Safety Guide

Contraindications

These conditions generally contraindicate ayahuasca or DMT use without clinical oversight:

• Cardiovascular: Uncontrolled hypertension, arrhythmias, history of MI or stroke
• Psychiatric: Active psychosis, schizophrenia, bipolar disorder (especially Type I)
• Neurological: Uncontrolled seizures, history of stroke
• Hepatic/Renal: Severe liver or kidney disease
• Pregnancy: Avoid; effects on fetus unknown

When in doubt, consult a physician familiar with psychedelics.

Drug Interactions: The Critical Issue

SSRI/SNRI Antidepressants (Sertraline, Paroxetine, Venlafaxine, etc.)

• Risk: Serotonin syndrome (tremor, hyperthermia, autonomic instability)
• Guidance: Many facilitated retreat programs recommend stopping SSRIs 2-4 weeks before ceremony under medical supervision
• Alternative: Consult a psychiatrist familiar with psychedelics about tapering and alternatives

MAOIs (including dietary): Ayahuasca contains MAOI plants

• Risk: Severe hypertensive crisis when combined with certain foods (aged meats, fermented foods) or other drugs
• This is why strict dieta is essential

Other drugs to disclose: Stimulants, opioids, anticonvulsants, lithium, tramadol—all have potential interactions.

Emotional Safety

• Difficult experiences happen: Fear, grief, or confrontation with shadow are not failures—they're often where healing lives.
• Trust the container: Trained facilitators know how to hold challenging material.
• You can pause: If overwhelmed, some retreats allow stepping out. Communicate needs clearly.
• Post-ceremony support: Access a therapist or integration coach if the experience destabilizes you.
• Reach out: If depression, dissociation, or intrusive thoughts persist beyond 2 weeks, seek professional help.

Retreat Safety Red Flags

🚩 Facilitators without proper training or certification 🚩 No medical screening or dismissal of health concerns 🚩 Pressure to use additional drugs or alcohol 🚩 Facilitators using their own plants unsupervised 🚩 Lack of emergency protocols or medical access 🚩 Isolation without communication to outside world 🚩 Inappropriate sexual or financial boundaries 🚩 No integration support or follow-up

See "How to Vet a Retreat" for vetting guidance.