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Taking both these drugs should not be harmful. The effects of both drugs are likely to be reduced.

Combining these drugs should not be harmful. However, they will mask each other’s effects, which might increase the risk of overdosing either drug. This combination is also hard on the heart due to each drug’s opposing action (7).

The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually. Users have reported diminished experiences, thus care should be taken with dosage.

This combination carries a low risk. Aspirin and cannabis are unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Cannabis and DMT is not usually a harmful combination, but cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics so beware when mixing these drugs.

There is no evidence to date showing interactions between paracetamol and 2C-B.

This combination is unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Taking both these drugs together is likely to cause an effect stronger than taking them individually. If used with care they are unlikely to cause an adverse or undesirable reaction.

We strongly recommend you avoid taking these drugs together, reactions are highly unpredictable and can be fatal. You will likely come to some degree of harm even if you take strong precautions.

Taking the combined oral contraceptive pill and cocaine together is not usually any more harmful than taking them individually. The drugs are not known to interact with each other, each positively or negatively46,47.

Taking both of these drugs together is not usually any more harmful than taking them individually. The drugs are not known to interact with each other, each positively or negatively.

Alcohol and GHB is an unsafe combination. Even in very low doses this rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

Be careful when mixing amphetamines and GHB. Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

Avoid benzos if you are taking allergy medicines. benzos and allergy medicines such as Benadryl, Piriton and Clarityn are depressants and both slow down your central nervous system. This can produce heightened side effects such as drowsiness, sedation and poor concentration. In extreme cases, loss of consciousness and may occur.

These two drugs potentiate each other strongly and unpredictably which might lead to memory loss, blackout and respiratory depression.

Using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before mixing drugs.

Effects will be stronger than taking either drug alone, however, it’s unlikely that there will be any adverse health reactions to this combination.

The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually. Users have reported diminished experiences thus care should be taken with dosage.

There is no evidence to date showing interactions between contraceptive pills and cannabis and generally this combination carries a low risk. However, cannabis will often intensify and alter your mood. If your contraception is causing significant changes in your mood, it is advisable to avoid cannabis as it may intensify mood swings.

This combination carries a low risk. Paracetamol and cannabis are unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

There is no evidence to date showing interactions between paracetamol and LSD. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

There is no evidence to date showing interactions between allergy medicines and LSD. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

There is no evidence to date showing interactions between ibuprofen and 2C-B. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

There is no evidence to date showing interactions between ibuprofen and benzos. This combination is unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before mixing drugs.

The effects of these two drugs are similar and synergistic, therefore mixing MDMA with 2C-B may increase the intensity of the experience.

Combining kratom with such depressants is contraindicated.Depressants have the same general effects as opiates. Therefore, combining them with kratom can cause a synergy effect of severe sedation, which can feel like overdosing. More sedation and respiratory depression can occur as a result. Memory blackouts are also likely to occur.

_Users report that the two herbs go well with each other, however, moderation is important when combining them. Keeping both doses low helps ensuring that you derive the highest possible positive effects without crossing the line to negative side-effects. You should go particularly light on cannabis dosage. Although rarely, some users report mild effects, such as feeling nauseous, sick and uncomfortable. Stronger side effects include anxiety and dizziness._

Be careful when taking paracetamol and cocaine. Paracetamol may increase the harmful effects of cocaine on the liver4.

Taking both these drugs together may produce unpleasant effects such as physical discomfort or overstimulation. High doses put you at risk. If you mix, start low and go slow

_Kratom leaves produce complex opioid-like analgesic effects, which could be potentiated with the use of ibuprofen._

Amphetamines and DMT is not usually a harmful combination but stimulants generally increase anxiety levels and the risk of thought loops which can lead to negative experiences.

Tricyclics (Amitriptyline, Anafranil, Asendin, Aventyl, Elavil, Endep, Norfranil, Norpramin, Pamelor, Sinequan, Surmontil, Tipramine, Tofranil, and Vivactil) is consistently reported as being very bad in combination with LSD. People attempting this combination are unable to communicate with others, they go into a fugue state where they wander away from home and don't know how they got there, and they are generally in a terrible state psychologically. Life-threatening seizures and at least one death have been reported to be triggered by the combination of LSD and tricyclics. If you are prescribed tricyclics for mental health problems, it is not a good idea to try LSD outside of a supervised medical setting, as it might worsen the symptoms.

Effects are additive. The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually.

This drug can have anxiogenic (anxiety-creating) effects which may create an unpleasant thoughts and discomfort.

Using these drugs together can cause an effect stronger than desired though they aren't likely to cause a serious adverse reaction if used carefully. Additional research should always be done before mixing drugs.

Using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before mixing drugs.

This combination is relatively safe and is unlikely to cause any unwanted effects.

Stimulants should not be combined with kratom, as they further increase the level of stimulation provided by the kratom. This results in the development of potentially severe side effects: anxiety, heart palpitations, excessive sweating, and general agitation. More life-threatening side effects that may result include: increased blood pressure. The lowering of the seizure threshold may also be observed.

Cannabis and mushrooms is not usually a harmful combination, but cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics so beware when mixing these drugs.

The combination is unlikely to cause any adverse or undesirable reactions beyond those that might ordinarily be expected from taking these drugs individually. Benzos lessen the effects of nitrous oxide due to both drugs acting on common receptors.

This combination carries a low risk. Ibuprofen and cannabis are unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

Cannabis and LSD is not usually a harmful combination, but cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics so beware when mixing these drugs.

These combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Be careful when mixing these drugs.

The effects of mixing these two drugs together can be unpredictable.

There is no evidence to date showing interactions between aspirin and benzos. This combination is unlikely to cause an adverse or undesirable reaction when used carefully and within the recommended dose.

There is a low risk when drinking a moderate amount of alcohol when using the recommended dose of aspirin.

Avoid alcohol if you are taking aspirin for a headache. Alcohol is likely to make a headache worse as it causes dehydration.

2C-X and GHB is not usually a harmful combination, it will tend to decrease the effects of both drugs.

_Reactions and side effects are rare, but using these drugs together can cause an effect stronger than taking them individually, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Kratom’s effects are due primarily to its interaction with mu-receptors in the brain, while SSRIs produce their effects by interacting with the serotonin receptors. It is hypothesized that, since both act on receptors that can sometimes be involved with each other in certain processes, an interaction may or may not occur. Interactions include risks such as_ [_serotonin syndrome_](https://www.mdedge.com/ccjm/article/120386/neurology/serotonin-syndrome-preventing-recognizing-and-treating-it)_. Additional research should always be done before mixing drugs._

[**Tramadol**](https://www.drugs.com/tramadol.html) can result in seizures when taken with LSD, as Tromadol lowers the seizure threshold.

There is no evidence to date showing interactions between ibuprofen and modafinil. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

Taking aspirin and cocaine together is not usually any more harmful than taking them individually. Aspirin is sometimes [used](https://www.the-hospitalist.org/hospitalist/article/125897/how-should-patient-cocaine-associated-chest-pain-be-treated) by doctors in response to cocaine associated chest pains51,52.

There is no evidence to date showing interactions between ibuprofen and ketamine. This combination is unlikely to cause an adverse or undesirable reaction when used carefully.

Caffeine and GHB have low risk and decreased synergy. Caffeine will mildly hide the depressant effects of GHB leading to a slightly increased risk of overdose.

### Websites

[https://psychonautwiki.org/wiki/DMT](https://psychonautwiki.org/wiki/DMT)

[https://www.medicalnewstoday.com/articles/306889.php](https://www.medicalnewstoday.com/articles/306889.php)

[https://erowid.org/chemicals/dmt/dmt.shtml](https://erowid.org/chemicals/dmt/dmt.shtml)

[https://erowid.org/library/books\_online/tihkal/tihkal06.shtml](https://erowid.org/library/books_online/tihkal/tihkal06.shtml)

[https://erowid.org/chemicals/dmt/dmt\_culture1.shtml](https://erowid.org/chemicals/dmt/dmt_culture1.shtml)

[https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation](https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation)

[https://www.legislation.gov.uk/ukpga/1971/38/contents](https://www.legislation.gov.uk/ukpga/1971/38/contents)

[https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation](https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation)

[http://drugs.tripsit.me/DMT](http://drugs.tripsit.me/DMT)

### Papers

Barker, S. (2018). N, N-Dimethyltryptamine (DMT), an Endogenous Hallucinogen: Past, Present, and Future Research to Determine Its Role and Function. _Frontiers in Neuroscience_, 12.

Nichols, D. (2016). Psychedelics. _Pharmacological Reviews_, 68(2), pp.264-355.

dos Santos, R., Bouso, J. and Hallak, J. (2017). Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies. _Therapeutic Advances in Psychopharmacology_, 7(4), pp.141-157.

Strassman, R. J. (1984). Adverse reactions to psychedelic drugs. A review of the literature. _The Journal of Nervous and Mental Disease_, 172(10), 577-595.

Szabo, A. and Frecska, E. (2016). Dimethyltryptamine (DMT): a biochemical Swiss Army knife in neuroinflammation and neuroprotection?. _Neural Regeneration Research_, 11(3), p.396.

Drugs are dangerous. Really, we should just avoid them, that much is true. But if you are going to take DMT then there are certain precautions that can reduce that risk. We’ve separated these into tips for preparing yourself beforehand, taking care of yourself and others during, and ways to mitigate the after-effects. **Head over to our** **ME** **section if you would like to know more about harm reduction.**

>>> tabs 

# Before 

### Before

- **Trip sitter.** It is imperative to have a trip sitter (someone with you who is completely sober). Mostly to take the pipe away after smoking to avoid burning yourself.
- **Set and setting.** Psychedelics amplify your state of mind so it’s important to be in a nice place with people you trust and are comfortable with (setting), but also in a good state of mind (set). This will help avoid a scary and overwhelming experience (bad trip)
- **Comfortable.** Make the area where you are about to trip comfortable (setting), gather pillows and blankets as you will really be able to during the experience.
- **Pen and paper.** The DMT experience is quite similar to a dream in the sense that it will start to fade rapidly. Jot down your experience and your thoughts quickly. This will also help when integrating your experience.
- **Hydration.** Drink some water before and have a bottle of water to hand.

# During

- **Careful with the pipe.** When your pipe is loaded, have someone else light it for you and make sure to signal to them to take it away, you are unlikely to be able to have more than 2-3 puffs before drifting into oblivion.

# After 

- **Integrate.** The DMT experience is extremely intense and short-lived. Take some time afterwards to process and integrate the experience back into your life.
- **Day off.** For at least 24 hours after taking DMT you will be slightly impaired physically and mentally. Avoid driving (and other technical activities) and complex thought tasks.
<<<

**DMT overdose**

Overdosing on DMT is rarely dangerous, physically, and no deaths have been attributed to DMT use alone. However, taking too much usually results in a bad trip and can be very disorienting and scary. In this situation reassurance by the trip-sitter that the experience will soon be over and deep breaths can help.

**DMT dependence**

DMT doesn’t cause dependence or addiction, and no physical withdrawal symptoms have been described. Unlike other psychedelics tolerance is not associated with its use.

**Long term effects of DMT use**

Hallucinogen Persisting Perceptual Disorder (HPPD) and flashbacks

[Hallucinogen Persisting Perceptual Disorder (HPPD)](http://www.ncbi.nlm.nih.gov/pubmed/26421858) and flashbacks both result in a re-experiencing of one or more of the psychedelic effects a long time after trying the drug (months or years). Scientists still don't agree on whether they are the same condition in varying degrees or completely separate; we need more research!

The main difference between HPPD and flashbacks is that the former is a distressing medical condition, while the latter can be experienced as either positive or negative. HPPD is a disorder described in DSM-V, but still this condition still remains poorly defined and studied. We still do not know how many people suffer from it, and what makes people vulnerable or optimal ways to treat it. People with HPPD experience visualizations that are frequent, and impinge upon their daily lives. Flashbacks are meant to be intermittent, infrequent experiences, whereas HPPD is described as a more persistent state. However, both terms are often used interchangeably.

If you decide to try this drug, the effects can be very disturbing in your everyday life. Visual effects seem to be more prominent (geometrical hallucinations, flashes or intensification of colour, movements, afterimages, trails and haloes).

If you think you have HPPD or are experiencing flashbacks, don't hesitate to seek medical help.

Here are the most common effects, not everyone necessarily experiences all of them every time they consume the drug and other effects not listed might be felt. **The likelihood of experiencing negative effects is far greater at high doses.**

The effects are (from positive to negative):

>>> effects 
++ Euphoria
++ Existential self-realization
++ Exposure to inner mechanics of consciousness
++ Ego death (personal bias suppression)
++ Unity and interconnectedness

== Hallucinations (vision, sound, and touch)
== Time distortion

-- Dysregulated body temperature
-- Emotion enhancement
-- Severe confusion/disorganized thinking
-- Unease and gloomy feelings
-- Anxiety/paranoia
<<<

A DMT overdose is rarely physically dangerous (it would take close to 100 times the typical dose); however, the experience can be incredibly overwhelming and disorienting. This can be tricky to notice externally so remember to take deep breaths and communicate your distress to the tripsitter who will attempt to soothe you. Take deep breaths and try to remember that it is only the effect of the drug ableand that it will be over soon.

### How? How Much? When? For how Long?

These are important considerations. DMT typically comes as crystals, to be smoked. Unless you had lab grade DMT, injecting it would be very dangerous due to impurities. As with any drug, the dose you take can vastly impact your experience so be careful. The effects you feel from a given dose of DMT will vary depending on many factors such as your weight, gender, [metabolism](https://www.pharmacologyeducation.org/pharmacology/drug-metabolism), and [tolerance](https://drugsand.me/en/me/#tolerance) from previous use. Read our section on [dosing](https://drugsand.me/en/me/#dosing) for more information. As DMT is a psychedelic, it is also strongly influenced by your mental state (“set and setting”).

**Read our section on dosing and tolerance in** [**ME**](https://www.drugsand.me/me/dosing) **for more information.**

### How you take it matters...

Smoking

This is the most common method of taking DMT. Usually a glass pipe, with a sieve or dried plant matter used to hold the crystals. You should expect to cough because the smoke can be quite harsh.

You should always have a trip sitter or sober friend with you. Agree a signal and get them to take the pipe as you will only be able to take 1-2 puffs before the effects come on and you might drop the pipe and burn yourself.

### How much?

Dosages for smoking DMT

- Threshold: 2-5 mg
- Light: 10-30 mg
- Medium: 30-50 mg
- Strong: 50-80 mg
- Heavy: 80-130 mg

### When do the effects kick in?

The **START** time below is when you will usually begin to feel the effects of DMT from the time when you first take it. **DURATION** is roughly the length of time you will experience the effects, after which the effects will start to wind down and you might start to feel the comedown effects.

Smoking DMT

- **START:** 15 – 60 seconds (usually on the exhale)
- **DURATION:** 5 – 20 minutes
- After effects: 15 – 60 minutes

Sometimes the drugs we think we are buying turn out to be something very different. Knowing of the common substitutes is an easy way to protect yourself and your friends.

### 5-MeO-DMT

Similar to DMT (part of the tryptamine class as well) and can be smoked as well but has a much lower dose range (active at 3-20mg). If confused for DMT it is likely to overdose and the effects likely be overwhelming mentally and very unpleasant. It may have some cardiogenic effects (increased heart rate, breathing, sweating etc).

### Europe

#### United Kingdom

DMT is a class A/schedule 1 drug, making it illegal to possess purchase or sell.

#### Germany

DMT is listed in Anlage 1 of the BtMG, making it illegal to possess, purchase or sell.

#### France

DMT, along with most of its plant sources, is classified as a _stupéfiant_ (narcotic).

#### Netherlands

DMT is banned and is on list 1 of the Opium Act. Producing, trading or possession of DMT is prohibited.

#### Portugal

Decriminalized drug possession in quantities for personal use

#### Russia

DMT is listed as schedule 1, making it illegal to possess purchase or sell.

### Americas

#### USA

DMT is classified as a Schedule I drug under the Controlled Substances Act of 1970.

#### Canada

DMT is listed as a schedule 3 drug.

#### Peru

Legal in ayahuasca and declared as a national cultural heritage.

#### Brazil

Legal in ayahuasca and declared as a national cultural heritage since 1992.

#### Ecuador

Decriminalized in ayahuasca.

### Asia and Australasia

#### Australia

Illegal

#### New Zealand

Illegal. Class A drug

#### Singapore

Illegal

#### Hong Kong

Illegal

#### Israel

Illegal

_The Drug Classroom -_ [_Dimethyltryptamine (DMT): What You Need To Know_](https://www.youtube.com/watch?v=JpzQTTMoL9U)

DMT doesn't mix well with stimulants, there's an increased chance of anxious states and repetitive thought loops, which can negatively affect the experience.

Tramadol and DMT should not be taken together. Tramadol is known to lower the seizure threshold, while DMT (and psychedelics in general) are known to occasionally cause seizures.

Drugs that have been associated with HPPD include CBD, LSD, DMT, 2C-E, 2C-I, 5-MeO-DMT, MDA, MDMA, psilocybin, diphenhydramine, PCP, synthetic cannabinoids, zolpidem, eszopiclone, and high doses of dextromethorphan. There have also been anecdotal reports of the atypical psychedelic _Salvia divinorum_ causing persisting symptoms consistent with HPPD.

It is imperative to have a trip sitter (someone with you who is completely sober). Mostly to take the pipe away after smoking to avoid burning yourself.

Tripsitter

To be in a good state of mind and a stable place in your life.

Psychedelics amplify your state of mind so it’s important to be in a nice place with people you trust and are comfortable with.

DMT

{The Spirit Molecule, Jungle Spice, Dimitri, the Businessman’s trip, Fantasia}

Harm Reduction

Before

References

Websites

Papers