The Origins and Theory Behind DMTx — Part 1

The history and future of extended-state DMT...

In the last few years, the extended-state DMT infusion technology, which has come to be known as DMTx, has cemented its position in public consciousness, at least within our small but growing circle of psychedelic-minded people. There’s been a lot of talk — for much of which I can be held at least partially responsible — about “mapping” the DMT space, establishing stable and reciprocated communication with its inhabitants and, whilst perhaps not becoming interdimensional citizens ourselves, at least achieving longer-term tourist visa status. As such, as the first DMTx pilot studies have been completed and prepared for publication, I think it time I discuss where DMTx came from and where I think it might be heading.

In the next post, I’ll talk more about the actual science behind DMTx. But, briefly, DMTx is a technique borrowed from anaesthesiology in which, rather than a bolus (i.e. all at once) injection, DMT is delivered into the blood stream using a programmable infusion machine at a variable rate (and this is the key point) designed to maintain a stable brain DMT concentration over time. This should, in theory, allow an individual to be induced into the DMT space and held there for an indefinite period of time — hours or longer. Rick Strassman and myself proposed this technique and published a preliminary proof-of-principle model for its implementation in 2016:

Download the paper for free here: https://www.frontiersin.org/articles/10.3389/fphar.2016.00211/full

Firstly, I should make it clear that I am not currently directly involved in any of the DMTx projects, only one of which — that of the Imperial College Centre for Psychedelic Research — has so far been completed in humans, although there are others either in the development or early implementation stages. What I hope Rick Strassman and myself were able to do, however, is spark an interest in the potential of this kind of work, whatever its ultimate aims and uses might be.

I suggested the moniker “DMTx” as a shorthand for “extended-state DMT” during a series of email exchanges with Daniel McQueen of Medicinal Mindfulness in June 2017, as I was preparing to give a lecture on the topic in Boulder, Colorado, which you can watch here (the DMTx discussion is in the second half of the talk):

Although I never specifically promoted the name, it has somehow become the unofficial official term to describe the technology, and I’ve come to see “DMTx” as a generic name for any target-controlled intravenous infusion protocol designed to induce and hold a subject within the DMT space for extended periods of time. It is not, and never should be, used to exclusively refer to a specific protocol or model used/owned/patented by any particular group.

The idea of infusing DMT, rather than the typical bolus injection (in which the DMT is injected over a few seconds), isn’t new. A group from the University of Cologne employed infusion of both DMT and ketamine (not at the same time!) in a phenomenological study in 2005 (link). However, as we state in our 2016 paper:

"This group’s infusion rates were established by observing the subjective effects of the drug, rather than taking into account its underlying pharmacokinetics or pharmacodynamics. That three of the 15 subjects dropped out of the study because of adverse psychological reactions suggests that this model resulted in an overly high infusion rate. A more pharmacokinetically-informed approach to infusion will allow the attainment and maintenance of a stable blood—and presumably brain—concentration of DMT, and thus provide a safe and effective prolonged immersion in the unique DMT state.”

Also, Gordon Todd Skinner (who was closely connected to LSD manufacturing legend William Leonard Pickard) developed his own DMT IV drip technique long before any of us scientists were thinking about it:

“Skinner’s favorite method for “time surfing” was taking DMT via an IV drip. He would prepare an isotonic solution with a tendency to be slightly hypertonic, using free amine 3, magnesium sulfate and acsorbic acid. Skinner did not use saline solution to get the density up, and rarely used 5% dextrose. He said that significant phantom pain radiated near the injection site for the duration of the trip and should be ignored. Drips often lasted up to 1-5 hours and gave the most signifcant afterglow of any psychedelic.” (link)

What I think Rick and myself brought to the table was the idea of drawing on the target-controlled intravenous infusion (TCIV) technology developed as a tool in anaesthesiology to account for the distribution, metabolism, and excretion of a drug so as to maintain a stable brain concentration. We would, however, replace the anaesthetic drug with DMT.

The idea for DMTx came to me sometime in 2015, as I was reading through some of Rick Strassman’s papers from his pioneering 1990s study. One study, in particular, caught my attention:

Volunteers were given a high (breakthrough) dose of DMT at 30 minute intervals and asked to complete Strassman’s Hallucinogen Rating Scale to quantify the intensity of the experience after each dose. Somewhat surprisingly, even after the fourth dose, the intensity of the subjective experience remained constant — there was no subjective tolerance. You can read the original paper here: https://maps.org/research-archive/w3pb/1996/1996_Strassman_22710_1.pdf

Having a passing familiarity with target-controlled intravenous infusion from my earlier studies in pharmacology, it immediately struck me that DMT seemed to possess the same pharmacological requisites as the anaesthetic drugs used to keep a patient unconscious during surgery: rapid onset of clinical effects; a short duration of action; favourable side-effect profile; and, as this study demonstrated, a lack of subjective tolerance.

At this point, I knew I needed more than just a proposal — little more than an idea really — but something more substantial. What I needed was an actual proof-of-principle model that would demonstrate, at least to the referees of a peer-reviewed academic journal, that this technology would not only be possible, but worthy of further development. So I emailed Rick.

The blood DMT concentration vs time plots presented in Rick’s papers meant he possessed — or, at least, used to possess — the required data for such a model. Fortunately, Rick quickly replied to my query, attaching an old Excel file containing all of the blood DMT data from this study. We were good to go. From opposite sides of the Pacific Ocean, we then worked on the paper together and finally submitted the manuscript to Frontiers in Pharmacology in April 2016. Although I half expected a curt rejection letter in return, we were soon notified that the article was with a pair of referees. The idea of using DMTx to test the ontology of the DMT “beings” by asking them to perform complex mathematical operations actually made it into the first draft of the manuscript. However, it was scrubbed after a gentle nudge from one of the referees:

“If we wish for this work to be taken seriously (as I believe it should), positing that TCI would allow us to ask DMT beings how to factor large primes will not enhance the credulity of critics and detractors – I suggest that it is removed.”

Rick filled the space with some stuff about treating people with depression, which seemed to satisfy the referee. I bit my tongue.

Not long after the paper was published, the first Vice article followed, as did the emails from somewhat over-keen prospective volunteers — I haven’t been keeping count, but should I ever decide to initiate my own DMTx project, I certainly won’t be short of willing subjects to inject.

https://www.vice.com/en/article/vdb8jm/dmt-trips-last-longer-strassman-gallimore-influence

As far as I’m aware, there are at least three separate groups with a DMTx project at some stage of development. The Medicinal Mindfulness DMTx project was the earliest and is probably closest to my original vision, the stated aim being to establish communication with the intelligences within the DMT space, whatever their nature or origin. However, despite being a largely non-academic group unaffiliated with a university, and consequently facing many more legal and regulatory obstacles in getting the project off the ground, their persistence and determination to pursue this project is admirable. Since getting the required permission to administer DMT to human volunteers looked to be an almost unsurmountable obstacle, they were initially looking to perform the actual studies outside of the USA (I believe Costa Rica and Jamaica were both considered). However, with the recent positive change in legal restrictions regarding psychedelic use in Colorado, this might no longer be necessary. I’m certainly looking forward to what they can achieve in the coming years. See their website, DMTx.org, for details.

Not too surprisingly, Imperial College’s Centre for Psychedelic Research in London have certainly progressed the furthest, having completed their first 30 min DMTx study, led by Chris Timmermann, in human volunteers in 2022, with the results being published sometime this year (hopefully). Although I’m not yet privy to the complete data, having heard Chris speak about the project on a couple of occasions, it’s evident that, as I had hoped and predicted, the subjective DMT state can be stabilised at several dose levels beyond the initial chaotic “rollercoaster” phase. The slide below shared by Chris on his Twitter feed shows how a DMT experience of fairly stable intensity (particularly at higher dose levels) can be maintained over 30 minutes (link).

Together with an improved pharmacokinetic model developed in collaboration with pharmacokineticist Dr. Michael Ashton of the University of Gothenburg, these results should provide the basis for more directed studies of the DMT space in the future.

Finally, Matthias Liechti’s group in Basel are planning (or perhaps have already started) infusions of up to 90 min, both for clinical and exploratory purposes. See here: https://clinicaltrials.gov/ct2/show/NCT05384678.

So what’s the purpose of DMTx? From the prosaic to the more otherworldly, the potential uses for DMTx are manifold. As we (well, Rick) discussed in our 2016 paper, a DMT infusion can provide much more control over both the duration and depth of the psychedelic state than achievable using LSD or psilocybin in clinical settings:

“Patients could be “titrated” for both the duration and intensity of the DMT state that was most useful for augmenting the psychotherapeutic process. For example, in the case of working through trauma, re-experiencing the feared stimulus in the altered state might be initiated with induction into a mildly altered state of relatively brief duration. In the course of treatment, a more prolonged and intense altered level of consciousness could be applied to a more extensive working through process, broadening and deepening the therapeutic gains begun with shorter and lighter exposures.”

Then there’s the opportunity, afforded by the extended experience duration, to study the DMT state itself in more depth and detail than has been possible previously. Whatever one might choose to believe regarding the “ontological status” of the DMT world and its inhabitants, it’s undeniable that the DMT state is a wildly novel neuropsychological phenomenon worthy of serious scientific investigation. What are the changes in neural activity that underlie the DMT experience? Why do they occur? Can we in some way map the structure and content of the DMT state? What can all of this tell us about the human brain, consciousness, and of our place within wider reality? These kinds of research questions are certainly worth pursuing even if you harbour no beliefs about the reality or otherwise of the DMT worlds.

Beyond this, I certainly haven’t shied away from the more “sci-fi” potential of the technology, particularly when discussing the entities encountered in the DMT space, and no doubt this helped pique the interest and imagination of those reading my work or listening to me speak on the subject: This wasn’t just going to be a useful tool for the MRI suite or the clinic, but a technology for discovering alien intelligence from beyond our universe. Or, at least, that was my original motivation for DMTx. I have neither an academic position nor a funding source to defend and am thus free to entertain ideas that, to many, would seem rather outlandish. This is a freedom I’m more than happy to exercise. Some of the news articles that followed publication of our paper were somewhat hyperbolic, and I personally remain largely agnostic as to the true origin and nature of the DMT entities, and don’t rule out the possibility that DMT might grant access to a truly autonomous conscious intelligence.

See these articles, for example:

https://therooster.com/blog/contact-has-been-made-scientists-build-dmt-machine-talk-aliens

https://therooster.com/blog/meet-the-real-life-people-probing-one-part-of-an-alex-jones-dmt-conspiracy-theory

It was perhaps Graham Hancock’s appearance on the Joe Rogan show in 2019 that brought DMTx to wider public attention, in which he referred to the possibility of “mapping” the DMT worlds using the technology:

Mapping the DMT space doesn’t refer to cartography in the traditional sense and I certainly don’t envision a DMT Space Ordinance Survey anytime soon. I see mapping in a more abstract sense: systematic surveys and analyses of the content and inhabitants of the space, developing a deeper understanding of its geometry, topology, and dynamics, as well as describing more formally the progression into the space from administration to breakthrough. Whenever I have spoken at length about DMTx, I have always stressed the importance of a multidisciplinary team beyond the neuroscientists, pharmacologists, and clinicians foundational to human psychedelic research: Anthropologists, mathematicians, linguists, artists, and perhaps even theologians might all find a role in these studies. Techniques for the real-time communication between the subject and those waiting on the outside would also need to be developed so as to avoid relying on memory to relay the rich and complex information collected from within the space. I could go on, but I think you get the idea. Although we’re likely a long way from the kinds of studies that will be able to assess the more controversial issues around ontology and discarnate intelligence, I can’t help but feel that we’re at the frontiers of human enquiry with this kind of work, and it’s nice to play a very small part in it.