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What Does DMT Withdrawal Look Like?

DMT is a hallucinogenic substance capable of inducing psychedelic experiences in those who use it. “DMT” is an abbreviation for N,N-dimethyltryptamine, which is an organic indole alkaloid molecule. Indole alkaloids are derived from the amino acid tryptophan, which is commonly (yet mistakenly) blamed for the sleepy feeling many people have after eating turkey for Thanksgiving.1,2  This indole alkaloid shares a structural similarity to serotonin, a neurotransmitter associated with feelings of wellness and relaxation. DMT is a naturally occurring substance and is endogenously produced by animals and specific plants, including the Acacia, Desmodium, and Psychotria; it has also been isolated in the leaves of certain citrus plants.3

DMT may be snorted, smoked, or brewed as a psychedelic tea commonly known as ayahuasca (or hoasca, aya, or yagé). It is categorized as a Schedule I substance under the Controlled Substances Act. This means that it has a high abuse potential and no currently accepted medical uses.4 As a hallucinogen, DMT can cause the user to both see, feel, or hear things that aren’t really there and to experience significant changes in their how perceive their surroundings as well as their own thoughts and emotions.5

Why Is DMT Used?

DMT spiritual ceremonyDMT is often called the “spirit molecule” because people use it to invoke spiritual or mystical experiences. It is one of the main components of many shamanistic compounds and has been used for centuries in South America in ayahuasca for its mind-altering properties and reputation for facilitating spiritual and physical healing.6

This brew is used as both a medicine and as a spiritual sacrament in Shamanic ceremonies of certain Amazonian tribes.7

What Are the Effects and Risks?

When taken in high concentrations, DMT is capable of producing brief, episodic visual hallucinations.”3 The onset of the psychedelic experience is usually very rapid but usually subsides after 30-45 minutes.4

DMT has been associated with a number of adverse psychological, behavioral, and physical effects, some of which can be severe and, in some cases, life-threatening. Symptoms can include:3,4,5,8

  • Changes in the perception of time (feeling that it is moving faster or more slowly than normal).
  • Depersonalization (not feeling like your emotions and experiences are your own).
  • Bizarre behavior in public places, which might prompt intervention from law enforcement professionals.
  • Agitation.
  • Feelings of grief.
  • Depression.
  • Dilated pupils.
  • Rapid heart rate.
  • Hypertension (high blood pressure).
  • Dizziness.
  • Nausea.
  • Severe vomiting (in the case of ayahuasca).
  • Involuntary and rapid eye movements.
  • Problems with muscle coordination.
  • Seizures.

Some cases have been reported where DMT users have experienced respiratory arrest or coma.

Person experiencing mood swingsAdditionally, some cases have been reported where DMT users have experienced respiratory arrest or coma.4 According to the National Institute on Drug Abuse, the long-term effects are mostly unknown;8 however, some classic hallucinogens (a classification of drugs to which DMT belongs) have been associated with a phenomenon known as persistent psychosis, which is a condition in which you can experience:8

  • Long-term visual disturbances.
  • Mood changes.
  • Disorganized thinking.
  • Paranoia.

Classic hallucinogen use may also be associated with a condition known as Hallucinogen Persisting Perception Disorder (HPPD), which involves lasting symptoms that can be extremely troubling such as:8

  • Re-experiencing of hallucinations (“flashbacks”).
  • Troubling visual problems like seeing halos or trails when looking at objects.
  • Perceiving objects as larger or smaller than they actually are.

Can It Cause Withdrawal?

Addict going through the stages of withdrawalCertain substances (e.g., alcohol, opioids) are associated with withdrawal syndromes in those who have developed significant enough physiological dependence to those drugs. A person is said to be dependent when they need a drug in order to feel normal and when, upon quitting or cutting back their use, they experience a variety of uncomfortable withdrawal symptoms that can make it very difficult to remain abstinent.

Fortunately, DMT does not appear to cause withdrawal symptoms, nor does it result in tolerance, a condition where your body adapts to the presence of the drug and you need higher amounts or more frequent doses to achieve previous results.8 More scientific research is needed to fully investigate the addictive potential of most hallucinogenic drugs.5 However, as HPPD may be a concern for users of classic hallucinogens like DMT, it’s possible that you’ll experience flashbacks (continuing to have hallucinations or other perceptual disturbances even without taking the drug).

Since DMT does not seem to induce any serious withdrawal symptoms, quitting is likely to be an easier and less dangerous process than for users of some other addictive substances, at least physically. However, keep in mind that the absence of withdrawal syndrome doesn’t remove the potential for addiction (clinically called a “hallucinogen use disorder”). It also doesn’t mean that you’re not causing harm to your body by using DMT. If you find it difficult to quit using DMT, you may still need treatment for addiction, even if you don’t have the strong cravings or serious physical withdrawal associated with other drugs like heroin.

What Are the Options for Help?

Doctor and patient having a conversation about treatmentAddiction is a chronic, relapsing disease where a person continues to use a substance despite knowing the negative impact it is having on their health, well-being, and ability to function. When people abuse a substance, it enters the brain and alters its normal functioning. Even if a person is not physiologically dependent on a substance like DMT, they can still develop a hallucinogen use disorder.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the guidebook used by mental health and substance abuse professionals to formulate a psychiatric diagnosis. The diagnostic criteria for a hallucinogen use disorder listed by the DSM include:9

  • Compulsive drug-seeking behaviors (such as constantly trying to get more of the substance or leaving work or school to obtain or use the drug).
  • Cravings for more of the substance.
  • An inability to control your DMT use (i.e. even if you intend not to use or intend to use less).
  • Continuing DMT use even though it negatively impacts social functioning or your ability to fulfill specific obligations.
  • Using in unsafe or hazardous situations, such as while driving or operating machinery.
  • Continuing to use DMT when you know it has caused a serious physical or psychological problem.

If you suspect that you or someone you care about might have a problem with DMT, it’s important to seek professional help. Rehabs and treatment centers know the most effective methods to help a person stop using drugs and start leading a clean and sober life.

Doctor comforting patientTo find a treatment center that best suits your needs, you can consult with a doctor or therapist or use the Substance Abuse and Mental Health Services Association’s (SAMHSA) Behavioral Health Treatment Services Locator. You can also call us any time of the day or night to discuss the right treatment option for you.

The rehab process often starts with detox, which is a set of professionally supervised interventions designed to help a person stop using drugs right away. While DMT might not produce withdrawal, many other substances do, and if you’re using 2 or more drugs you (like DMT and alcohol), you may very well need to begin your addiction treatment with detox. Be sure to speak to your physician about the right course of action.

If you do need to begin with detox, you might choose an inpatient detox, where you live at the facility during the course of your acute withdrawal and receive round-the-clock monitoring, supervision, and care. If your doctor advises that it’s safe, you could also choose to detox on an outpatient basis with regular visits to a hospital, doctor’s office or treatment facility for treatment sessions.11

Once detox is complete, treatment should continue at a professional drug addiction treatment center. This provides the education, support, and tools needed to remain abstinent and lead a drug-free life. DMT treatment settings include:

  • Inpatient treatment centers. A residential setting that provides intensive, 24/7 care and supervision, inpatient treatment is often best suited for those who have more severe or longstanding addictions. Most inpatient treatment lasts 30–90 days, but the length of stay can vary based on your specific needs.
  • Outpatient treatment centers. This form of treatment is well-suited to people who have less severe addictions and who cannot take time away from work or other obligations to attend inpatient treatment. You live at home but travel to a rehab center on a regular schedule. Evening and weekend sessions are usually available. You participate in the same forms of treatment as those offered at inpatient centers but on a less intensive basis. People who opt for outpatient but who need more support than the standard outpatient treatment might opt for partial hospitalization or intensive outpatient programs (IOPs), which involve more hours of treatment and more intensive care.

Some of the types of treatments used for addiction include:5, 10

  • Behavioral counseling. This is a technique used to help identify and change negative, drug-seeking behaviors and teach specific skills (such as stress management techniques) to help you stay clean and sober.
  • Group therapy. Some people feel more comfortable in a group, where they can gain support from others who have been in their shoes. Group therapy sessions may occur once or a few times per week and are facilitated by a qualified mental health/substance abuse counselor. Group therapy is often used as an adjunct to individual therapy sessions.
  • Cognitive-behavioral therapy. This is used to help you identify and change negative thought patterns that may contribute to substance abuse, such as negative self-talk (e.g., “I don’t deserve to be happy”).
  • Family therapy. The family unit may be involved with or affected by your substance abuse, which is why many rehabs include family therapy when appropriate.
  • Pharmacotherapy. While there are currently no government-approved medications to treat hallucinogen addiction, you may receive medication to treat other co-occurring mental health symptoms, such as depression or anxiety.
  • Vocational rehabilitation. Addiction can affect your career and chances of obtaining employment. Vocational rehabilitation helps address potential barriers to finding suitable and meaningful work.
  • Education and relapse prevention training. This is a core part of treatment and teaches you strategies and techniques to prevent relapse.
  • Self-help or peer support groups. Many people rely on 12-step or non-12-step groups to help them stay on the road to recovery. The group aspect and sponsor system can provide a strong sense of fellowship and support that can be an anchor to sobriety when needed.
  • Aftercare. The concept of aftercare applies to a number of types of ongoing support (12-step meeting attendance, individual counseling, additional outpatient treatment enrollment, etc.) used to help prevent relapse once you complete an addiction treatment program.

References

  1. Kennedy, D. (2014). Plants and the Human Brain. New York: Oxford University Press.
  2. Georgia State University Villager. (2009). Three Questions: Organic Produce, Iron and Iodine, and Tryptophan.
  3. Carbonaro, T. M., & Gatch, M. B. (2016). Neuropharmacology of N,N-DimethyltryptamineBrain Research Bulletin126(Pt 1), 74–88.
  4. Drug Enforcement Administration. (2016). N,N-Dimethyltryptamine (DMT).
  5. National Institute on Drug Abuse. (2016). DrugFacts: Hallucinogens.
  6. Frecska, E., Bokor, P., & Winkelman, M. (2016). The Therapeutic Potentials of Ayahuasca: Possible Effects Against Various Diseases of CivilizationFrontiers in Pharmacology7, 35.
  7. Malcolm, B. & Lee, K. (2017). Ayahuasca: An Ancient Sacrament for Treatment of Contemporary Psychiatric Illness? Mental Health Clinician, 7(1), 39–45.
  8. National Institute on Drug Abuse. (2015). Hallucinogens and Dissociative Drugs: How Do Hallucinogens (LSD, Psilocybin, Peyote, DMT, and Ayahuasca) Affect the Brain and Body?
  9. Substance Abuse and Mental Health Services Administration. (2015). Substance Use Disorders.
  10. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): What is Drug Addiction Treatment?
  11. Hayashida, M., M.D., Sc.D. An Overview of Outpatient and Inpatient Detoxification. Alcohol Health and Research World, 22(1), 45-46.