OPEN Foundation

Psychology

The epidemiology of 5-methoxy- N,N-dimethyltryptamine (5-MeO-DMT) use: Benefits, consequences, patterns of use, subjective effects, and reasons for consumption

Abstract

BACKGROUND/AIM:
5-Methoxy- N,N-dimethyltryptamine (5-MeO-DMT) is a psychoactive compound found in several plants and in high concentrations in Bufo alvarius toad venom. Synthetic, toad, and plant-sourced 5-MeO-DMT are used for spiritual and recreational purposes and may have psychotherapeutic effects. However, the use of 5-MeO-DMT is not well understood. Therefore, we examined patterns of use, motivations for consumption, subjective effects, and potential benefits and consequences associated with 5-MeO-DMT use.
METHODS:
Using internet-based advertisements, 515 respondents ( Mage=35.4. SD=11.7; male=79%; White/Caucasian=86%; United States resident=42%) completed a web-based survey.
RESULTS:
Most respondents consumed 5-MeO-DMT infrequently (<once/year), for spiritual exploration, and had used less than four times in their lifetime. The majority (average of 90%) reported moderate-to-strong mystical-type experiences ( Mintensity=3.64, SD=1.11; range 0-5; e.g., ineffability, timelessness, awe/amazement, experience of pure being/awareness), and relatively fewer (average of 37%) experienced very slight challenging experiences ( Mintensity=0.95, SD=0.91; range 0-5; e.g., anxiousness, fear). Less than half (39%) reported repeated consumption during the same session, and very few reported drug craving/desire (8%), or legal (1%), medical (1%), or psychiatric (1%) problems related to use. Furthermore, of those who reported being diagnosed with psychiatric disorders, the majority reported improvements in symptoms following 5-MeO-DMT use, including improvements related to post-traumatic stress disorder (79%), depression (77%), anxiety (69%), and alcoholism (66%) or drug use disorder (60%).
CONCLUSION:
Findings suggest that 5-MeO-DMT is used infrequently, predominantly for spiritual exploration, has low potential for addiction, and might have psychotherapeutic effects. Future research should examine the safety and pharmacokinetics of 5-MeO-DMT administration in humans using rigorous experimental designs.
Davis, A. K., Barsuglia, J. P., Lancelotta, R., Grant, R. M., & Renn, E. (2018). 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, 0269881118769063. 10.1177/0269881118769063
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The epidemiology of 5-methoxy-N, N-dimethyltryptamine (5-MeO-DMT) use: Benefits, consequences, patterns of use, subjective effects, and reasons for consumption

Abstract

Background/aim:

5-Methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a psychoactive compound found in several plants and in high concentrations in Bufo alvarius toad venom. Synthetic, toad, and plant-sourced 5-MeO-DMT are used for spiritual and recreational purposes and may have psychotherapeutic effects. However, the use of 5-MeO-DMT is not well understood. Therefore, we examined patterns of use, motivations for consumption, subjective effects, and potential benefits and consequences associated with 5-MeO-DMT use.

Methods:

Using internet-based advertisements, 515 respondents (Mage=35.4. SD=11.7; male=79%; White/Caucasian=86%; United States resident=42%) completed a web-based survey.

Results:

Most respondents consumed 5-MeO-DMT infrequently (<once/year), for spiritual exploration, and had used less than four times in their lifetime. The majority (average of 90%) reported moderate-to-strong mystical-type experiences (Mintensity=3.64, SD=1.11; range 0–5; e.g., ineffability, timelessness, awe/amazement, experience of pure being/awareness), and relatively fewer (average of 37%) experienced very slight challenging experiences (Mintensity=0.95, SD=0.91; range 0–5; e.g., anxiousness, fear). Less than half (39%) reported repeated consumption during the same session, and very few reported drug craving/desire (8%), or legal (1%), medical (1%), or psychiatric (1%) problems related to use. Furthermore, of those who reported being diagnosed with psychiatric disorders, the majority reported improvements in symptoms following 5-MeO-DMT use, including improvements related to post-traumatic stress disorder (79%), depression (77%), anxiety (69%), and alcoholism (66%) or drug use disorder (60%).

Conclusion:

Findings suggest that 5-MeO-DMT is used infrequently, predominantly for spiritual exploration, has low potential for addiction, and might have psychotherapeutic effects. Future research should examine the safety and pharmacokinetics of 5-MeO-DMT administration in humans using rigorous experimental designs.

Davis, A. K., Barsuglia, J. P., Lancelotta, R., Grant, R. M., & Renn, E. (2018). 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, 0269881118769063.
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Gnosis Potency: DMT Breakthroughs and Paragnosis

Abstract

DMT (N,N-dimethyltryptamine) is a powerful tryptamine that has experienced growing appeal in the last decade, independent from ayahuasca, the Amazonian visionary brew in which it is an integral ingredient. Investigating user reports available from literary and online sources, this chapter focuses on the gnosis potency associated with the DMT “breakthrough” experience. I explore the parameters of the tryptaminal state and, in particular, the extraordinary paragnosis associated with the DMT event, perceived contact with “entities,” and the transmission of visual language. As the reports discussed illustrate, for milieus of the disenchanted, among other entheogens, DMT is venerated as a gift that enables connection to a reality (nature, the universe, divinity) from which modern humanity is imagined to have grown alienated. Through an exploration of the legacy of principal actors, including Terence McKenna, Jonathan Ott, Jim DeKorne, and Nick Sand, the chapter navigates the significance of DMT in modern Western esotericism.

St John, G. (2018). Gnosis Potency: DMT Breakthroughs and Paragnosis. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 205-222. 10.1007/978-3-319-76720-8_12
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Integrating Psychedelic Medicines and Psychiatry: Theory and Methods of a Model Clinic

Abstract

The past two decades has seen a significant increase in both popular and scientific interest in psychedelic substances and plants as therapeutics for mental illness, addictions, and psychospiritual suffering. Current psychiatric practice privileges a biological paradigm in which the brain is considered the locus of mental illness and symptom-focused treatments are delivered to patients as passive recipients. In contrast, a psychedelic healing paradigm, constructed through examination of different ontologic understandings of plant medicines, is based on a complex multidimensional perspective of human beings and their suffering. This paradigm actively engages the sufferer in addressing root causes of illness through healing on multiple levels of existence, including spiritual and energetic domains. Numerous theoretical, methodological, and ethical challenges complicate the integration of the psychedelic healing paradigm into psychiatric practice. These include developing coherent therapeutic narratives that account for the complex processes by which psychedelic healing occurs and overcoming reductionist tendencies in the medical sciences. Tasked with overcoming such challenges, a model clinic is proposed that seeks to implement and study the psychedelic healing paradigm in a critical, interdisciplinary, and reflexive manner. Such “critical paradigm integration” would employ multimodal patient formulation and treatments, as well as a range of knowledge generation and sharing practices. Outcomes-oriented research would seek to establish an evidence base for the model, while critical dialogues would advance understandings of psychedelic substances and plants and related practices more generally. The clinic would serve as proof of concept for a new model of studying, conceptualizing, and treating mental illness.

Sloshower, J. (2018). Integrating Psychedelic Medicines and Psychiatry: Theory and Methods of a Model Clinic. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 113-132. 10.1007/978-3-319-76720-8_7
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Placebo Problems: Boundary Work in the Psychedelic Science Renaissance

Abstract

The revitalization of clinical trials with psychedelics has produced an array of studies investigating different combinations of therapeutic substances and diagnoses. In addition to the bureaucratic negotiations to gain approval for this research, this new wave of studies is also negotiating a new methodological landscape of clinical research. Mid-twentieth century research with drugs like LSD and psilocybin involved both case studies and double-blind studies. However, today, placebo-controlled randomized controlled trials (RCTs) are the institutional standard for research with psychopharmaceuticals. Because psychedelic therapy seeks to induce a radical change in consciousness—to make a subject feel different from her everyday self—blinding these studies using placebo controls has emerged as a methodological sticking point. However, this chapter argues, it is also a rich site for interrogating boundary work around science and psychedelics. While anthropologists have examined placebos as examples of the power of symbolic healing within Western medicine, or as ethically fraught territory of nontreatment, this chapter examines placebos as a research technique around which the scientific status of a study is negotiated. While psychedelic therapy challenges the model of pharmaceutical intervention used in psychiatry today, it must do so while also working within psychopharmacology’s evidentiary norms.

Hendy, K. (2018). Placebo Problems: Boundary Work in the Psychedelic Science Renaissance. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 151-166. 10.1007/978-3-319-76720-8_9
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Who Is Keeping Tabs? LSD Lessons from the Past for the Future

Abstract

Psychedelics fell from medical grace nearly half a century ago, but recent activity suggests that some researchers are optimistic about their return. Are they at risk, however, of facing the same historic challenges with a new generation of psychedelic enthusiasts, or have the circumstances changed sufficiently to allow for a new path forward? The twenty-first-century incarnation of psychedelic research resurrects some anticipated hypotheses and explores some of the same applications that clinicians experimented with 50 years ago. On the surface then, the psychedelic renaissance might be dismissed for retreading familiar ground. A deeper look at the context that gave rise to these questions, though, suggests that while some of the questions are common, the culture of neuroscience and the business of drug regulation have changed sufficiently to warrant a retrial. A close look at the history of psychedelics encourages us to think carefully about the roles of regulators, the enthusiasm of researchers, and our cultural fascination and/or repulsion with mind-altering molecules.

Dyck, E. (2018). Who Is Keeping Tabs? LSD Lessons from the Past for the Future. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 1-17. 10.1007/978-3-319-76720-8_1
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The Use of Salvia divinorum from a Mazatec Perspective

Abstract

Salvia divinorum is a medicinal and psychoactive plant endemic to the Sierra Madre Oriental of Oaxaca, Mexico. The Mazatec people have been using the leaves for centuries in ceremonies for its psychoactive properties and as a treatment for arthritis and inflammation, gastrointestinal problems, headaches, and addictions, among other uses. The active principle of Salvia divinorum, the terpene salvinorin A, is a uniquely potent and highly selective kappa-opioid receptor agonist and, as such, has enormous potential for the development of valuable medications. Among them, the most promising include safe and nonaddictive analgesics, neuroprotectors, short-acting anesthetics that do not depress respiration, antidepressants, anti-inflammatories, medications for the treatment of addiction to stimulants and alcohol, and drugs to treat disorders characterized by alterations in perception. The Mazatec consider Salvia divinorum to be a very powerful plant spirit that should be treated with utmost respect, and the preparation for the ceremony requires a strict regimen. They chew the fresh leaves at night while chanting and praying. In the Western use, the dry leaves are potentiated in extracts to be smoked. A lack of information about the appropriate doses and other considerations while smoking the extracts could result in overwhelming experiences due to the high potency and fast onset of the substance. For the Mazatec, smoking the plant is not the preferred mode. How could we create a bridge between the two perspectives? In this chapter, I will try to clarify the best ways to use Salvia divinorum for medicinal, psychotherapeutic, and inner exploration purposes.

Maqueda, A. E. (2018). The Use of Salvia divinorum from a Mazatec Perspective. Plant Medicines, Healing and Psychedelic Science: Cultural Perspectives, 55-70. 10.1007/978-3-319-76720-8_4
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Psilocybin modulates functional connectivity of the amygdala during emotional face discrimination

Abstract

Recent studies suggest that the antidepressant effects of the psychedelic 5-HT2A receptor agonist psilocybin are mediated through its modulatory properties on prefrontal and limbic brain regions including the amygdala. To further investigate the effects of psilocybin on emotion processing networks, we studied for the first-time psilocybin’s acute effects on amygdala seed-to-voxel connectivity in an event-related face discrimination task in 18 healthy volunteers who received psilocybin and placebo in a double-blind balanced cross-over design. The amygdala has been implicated as a salience detector especially involved in the immediate response to emotional face content. We used beta-series amygdala seed-to-voxel connectivity during an emotional face discrimination task to elucidate the connectivity pattern of the amygdala over the entire brain.

When we compared psilocybin to placebo, an increase in reaction time for all three categories of affective stimuli was found. Psilocybin decreased the connectivity between amygdala and the striatum during angry face discrimination. During happy face discrimination, the connectivity between the amygdala and the frontal pole was decreased. No effect was seen during discrimination of fearful faces. Thus, we show psilocybin’s effect as a modulator of major connectivity hubs of the amygdala. Psilocybin decreases the connectivity between important nodes linked to emotion processing like the frontal pole or the striatum. Future studies are needed to clarify whether connectivity changes predict therapeutic effects in psychiatric patients.

Grimm, O., Kraehenmann, R., Preller, K. H., Seifritz, E., & Vollenweider, F. X. (2018). Psilocybin modulates functional connectivity of the amygdala during emotional face discrimination. European Neuropsychopharmacology. 10.1016/j.euroneuro.2018.03.016
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Assessment of Alcohol and Tobacco Use Disorders Among Religious Users of Ayahuasca.

Abstract

The aims of this study were to assess the impact of ceremonial use of ayahuasca-a psychedelic brew containing N,N-dimethyltryptamine (DMT) and β-carboline -and attendance at União do Vegetal (UDV) meetings on substance abuse; here we report the findings related to alcohol and tobacco use disorder. A total of 1,947 members of UDV 18+ years old were evaluated in terms of years of membership and ceremonial attendance during the previous 12 months. Participants were recruited from 10 states from all major regions of Brazil. Alcohol and tobacco use was evaluated through questionnaires first developed by the World Health Organization and the Substance Abuse and Mental Health Services Administration. Analyses compared levels of alcohol and tobacco use disorder between the UDV and a national normative sample (n = 7,939). Binomial tests for proportions indicated that lifetime use of alcohol and tobacco was higher in UDV sample compared to the Brazilian norms for age ranges of 25-34 and over 34 years old, but not for the age range of 18-24 years old. However, current use disorders for alcohol and tobacco were significantly lower in the UDV sample than the Brazilian norms. Regression analyses revealed a significant impact of attendance at ayahuasca ceremonies during the previous 12 months and years of UDV membership on the reduction of alcohol and tobacco use disorder.
Ribeiro Barbosa, P. C., Tofoli, L. F., Bogenschutz, M. P., Hoy, R., Berro, L. F., Marinho, E. A., … & Winkelman, M. J. (2018). Assessment of alcohol and tobacco use disorders among religious users of ayahuasca. Frontiers in psychiatry9, 136., 10.3389/fpsyt.2018.00136
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Ketamine Effects on EEG during Therapy of Treatment-Resistant Generalized Anxiety and Social Anxiety

Abstract

BACKGROUND:
Ketamine is swiftly effective in a range of neurotic disorders that are resistant to conventional antidepressant and anxiolytic drugs. The neural basis for its therapeutic action is unknown. Here we report the effects of ketamine on the EEG of patients with treatment-resistant generalized anxiety and social anxiety disorders.
METHODS:
Twelve patients with refractory DSM-IV generalized anxiety disorder and/or social anxiety disorder provided EEG during 10 minutes of relaxation before and 2 hours after receiving double-blind drug administration. Three ascending ketamine dose levels (0.25, 0.5, and 1 mg/kg) and midazolam (0.01 mg/kg) were given at 1-week intervals to each patient, with the midazolam counterbalanced in dosing position across patients. Anxiety was assessed pre- and postdose with the Fear Questionnaire and HAM-A.
RESULTS:
Ketamine dose-dependently improved Fear Questionnaire but not HAM-A scores, decreased EEG power most at low (delta) frequency, and increased it most at high (gamma) frequency. Only the decrease in medium-low (theta) frequency at right frontal sites predicted the effect of ketamine on the Fear Questionnaire. Ketamine produced no improvement in Higuchi’s fractal dimension at any dose or systematic changes in frontal alpha asymmetry.
CONCLUSIONS:
Ketamine may achieve its effects on treatment-resistant generalized anxiety disorder and social anxiety disorder through related mechanisms to the common reduction by conventional anxiolytic drugs in right frontal theta. However, in the current study midazolam did not have such an effect, and it remains to be determined whether, unlike conventional anxiolytics, ketamine changes right frontal theta when it is effective in treatment-resistant depression.
Shadli, S. M., Kawe, T., Martin, D., McNaughton, N., Neehoff, S., & Glue, P. (2018). Ketamine Effects on EEG during Therapy of Treatment-Resistant Generalized Anxiety and Social Anxiety. International Journal of Neuropsychopharmacology. 10.1093/ijnp/pyy032
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