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

Introduction

Psychedelic tryptamines are a class of substances that alter perception, thought, and affect; examples include psilocybin, DMT, and 5-MeO-DMT. Earlier research has reported both potential therapeutic benefits (for example reductions in depression, anxiety and substance use) and rare but serious adverse events associated with tryptamine exposure. 5-MeO-DMT has gained recent popularity because of its rapid onset, short duration, and reports of intense, reliably produced mystical-type experiences, yet population prevalence appears low and the drug has a steep dose–response curve that could increase risk. Lancelotta and colleagues note that anecdotal reports suggest users intentionally employ cognitive, behavioural and contextual tactics to increase positive effects and reduce challenging effects, but no empirical study had systematically examined such strategies among 5-MeO-DMT users. This study therefore aimed primarily to document the prevalence of 14 benefit enhancement (BE) strategies in a large survey of lifetime 5-MeO-DMT users (N = 515). As a secondary aim, the investigators examined, in a subset of respondents who reported using 5-MeO-DMT only once (n = 116), whether use of individual BE strategies was associated with the intensity of acute mystical-type and challenging experiences and with enduring appraisals of personal meaning, spiritual significance, and changes in well-being attributed to that single experience. The authors framed the concept as "benefit enhancement" rather than "harm reduction" because their primary outcomes of interest were positive acute and lasting effects; they drew BE items from clinical psychedelic practice, online reports, and neoshamanic ceremonial practices to capture psychological, environmental and physiological tactics employed before, during or after sessions.