Anecdotal data suggests that “reactivations,” or flashback experiences of past drug effects, are relatively common with 5-MeO-DMT, commonly known as “the toad” (it comes from toad venom) or “5-MeO.” A new study published this week investigated whether 5-MeO-DMT flashbacks were more common in certain groups of people or under certain conditions.

Over 500 people who had used 5-MeO-DMT in naturalistic (real-life, not clinical) settings were surveyed about their experiences with reactivations. The survey revealed that reactivations were more common in people who were female, older at the time of the first dose, more educated, and dosed in a structured group setting (as opposed to dosing at home or outdoors).

Most flashbacks occurred a few days to a few weeks after dosing and subsided with time, although flashbacks can persist in some people.

Are 5-MeO-DMT Flashbacks Bad?

Is a 5-MeO-DMT reactivation a bad thing? Not necessarily. Most participants reported that their reactivations were positive.

Notably, 86% of people who took 5-MeO-DMT in a structured setting reported their reactivation event as positive, while 10% said the flashback was neither positive nor negative and 4% of respondents reported their reactivation event as negative. For participants who dosed in a non-structured setting, 73% reported their reactivation event as positive, 20% said it was neutral and 7% reported a negative flashback.

Flashbacks in Structured Groups vs. Unstructured Dosing

Why would a group setting correlate with more positive flashback experiences? Expectancy bias could be a factor. The authors point out that in a structured group, participants undergo an orientation session and are informed of the possibility of reactivations. In the general population sample, participants may not have known about possible reactivations. According to expectancy bias, the expectation of an outcome is sometimes enough to produce the outcome.

Future Research About 5-MeO-DMT Flashbacks

The researchers end with recommendations for areas of future research: How long does each flashback last? How disruptive are negative reactivations? How long after 5-MeO-DMT use do reactivations tend to occur, and how often do they happen? What triggers a flashback?

These and other uncertainties will have to be addressed before 5-MeO-DMT and other therapies can be applied in a medical setting. Clinicians and patients will need to know what to expect and how best to reduce the risk of an untimely flashback and potential distress during dosing as well as in the days and weeks that follow.




Ortiz Bernal, A. M., Raison, C. L., Lancelotta, R. L., & Davis, A. K. (2022). Reactivations after 5-methoxy-N,N-dimethyltryptamine use in naturalistic settings: An initial exploratory analysis of the phenomenon’s predictors and its emotional valence. Frontiers in Psychiatry, 13.