Psychedelic Medicine


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N,N-Dimethyltryptamine, or simply DMT, is a classic psychedelic compound and is one of the main ingredients in the psychedelic brew known as ayahuasca. DMT, like psilocybin and LSD, is a serotonergic psychedelic and due to its unique properties, there is a blossoming field of scientific research investigating DMT.

The History of DMT

While DMT exists as a natural alkaloid within a number of species of plants—such as the root bark of mimosa hostilis or acacia confusa—the compound can also be synthesized in a lab, an endeavor first accomplished by German chemist Richard Helmuth Fredrick Manske. Though the use of DMT as a psychedelic drug is a recent development in the Western world, the compound has been consumed in the form of ayahuasca for religious ceremonies in a variety of indigenous cultures, such as the Shipibo people of South America. 

DMT entered the broader cultural consciousness in the West through the counter-cultural movement of the 1960s, where the drug was praised for its mystical and consciousness-raising properties by significant cultural figures such as Terence McKenna. 

More recently, research by Rick Strassman presented in his book DMT: The Spirit Molecule: A Doctor's Revolutionary Research into the Biology of Near-Death and Mystical Experiences produced fascinating results and helped spur additional curiosity and scientific studies on this intriguing compound.

How Do You Take DMT?

In its pure form, DMT is a off-white powder or crystalline substance, and unlike many other psychedelics, it cannot be administered orally to induce its hallucinogenic effects. In the case of ayahuasca there is an additional compound present—a monoamine oxidase inhibitor or MAOI—which allows the DMT to be consumed orally. 

Aside from ayahuasca, the most popular methods for consuming DMT are to either smoke or vaporize the substance. There are a variety of techniques for vaporizing DMT, some of which use specially designed devices, others of which rely on simple household items such as glass bottles or lightbulbs. For smoking DMT, the most common method is to sandwich the DMT between marajuana or non-psychoactive herbal material and utilize an instrument designed for cannabis consumption. These complicated techniques are necessary due to the fact that a direct flame is too intense and results in the DMT degrading before it can enter the body. In the context of scientific research such as Strassman’s, DMT is introduced via IV to allow for more consistent and precise dosage, though injecting the substance for recreational use is practically unheard of.

The experiences induced as a result of consuming this psychoactive substance vary in intensity depending on dose, though unlike psilocybin or LSD, effects last for only a short period of time, with even the most intense experiences lasting often no more than thirty minutes. Lower doses produce altered and enhanced perceptions, whereas with higher doses experiences of entering another dimension, entity contact, ego dissolution, and mystical union are all frequently reported.

Is DMT Legal?

DMT remains illegal to possess in much of the world and it is listed as a Schedule I controlled substance in the United States. Due to the fact that DMT also occurs naturally in numerous organisms, there is often a legal grey area when it comes to buying and selling species such as mimosa hostilis

Additionally, due to the fact that this substance has a history of religious and sacramental use, laws surrounding ayahuasca often differ from those which address DMT as an isolated compound. In fact, no DMT-containing plants are themselves scheduled under the United Nations 1971 Convention on Psychotropic Substances, allowing for more variance in legality country-to-country.

DMT Pharmacology

Regarding pharmacology, N,N-DMT is very similar to other serotonergic psychedelics such as psilocybin and 5-MeO-DMT. Like these other compounds, DMT is classed as a tryptamine, meaning the core structure of the drug is an indole ring with a two-carbon sidechain attaching an amino group. As a serotonergic psychedelic, DMT binds to the 5-HT receptors—the receptors typically associated with the neurotransmitter serotonin, hence the name serotonergic psychedelic. The action of DMT and other serotonergic psychedelics on these receptors, and in particular the 5-HT2A receptor, is thought to be the primary mechanism which is responsible for the psychedelic effects of these substances.

Is DMT Harmful?

DMT has not been found to present any major concerns when it comes to the physiological effects of the compound and scientific research investigating the effects of DMT has found the drug to be generally well-tolerated by subjects. Like other serotonergic psychedelics, DMT is considered non-addictive and has a low potential for abuse. Additionally, the median lethal dose of DMT in humans has never been documented, showing the toxicity of the substance relative to dose is extremely low. 

Despite the lack of toxicity and low potential for abuse, there are still potential harms associated with the use of DMT. One potential concern is nausea and vomiting, which is extremely common following the ingestion of ayahuasca, though relatively rare in the case of smoked or vaporized DMT. However, due to the potential loss of wakeful consciousness when consuming larger quantities of DMT, it is an important harm reduction practice to be supervised by a sober trip sitter to ensure the airway does not become blocked in the case of vomiting. 

Interactions Between DMT and Other Medications

As is the case with psilocybin, DMT use is not recommended for individuals taking either lithium and tramadol. While thorough scientific investigation is still needed to better understand these interactions, there is good reason to believe that combining these medications and a serotonergic psychedelic could lead to seizures or psychosis. Additionally, SSRI antidepressants interact with DMT, and while the interaction does not seem to precipitate harm, SSRIs do reduce the psychedelic properties of DMT.

Other Risks & Contraindications of DMT Use

While DMT presents relatively few risks, proper education in harm reduction is necessary to avoid potential dangers associated with consuming this psychedelic substance. Unlike other tryptamines such as LSD or psilocybin, the psychedelic experiences brought on by DMT are short in duration, meaning there is less time to engage in potentially dangerous behavior while under the influence of the drug. In larger doses, DMT often renders users imobile, with the most intense experiences resulting in the loss of wakeful consciousness. As such, it is crucial that DMT is only ingested in a safe and secure setting where emergencies are unlikely to happen. Here again it is necessary to emphasize the necessity of a sober trip-sitter to ensure a stable and comfortable environment for the duration of the experience.

Like the other serotonergic psychedelics, perhaps the greatest risk of DMT consumption is negative psychological outcomes. While there is growing research that DMT could have benefits for individuals struggling with various mental health conditions, these results are mediated by robust clinical and therapeutic practices, and without this container DMT consumption may result in negative mental health outcomes instead. Due to the intense nature of many experiences induced by this psychedelic drug, anxiety, paranoia, and even psychosis are all possible results of consuming DMT. As such, individuals with a history of certain mental health conditions are discouraged from using DMT except in a clinical setting where they may be guided and monitored by trained medical professionals.

Current DMT Research

As previously mentioned, Rick Strassman’s work on DMT has been instrumental in encouraging this field of research to develop in the 21st century, despite significant legal and regulatory roadblocks. In recent times, DMT and ayahuasca in particular have been studied for their potential clinical applications for treating a variety of mental health conditions such as anxiety, depression, PTSD, and even addiction. Due to the existence of many retreat centers which offer ayahuasca ceremonies, much of this research has been observational in nature, so additional scientific investigation is still needed in the form of new randomized controlled trials. From the data available, however, it seems there are many promising clinical applications for this substance and DMT will likely have a place in the emerging field of psychedelic-assisted therapy.


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