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  We clearly had broken through the “psychedelic threshold.” The suddenness and intensity of onset, the irrefutable nature of the experience, the inhabited sense Nils described, all added up to a “full” DMT trip. But was it too far beyond the psychedelic barrier? Nils was a self-acknowledged “hard head,” requiring higher doses than many to attain comparable levels of altered perceptions from the same drug. How would Philip fare?

  Philip and I walked down the Research Center’s brightly lit hall. We passed Nils at the nurses’ station, looking for more food. He felt great. It was reassuring to see how well he looked so quickly after his harrowing jump off the psychic cliff.

  I asked Philip, “Are you sure you want the same dose?”

  “Yes.” There was absolutely no hesitation.

  I was not so sure.

  If Philip declined undergoing an experience similar to Nils’s, my anxiety would have become more tolerable. Perhaps he would settle for 0.5 or 0.4 mg/kg. This would be easy enough to do—I could simply stop short of emptying the entire syringe full of DMT solution. While I believed 0.6 mg/kg most likely was physically safe, the potentially shattering mental effects loomed in front of all of us even more dramatically than they had before Nils’s session. However, Philip was not to be outdone by his friend and fellow “psychonaut.” He was ready for his 0.6 mg/kg dose.

  This tendency in our volunteers, to persevere even under the possibility of an annihilating psychedelic experience, was marked. It was most apparent during our tolerance study, which took place the next year, in 1991, in which volunteers received four large doses of DMT, each separated by only 30 minutes. Not one volunteer, no matter how worn out, refused that fourth and final high dose of DMT.

  Philip’s desire to take the same dose as Nils confronted me with a scientific, personal, and ethical dilemma. My training had taught me that one should not shy away from prescribing a little too much of a medication if the circumstances called for doing so. For example, very high doses might be necessary for a full therapeutic response in otherwise treatment-resistant patients. In addition, it was important to learn about toxic effects, to be able to recognize them quickly in various circumstances. This latter point is even more important when studying a new experimental drug.

  It was within my authority and responsibility as the principal investigator of the project to tell Philip I did not want him to repeat a Nils-like 0.6 mg/kg DMT experience. However, Nils seemed fine now. Most importantly, he was the first and only person to get this dose. I had planned on two 0.6 mg/kg sessions that morning so that I could determine if this dose caused similar responses in two different people.

  I liked Philip, and he did want his 0.6 mg/kg dose. But how much of a role did our friendship play? I didn’t want to do as he requested just so that I wouldn’t jeopardize our relationship, but I wanted his participation in this early stage of the study to be worth his while. He was, in some ways, “doing us a favor.” Philip lived far from Albuquerque, and asking him to return once more to get 0.6 mg/kg, if 0.4 or 0.5 were not a full-enough dose, would have inconvenienced him. There were many competing priorities. I hoped I made the right decision by agreeing to give Philip 0.6 mg/kg.

  Entering his room, Philip and I said hello to Cindy and Robin, Philip’s girlfriend, who were already there, waiting for us. He made himself comfortable on the bed. Another 0.6 mg/kg IV DMT session was about to begin.

  Philip’s bare and sterile room featured brightly waxed linoleum floors, salmon pink walls, and tubes for oxygen, suctioning of secretions, and water exiting from behind the bed. He had taped a poster of Avalokitesvara, the one-thousand-armed Buddhist saint of compassion, on the outside of the closed wooden bathroom door that faced his bed. A television attached by a maze of cables hung from the ceiling, looking down at his mechanized, narrow bed, which was covered with thin hospital sheets. The air conditioning hummed loudly. He lay down on the bed and made himself as comfortable as possible.

  Cindy smoothly and skillfully placed an intravenous line into one forearm vein. The blood pressure cuff was also wrapped around this arm. Philip’s other arm had inserted into it a larger IV line from which we could draw blood, so we could measure concentrations of DMT in his blood after administering it. This line was attached to a clear plastic bag that dripped sterile saltwater into the vein so that there would be no clotting in the blood-drawing tube. Cindy and I sat on either side of Philip, not sure what to expect in light of Nils’s earlier reaction. Robin sat off to the side, near the foot of the bed.

  Philip, fresh from Nils’s unnerving session only an hour ago, needed little preparation. He knew what to expect from us while he was lying in his bed under the influence. He had seen that we would help him immediately if he seemed in need of assistance. We wished him luck. He closed his eyes, lay back, took some deep breaths, and said, “I’m ready.”

  I watched the second hand of the clock on the wall, waiting for it to hit the “6” so that I could time the 30-second injection to finish when the second hand hit the “12,” which would be “time zero.” It was nearly 10 A.M.

  Just as I finished inserting the needle of the syringe into Philip’s line, but before depressing the plunger and emptying the DMT solution into Philip’s vein, there was a loud, insistent knocking on the door. I looked up, paused, removed the needle from the line, capped it, and placed it on the nightstand next to Philip’s bed.

  The director of the Research Center laboratory was waiting outside the door. I stepped into the hall, out of earshot from the room. He said that the previous blood samples for DMT analyses were collected incorrectly, and that we needed to change how we did this. I told him we would modify our technique accordingly.

  I let myself back into Philip’s room and took the chair by the side of his bed once more. He seemed unaware of the interruption, having begun the inward turning and letting go that we found allows for the smoothest possible entry into the DMT realms. For him, the trip had already begun.

  I apologized for the interruption and, trying to lighten the mood, said, “Where were we now?” Philip replied with only a grunt; he opened his eyes, nodded for me to proceed, and closed them again. I uncapped the syringe and reinserted the needle into his IV tubing. Cindy nodded that she was ready, too.

  I said, “Okay, here’s the DMT.”

  I slowly and carefully began infusing 0.6 mg/kg DMT into Philip’s vein.

  Halfway through the injection, Philip’s breath caught in his throat, sounding like a cough that never quite got out. We quickly learned that whenever this catching in the throat followed a high-dose injection, we were in for a wild ride.

  Quietly, I let Philip know, “It’s all in.”

  Twenty-five seconds after the infusion was complete, he began groaning,

  I love, I love . . .

  His blood pressure rose moderately, but his heart rate jumped to 140 beats per minute, up from his resting level of 65. This increase in pulse is equivalent to that which might occur after racing up three or four flights of stairs. But in this case, Philip hadn’t moved an inch.

  At 1 minute, Philip sat up, looking at Cindy and me with saucer-sized eyes. His pupils were hugely dilated. His movements were automatic, jerky, puppetlike. There seemed to be “no one home” behind Philip’s actions.

  He leaned toward Robin and stroked her hair:

  I love, I love . . .

  Twice that morning, then: a volunteer in a dazed DMT state, attracted to a woman’s hair. Nils to Cindy’s, Philip to Robin’s. Perhaps it was the most powerful image of living, organic, familiar reality available when one looked around a dreary hospital room in such a highly psychedelic state.

  To our relief, he laid back down without prompting or assistance. His skin was cold and clammy, as had been Nils’s. His body was in a classic “fight-or-flight” reaction: high blood pressure and heart rate, blood moving from the skin deeper into the vital internal organs, but all while he was performing almost no actual physical activity. It was difficult to draw
Philip’s blood—the high levels of stress hormones caused the tiny muscles lining the veins to clamp down, reducing unnecessary blood flow to the skin.

  At 10 minutes, Philip began to sigh,

  How beautiful, how beautiful!

  Tears began streaming down his cheeks.

  Now that was what you would call a transcendent experience. I died and went to heaven.

  By 30 minutes after the injection, his pulse and blood pressure were normal.

  It was flying within a vastness. There was no relative space or size.

  I asked, “What did you feel when your breath caught in your throat?”

  I felt a cold, contracting feeling in my throat. It frightened me. I thought maybe I would stop breathing. The thought, “Let go, surrender, let go,” was there for a split second, then the rush of the drug swept even that away.

  “Do you recall sitting up and stroking Robin’s hair?”

  I did what?

  Forty-five minutes after the injection, drinking tea and no longer feeling any effects of the drug, Philip could not remember sitting up, looking at us, or touching Robin. Soon thereafter, he seemed comfortable and we were confident Robin could look after him.

  Philip and I spoke the following evening. He felt a little run down, but had slept very well. His dreams were “more interesting than usual,” although not particularly bizarre. Nevertheless, he could not remember any of them. He worked a full ten hours the next day, although “not at full steam.” However, he said, “Nobody but I would have noticed I was tired.”

  Amazingly, these are all the notes I have from that session and the next day’s report. This contrasts strikingly with Philip’s usually quite eloquent descriptions of his drug sessions. Perhaps his getting through the morning safely was the most important information we needed to learn.

  Driving home that evening into the mountains outside of Albuquerque, I used the time to think about the day’s events. I was glad that both Nils and Philip had emerged intact from their 0.6 mg/kg IV DMT encounters. However, I had not learned much about what their experiences were really like. Their reports were remarkably brief and lacked detail.

  Why were Nils’s and Philip’s reports so sparse?

  One possibility was “state-specific memory.” This refers to the phenomenon in which events experienced in an altered state of consciousness can be recalled clearly only upon reentering that state, and not in the normal one. This happens under the influence of substances such as alcohol, marijuana, or prescription drugs like the sedatives Valium, Xanax, or barbiturates. It also results from non-drug-induced altered states, such as hypnosis or dreams. In Philip’s and Nils’s cases, this explanation would be likely if they later recalled more of their 0.6 mg/kg sessions while working with lower, more manageable doses of DMT. However, this did not occur to any extent in either man during their subsequent participation in the project.

  Another possibility is that Nils and Philip suffered a brief delirium, an “acute organic brain syndrome,” or “acute confusional state.” Delirium derives from the Latin de, meaning “from” or “out of,” and lira, “a furrow”; literally, “going out of the furrow,” or “out of it.” Delirium can result from physical factors such as fever, head injury, lack of oxygen, or low blood sugar. In addition, a profoundly traumatic psychological experience may produce a delirious state, such as what happens in survivors of severe trauma or disasters.

  I was uncertain to what degree “psychological trauma” contributed to Nils’s and Philip’s confusion in, and inability to remember much of, their DMT sessions. How much was a psychological reaction to the drug’s effects, rather than a direct effect of the drug itself? That is, climbing a ladder to view a scene of unimaginable shock value might throw one into a delirious or confused state, but it is not the ladder but rather the view the ladder provides that is responsible. Was what Nils and Philip saw so bizarre, so incomprehensible, so utterly aberrant that their minds simply turned off to spare them from seeing clearly what was there? Maybe it was better to forget.

  In either case, whether too much drug or too much experience, whatever 0.6 mg/kg IV DMT did to these two seasoned psychedelic veterans, it came down to just this: “too much.” As Philip said later,

  It was a cosmic blowtorch, a tempest of color, bewildering, like I was thrown overboard into a storm and was spinning out of control, being tossed like a cork.

  I called Dave Nichols again to discuss the DMT dose. What should be a lower “high” dose? A reduction to 0.5 mg/kg would be lowering the dose by only one-sixth, while 0.4 mg/kg was fully one-third less. We went back and forth. While I wanted to make certain the high dose elicited a full effect, I did not want to psychologically traumatize our volunteers. I was feeling a little tentative after the day’s events with Philip and Nils. “First, do no harm” is the overriding dictum for medicine in general, and even more so for human research. Creating a group of psychically damaged volunteers was not an option. Keeping the effects of Philip’s and Nils’s 0.6 mg/kg sessions in the forefront of our discussion, we decided to make 0.4 mg/kg the top DMT dose for the study.

  A few days later, I called the early DMT pioneer Dr. Stephen Szára to discuss these dosage issues. Dr. Szára had discovered the psychedelic effects of DMT by injecting it into himself in his laboratory in Budapest, Hungary, in the mid-1950s. (During the first phases of human psychedelic research, it was common for the researchers themselves to “go first.”) He now was completing a long and distinguished career at the U.S. National Institute on Drug Abuse in Washington, D.C.

  I asked him, “Did you ever give too much DMT to your volunteers?”

  Dr. Szára thought for a moment, then answered in his refined Eastern European accent, “Yes. They could not remember anything. They could not bring back memories of the experience. The only thing that remained with them was the feeling that something frightening had happened. We did not believe it worthwhile administering those kinds of doses.”

  It is fascinating how many of the themes that would emerge over the next five years appeared that December morning when I administered 0.6 mg/ kg IV DMT doses to Philip and Nils. We hear about near-death and spiritual experiences, and contact with “them” in the DMT realms. I felt conflicting priorities around friendship and research goals. The drawbacks of the hospital setting and medical model quickly were apparent. The need to give full psychedelic doses was already tempered by an awareness of their potential for negative reactions. There was a far-flung network of colleagues and regulators who variously assisted the project. All were there in some form or another in Philip’s and Nil’s 0.6 mg/kg IV DMT sessions.

  Let’s now turn to the background for this research, the vast amount we know about psychedelic drugs, and the way our science and society have used that information. Then we can begin to understand the unique role DMT plays in our bodies, and the astonishing functions it may serve in our lives.

  Part I

  The Building Blocks

  1

  Psychedelic Drugs: Science and Society

  The history of human use of plants, mushrooms, and animals for their psychedelic effects is far older than written history, and probably predates the appearance of the modern human species. Ronald Siegel and Terence McKenna, for example, suggest that our apelike ancestors imitated other animals by eating things that caused unusual behavior. In this way, they discovered the earliest mind-altering substances.

  There is growing physical evidence that many ancient cultures used psychedelics for their effects on consciousness. Archaeologists have uncovered ancient African images of mushrooms sprouting from a human body, and recent discoveries of prehistoric northern European rock art strongly suggest the influence of psychedelically altered consciousness.

  Some authors have proposed that language developed out of psychedelically enhanced appreciation of, and associations with, early hominid mouth sounds. Others suggest that psychedelic states formed the basis of humans’ earliest awareness of religious experience.
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br />   The visions, ecstatic states, and flights of imagination made possible by psychedelic drugs gave these substances an important role in many ancient cultures. Hundreds of years of anthropological research have demonstrated that these societies used psychedelics to maintain social solidarity, aid the healing arts, and inspire artistic and spiritual creativity.

  New World aboriginal people used, and continue to use, a wide range of mind-altering plants and mushrooms. Most of what we know about psychedelics comes from investigating chemicals first found in Western Hemisphere materials: DMT, psilocybin, mescaline, and several LSD-like compounds.

  The depth and breadth of psychedelic plant use by New World residents surprised and alarmed European settlers. Their reaction may have been due to the relative lack of psychedelic plants and mushrooms in Europe. Just as important was the association of mind-altering substances with witchcraft. The Church effectively suppressed information about the use of those materials in both the Old and New Worlds and persecuted bearers and practitioners of that knowledge. It is only in the last fifty years that we have realized that Mexican Indian use of magic mushrooms did not entirely die out in the sixteenth century.

  In Europe, there was little interest in, or access to, psychedelic plants or drugs until the end of the late 1800s. Some authors described their own “psychedelic” reactions to opium or hashish, but the amount required for psychedelic effects was difficult to consume, excessive, or dangerous. This situation began to change with the discovery of mescaline in peyote, a New World cactus.

  German chemists isolated mescaline from peyote in the 1890s. The more literary among those exploring its effects hailed its ability to open the gates of an “artificial paradise.” However, medical and psychiatric interest in mescaline was surprisingly restrained, and researchers published only a limited number of papers by the end of the 1930s. The unpleasant nausea and vomiting that often occur with mescaline may have had something to do with the lack of interest in it.