Skip to main content
NCBI home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2025 Nov 19.
Published in final edited form as: J Psychoactive Drugs. 2024 Oct 15;57(5):486–495. doi: 10.1080/02791072.2024.2413984

Inhaled Dimethyltryptamine (DMT): Use Patterns and Predictors of Consumption Frequency

Jamie E Parnes a,b, Mitch Earleywine c
PMCID: PMC11997157  NIHMSID: NIHMS2028148  PMID: 39402982

Abstract

Despite increasing interest in psychedelics and their potential therapeutic effects, research on inhaled N,N-Dimethyltryptamine (DMT) remains limited. Inhaled DMT has a reputation for rapid, dramatic onset and a brief duration, but correlates of use frequency remain poorly understood. A sample recruited from relevant internet sites, including nearly 400 people who had inhaled DMT, reported substance use histories, motivations for use, DMT sources, risk perceptions, and other variables. Generally, participants reported initiation motivated by curiosity about DMT’s effects, interest in psychedelics more broadly, and potential spiritual benefits. Those who had used other psychoactive substances (especially ayahuasca) and who had extracted DMT themselves reported inhaled DMT more frequently. Most (>60%) reported obtaining DMT from a friend and claimed it was “slightly difficult” to procure. Participants most commonly inhaled DMT from a glass pipe, in private homes, frequently alone or in small groups. Salient positives associated with inhaling DMT included psychologically cleansing or cathartic experiences. Associated challenges concerned difficult integration, aversive experiences, or “bad trips.” Participants rated DMT as very or slightly safe. These data underscore the need for continued work on this topic to inform education and harm reduction efforts, particularly as the molecule’s reputation for ameliorative effects receives media coverage.

Keywords: psychedelics, hallucinogen, ayahuasca

N,N-Dimethyltryptamine (DMT), a serotonergic psychedelic appearing naturally in several plants, has also emerged in inhaled extracted and synthetic forms (Davis et al., 2018). Historically, South American indigenous tribes consumed DMT orally in ayahuasca for ritualistic and spiritual ceremonies (Cakic et al., 2010). Compared to ayahuasca’s one-hour onset and several-hour duration, inhaled DMT (also referred to as “smoked” DMT) effects peak within minutes and last acutely up to 30 minutes (Strassman et al., 1994; Winstock et al., 2014). DMT’s reputation for intense psychedelic experiences includes strong visual hallucinations, perceptual and cognitive changes, encounters with mystical or God-like beings, and perceived near-death experiences (Davis et al., 2020; Lawrence et al., 2022; Strassman et al., 1994; Timmermann et al., 2018; Michael et al., 2021; Luke, 2011; Lawrence et al., 2023; Hase et al., 2022; Griffiths et al., 2019; Gouzoulis-Mayfrank et al., 2005; Cott and Rock, 2008). Recent research addresses potential therapeutic effects for conditions like anxiety and depression (Rodrigues et al., 2019). Conversely, concerns about DMT use include acute injury, cardiac stress, and psychiatric issues (e.g., psychosis; Gable, 2007; Warren et al., 2013).

As of 2021, approximately 9% of individuals who had ever used recreational drugs had tried DMT, with about 4% of the sample endorsing past-year use (Winstock et al., 2021). Broadly, adult psychedelic use has steadily increased, reaching a record high of 4.1% of adults endorsing past-year use in 2022. Despite the prevalence of DMT, data on correlates of use and associated harms remain limited. Three studies provide an epidemiological overview from samples across the globe (Winstock et al., 2014; Davis et al., 2018) and in Australia (Cakic et al., 2010). Most participants were employed, heterosexual White men with college education, primarily in their early- to mid-30’s. Frequency of use varied. Many participants reported four experiences or fewer; others averaged two episodes in the past month and 10–15 in their lifetimes (Cakic et al., 2010; Davis et al., 2020; Davis et al., 2018). Inhaled DMT was the predominant route of administration, with far fewer participants using other methods. Most individuals discovered and obtained DMT through friends or the internet, but a minority (~26% in one study) extracted it themselves (Cakic et al., 2010; Davis et al., 2018). Typical settings for DMT use were at home with a few others present (Cakic et al., 2010; Davis et al., 2018).

Motives for use also vary. Most participants in one study used DMT for spiritual exploration (Davis et al., 2018). Two qualitative studies identified themes like curiosity about psychedelics/DMT, desire for mystical/spiritual experiences, potential therapeutic effects, and seeking fun or pleasure (Cakic et al., 2010; Kazmarek, 2020). Compared to other common psychedelics, individuals described DMT as more intense and shorter in duration (Davis et al., 2018; Winstock et al., 2014). Positive aspects of use included insightful or spiritual experiences, euphoria, short duration, and intense visualizations (Cakic et al., 2010). Some studies suggest potential therapeutic benefits for mental health (e.g., anxiety, depression, substance use), physical health (e.g., blood pressure), and personal growth (Rodrigues et al., 2019; D’Souza et al., 2022; Davis et al., 2018).

Despite many individuals describing DMT use as relatively safe, researchers have identified potential harms, including risks from impure extractions, challenging experiences, unintentional injury, difficult integration, and respiratory irritation (Rossi et al., 2019; Lawrence et al., 2022; Kagan, 2023; Cakic et al., 2010; Davis et al., 2018). Strategies to mitigate these harms and enhance benefits parallel other recommendations for reducing psychedelics’ harms (Mian et al., 2023) and enhancing integration (Earleywine et al., 2022). These techniques include education about safe use, a suitable mindset and location, limited consumption frequency, identifying a trusted source, ensuring purity, using among trusted people, abstaining from other substance use, setting positive intentions, and writing about the experience afterwards (Cakic et al., 2010; Lancelotta and Davis, 2020).

Previous research provides only an overview of characteristics of people who use DMT, their motives, experiences, perceived benefits, and potential risks (Davis et al., 2018; Cakic et al., 2010). Additionally, while prior research identified many predictors of substance use frequency, such as age of initiation, number of substances tried, positive outcomes of use, and negative consequences of use (Richmond-Rakerd et al., 2017; Parnes et al., 2024; Miguel et al., 2015; Kelly et al., 2015), no studies to our knowledge have reported comparable predictors of DMT use frequency. Only one study (Cakic et al., 2010) compared people who have inhaled DMT to those who have also used ayahuasca. This preregistered study aims to address these gaps by examining demographic characteristics, patterns of inhaled and oral DMT use, and other substance use patterns among individuals who have inhaled DMT (https://doi.org/10.17605/OSF.IO/JQWGN). We hypothesized multiple predictors of frequency of use, including: younger age of initiation, greater perceived safety of use, a greater number of other substances tried, ayahuasca consumption, personal experience with extraction, greater positive subjective DMT experiences, and lower negative subjective DMT experiences. We also proposed an exploratory hypothesis addressing differences in perceived safety of DMT between individuals who only have inhaled DMT compared to those who have also used ayahuasca.

Method

Participants and Procedures

Online advertisements (e.g., Craigslist) requested adults (>18 years old) who had inhaled DMT to complete an anonymous survey, emphasizing anonymity and freedom to leave items blank. A university’s institutional review board approved procedures.

Measures

Demographics

Participants (N = 393) reported their age in years (M = 26.39, SD = 7.45), assigned sex (70.6% male), level of education, employment status, and religious affiliation (see Table 1).

Table 1.

Participant Demographic Characteristics

Full Sample
(N = 393)		 DMT Use Frequency Sample
(N = 242)
M SD M SD
Age 26.36 7.45 25.43 6.82
N % N %
Sex
 Male 277 70.5 159 65.7
 Female 115 29.3 82 33.9
Religion
 Christian 46 11.7 28 11.6
 Jewish 18 4.6 8 3.3
 Buddhist 18 4.6 14 5.8
 Hindu 4 1.0 3 1.2
 Not Religious 247 62.8 153 63.2
 Other 59 15.0 35 14.5
Education
 Less than high school 8 2.0 7 2.9
 High school degree or equivalent 48 12.2 37 15.3
 Some college 114 29.0 76 31.4
 Current college student 83 21.1 55 22.7
 Associate’s degree 28 7.1 17 7.0
 Bachelor’s degree 94 23.9 41 16.9
 Graduate degree 18 4.6 9 3.7
Employment Status
 Part time (<40 hours/week) 91 23.2 66 27.3
 Full time (40+ hours/week) 146 37.2 74 30.6
 Unemployed 67 17.0 45 18.6
 Student 75 19.1 46 19.0
 Retired 6 1.5 3 1.2
 Disabled or not able to work 7 1.8 7 2.9
Open in a new tab

Note: Among Full Sample participants reporting “Not religious” or “Other” religion, n = 24 (6.1%) described themselves as spiritual, n = 8 (2.0%) identified as agnostic, n = 4 (1.0%) identified as Taoist, while the rest described other beliefs. Categories that do not total 100% are due to missing data.

DMT Use

General Use.

Several items addressed general DMT use as in previous work (Cakic et al., 2010). Items included age of DMT initiation, where participants first heard about DMT, and how many of their friends had used DMT. Participants endorsed motives for use (e.g., interest in psychedelics, potential spiritual benefits; see Results for a complete list) using a 5-point Likert scale from 1 = strongly disagree to 5 = strongly agree (Cakic et al., 2010). Items also assessed routes of administration, locations, simultaneous use of other substances, and with whom they had used DMT. Participants also reported where they obtained DMT, rated difficulty obtaining DMT (5-point Likert-style scale from 1 = very difficult to 5 = very easy, or unsure), average cost of 1 gram, personal experience with DMT extraction, difficulty in obtaining materials and performing the extraction (from 1 = very difficult to 5 = very easy).

Inhaled DMT Use.

Participants also rated positive (e.g., spiritual experience, euphoria) and negative (e.g., coughing, anxiety) effects of inhaled DMT from 1 = not at all to 3 = very much (see Table 3; Cakic et al., 2010). Perceived positive (α = .72) and negative (α = .68) effects were mean scored for regression analyses. Participants could also enter unlisted positive and negative effects.

Table 3.

Positive and Negative Aspects of DMT Use

Smoked DMT Positive Aspects M SD
Intense Visual Hallucinations 2.73 0.53
Quick Onset 2.72 0.50
Meaningful/Insightful Experience 2.58 0.61
Brief Duration 2.53 0.60
Euphoria 2.52 0.65
Spiritual Experience 2.48 0.71
Smoked DMT Negative Aspects M SD
Bad Taste 2.04 0.69
Illegality 1.90 0.86
Brief Duration 1.87 0.75
Quick Onset 1.65 0.79
Coughing/Respiratory Problems 1.62 0.69
Intense Visual Hallucinations 1.60 0.79
Difficulty Integrating Experiences After DMT Wore Off 1.53 0.66
Anxiety/Stress 1.43 0.63
Psychospiritual Conflicts 1.35 0.57
Ayahuasca Positive Effects M SD
Psychologically Cleansing/Cathartic 2.78 0.55
Meaningful/Insightful Experience 2.76 0.56
Smoother Onset 2.58 0.65
Unusual Psychic Experiences (e.g., out-of-body, near death) 2.54 0.65
Longer Duration 2.53 0.62
Ayahuasca Negative Effects M SD
Nausea, Bad Taste, Purging 2.31 0.77
Intensity 1.90 0.77
Long Duration 1.82 0.73
Poorly Prepared Brews 1.76 0.78
Psychospiritual Distress 1.51 0.65
Open in a new tab
Oral DMT Use (Ayahuasca).

Participants who endorsed ever using ayahuasca (0 = no, 1 = yes) also reported lifetime frequency, and positive (e.g., meaningful/insightful experience) and negative (e.g., psychospiritual distress) effects from 1 = not at all to 3 = very much (see Table 3; Cakic et al., 2010). They could also enter their own effects.

DMT Use Safety.

We assessed perceived use safety from 1 = very dangerous to 5 = very safe. Participants reported if they had ever received medical attention due to DMT, and rated the likelihood of several risks (e.g., frightening experiences) from 1 = very unlikely to 5 = very likely. They also rated perceptions of the import of several harm reduction strategies (e.g., suitable location, education about safe use) from 1 = not at all to 3 = very much.

Other Substance Use

Participants indicated how recently they had used each of several substances from never, more than one year ago, in the past year, in the past six months, in the past 30 days, and in the past 7 days. They also provided the number of days in the past 30 days that they had used each substance (0–30).

Analysis

SPSS version 29 (IBM, 2022) provided all analyses. Only N = 242 reported lifetime DMT use frequency which restricted the sample for related analyses. Lifetime inhaled DMT use, a frequency count with variance greater than its mean, required negative binomial regression or Poisson approaches. We used negative binomial and Poisson modeling to regress age of initiation, perceived use safety, number of substances tried, personal use of ayahuasca, having ever extracted DMT, positive inhaled DMT experiences, and negative inhaled DMT on lifetime frequency of inhaled DMT. We compared Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) values from both models to select the best fitting model (Wagner et al., 2015)1. Count regression models employed boostrapping (10,000 samples) at α = .05. Parameter estimates from the count models were exponentiated to calculate incidence rate ratios (IRR), revealing the percentage increase in the outcome per one-unit increase in the predictor (Hilbe, 2014). We used a t-test to evaluate group difference between those who had and had not used ayahuasca, with an exploratory α = .01.

Results

DMT Use Characteristics

Initiation characteristics.

On average, participants were 22.30 years old (SD = 5.63, range 13 – 56) at initiation of inhaled DMT. Most participants first heard about DMT from a friend (68.4%), followed by the internet (22.4%), print media (4.3%), television/movie (1.5%), or other (2.8%, e.g., music festival, celebrities). Although 3.3% did not have friends who had used DMT, others had 1–2 (18.3%), 3–5 (32.1%), 6–10 (20.6%), 11–20 (11.5%), 21–50 (9.7%), 50–100 (3.3%), and more than 100 friends (1.3%) who had. Motives for first trying DMT varied. Curiosity about DMT (M = 4.78, SD = 0.56) and interest in psychedelics (M = 4.67, SD = 0.74) were most common motives, followed by potential spiritual benefits (M = 4.26, SD = 1.11), interest in plant-based drugs (M = 4.17, SD = 1.06), friend recommendation (M = 3.95, SD = 1.22), potential psychotherapeutic benefits (M = 3.90, SD = 1.25), for fun (M = 3.87, SD = 1.31), and to become intoxicated (M = 2.59, SD = 1.43).

Route of administration.

All participants reported inhaling DMT; some had used oral/ayahuasca (12.7%), insufflation (3.8%), injection (1.3%), or other routes (4.1%, e.g., vaporization). Most had used only one route (i.e., inhaling; M = 1.16, SD = .42).

Locations of consumption.

Participants used DMT at a friend’s home (63.4%) or their own home (60.6%), followed by outdoors (48.9%), concerts/raves (23.9%), a private party (16.3%), an acquaintance’s home (14.5%), a public place (13.5%), a stranger’s home (3.1%), or another location (3.3%, e.g., car, hotel). Most had used DMT in two locations (M = 2.44, SD = 1.75). Participants reported using DMT alone (34.9%), with a small group of 4 or fewer people (83.0%), with a large group of 5 or more people (18.6%), with their partner (22.4%), as part of a ceremony (7.1%), or another group (2.0%, e.g., with others who remained sober). Although some participants had not combined DMT with other substances, simultaneous use was evident (see Table 2), averaging 1.89 other substances (SD = 1.86, range 0 – 10).

Table 2.

Substance Use Frequency

Substance Ever Used Past 30-Day Use Frequency Past Week Use Combined with DMT
% Endorsed M SD % endorsed % endorsed
Alcohol 98.5 8.94 8.06 68.70 30.0
Cannabis 98.2 16.25 12.50 70.00 73.8
Psilocybin 89.6 0.45 2.00 4.33 11.2
Tobacco 88.3 13.93 14.67 52.67 -
MDMA/MDA/ecstasy 87.3 0.55 1.60 6.11 20.1
LSD 83.5 0.49 2.06 4.32 21.1
Cocaine 79.1 0.84 2.95 5.85 5.3
Opiate medications 77.4 1.73 5.46 8.14 3.8
Benzodiazepines 72.0 2.31 6.51 11.96 6.1
Nitrous oxide 62.1 0.45 2.32 2.54 -
Salvia divinorum 60.3 0.12 1.60 0.51 -
Amphetamine/methamphetamine 55.0 1.25 4.72 8.14 3.8
Synthetic psychedelics 49.6 0.10 0.94 1.02 -
Ketamine 46.8 0.41 2.22 2.54 6.9
DXM 39.7 0.04 0.32 1.53 -
Mescaline 39.5 0.05 0.30 1.02 -
Heroin 28.2 0.48 2.83 2.80
Monoamine oxidase inhibitors 19.3 0.11 1.34 0.51 5.9
PCP 15.0 0.02 0.17 0.51 0.3
Open in a new tab

Note: Missing percentages for substances combined with DMT were not assessed. 19.3% of participants had not combined DMT with another substance and 4.1% endorsed combining DMT with a substance not listed in that item (e.g., nitrous oxide, synthetic psychedelics). All participants endorsed smoked DMT use, 12.5% of participants endorsed ayahuasca (oral DMT) use, and we did not assess past 30-day or week DMT use.

Acquiring DMT.

Most obtained DMT from a friend (62.8%) or acquaintance (25.7%), followed by a friend who is a dealer (16.0%), an unknown dealer (15.5%), a known dealer (11.5%), or another source (7.9%, e.g., self-extraction, online). On average, participants said DMT was “slightly difficult” to obtain (M = 2.28, SD = 1.21), although 4.3% were unsure of difficulty. The median estimate cost of 1 gram of DMT was US$70.00 (M = $76.80, SD = $77.60, range $10-$900, n = 310). Several participants had never paid for DMT (13.5%) or did not know the cost (6.9%). A total of 16.5% of participants had extracted DMT themselves. Among these participants, the median response to difficulty obtaining the materials (M = 3.77, SD = 1.21) and performing the extraction (M = 3.49, SD = 1.26) was “slightly easy.”

Frequency, method, and effects of inhaled use.

Participants had inhaled DMT 6.95 times in their lifetimes (SD = 13.12, median = 3, mode = 2, range 1 – 100). A glass pipe (77.6%) was the most common method of use, followed by a water pipe/bong (32.8%), rolled joint/cigarette (16.3%), vaporizer (14.5%), non-glass pipe (9.4%), and another method (6.6%, e.g., freebase with tinfoil, lightbulb). Participants rated intense visual hallucinations and quick onset as the most positive effects (see Table 3). Written responses included out-of-body experience and sense of connectedness. The most negative effect was bad taste (see Table 3). Written responses included: bad trip, incapacitation, and dissociation.

Oral (ayahuasca) consumption.

Forty-nine participants (12.5%) endorsed ayahuasca use (M = 4.42 events, SD = 8.64, median = 2, mode = 1, range 1 – 50). Participants rated psychologically cleansing/cathartic experience as the most positive effect; nausea, bad taste, and purging were the most common negatives (see Table 3). Positive written responses included auditory hallucinations; negatives included incapacitation and social stress if others were present.

Perceptions of safety.

Participants rated DMT use as very or slightly safe (M = 4.02, SD = 1.05); only one participant (<0.5%) reported receiving medical attention due to DMT use. Nonetheless, participants endorsed challenges related to difficulty integrating experiences (M = 3.12, SD = 1.27), falling over (M = 3.12, SD = 1.34), having a frightening or bad trip (M = 3.10, SD = 1.24), and experiencing spiritual conflicts (M = 3.02, SD = 1.24), respiratory irritation (M = 2.90, SD = 1.21), nausea (M = 2.73, SD = 1.20), disrespectful/irreligious use (M = 2.69, SD = 1.34), and burning yourself (M = 2.44, SD = 1.17), as well as written options (e.g., disconnect from reality). They endorsed several strategies for mitigating harm, including having a suitable location (M = 2.89, SD = 0.38) and appropriate/prepared mindset (M = 2.88, SD = 0.41), as well as ensuring DMT purity (M = 2.82, SD = 0.44), education about safe use (M = 2.74, SD = 0.52), limiting use frequency (M = 2.63, SD = 0.62), having a sober “trip-sitter” (M = 2.59, SD = 0.62), having another participant (M = 2.55, SD = 0.65), and changes in legislation (M = 2.53, SD = 0.71). Written recommendations stressed no other simultaneous substance use and regular meditation practice.

Other substance use.

Participants endorsed lifetime consumption of alcohol, cannabis, and other psychedelics, among others (M = 11.86 other substances, SD = 3.85, range 2 – 19, see Table 2). Past-month and -week alcohol, cannabis, and tobacco use were notable.

Factors Associated with DMT Use

We regressed age of initiation, perceived use safety, number of substances tried, personal use of ayahuasca, DMT extraction experience, positive inhaled DMT experiences (M = 2.59, SD = 0.39), and negative inhaled DMT experiences (M = 1.63, SD = 0.37) on inhaled DMT use frequency (see Table 4 for bivariate associations). The model omnibus test was significant (χ2(7) = 83.68, p<.001). Each additional substance tried was associated with an 9% increase in frequency of inhaled DMT (p<.001), having extracted DMT was associated with a 124% increase (p = .002), and having used ayahuasca was associated with an 83% increase (p = .009) in inhaled DMT use frequency. Age of initiation (p = .49), perceived use safety (p = .68), positive experiences (p = .20), and negative experiences (p = .75) were not associated significantly with inhaled DMT use frequency, while controlling for other predictors (see Table 5).

Table 4.

Bivariate Associations among DMT Frequency Predictors

Variable 1 2 3 4 5 6 7
1. Age of Initiation -
2. Perceived Safety .06 -
3. Number of Substances Tried −.07 .05 -
4. Having Ever Used Ayahuasca −.07 .09 .18** -
5. Having Ever Extracted DMT −.05 .21*** .17** .39*** -
6. Positive Smoked DMT Experiences .04 .26*** −.04 .05 −.03 -
7. Negative Smoked DMT Experiences −.01 −.21*** .03 −.01 .00 −.10* -
Open in a new tab

Note:

*

p < .05,

*

p < .01

**

p < .001.

Table 5.

Predictors of Lifetime Smoked DMT Use Frequency

Variable b IRR SE p
Intercept 0.80 2.23 1.27 .50
Age of Initiation 0.01 1.01 0.02 .49
Perceived Use Safety −0.04 0.96 0.09 .68
Number of Substances Tried 0.09 1.09 0.02 <.001
Having Ever Used Ayahuasca 0.61 1.83 0.24 .009
Having Ever Extracted DMT 0.81 2.24 0.27 .002
Positive Smoked DMT Experiences 0.33 1.39 0.27 .20
Negative Smoked DMT Experiences 0.09 1.09 0.29 .75
Open in a new tab

Note: Beta (b), incidence rate ratio (IRR), standard error (SE), and p-value (p). Negative binomial regression results were estimated using bootstrapping (10,000 samples).

We examined other differences between people who had and had not used ayahuasca as well. The number of substances tried was better modeled using Poisson regression (AIC = 2119.25, BIC = 2127.12) than negative binomial regression (AIC = 2669.29, BIC = 2677.16). The model omnibus test was significant (χ2(1) = 14.25, p<.001). Having used ayahuasca was associated with a 17% increase in the number of substances tried (b = 0.16, IRR = 1.17, SE = 0.04, p<.001; exponentiated intercept = 11.63, SE = .02, p<.001; i.e., approximately two more substances). Lastly, those who had used ayahuasca did not differ significantly from those who had not in perceived safety of inhaled DMT use (t(366) = 1.76, p = .08).

Discussion

The present study addressed demographic characteristics, patterns of DMT use, and other substance use among individuals who have inhaled DMT. As hypothesized, the lifetime number of substances consumed and the experience of extracting DMT increased with DMT use frequency. Additionally, ayahuasca consumption was associated with increased inhaled DMT use frequency and the total number of substances ever consumed. Contrary to hypotheses, age of initiation, perceived safety of use, positive experiences, and negative experiences were not significantly related to frequency of inhaling DMT. Nevertheless, having extraction experience held novel associations with frequency of DMT consumption, with considerable intuitive appeal. Our exploratory hypothesis was also not supported; perceived safety of inhaled DMT did not vary with ayahuasca use history.

Descriptive results add to literature characterizing inhaled DMT use. As in previous work, most participants first heard about and obtained DMT from a friend. Participants reported an average of 7 lifetime administrations (median=3), also much like previous estimates (<4 to 15; Cakic et al., 2010; Davis et al., 2018; Davis et al., 2020). Other lifetime substance use also paralleled previous work (Cakic et al., 2010; Davis et al., 2018; Lawrence et al., 2022), highlighting alcohol, cannabis, tobacco, and other psychedelic use. Drug use was also markedly higher than in the general population across studies (Center for Behavioral Health and Quality, 2022). These results might reflect common trait-like characteristics or enhanced access to various drugs.

Many of the current results replicated the one study addressing comparable questions (Cakic et al., 2010). Both samples reported home use, and in small groups, as most common, also like other studies (Lawrence et al., 2022; Davis et al., 2018). Use at a friend’s home was higher among the current participants (63% vs. 14–52%). Safety ratings appeared lower in the current sample, with fewer “very” (41% currently vs 55% previously) or “quite” (25% vs 38%) safe ratings (Cakic et al., 2010). Like past work, use was generally considered safe (Winstock et al., 2014; Cakic et al., 2010; D’Souza et al., 2022). Primary motives also replicated, with interest in psychedelics and in DMT rated highest. Spiritual benefits also commonly motivated use in our study and others (Davis et al., 2018; Griffiths et al., 2019), while few reported seeking intoxication (Davis et al., 2018; Cakic et al., 2010).

Both samples expressed concerns about a bad trip, along with other studies (Lawrence et al., 2022); the current sample also emphasized difficulty integrating experiences and falling over. In the previous work (Cakic et al., 2010), recommended harm reduction strategies focused on education about use and the presence of another person (“sitter”). The current sample emphasized appropriate mindset and suitable location as the most helpful, consistent with known psychedelic harm reduction strategies (Mian et al., 2023; Lancelotta and Davis, 2020). Simultaneous use of other psychoactives also varied across samples (81% vs. 68% total), particularly with cannabis (74% vs. 53%). More of the current sample employed a glass pipe for inhaling DMT (78% vs. 55%); fewer used a bong (33% vs. 56%). Current participants rated visual hallucinations and quick onset as the most positive effects, unlike the insightful and spiritual experiences noted before. Both studies identified bad taste as the most negative effect, along with other studies (Lawrence et al., 2022), despite reports of anxiety and depression.

Ayahuasca use was less frequent in the current study (13% vs. 31%; Cakic et al., 2010). Common effects of ayahuasca replicated. Both samples reported psychologically cleansing and cathartic experiences as positive effects of ayahuasca. Both rated nausea, bad taste, and long duration as the most negative. The current sample also highlighted the strong intensity as a negative. Less of the current sample (17% vs. 26%) reported extracting DMT, but perceptions of associated difficulties were comparable. Although participants rated extraction as “slightly easy,” internet instructions for DMT extraction can yield impure, dangerous products (Rossi et al., 2019).

As hypothesized, experience extracting DMT and the number of substances tried were associated with greater inhaled DMT use frequency. Individuals who have extracted DMT likely have greater access and larger quantities of DMT compared to those who have not, which may enable more frequent use. Moreover, since some materials and the extraction process are illegal (Chambers et al., 2020), those willing to take greater legal risks might reflect greater interest in DMT use. Similarly, individuals who have tried more substances may have greater general interest in substance use, and congruent with prior research (Kelly et al., 2015), are likely to use substances more frequently. Consistently, individuals who tried more substances also inhaled DMT more frequently. Surprisingly, age of initiation, perceived safety of use, positive experiences, and negative experiences were not associated with inhaled DMT use frequency. Given the lack of research in this area, future studies should replicate these analyses to evaluate the stability of findings. Additionally, to better understand who may perform DMT extraction, future research should examine motivations for DMT extraction, and how DMT use motives relate to DMT extraction experience.

Consistent with prior research, individuals who endorsed ayahuasca use also reported more frequent overall DMT use (Cakic et al., 2010). Since ayahuasca has a longer duration and potentially more involved experience (e.g., ceremonial use), people who enjoy DMT might progress from inhaled to ayahuasca use, especially for seeking a longer duration than inhaled DMT. Ayahuasca use was also associated with having tried more substances, perhaps reflecting a greater general interest in substance use. Nonetheless, ayahuasca use was not also associated with differences in perceived safety of DMT use.

The current data have meaningful limitations that suggest future research. The absence of data on ethnicity, race, and country of origin limits any claims about generalization, especially for those with minoritized identities. Similarly, using online message board recruitment likely attracted individuals with greater interest in DMT, and thus biased our sample away from individuals with infrequent use or less interest in DMT. Given legal prohibitions, some people might have been hesitant to respond to an online advertisement or answer sensitive questions honestly. In sum, the current data provide an approximation of the overall population of individuals who use DMT. Future research should collect more detailed participant characteristics and use varied recruitment methods. Missing data also suggest cautions. Given that 38% of participants did not provide an estimate of their lifetime inhaled DMT use frequency, present estimates could vary from population parameters in unpredictable ways. We also did not assess DMT dose information, and therefore cannot determine typical quantities used or how quantity associated with other constructs. We only assessed the likelihood of potential risks occurring and perceived efficacy of harm reduction strategies. Future research should examine severity of potential risks and actual use of harm reduction strategies. Additionally, the cross-sectional nature of data collection prohibits causal inferences.

Despite these limitations, these data provide meaningful contributions to the dearth of recreational DMT research. Since substance use frequency often covaries with harms of use (e.g., Neugebauer et al., 2019; Bravo et al., 2017), the current findings highlight two participant-level factors (i.e., extracting DMT, number of substances tried) that might increase susceptibility to harms from use. Harm-reduction efforts might target those with extraction experience to train them in relevant psychedelic harm reduction strategies (Mian et al., 2023).

While these data add nuance and detail to existing research, continued research is essential to best understand the safety profile, potential benefits and harms, and harm reduction strategies for DMT use. Given the wide range of lifetime DMT use frequency, research should also disentangle those who try DMT from those who escalate their use. Details on decisions about discontinuation of use could also prove illustrative. Moreover, continued research could evaluate possible discrepancies between perceived and experienced benefits of use. Although DMT use remains relatively rare and understudied, the allure of potential therapeutic effects, psychospiritual benefits, intense psychedelic experiences, and potential risks suggest that continued examination could minimize aversive experiences or problematic outcomes.

Acknowledgements:

This study was preregistered (https://doi.org/10.17605/OSF.IO/JQWGN). Parnes’s effort was supported by the National Institute of Drug Abuse (F32DA054718, K99DA057994).

Footnotes

Disclosures: The authors have no conflicts to disclose.

1

Due to concerns that arose during data analysis, this approach deviates from our preregistered analytic plan. While we ultimately selected a different count distribution (Poisson) than we preregistered (negative binomial) due to better fit, results were consistent across both models.

Data Availability:

Data for this study is available at https://doi.org/10.17605/OSF.IO/8BACU.

References

  1. Bravo AJ, Prince MA and Pearson MR (2017) Can I Use Marijuana Safely? An Examination of Distal Antecedents, Marijuana Protective Behavioral Strategies, and Marijuana Outcomes. J Stud Alcohol Drugs 78(2): 203–212. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cakic V, Potkonyak J and Marshall A (2010) Dimethyltryptamine (DMT): Subjective effects and patterns of use among Australian recreational users. Drug and alcohol dependence 111(1): 30–37. [DOI] [PubMed] [Google Scholar]
  3. Center for Behavioral Health S and Quality (2022) 2021 National Survey on Drug Use and Health: Detailed Tables. Reportno. Report Number|, Date. Place Published|: Institution|. [Google Scholar]
  4. Chambers MI, Appley MG, Longo CM, et al. (2020) Detection and Quantification of Psychoactive N,N-Dimethyltryptamine in Ayahuasca Brews by Ambient Ionization High-Resolution Mass Spectrometry. ACS Omega 5(44): 28547–28554. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cott C and Rock A (2008) Phenomenology of N,N-Dimethyltryptamine use: A thematic analysis. Journal of Scientific Exploration 22(3): 359–370. [Google Scholar]
  6. D’Souza DC, Syed SA, Flynn LT, et al. (2022) Exploratory study of the dose-related safety, tolerability, and efficacy of dimethyltryptamine (DMT) in healthy volunteers and major depressive disorder. Neuropsychopharmacology 47(10): 1854–1862. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Davis AK, Barsuglia JP, Lancelotta R, et al. (2018) The epidemiology of 5-methoxy- N, N-dimethyltryptamine (5-MeO-DMT) use: Benefits, consequences, patterns of use, subjective effects, and reasons for consumption. J Psychopharmacol 32(7): 779–792. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Davis AK, Clifton JM, Weaver EG, et al. (2020) Survey of entity encounter experiences occasioned by inhaled N,N-dimethyltryptamine: Phenomenology, interpretation, and enduring effects. J Psychopharmacol 34(9): 1008–1020. [DOI] [PubMed] [Google Scholar]
  9. Earleywine M, Low F, Lau C, et al. (2022) Integration in psychedelic-assisted treatments: Recurring themes in current providers’ definitions, challenges, and concerns. Journal of Humanistic Psychology. 00221678221085800. [Google Scholar]
  10. Gable RS (2007) Risk assessment of ritual use of oral dimethyltryptamine (DMT) and harmala alkaloids. Addiction 102(1): 24–34. [DOI] [PubMed] [Google Scholar]
  11. Gouzoulis-Mayfrank E, Heekeren K, Neukirch A, et al. (2005) Psychological effects of (S)-ketamine and N,N-dimethyltryptamine (DMT): a double-blind, cross-over study in healthy volunteers. Pharmacopsychiatry 38(6): 301–311. [DOI] [PubMed] [Google Scholar]
  12. Griffiths RR, Hurwitz ES, Davis AK, et al. (2019) Survey of subjective “God encounter experiences”: Comparisons among naturally occurring experiences and those occasioned by the classic psychedelics psilocybin, LSD, ayahuasca, or DMT. PLOS ONE 14(4): e0214377. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hase A, Erdmann M, Limbach V, et al. (2022) Analysis of recreational psychedelic substance use experiences classified by substance. Psychopharmacology (Berl) 239(2): 643–659. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hilbe JM (2014) Modeling count data. New York, NY. [Google Scholar]
  15. IBM (2022) SPSS Statistics for Windows. Armonk, NY. [Google Scholar]
  16. Kagan S (2023) The content of complex psychedelic experiences resulting from inhalation of N,N-dimethyltryptamine. Journal of Psychedelic Studies 6(3): 222–231. [Google Scholar]
  17. Kazmarek T (2020) Intrinsic Motivations and Perceived Benefits of US Males for Taking Dimethyltryptamine. Walden University. [Google Scholar]
  18. Kelly AB, Evans‐Whipp TJ, Smith R, et al. (2015) A longitudinal study of the association of adolescent polydrug use, alcohol use and high school non‐completion. Addiction 110(4): 627–635. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Lancelotta RL and Davis AK (2020) Use of Benefit Enhancement Strategies among 5-Methoxy-N,N-Dimethyltryptamine (5-MeO-DMT) Users: Associations with Mystical, Challenging, and Enduring Effects. J Psychoactive Drugs 52(3): 273–281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Lawrence DW, Carhart-Harris R, Griffiths R, et al. (2022) Phenomenology and content of the inhaled N, N-dimethyltryptamine (N, N-DMT) experience. Sci Rep 12(1): 8562. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Lawrence DW, DiBattista AP and Timmermann C (2023) N, N-Dimethyltryptamine (DMT)-Occasioned Familiarity and the Sense of Familiarity Questionnaire (SOF-Q). Journal of Psychoactive Drugs. DOI: 10.1080/02791072.2023.2230568. 1–13. [DOI] [PubMed] [Google Scholar]
  22. Luke D (2011) Discarnate entities and dimethyltryptamine (DMT): Psychopharmacology, phenomenology and ontology. Journal of the Society for Psychical Research 75(902[1]): 26–42. [Google Scholar]
  23. Mian MN, Altman BR, Low F, et al. (2023) Development of the Protective Strategies for Psychedelics Scale: A novel inventory to assess safety strategies in the context of psychedelics. Journal of Psychopharmacology. DOI: 10.1177/02698811231214060.02698811231214060. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Michael P, Luke D and Robinson O (2021) An Encounter With the Other: A Thematic and Content Analysis of DMT Experiences From a Naturalistic Field Study. Front Psychol 12: 720717. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Miguel A, Yamauchi R, Simões V, et al. (2015) From theory to treatment: Understanding addiction from an operant behavioral perspective. Journal of Modern Education Review 5(8): 778–787. [Google Scholar]
  26. Neugebauer RT, Parnes JE, Prince MA, et al. (2019) Protective Behavioral Strategies Mediate the Relation Between Sensation Seeking and Marijuana-Related Consequences. Subst Use Misuse 54(6): 973–979. [DOI] [PubMed] [Google Scholar]
  27. Parnes JE, Prince MA, & Conner BT (2024). Development and Validation of the Positive Outcomes of Cannabis Use Scale (POCUS) Among Predominantly White Adults in the United States. Assessment, 10731911241240618. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Richmond-Rakerd LS, Slutske WS and Wood PK (2017) Age of initiation and substance use progression: A multivariate latent growth analysis. Psychology of Addictive Behaviors 31(6): 664. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Rodrigues AV, Almeida FJ and Vieira-Coelho MA (2019) Dimethyltryptamine: Endogenous Role and Therapeutic Potential. J Psychoactive Drugs 51(4): 299–310. [DOI] [PubMed] [Google Scholar]
  30. Rossi GN, Crevelin EJ, de Oliveira Silveira G, et al. (2019) Internet method for the extraction of N,N-dimethyltryptamine from Mimosa hostilis roots: Does it really extract dimethyltryptamine? Journal of Psychedelic Studies 3(1): 1–6. [Google Scholar]
  31. Strassman RJ, Qualls CR, Uhlenhuth EH, et al. (1994) Dose-response study of N,N-dimethyltryptamine in humans. II. Subjective effects and preliminary results of a new rating scale. Arch Gen Psychiatry 51(2): 98–108. [DOI] [PubMed] [Google Scholar]
  32. Timmermann C, Roseman L, Williams L, et al. (2018) DMT Models the Near-Death Experience. Front Psychol 9: 1424. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Wagner B, Riggs P and Mikulich-Gilbertson S (2015) The importance of distribution-choice in modeling substance use data: a comparison of negative binomial, beta binomial, and zero-inflated distributions. Am J Drug Alcohol Abuse 41(6): 489–497. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Warren JM, Dham-Nayyar P and Alexander J (2013) Recreational use of naturally occurring dimethyltryptamine – contributing to psychosis? Australian and New Zealand Journal of Psychiatry 47(4): 398–399. [DOI] [PubMed] [Google Scholar]
  35. Winstock AR, Kaar S and Borschmann R (2014) Dimethyltryptamine (DMT): prevalence, user characteristics and abuse liability in a large global sample. J Psychopharmacol 28(1): 49–54. [DOI] [PubMed] [Google Scholar]
  36. Winstock AR, Maier LJ, Zhuparris A, et al. (2021) Global Drug Survey 2021 Key Findings Report. Reportno. Report Number|, Date. Place Published|: Institution|. [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

Data for this study is available at https://doi.org/10.17605/OSF.IO/8BACU.

RESOURCES