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From personal experience, I can tell you 5-meo-dmt is mostly worse for most people than DMT. It's darker, more nausea inducing (normally the caapi in ayahuasca is the thing that makes you sick, not really the DMT), the body load is higher and it's just a more stressful experience all around than DMT.
Last time I drank ayahuasca with huambisa/chaliponga (contains 5-meo-dmt) I vomited every 5-10 minutes for about 4 hours. It was horrible, and I had to ask for help because I couldn't even get up and refill my water bottle. Chacruna is more gentle and smooth.
Drink pomegranate juice and eat some ginger 20 minutes before. That stops any nausea with Ayahuasca for 6-8 hours, it evens "fix" the horrible taste to many.
I think it’d be counterproductive to stop the nausea, when nausea is an integral part of the Ayahuasca process of letting go, in addition to crying, yawning, sweating, etc. I just listen to my body and let it do its thing; sometimes I need to purge, sometimes I don’t need to purge.
It stops the nausea, but you still can purge (can't tell why). But it feels that you are just cleaning your body. And without nausea you can listen, IMHO, to your body, more carefully
I never imagined being able to vomit without the nausea, so that’s pretty interesting hah
YMMV, but for several friends and me, the urge comes all at once and the purge happens. It's like an "immediate" nausea.
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The purge isn't necessary for healing, shamans use your physical purging as an anchor to help you emotionally purge, but that's just another technique.
Was the 5-MEO from the plants or toad? I heard that the toad one is much lighter than the plant one
I've had both chaliponga and lab 5-meo. I find oral lab 5-meo unpleasant, but chaliponga does have some other impurities that amplify the problem. I think smoking 5-meo makes a lot of the side effects less noticeable compared with regular DMT, but it still has this more dark, muddy, wild feeling and a weight, whereas I find regular DMT to be clear and light by comparison.
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I'm not trying to tell anyone what to do.. but these toads (like the Sonoran desert toad) are increasingly becoming endangered due to poaching. It is possible to milk the venom without harming them, but a lot of poachers aren't careful or use the wrong techniques.

I also understand people believe that there is a qualitative difference between the venom and synthetic, but it's the same compound at the end of the day.

The experience is highly dependent on dosage (it's harder to fight the big dose) and on how willing you are to let go (of everything- all your storylines, loved ones, your life itself). The freakouts and struggles you see on youtube happen when one can't fully give in to it. IME, after the (very intense) come up, it is pure love and bliss. Going all the way feels like dissolving into god, and coming back you feel indescribably light and reborn. It's quite literally an ineffable experience at points, as if it turns off your mind (ego death/dissolution?) and you experience life temporarily from the heart with a completely non-dual view. (YMMV, I love the stuff but I also have a bit of experience in these more intense states; I work at a traditional ayahuasca healing center and usually drink 4 times a week). It's definitely not a recreational substance.
4 times per week? That's insane, how do you cope with that? Is it always equally pleasant?
It's definitely not for everyone haha. You get a rhythm with it, take lots of naps etc. The medicine does give you some energy to do the work, and you generally feel good from the vine. We take a couple months off a year and don't usually drink during those breaks. It's hardest when we ourselves are also doing master plant diets (even more restrictive than the usual "ayahuasca diet", no salt/oil/etc).

Always equally pleasant? No of course not. Some nights it's unbelievable and profound. The "hard" nights are still good as we're still learning to clean the things causing it. It's rarely mundane and (through the tradition we practice) there's always something to do, in ourselves or for our guests.

I should qualify, I've been a practitioner for quite a while now, so I've crossed over many times. Above ego dissolution threshold, a lot of stuff feels pretty similar, but each molecule definitely has its own character.

My personal preference is a mixture of caapi paste and a citrus juice extraction of p. cubensis and dried kratom leaf. The progression is quite fast and it can be incredibly intense but the body load and nausea are much reduced.

Where is this center located? Near Iquitos by any chance? And in that case, do you have Starlink, and if so, what speeds do you get?
We're actually located in southern Mexico, a couple hours from Belize (our maestros dieted and trained with a maestro near Iquitos, and operate in that lineage). But we do have starlink here and it's miles better than what we previously had. I don't have numbers handy, it does vary a bit throughout the day (but is very reliable nonetheless).
yikes, my DMT experiences were dark enough already, thank you
I know someone who tried DMT and it triggered severe long term anxiety in them. They went from a functional professional who had some issues to someone who couldn't leave the house. That was six years ago and last I checked on them in February their condition has been deteriorating.

I don't believe any of these substances will ever be approved for legal medical use. They just seem to unpredictable and can cause as much harm as healing.

Most (all?) drugs have some side effects for at least some people. These things are decided on a case by case basis.
And prescription medications don’t have rare but nasty side effects?

If these things are unpredictable it’s likely because they simply haven’t been studied in a medical context. At the very least it’s reasonably clear that long-term and debilitating side effects are generally exceedingly rare.

More people than you probably expect die from tylenol.

I can’t think of a single prescription medication which, when taken according to recommendations, causes permanent, irreversible, traumatic psychological damage after one dose.
Suicidality is a common side effect of many antidepressants.
Not after one prescribed dosage though…that’s the point.
But compared to regular Big Pharma meds, one dose of psychedelics is usually the whole treatment.

Getting out of depression or other severe conditions is hard, whether using psychedelics or SSRI. Take care of yourself so you don't get there in the first place.

That's not what this story, or the longer linked New Yorker story about Octavio Rettig, suggests. Further, it's besides the point: the thread you're commenting on is about the potential for grave side effects after a single dose.
"I can't think of" probably isn't the right bar to set for something like this.
The fact that you can't think of it just mean you don't know. Lots drugs have rare but potentially deadly side effects.
Medical student here : corticoids definitely can trigger "traumatic psychological damage after one dose". It's also rare but documented. And this serves OPs point well because its so rare partly because we can screen susceptible patients in advance.
"If these things are unpredictable its likely cause they have not been studied..."

Sorry but this is a very ignorant perspective in my opinion. Psychedelics are wildly ubpredictable in their effects, even those that have been extensively studied, like LSD. You cannot predict how an individual will respond.

This is also true of many prescription meds.

wind is unpredictable until you start to study weather patterns
Not saying we cant get an understandjng our shouldnt try, but thats not currently where were at.
I’m really sorry to hear about your friend. I’ve also had friends who experienced severe mental health issues after big trips. It can really mess things up for people with predispositions. I know many more who find the occasional trip to be a deeply spiritual and restorative experience. Hopefully research can help bring more predictability to reduce the risk. I hope your friend gets the support and treatment they need.
there was a woman that moved from the East Coast to California after the untimely death of her adult son. Filled with severe grief she sought out shamanic treatment and bonded with the culture and practices. After a self-described "more than three dozen" full ayahuasca sessions she had a functional life and new interests, came across as a regular adjusted person and overall seemed to be much healed. ymmv
Not to take away from the utility of psychedelics as a tool, but I wonder how much healing came from increased community and hobbies. We underestimate how necessary those are for a healthy mindset.
If a person hadn't experienced a debilitating depression it's hard to imagine what another person is experiencing. All those walks in the park and hobbies sound logical and wonderful, on paper. Reality is a bit different.
I agree that it is quite difficult to bootstrap a hobby practice, or repeatedly involve oneself socially when depressed. Speaking from personal experience in the deep dark pits, what I mean is that we should look at the problem through the lense of the BioPsychoSocial model.

Modern medicine is irreplacable but relying solely on medication is a pitfall of modern treatment. It turns out, for example, that chronic pain and depression are interlinked. A messed up neurochemical balance contributes to the erroneous interpretation of signals by the brain as pain (even when no bodily damage exists anymore). So what I'm saying is that while it may seem pointless initially to do that which falls flat in the estimation of a depressed mind (say due to anhedonia) those brief but regular walks in the park contribute to re-stabilization of neurotransmitters along with the medication.

Psychedelics aren't to be taken lightly and should never be first line treatment in my opinion. They can pull down your defense mechanisms, some of which can be very strong, and if you're not ready for it then it can definitely leave you worse off. That doesn't mean they don't have value in a carefully controlled set/setting and dose. Accepted treatments like ECT can absolutely also leave you worse off but in the right people the risk is worth the potential payoff for both.
It’s probably important to differentiate NN-DMT and 5-MEO-DMT. I’ve heard that 5-MEO is much more intense than NN-DMT.

I’m assuming that you’re talking about NN-DMT. It can definitely shake up the foundations of your world view, especially if not taken with the right set and setting.

I don’t think it’s as common with the pure form, but there is a slight possibility of it revealing some underlying emotional issues. There are plenty of functional professionals who carry some significant childhood traumas and issues that may bubble up to the surface through these experiences.

yes, N,N-DMT

From what I gather, this person took the DMT in a therapeutic set/setting.

I’ve also had mostly negative experiences with psylocybin for example. I have some anxiety but it kicks that and mania into a level that I never get in normal life
Not everyone should do psychedelics. Your friend is probably one of those people. I'm curious if they had ever tried any other psychedelics before going to DMT? I think that eating a low dose of psilocybin mushrooms is a much easier way to get introduced to psychedelics, and then if things go well, increase the dose. If the DMT was smoked, then maybe smoking a bit less would be advised at first. Going straight for a high dose of DMT without ever having done any psychedelics before isn't really the best way. I've also witnessed a couple of people take massive hits of DMT and not feel a single thing, which was rather curious.

But I doubt that DMT alone would cause the problems in your friend, as NN-DMT is endogenous, it's created in your pineal gland and is thought to have a role in REM sleep. If it was smoked instead of ingested (ayahuasca) then it's metabolized quite rapidly and the trip lasts only about 10 minutes. I'd probably never do the ayahuasca form, as it's a far longer trip and can be difficult to handle (so I've heard). Smoked DMT is really easy in comparison, but can also be very intense.

but how do you know ahead of time who should and shouldn't use these?
1 in 100 people (or os) is schizophrenic. It's quite predictable what happens when a schizophrenic person takes psychedelics. I am not saying this is your case here. However, if anything your single case example shows inadequacy in the health- and social care systems and not unpredictability of DMT.
Well, doing blinded studies will certainly be a challenge.
Hahaha, maybe if they control with LSD which we've studied extensively since sixties... Not.
I wonder how strong the placebo effect can be in this kind of a study.
To say that 5-MeO is a short duration psychedelic doesn't convey what's actually happening -- basically, you go from your normal waking state to likely the most profound experience of your life, and then, if you felt so inclined, back to work...all within 10-20 minutes.

That's precisely what I didn't like about it, the rapid shift back to everyday consciousness. At least with other psychedelics you can spend an entire day in the woods, feeling the entire ebb and flow of the experience, and perhaps learn something in that process.

With 5-MeO it's just instant God realm, and then, hmmm, what's for breakfast? Strange substance :)

Finally, it's not for the feint of heart; until you try it you have no idea what you're getting into -- there is no preparation for the rocketship that is 5-MeO.

Insulfated 5-meo is the way to go. Slower come up (10-15 mins) and lasts quite a bit longer. Still very intense but not the rocket ship.
It was amazing for me. "Amazing" ofc does not mean easy or fun. But words only poorly convey what the sensations are like.
I’ve read of people taking it, experiencing a whole life (some up to 60+ years), and then coming back

The experience is not exclusive to psychedelics either. It can happen through intense physical trauma, like a car accident. There’s a case of a guy who, while unconscious after a car crash, had the experience of being married and having kids, spending several years in that life. Then after waking up, he got depressed missing the family he had while unconscious

Wild

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