instruction: What types of ritual use Ayahuasca?
output: Ayahuasca is used both socially and as a ceremonial or shamanic spiritual medicine
input: Ayahuasca[note 1] is a South American psychoactive and entheogenic brewed drink traditionally used both socially and as a ceremonial or shamanic spiritual medicine among the indigenous peoples of the Amazon basin, and more recently in North America and Europe. The tea causes altered states of consciousness often known as "psychedelic experiences" which include visual hallucinations and altered perceptions of reality.