Use of Benefit Enhancement Strategies among 5-Methoxy-N,N-Dimethyltryptamine (5-MeO-DMT) Users: Associations with Mystical, Challenging, and Enduring Effects

This observational survey study (n = 515) examines the prevalence of benefit enhancement (BE) strategies using secondary data from a survey of 5-MeO-DMT users and its associations with “mystical”, challenging, and enduring effects. It concluded that the BE strategies were common in use and BE strategies were linked to increases in positive mystical-type and enduring effects.

Abstract

“Introduction: 5-Methoxy-N,N-Dimethyltryptamine (5-MeO-DMT) is a potent, fast-acting psychedelic. Anecdotal reports from 5-MeO-DMT users suggest that they employ a variety of benefit enhancement (BE) strategies aimed to increase positive effects and decrease any potential challenging effects of the substance, but no empirical study has investigated this claim.

Methods: We examined the prevalence of BE strategy use using secondary data from a survey of 5-MeO-DMT users (n = 515; M_age = 35.4, SD = 11.7; Male = 79%; White/Caucasian = 86%). As a secondary aim, we assessed whether the use of BE strategies was associated with acute subjective (i.e., mystical-type, challenging) and persisting effects of 5-MeO-DMT among a subset of respondents who reported using 5-MeO-DMT once in their lifetime (n = 116).

Results: Results indicated that BE strategy use was common in this sample. Results showed that the use of several BE strategies were associated with significantly more intense mystical-type effects and enduring beliefs about the personal meaning and spiritual significance of their experience, and some BE strategies were associated with less intense or challenging experiences.

Discussion: Data suggests that BE strategies are commonly used, and that the use of BE strategies may be associated with increases in positive mystical-type and enduring effects. The causal influence of BE strategies on acute/persisting effects of 5-MeO-DMT should be examined in longitudinal research.”

Authors: Rafael L. Lancelotta & Alan K. Davis

Summary

5-MeO-DMT is a potent, fast-acting psychedelic. A survey of 5-MeO-DMT users showed that benefit enhancement strategies were common, and that the use of BE strategies was associated with more intense mystical-type effects and enduring beliefs about the personal meaning and spiritual significance of their experience.

Introduction

Psychedelic tryptamines include substances such as psilocybin, DMT, and 5-MeO-DMT, and can be found in plants and mushrooms, synthetically produced, and in small quantities in human tissues. Research has found that tryptamine use is associated with reduced odds of psychological distress, suicidal thinking, suicidal planning, and suicide attempt.

Tryptamine use has been associated with physical, cognitive, and emotional risks, including agitation, tachycardia, hyperthermia, seizures, coma, increased serum creatinine, and life-threatening experiences such as cardiac arrest, and possible death.

Most reports of tryptamine benefits and negative effects involve psilocybin, with fewer reports published on other tryptamines. 5-MeO-DMT is an emerging popular psychedelic substance that interacts with several serotonin (5-HT) receptor subtypes.

There is evidence of 5-MeO-DMT use in indigenous cultures, but anecdotal evidence does not support this claim. The recent discovery of 5-MeO-DMT in toad venom is thought to be of more recent origin.

5-MeO-DMT use in the general population appears to be low, but it has several risks, including a steep dose-response curve, rapid onset of effects, and short duration of action. Nevertheless, it is important to implement protective cognitive and behavioral strategies to reduce potentially challenging effects.

The harm reduction model represents a compassionate and pragmatic approach to reduce potential harms associated with substance use. It includes strategies such as alternating alcoholic and nonalcoholic drinks, quitting drinking at a predetermined time, drinking water while drinking alcohol, avoiding drinking games, and using a designated driver.

We used secondary data from a large epidemiological survey to examine the prevalence of using 14 benefit enhancing strategies among people who use 5-MeO-DMT. We found that use of these strategies was associated with acute positive mystical-type effects, acute challenging effects, enduring beliefs about the personal meaning or spiritual significance of their acute 5-MeO-DMT experience, and well-being/life satisfaction.

Procedure

A secondary data analysis of a larger epidemiological study was conducted among an international sample of 5-MeO-DMT users. The study collected information regarding patterns of use, motivations for consumption, benefits/consequences, and acute subjective effects of 5-MeO-DMT.

5-MeO-DMT survey

The survey included questions about the type of 5-MeO-DMT that one might have tried, frequency of use, and reasons for using 5-MeO-DMT.

Benefit enhancement strategies

We included 14 items on a questionnaire to assess whether a respondent had engaged in BE strategy use (yes/no) in order to protect themselves from possible harms that might occur during their 5-MeO-DMT experience. These strategies included focusing on one’s intentions and utilizing ceremonial or shamanic techniques.

Acute mystical-type experiences

We used the 30-item Mystical Experiences Questionnaire to examine the acute mystical-type effects that could occur after taking a classic hallucinogen.

Acute challenging experiences

We used the 26-item Challenging Experiences Questionnaire to examine the acute challenging psychological or physical experiences that could occur after taking a classic hallucinogen.

Enduring effects

We included three items from the Persisting Effects Questionnaire to assess whether respondents believed their first experience with 5-MeO-DMT was personally meaningful, spiritually significant, and contributed to changes in personal well-being or life satisfaction.

Data analyses

We conducted frequency counts, descriptive analyses, and t-tests on all respondents, 5-MeO-DMT use, acute subjective mystical-type and challenging effects, and beliefs about persisting effects. We calculated effect sizes for each test as a measure of meaningful effects.

Respondent characteristics

Respondents were primarily Caucasian, male, and heterosexual, and reported consuming a variety of substances, including marijuana/cannabis, alcohol, and tobacco.

The use of benefit enhancement strategies

Most respondents reported using a variety of BE strategies when they consumed 5-MeO-DMT, including preparing a comfortable place for the session, preparing a safe space for the session, making sure that there won’t be distractions, focusing on their intentions, and using with friends or people they are familiar with.

Benefit enhancement strategies provided by respondents

We asked respondents to report other BE strategies they had used prior to, during, or after their 5-MeO-DMT sessions. We created themes from the responses and identified 15 responses reflecting Meditative/Mindfulness Practice, 6 responses reflecting Spiritual Rituals/Practices, 25 responses reflecting Environmental/Bodily Preparations, and 12 responses reflecting Pharmacological/ Medical Preparations.

Relation of benefit enhancement strategy use and mystical-type and challenging experiences

Of the 14 BE strategies, 4 had a positive association with the intensity of mystical-type experiences, and 1 had a positive association with the intensity of challenging experiences.

Relation of benefit enhancement strategy use and enduring effects

Of the 14 BE strategies, 3 were associated with higher ratings of personal meaning and spiritual significance of the 5-MeO-DMT session, and 4 were associated with higher ratings of change in sense of well-being and life satisfaction following the 5-MeO-DMT session.

Discussion

5-MeO-DMT users reported employing a variety of BE strategies, including preparation, safe space, focused intentions, and using with friends or familiar people. These strategies were associated with more intense acute positive mystical-type effects of the drug.

Consistent with prior studies among people who use alcohol, cannabis, and MDMA, 5-MeO-DMT users used similar protective behavioral strategies to those used by these other drugs. These strategies include obtaining the drug from a trusted source, using with friends, and abstaining from other substances during a use episode.

When administering psychedelics in laboratory settings, one should use music, meditate, and set aside time for integrating the experience.

In this sample of 5-MeO-DMT users, the use of BE strategies was associated with less intense challenging experiences and more intense positive mystical-type effects. This suggests that the context of use is an important factor associated with the acute experience of the drug.

This study was a cross-sectional study, and the retrospective reporting is subject to recall bias and subjective interpretations of experience. It also does not measure the dose of 5-MeO-DMT consumed by respondents, and the sample was comprised mostly of white, heterosexual men.

These results support the need for further research into the use of BE strategies among people who consume 5-MeO-DMT, and could be used by researchers conducting laboratory studies with the drug. Researchers should pay particular attention to the context in which they administer 5-MeO-DMT, and harm reduction workers, peer support volunteers at music and art festivals, and others in a position to provide important prevention information can use this study’s data to help those who seek out 5-MeO-DMT experiences.