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Drawing on semi-structured interviews with 27 people (including photo-elicitation interviews), observations of six ceremonies, and unrecorded ethnographic interviews, we examine perceived place of ceremonial use of peyote in personal change. Participants attributed significant change in thinking and behavior to ceremonial peyote use. Pharmacological effects on outlook, the hallucinogenic experience, fellowship, and enduring challenges of taking the drug contributed. Changes include anxiety and stress relief, easing symptoms of traumatic experiences, invigorated spirituality, introspection, and diminished substance abuse. Many participants experienced lasting philosophical or perceptual changes. Often, however, the full power of effects on stress, anxiety and especially substance abuse diminished with time. Photographs emphasized memorable moments under the influence related to changes in interpersonal insight, nature connection, transcending daily concerns, and spiritual awakening.