat market is large, unregulated in most jurisdictions, and uneven in quality.
A good setting will require a medical screening before accepting your booking. They will ask for a full list of every medication you are on, including over-the-counter and supplements. They will request that you discontinue contraindicated medications under medical supervision with appropriate washout periods. They will refuse to take you if your psychiatric history is a clear contraindication. They will say no when no is the right answer.
A good setting will employ trained facilitators with documented lineage or formal training, and sometimes both. The ceremony space will have a designated medical or first-aid resource. There will be sober support staff in addition to the curandero or shaman. The number of participants per facilitator will be small enough that someone is paying attention to you, not just to the room.
A good setting will not promise outcomes. Anyone who tells you ayahuasca will cure your addiction is selling something. The honest pitch is that the medicine is a powerful catalyst whose value depends on preparation, intention, and what you do afterward.
The red flags are easy to learn:
- No medical screening, no requirement to disclose medications.
- Marketing language about miracles, guarantees, or one-ceremony cures.
- Refusal to discuss who is leading the ceremonies and how they were trained.
- A single facilitator running ceremonies for large groups with no support staff.
- No integration follow-up included or offered.
- No written safety policy regarding physical and sexual contact during ceremonies. Sexual abuse by facilitators in retreat settings is a documented and persistent problem in the broader industry, and a setting that takes safety seriously will have an explicit written policy you can read before booking.
- Pressure to attend before you have asked your doctor.
- Cash-only or unusually opaque payment terms.
Cost is real. A serious supervised retreat is rarely cheap. The cheap option is rarely safe.
Integration and What Recovery Actually Looks Like
Ceremony is not the work. Ceremony is the door to the work.
The largest qualitative study of ayahuasca integration to date drew on 1,630 drinkers from a global survey. It found that integration was experienced as long-term, communal, and challenging, rather than as a brief individual debrief (Cowley-Court et al., 2023).
People reported that the months and years after the medicine were where the changes either landed or did not. Therapy helped. Community helped. Returning to ceremony helped, in moderation. The thing that did not work was treating one big experience as the end of the story.
For someone working on addiction specifically, integration matters even more.
The neurobiological window of plasticity that follows the medicine is real, and it is also limited. New patterns laid down in the weeks after a ceremony, through therapy, through sober community, through changes in environment, through the small daily practices of recovery, become the durable change. The ceremony lit the room. The next thing is to redecorate.
This is also where ayahuasca and conventional recovery start to look less like alternatives and more like complements. Many people who do meaningful work in ceremony find their way to AA, SMART Recovery, therapy, medication-assisted treatment, or some combination. Others use ceremony to reset their relationship to a programme they had been in for years and were ready to leave. The medicine does not replace the work of a recovering life. It can sometimes make that work newly possible.
If you are considering ayahuasca for addiction, the question to keep close is not “will this fix me.” It is “what am I willing to build in the year after.” The answer to that question is the difference between a profound experience and a different life.
If you or someone you love is in crisis with substance use, the SAMHSA National Helpline is free, confidential, and available 24 hours: 1-800-662-HELP (4357).
Feel deeply.
Show up fully.
About the Author
Yasha Shah is the founder of MahaDevi Ayahuasca, a retreat center in Colombia. He has been working with ayahuasca since 2017, with experience across hundreds of ceremonies as both a participant and retreat organizer. Trained within the Shipibo and Camsá traditions, his work bridges indigenous wisdom, harm-reduction principles, and practical integration for modern seekers. Yasha writes about ayahuasca, plant medicine, and psychedelics, covering integration, preparation, and harm reduction to help readers make informed and responsible decisions.
Frequently Asked Questions
Is ayahuasca addictive?
Not in the chemical sense. There is no published evidence that DMT or the harmala alkaloids in ayahuasca produce tolerance, withdrawal, or compulsive use (ICEERS, 2024). Standard safety reviews state plainly that ayahuasca does not produce dependence at typical ceremonial doses. Behavioural attachment to ceremony is a separate phenomenon and is real for a small subset of frequent users, particularly in the absence of integration work.
Can ayahuasca cure addiction?
It is a tool, not a cure. The available evidence, including a systematic review of clinical trials (dos Santos et al., 2016) and a large study of long-term ceremonial users (Barbosa et al., 2018), shows real anti-addictive effects across alcohol, tobacco, and other substances. Outcomes depend heavily on screening, setting, and integration. A single ceremony does not undo a substance use disorder. The arc that matters is months and years long.
What does ayahuasca do to the brain long term?
The acute effects are well-mapped: modulation of the default mode network and increased neuroplasticity through BDNF signaling and 5-HT2A receptor activation (De Vos et al., 2021). Long-term effects in regular ceremonial users include some structural cortical differences that remain within healthy ranges, and consistent self-reported improvements in mood and cognitive flexibility. There is no published evidence of brain damage from supervised ceremonial use at standard doses.
Who should never take ayahuasca?
People taking SSRIs, SNRIs, MAOIs, lithium, tricyclics, methadone, or other serotonergic medications without an appropriate medical washout (Malcolm & Lee, 2018). People with a personal or close family history of schizophrenia, psychotic disorder, bipolar I disorder, or psychotic mania (dos Santos et al., 2017). People with serious uncontrolled cardiovascular disease, recent cardiac events, or unmanaged hypertension. Pregnant women. Anyone whose retreat is not screening for these factors before accepting their booking.
Is ayahuasca legal in the United States?
Federally, no. DMT is a Schedule I controlled substance under the Controlled Substances Act (DEA, 2024). The 2006 Supreme Court ruling in Gonzales v. UDV granted a religious exemption for the União do Vegetal church specifically (Gonzales v. UDV, 2006), and Santo Daime later won a similar accommodation. Colorado decriminalised personal possession in 2022. Outside those carve-outs, ayahuasca remains illegal under federal law, though enforcement varies by state and context.
How does ayahuasca compare to AA or 12-step recovery?
Different tools for different situations and not necessarily competitors. AA gives free, daily, lifelong group accountability and an abstinence model. Ayahuasca gives a small number of intense ceremonial experiences, typically expensive, geographically scarce, and dependent on integration. People who have not done well in 12-step sometimes find traction in ceremony. People who find ceremony overwhelming sometimes do well in 12-step. Many people use both.
What is the difference between ayahuasca and ibogaine for addiction?
Different mechanisms, different evidence bases, different risk profiles. Ibogaine has the stronger signal for opioid use disorder specifically, where a single dose can substantially interrupt withdrawal and cravings (Mash et al., 2018). It also carries higher cardiac risk and requires ECG screening (Meisner et al., 2016). Ayahuasca has a broader signal across substances and works through a longer arc of insight and integration rather than acute receptor reset.
Can you die from ayahuasca?
Rarely, but yes. A ten-year US poison-control review reported three fatalities and four cardiac arrests across 531 ayahuasca exposure calls (Heise & Brooks, 2017). The 2025 U.S. Embassy Lima health alert documented several American deaths in 2024, almost all in unscreened, unsupervised retreats (U.S. Embassy Lima, 2025). The pattern is consistent: deaths are concentrated in people taking contraindicated medications, with undiagnosed psychiatric or cardiac conditions, or in unsafe settings.
Conclusion
Addiction is rarely about the substance. The substance is the place the pain landed. The harder questions are underneath: what happened, what was unbearable, what was unspoken, what made the relief of using stronger than the cost of using.
Ayahuasca, when it works, works on those questions. Not on the chemistry of dependence, which is not where it has leverage, but on the architecture of the self that was using.
The medicine does not produce sobriety. It produces, sometimes, a clearer view of what sobriety would be in the service of.
The clearer view is not the cure. The cure is what gets built in the year after.
Twelve-step works for the people for whom it works. Rehab works for the people for whom it works. Ayahuasca works for the people for whom it works, in the right hands, with the right preparation, and the right integration. What does not work is doing any of these things alone, untreated, unscreened, or unsupervised.
There is no version of recovery that does not require help.
References
U.S. Embassy Lima, Peru. (2025). Health Alert: Do Not Use Ayahuasca/Kambo. U.S. Department of State.