Extending the Experience: Interview With DMT Pioneer Rick Strassman

This article by Lester Black was originally published on Microdose and appears here with permission.

DMT earned its “businessman’s lunch” nickname in the 1980s thanks to the molecule’s paradoxically strong yet short-acting psychedelic effects. With a high that can be as short as 20 minutes, someone can be transported to a new reality full of sentient elves and then return to earth before their lunch break is over.

But what happens if you take this potent psychedelic and extend it for 1, 2, 3, or even 9 hours?

That’s the provocative idea proposed by Rick Strassman, a medical doctor and former University of New Mexico professor who deserves more credit for bringing DMT into mainstream academia than any other scientist. In the early 1990s, Strassman conducted a series of clinical trials that injected dozens of subjects with DMT (N,N-Dimethyltryptamine) and documented the psychedelic drug’s fascinating effects. DMT is the primary active ingredient in ayahuasca but Strassman’s trials showed that when you use a purified version of the drug, instead of the complex mixture found in the Amazonian ayahuasca medicine, subjects are almost immediately transported into a seemingly distant dimension with very peculiar effects, like patients encountering sentient humanoid beings.

Strassman gave his subjects a single, intravenous dose of DMT that sent the patients on the classically intense and short psychedelic trip. But in 2016, Strassman co-authored a paper that explained how giving a continuous intravenous drip of DMT—similar to how anesthesia is used during surgeries—could allow patients to be kept inside this DMT state for an extended period of time. At least two labs are taking Strassman’s theory to reality: a team at Imperial College is running a pilot study where volunteers are continuously given DMT for 30 minutes and a team at University Hospital Basel is running a Phase 1 trial where volunteers are given continuous DMT transfusions for 90 minutes.

These teams are doing the foundational work that could turn into much longer DMT experiences if Strassman’s method proves effective. To learn more about the possibilities of this kind of DMT experience, I recently chatted with Strassman over Zoom to learn about how extending the DMT experience could help psychotherapy, how it could allow us to explore the peculiarities of the DMT trip, and if he thinks humans could be living in a DMT hallucination.

This interview has been lightly edited for length and clarity.

Lester Black: Your pioneering DMT clinical trials in the 1990s gave scientists a foundational understanding of DMT. But have you have said that the trials’ use of one-time, intravenous injections of DMT made it hard to fully understand the DMT experience. Why is it difficult to study DMT through both intravenous injections and the common method of smoking DMT?

Dr. Rick Strassman: It is just too fast and short. By the time you orient yourself and start to get a good lay of the land you start coming down. 

Your 2016 paper with Andrew Gallimore describes how continuously giving DMT—similar to how anesthesia is continuously given during surgeries—would allow researchers to better understand and utilize DMT. Why would this be more effective than just giving larger doses or giving repeated oral doses?

DMT is orally inactive, you need to combine it with another compound to inhibit its metabolism in the gut [like what is done with ayahuasca]. So, in a way, you could look at ayahuasca as a prolonged oral DMT experience. But it’s not exactly the same thing because of the effect of ayahuasca’s beta-carbolines, including harmine, harmaline, and tetrahydroharmine. Those contribute to both the gastrointestinal side effects but they also have their own psychological effects, so it’s not a pure DMT experience. So you really can’t study pure oral DMT. 

If you gave a larger injected dose you would become confused. We gave two volunteers a higher dose than the one we ended up using as a high dose and it was disorienting, they couldn’t remember much about it. 

The question of repeated dosing is a good one. We did that in a tolerance study giving DMT every half hour four times in the morning, and there was no tolerance to the subjective effects. The intensity of the fourth injection was as strong as the first. So you could give repeated dosing, you go up, you come down, then you go up, then you come down. This way, you can check in with the subject in between doses. And there’s nothing sacred about ½ hour intervals in this model—you can lengthen it if you wish. With a continuous infusion you can keep people at a specific level for as long as you want. You can also take them out of it, because the drug is metabolized so quickly you return to baseline in 10 or 20 minutes.

I’m curious about your general interest in this idea. It seems like there’s practical applications for continuously giving DMT for medicinal use, but it seems like you’re also curious about this to conduct a type of DMT fact finding mission. Am I getting that right? 

From the clinical or therapeutic perspective, you could do more psychotherapeutic work with a continuous or repeated dosing DMT model. In psychotherapy, you might be interested in a mild intoxication as you’re getting into particular issues, you can come down and talk to your therapist about what you want to do next. You can increase the dose and go more deeply into some of those things. If you want to completely dissolve your sense of self you can agree on a certain time period where you’re completely dissociated. You could be sober for as long as you want, too, to process your experience. So you could do a lot of therapeutic work using that model.

One of the reasons for using more extensive exposure is exploratory. People can’t really negotiate in the DMT space after one single big dose to get a good idea of what’s going on. So a continuous infusion could allow you to characterize the state much more carefully. One of the more interesting aspects of the DMT experience is the experience with these beings, these seemingly autonomous, sentient, powerful entities. And one of the drawbacks of the single bolus model is that it can take some time to establish a common language with these beings. And oftentimes you’re so startled by their appearance (even though it happens over and over) that it can take some time to recover from the surprise. So if you’re able to extend your contact with them, so to speak, you could start working on a more leisurely, less frantic means of interacting with those beings. 

You could also start working with other contents of this state. For example, there are all these objects in the DMT world and you could explore them more carefully. A lot of the visual experience is described as jewel-like, so what is the consistency or quality of those jewels? If you took a hammer to it would it spark? Would your hammer disappear into it? What is the nature of some of the other objects in the DMT space?

It’s interesting to hear you describe this as the “DMT world,” because people who use DMT often say it allows you to access a separate world. People in your trials reported that taking DMT didn’t give them a hallucination as much as the DMT took them to another world that felt very real, or even more than real than our normal reality. Why do you think that DMT can affect our sense of reality?

Reality is a feeling, a sense that certain things have a reality value that is attached to them. We can distinguish between everyday reality and dreams, for example, in this way. So there is probably some mechanism in the brain that regulates the sense of reality. And because that part of the brain is perhaps more active on DMT, it feels more real. 

But then you have a chicken and egg situation. Because DMT feels more real does that mean it is real? So it’s really hard to pinpoint what that means. It could mean that the DMT state is more real than real. And so that’s why the brain is responding to the immersion in that state. Or it could be vice versa; that it’s just “your brain on drugs,” and it’s simply that the “reality center” of your brain is being activated. It could also be that because the hallmark of the DMT experience is the feeling that things are more real than real, then perhaps the putative DMT neurotransmitter system–hinted at by such high levels of endogenous DMT in mammalian brain–is regulating our sense of reality.

Some people who take DMT react to it in spiritual or mythical ways where they think they’re interacting with another dimension. Do you personally leave open the possibility that there could be something more here than just your brain being on drugs? That maybe DMT allows us to access some other dimension?

We just can’t say. And I’ve pondered this. What would change if this world turned out to be a DMT hallucination that we’re all living in? Would you live your life any differently? Would you be a psychopath or would you be nicer?

Cause and effect seem to take place in the DMT world, and cause and effect are the basis of everyday reality. I think in some ways it doesn’t really matter. If you subscribe to the notion that DMT allows entrance into a spiritual world that is independent and parallel to this one, then so what? Are you going to be a better person? Are you going to care more about the spiritual world and its contents? I think the jury is still out, I think we have a lot more work to do before we can say anything with certainty. 

When we spoke back in 2018 [for a story in Seattle’s The Stranger newspaper] you mentioned that you thought DMT was being overlooked. 

I still think that. Even more so.

What would make you change your mind, what would make you think DMT is getting enough research interest?

I think there should be a lot more money directed at research that attempts to explicate the reasons why our brains make DMT. I think we ought to try to understand what naturally occurring DMT is doing. Colleagues at the University of Michigan who published that 2019 paper on how the brain makes DMT can’t get funding for additional research.

If there’s a DMT neurotransmitter system, it may be involved for example with naturally occurring psychosis. If for example you produce too much DMT, which is still a viable model for schizophrenia, you could then work on blockading those receptors for DMT. Would that be an effective treatment? Or if you don’t produce enough DMT and you’re depressed, you could suppress the reuptake like you do with SSRIs and increase the amount of DMT to get back to normal. How about the dream state? The Michigan studies demonstrated high levels in dying rodent visual cortex, so endogenous DMT’s role in the near-death experience is of great interest. I think it takes some farsightedness, and not that much, to see the implications of understanding the importance of a potential DMT neurotransmitter system.