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Integrative Psychiatry

Spirit Molecules, Sacred Ecosystems: Clinical Developments and Sustainability of DMT

By January 15, 2025No Comments

Often called the “spirit molecule,” dimethyltryptamine (DMT) is known for its ability to induce profoundly mystical psychedelic experiences. Curiously, DMT is an endogenous compound, meaning our own bodies create it—although its function and biological purpose in humans is not well understood. Different forms of DMT are produced throughout the animal and plant kingdoms. Two primary forms include N,N-DMT and 5-MeO-DMT. While both exist in a number of different species, N,N-DMT is famously found in the traditional Amazonian brew, ayahuasca, while 5-MeO-DMT is commonly extracted from the Colorado River Toad (Bufo alvarius). 

So what are the differences between these two forms of DMT, and what are the cultural, ecological, and ethical implications of their growing popularity? 

N,N-DMT

N,N-DMT is a molecule that occurs naturally in various plants and in trace amounts in the human body. When smoked or vaporized, N,N-DMT delivers a short but intense psychedelic experience that lasts 10–15 minutes. Users describe being transported to vivid, otherworldly realms filled with intricate patterns and, sometimes, encounters with mysterious entities. The experience often feels like a journey into another dimension.

When consumed in ayahuasca, however, N,N-DMT’s effects last several hours. This is because other plants added to the beverage contain monoamine oxidase inhibitors (MAOIs), which makes the DMT orally active and slow to metabolize. The DMT that is found in ayahuasca is extracted from plants like Psychotria viridis or Mimosa hostilis, which are considered sustainable to cultivate and harvest. The ceremonies cultivated around ayahuasca are spiritual experiences that are important to many different Indigenous cultures of the Amazon; often, these rituals focus on human-nature relationships with the sacred plants and other nonhuman beings. Ayahuasca’s traditional context reflects a deep respect for the natural world and ecological harmony.

5-MeO-DMT

While structurally similar to N,N-DMT, 5-MeO-DMT is a distinct molecule with its own properties and effects. 5-MeO-DMT tends to produce a more somatic and non-visual experience, characterized by ego dissolution, a sense of unity, and profound emotional states. Similar to N,N-DMT, effects are short-lived, typically 10–20 minutes—but the impact of experiencing pure, unfiltered divinity can be life-changing.

5-MeO-DMT has a less obvious cultural history than N,N-DMT. While there is actually no archeological evidence to determine ceremonial work with toad-derived DMT (although speculated), there is clear evidence pointing to the consumption of other sources of 5-MeO-DMT. Today, however, 5-MeO-DMT is harvested from Bufo venom due to its high concentration. To extract the venom, toads are captured, “milked,” and released back into the wild. However, the growing demand for 5-MeO-DMT has led to unsustainable practices, including overharvesting and killing of toads. Advocates of ecological sustainability are calling for awareness and change through education, policy, and support for ethical guidelines.

Clinical Contexts of DMT 

Researchers are excited about the potential of both N,N-DMT and 5-MeO-DMT to treat depression. Clinicians speculate that its rapid and profound shifts in consciousness could be valuable for individuals who haven’t responded to first-line treatments. Several biotechnology companies are currently studying their particular, synthetic version of DMT for safety and efficacy in humans. Preliminary results suggest that these medicines improve mood and emotional resilience, possibly by disrupting rigid thought patterns. Other research groups are exploring how DMT might affect neuroplasticity and emotional processing. 

Conclusion

DMT is on the verge of becoming a potential mental health treatment. As we continue to develop a more clinical and scientific relationship with this medicine, it is important to protect the ecosystems and cultures that make this work possible. Because we can’t heal ourselves if we aren’t healing the planet, advocating for ethical sourcing of DMT and considering cultural traditions of this medicine are essential in practice. Integrating ancient wisdom with modern scientific insight may be one path forward toward holistic wellness. 

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.