DMT

DMT (N,N-dimethyltryptamine) is a short-acting classic psychedelic substance. It occurs naturally in many species, including in the human body and in many plants. Plants containing DMT have been used for shamanistic purposes by a number of South American tribes for at least 500 years [1–3], but the compound itself was only synthesized in 1931 [4]. Although DMT itself is on the narcotics list in Norway, this does not apply to plants containing DMT.

DMT generally occurs as freebase crystals, which are typically vaporized in a glass pipe and inhaled. Eating it produces no effects unless combined with a monoamine oxidase inhibitor (MAOI) [5]; however, this combination makes the effects last much longer and involves a high risk of dangerous interactions with many recreational drugs and medications. For this reason, this article only covers the effects of smoking or vaporizing pure DMT. For information about DMT+MAOI combinations, see our article on ayahuasca and changa.

Although it is not habit-forming and has very low toxicity on its own, frequent inhalation of vaporized DMT may still lead to airway irritation and respiratory problems [6,7]. DMT should nevertheless be treated with respect due to the often extreme intensity of its psychoactive effects. At high doses, users typically report highly detailed out-of-body experiences, often involving transportation to a different universe and/or interactions with strange entities [8]. DMT should therefore only be used in a safe and calm setting, preferably with eyes closed while sitting or lying down.

Please see our 10 general rules for sensible drug use. You should also be mindful of the following:

• Avoid using DMT if you or anyone in your immediate family suffer from a psychotic disorder such as schizophrenia. Also take extra care if you suffer from a severe anxiety disorder.
• Avoid using DMT if you take medications containing lithium or tramadol, as these combinations may lead to seizures.
• Avoid combining DMT with cannabis, central nervous system stimulants, or alcohol, as these combinations can lead to severe confusion.
• If you are trying DMT for the first time, it is highly recommended to have an experienced "trip sitter" with you.
• Do not try DMT spontaneously, e.g. at a party. Instead, give yourself enough time to read up on what to expect in order to mentally prepare yourself for the experience.
• Assess your current mood, situation, and immediate surroundings, and the people around you. Put away your phone and make sure you have no appointments or chores for the next few hours.
• DMT's effects take hold very fast, so make sure you are already in a safe, quiet, comfortable spot when you smoke. Lie down or lean back as soon as you feel the effects. Do not smoke DMT standing up, as you may lose balance and fall over.
• If you start to feel anxious while on DMT: focus on calming your breath, and try to give in to the experience instead of resisting it. Remember, it will soon pass. Breathing deeply and calmly can help to both prevent and reduce your anxiety. Many find it easier to handle the DMT experience with their eyes closed.

We employ a five-step risk scale with values ranging from "very low" to "very high" within six categories: Acute toxicity, Long-term toxicity, Dependence, Cognitive problems, Unpleasant events, and Interactions.

These values are based on qualitative reviews of available knowledge, and should only be viewed as guidelines. They are also relative, so a score of "very low risk" does not mean the substance is risk-free. The scale assumes users are normal, healthy individuals; beware that even drugs which are well-tolerated by most people may nevertheless be harmful to some users. It also assumes normal use patterns; that is, if a given drug is only harmful when used in a certain way, yet is almost never used in that way, then the drug will be considered less harmful compared to a similar drug which is commonly used in a harmful way.


ACUTE LETHALITY

⦿⦾⦾⦾⦾ (Very low risk)

There are no documented cases of lethal overdose from DMT alone. Based on animal experiments, it appears impossible to ingest a lethal dose of DMT via normal routes of administration [6,7]. People with cardiac problems should nevertheless be careful, as DMT can produce significant short-term increases in both heart rate and blood pressure [9-11]. There are also a few individual case reports where DMT has led to a dramatic drop in blood pressure [12].

LONG-TERM TOXICITY

⦿⦾⦾⦾⦾ (Very low risk)

DMT occurs naturally in the human body and appears to have very low toxicity overall [11, 13–15]. As with all smoked substances, frequent DMT use can lead to irritation or even long-term damage to the lungs and airways; however, vaporizing is less harmful than smoking, and highly frequent use of DMT is not common [5].

DEPENDENCE

⦿⦾⦾⦾⦾ (Very low risk)

DMT is not habit-forming in humans or other animals and does not lead to tolerance, and sudden cessation of use is not associated with any withdrawal effects [5,10,15]. Although the intensity of the DMT experience makes most people want to use it only rarely, some individuals with a strong reality-escaping or thrill-seeking drive may end up using DMT more often than others.

COGNITIVE PROBLEMS

⦿⦿⦾⦾⦾ (Low risk)

Research has not found any statistical correlation between psychedelics use and mental illness at the population level [5,12,16–18]. However, some users do experience passing anxiety and/or delusions under the influence of DMT, particularly after taking very large doses or using the drug under suboptimal circumstances. People with psychiatric disorders, or who have a close family member suffering from a psychotic disorder, are advised to be especially cautious with psychedelics or avoid them altogether [19].

Some psychedelics users experience long-term visual disturbances, which are reminiscent of certain visual effects typically seen on psychedelics, called hallucinogen persisting perception disorder (HPPD) [20,21]. It is unclear to what extent HPPD is caused by psychedelics use, as similar symptoms have been documented following use of other recreational drugs unrelated to classic psychedelics, as well as in people suffering from anxiety disorders who have never used recreational drugs [21,22]. HPPD tends to go away by itself if one stops using recreational drugs [20,22], and the psychiatric drug lamotrigine may be effective in treating the condition [21].


UNDESIRABLE EVENTS

⦿⦿⦾⦾⦾ (Low risk)

People on DMT are unlikely to act aggressively due to the introspective nature of the experience. However, they may be confused or unaware of what is happening around them, leading to a higher risk of accidents in unsafe circumstances or in a situation where their full attention is needed [12]. Smoking DMT while standing up involves a risk of falling over and injuring oneself once the effects suddenly kick in; for this reason, it is best to already be seated when taking DMT, and then lean or lie back in a comfortable position as soon as the effects are felt. DMT should never be used while bathing or swimming, as people have been known to drown this way.

The risk of encountering a dangerous situation on DMT is generally far lower than other classic psychedelics, owing to its short-acting effects and the necessity of sitting or lying down in a calm place in order to take it [5]. However, someone who is mentally unprepared and unfamiliar with how to safely use DMT will naturally run a much higher risk than someone who is well-prepared and knowledgeable.

INTERACTIONS

⦿⦿⦾⦾⦾ (Low risk)

Combining DMT with other recreational drugs poses relatively little danger unless it is taken with a monoamine oxidase inhibitor (MAOI). MAOIs – which include naturally occurring substances like harmine/harmaline as well as atypical antidepressants like moclobemide or phenelzine – make DMT orally active, and as such, they are often taken together, in forms variously known as ayahuasca, yage, pharmahuasca, or changa. MAOIs interact with a wide range of recreational drugs and medications, and some of these interactions can be lethal [6].

Cannabis, alcohol, and central nervous system (CNS) stimulants have all been reported to trigger anxiety and confusion when taken with DMT. Combinations of DMT with either CNS depressants (apart from alcohol), other psychedelics, MDMA, or dissociatives appear to be generally unproblematic, although these can significantly alter the overall character of the experience.

DMT has no known dangerous interactions with normal medications; however, there is reason to believe that both lithium and tramadol should be avoided, as these have been known to cause seizures in combination with other classic psychedelics [23,24].

Before taking any drug, it is important to confirm that the substance you have really is the drug you think you are taking. Professional chemical analysis is the only option that gives a more or less definitive answer, and we offer one such service in Oslo, although we can only accept samples in person. See how to book an appointment here.

If you do not have the option to have your sample analyzed in Oslo, there is a paid service in Spain called Energy Control which accepts drug samples from abroad by post, 100% anonymously.

Rapid reagent kits (test kits) are less reliable, but still very useful, and should always be used whenever a professional analysis is not possible. Test kits should be stored in a refrigerator and used within the expiration date, as expired tests can give misleading color reactions.

DMT gives the following color changes:

• Erlich reagent: weak purple
  
  
• Hofmann reagent: yellow
  
  
  • NOTE: 5-MeO-DMT, which is roughly 5x more potent than DMT and has a different risk profile [25], yields a green reaction with the Hofmann reagent. This reagent can thus be used to rule out whether one has 5-MeO-DMT instead of DMT.
    
• Marquis reagent: orange, eventually turning brown
  
  
• Mecke reagent: yellow, eventually turning dark green/black
  
  

DOSAGE

When DMT is vaporized and inhaled, it normally takes a dose of between 2 and 10 mg to produce noticeable effects. A dose up to 20 mg will usually be mild enough for the user to relate to their surroundings without too much trouble. Higher doses than 20 mg are likely to produce so-called "breakthrough" experiences (more on this below), as well as uncomfortable experiences [5,26,27].

FORM

DMT is normally encountered as crystals or a coarse powder of the freebase form, as opposed to a salt. The freebase has a lower boiling than the salt, making it preferable for vaporizing/smoking as the vapor is colder and less harsh on the airways.

ROUTE OF ADMINISTRATION

The most common way of taking DMT (without the use of a MAOI) is by heating the crystals in a "lightbulb"-style glass pipe, and then inhaling the resulting vapor [5]. It is also possible to smoke DMT in an e-cigarette by dissolving the crystals in a (nicotine-free) e-cigarette liquid.

DMT can also be insufflated (snorted/sniffed) or administered rectally (boofed/plugged), but this greatly irritates the mucus membranes and is very painful.

Although DMT has been injected in clinical experiments, this is virtually unknown in any other context, and furthermore requires DMT in the form of a salt rather than a freebase [9–11].

MECHANISM OF ACTION

DMT, like other classic psychedelics, imitates serotonin (hydroxytryptamine or HT) in the brain and activates the serotonin receptor subtype 2A (commonly abbreviated HT-2A). However, it is also active on a wider range of serotonin receptor subtypes than other classic psychedelics, as well as other receptors altogether, including the poorly understood sigma-1 receptor [28,29].

DURATION

On its own (without an MAOI), DMT has an extremely short duration of action compared to other psychedelic drugs. The effects normally last between 5 and 20 minutes, although minor effects may be felt for up to an hour after intake. When vaporized/smoked, effects kick in almost instantly [5,26,27].

SUBJECTIVE EFFECTS

Although all psychedelics are generally considered to be hallucinogens, DMT is notable for its ability to produce downright hallucinations (visual imagery with no external basis) with eyes closed as well as open. These visuals often manifest as complex, animated geometric patterns, but may also include landscapes and creatures or "entities". While it is normally possible to distinguish these hallucinations from external reality, transient delusions may arise at higher doses [12,26,27].

Very high doses can produce a so-called "breakthrough" experience, where the subject is drawn into a surrealistic, abstract universe with extremely life-like hallucinations, some of which are both highly specific and remarkably consistent between users. For instance, it is very common to report meetings or interactions with seemingly sentient "entities" who appear to want to show or tell the user something. These visions are usually imbued with a profound sense of meaningfulness or importance, even though their content tends to be highly vague or ambiguous [8,12]. Lower doses rarely yield such experiences, but rather a vibrant geometric "light show" behind closed eyes, along with dreamlike trains of thought.

While other classic psychedelics produce strong audiovisual synesthesia (sensory blending, e.g. seeing sounds or hearing colors), especially when listening to music, this effect is much less pronounced in DMT. On the contrary, users frequently report that music disturbs their DMT experience more than it contributes to it, and many thus prefer to take DMT in silence. Some also experience auditory hallucinations on DMT, usually in the form of indistinct whispering or high-frequency whistling.

As is typical with psychedelics, DMT can distort one's perception of time. High-dose "breakthrough" experiences in particular are often reported as seeming to last very long, despite actually only lasting a few minutes. It is also possible to experience a so-called "ego death", a state where one's self or first-person perspective seems to dissolve, and one instead feels indistinguishable from one's surroundings, other people, or the universe itself [8,17,18].

Powerful and/or deeply meaningful experiences:

Like most psychedelics, DMT tends to enhance free associative thinking, which means that unwanted or "dark" thoughts can end up steering the experience in an unpleasant direction. Users must therefore learn to either mindfully accept every thought that arises during the experience, or to steer their thoughts into a more desirable direction. Set and setting (mindset, mood, location, music, social setting) play a major role in deciding how easily one is able to achieve a pleasant or desirable experience.

The easiest way to avoid a difficult experience is to simply take a moderate dose. Some people may also be more prone to difficult experiences than others; people who struggle with anxiety or intrusive thoughts, for instance, should either avoid psychedelics altogether or begin cautiously with low doses. Some women also report that their menstrual cycle can influence the risk of having a difficult experience.

If you are having a difficult experience, it is best to simply "let go" and allow your thoughts to come and go on their own, rather than try to control or resist them [30]. In such cases it can be helpful to have a calm place to lie down and rest until you feel better, and to have a friend nearby who can occasionally remind you that you are safe and that the experience will pass. Many users report that it helps to focus on breathing deeply and calmly.

Read more about how to handle difficult experiences and psychedelic crises.

SIDE EFFECTS

Some people may feel nausea or mild abdominal pain on DMT [26]. People with sleep apnea may also have trouble breathing if they are lying on their back, and should thus opt for sitting upright or lying on their side.

Inhaling DMT can cause discomfort to the airways, especially if the substance is not pure or the vapor does not have time to cool down before inhalation. This leads many people to cough powerfully after smoking DMT, especially those who are not accustomed to smoking or inhaling drugs in general. People with asthma should be especially careful with smoking DMT, as it may trigger an asthma attack.

DMT may temporarily increase heart rate and blood pressure, especially when administered intravenously; however, no major complications have been associated with smoked/vaporized DMT [9,11,15].

DMT has very few after-effects and produces no hangover, although many people find they yawn a lot and/or feel sleepy immediately after a DMT experience. On the other hand, difficult experiences can cause users to feel more agitated and alert immediately afterwards. Most people report normal cognitive function the day after taking DMT [5,18].

DMT is listed as an illicit drug in Norway (narkotikalisten, narkotikaforskriften, legemiddelloven §22). This means it is punishable by law to use, possess, sell, manufacture, import, acquire, store, or ship DMT without a special license for medical or scientific research purposes (legemiddelloven §31, §24; straffeloven §231).

Plants containing DMT are not listed as illicit drugs. This means they are not considered illict drugs despite containing significant quantities of DMT, following the supreme court's requirement that any species which naturally contains an illicit substance must be listed individually in the illicit drugs list in order to be counted as such. However, cultivating any of these plants for the sole purpose of producing DMT in any of its listed forms is considered manufacturing of illicit drugs, and is illegal (narkotikaforskriften §7, legemiddelloven §22). Based on this, it is also illegal to import and distribute seeds of DMT-producing plants (såvareforskriften §28).

Plants containing DMT are considered herbal drugs, making them prescription medications (legemiddelforskriften §3–8). This means it is punishable by law to import or sell them without the required permission (legemiddelloven §13, §16, §31; forskrift om tilvirkning og import av legemidler § 3-2). However, live plants for decorative purposes are not considered herbal drugs. Furthermore, any transport, storage, sale, distribution or procurement of illegaly imported DMT-containing plants can likely be punished in accordance with § 322 of the Norwegian criminal code as possession of smuggled goods.

1. Grob, C.S., et al., Human psychopharmacology of hoasca, a plant hallucinogen used in ritual context in Brazil. J Nerv Ment Dis, 1996.

2. Hamill, J., et al., Ayahuasca: Psychological and Physiologic Effects, Pharmacology and Potential Uses in Addiction and Mental Illness. Curr Neuropharmacol, 2019.

3. Miller, M.J., et al., Chemical evidence for the use of multiple psychotropic plants in a 1,000-year-old ritual bundle from South America. Proceedings of the National Academy of Sciences of the United States of America, 2019.

4. Barker, S.A., N, N-Dimethyltryptamine (DMT), an Endogenous Hallucinogen: Past, Present, and Future Research to Determine Its Role and Function. Frontiers in neuroscience, 2018.

5. Winstock, A.R., S. Kaar, and R. Borschmann, Dimethyltryptamine (DMT): prevalence, user characteristics and abuse liability in a large global sample. J Psychopharmacol, 2014.

6. Gable, R.S., Risk assessment of ritual use of oral dimethyltryptamine (DMT) and harmala alkaloids. Addiction, 2007.

7. Gable, R.S., Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction, 2004.

8. Michael, P., D. Luke, and O. Robinson, An Encounter With the Other: A Thematic and Content Analysis of DMT Experiences From a Naturalistic Field Study. Front Psychol, 2021.

9. Strassman, R.J., Human psychopharmacology of N,N-dimethyltryptamine. Behav Brain Res, 1996.

10. Strassman, R.J., C.R. Qualls, and L.M. Berg, Differential tolerance to biological and subjective effects of four closely spaced doses of N,N-dimethyltryptamine in humans. Biol Psychiatry, 1996.

11. Strassman, R.J. and C.R. Qualls, Dose-response study of N,N-dimethyltryptamine in humans. I. Neuroendocrine, autonomic, and cardiovascular effects. Arch Gen Psychiatry, 1994.

12. Strassman, R., DMT: The Spirit Molecule. 2001, Rochester, Vermont: Park Street Press.

13. Barker, S.A., E.H. McIlhenny, and R. Strassman, A critical review of reports of endogenous psychedelic N, N-dimethyltryptamines in humans: 1955-2010. Drug Test Anal, 2012.

14. Dean, J.G., et al., Biosynthesis and Extracellular Concentrations of N,N-dimethyltryptamine (DMT) in Mammalian Brain. Scientific reports, 2019.

15. Schlag, A.K., et al., Adverse effects of psychedelics: From anecdotes and misinformation to systematic science. Journal of psychopharmacology (Oxford, England), 2022.

16. Johansen, P. and T.S. Krebs, Psychedelics not linked to mental health problems or suicidal behavior: a population study. J Psychopharmacol, 2015.

17. Strassman, R.J., et al., Dose-response study of N,N-dimethyltryptamine in humans. II. Subjective effects and preliminary results of a new rating scale. Arch Gen Psychiatry, 1994.

18. Gouzoulis-Mayfrank, E., et al., Psychological effects of (S)-ketamine and N,N-dimethyltryptamine (DMT): a double-blind, cross-over study in healthy volunteers. Pharmacopsychiatry, 2005.

19. van Amsterdam, J., A. Opperhuizen, and W. van den Brink, Harm potential of magic mushroom use: a review. Regul Toxicol Pharmacol, 2011.

20. Halpern, J.H., A.G. Lerner, and T. Passie, A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD. Curr Top Behav Neurosci, 2018.

21. Nichols, D.E., Psychedelics. Pharmacological reviews, 2016.

22. Martinotti, G., et al., Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives. Brain Sciences, 2018.

23. throwaway_naut. WARNING: LSD + Lithium = disaster. 2013; Tilgjengelig fra: https://www.reddit.com/r/LSD/comments/17wn82/warning_lsd_lithium_disaster/.

24. Beyaz, S.G., et al., Seizures associated with low-dose tramadol for chronic pain treatment. Anesthesia, essays and researches, 2016.

25. Davis, A.K., et al., The epidemiology of 5-methoxy- N, N-dimethyltryptamine (5-MeO-DMT) use: Benefits, consequences, patterns of use, subjective effects, and reasons for consumption. Journal of psychopharmacology (Oxford, England), 2018.

26. PsychonautWiki. DMT. 2022; Tilgjengelig fra: https://psychonautwiki.org/wiki/dmt.

27. Erowid. DMT: Effects. 2015; Tilgjengelig fra: https://www.erowid.org/chemicals/dmt/dmt_effects.shtml.

28. Fontanilla, D., et al., The hallucinogen N,N-dimethyltryptamine (DMT) is an endogenous sigma-1 receptor regulator. Science (New York, N.Y.), 2009.

29. Rickli, A., et al., Receptor interaction profiles of novel psychoactive tryptamines compared with classic hallucinogens. Eur Neuropsychopharmacol, 2016.

30. Johnson, M., W. Richards, and R. Griffiths, Human hallucinogen research: guidelines for safety. J Psychopharmacol, 2008.

31. Fadiman, J., The Psychedelic Explorer's Guide: Safe, Therapeutic and Sacred Journeys. 2011, Rochester, Vermont: Park Street Press.

32. Erritzoe, D., et al., Recreational use of psychedelics is associated with elevated personality trait openness: Exploration of associations with brain serotonin markers. J Psychopharmacol, 2019.