Shamanism has a number of bases in humans’ evolved psychology that provide platforms and processes for the application of this ancient technology of consciousness and healing in the treatment of addictions. A biogenetic structural approach to the evolution of shamanism reveals significant biological features involving: ritual participation and the mimetic expressive capacities, including dance, music and enactment; alterations of consciousness produced through these processes as well as the psychedelics; special experiences of self manifested in spirit identities and allies and the out-of-body experience. The applications of shamanic alterations of consciousness to addictions treatment are discussed in terms of the ability of these experiences to: modulate responses of the serotonergic and dopaminergic neurotransmitter systems; enhance access to dynamics of the unconscious; and stimulate endogenous healing responses. Similar effects are attributed to ritual practices, as well as their ability to produce a social dynamic that enhances well-being at biological, social and psychological levels. Clinical evidence for the effectiveness of drumming and singing are review in support of the use of shamanic practices as adjuncts for all substance abuse rehabilitation programs.