SAFETY & CONTRAINDICATIONS

Before the Circle

Plant medicine works on the body as much as the mind. Some combinations of medicine, substances, or health conditions aren't just unwise, they can be dangerous. Please read this in full before your ceremony, and reach out if anything is unclear.

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SCREENING & INTAKE

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We take a substance free container seriously, for your safety and for the group's. Every participant is screened before ceremony.

 

All participants complete a urine drug screen before the first ceremony. This isn't about judgment, it's a physiological safety check, since several common substances interact dangerously with plant medicine.

Alcohol and recreational drugs must be fully cleared from your system before ceremony, not just "not felt," but cleared. If a screen or our intake conversation raises a concern, we will postpone your participation until it's safe to proceed.

 

Many psych meds are contraindicated with these medicines. Some require a taper of several weeks under medical supervision, not just skipping a dose. See the medicine specific lists below, and talk to us early, this needs planning, not a last minute stop.

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Please disclose all medications, supplements, health conditions, and substance use during intake, even if you're embarrassed or think it doesn't matter. What you leave out is what puts you at risk in ceremony.

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CONTRAINDICATIONS BY MEDICINE

Each medicine carries its own risk profile. This list covers the most important interactions, it is not exhaustive, and your intake screening is where we go through your personal history in detail.

 

AYAHUASCA (contains MAOIs / harmala alkaloids, serotonin syndrome risk)

Contraindicated medications:

• SSRIs / SNRIs: fluoxetine, sertraline, escitalopram, venlafaxine, duloxetine, and similar

• MAOIs: phenelzine, tranylcypromine, and other prescribed MAO inhibitors

• Tricyclic antidepressants: amitriptyline, nortriptyline, and similar

• Lithium

• Stimulants: amphetamines, methylphenidate, cocaine, MDMA

• Certain opioids: tramadol and meperidine carry particular risk

• Dextromethorphan, found in many OTC cough/cold medicines

• St. John's Wort and other serotonergic supplements

• Blood thinners / anticoagulants: purging (vomiting) is a normal part of this medicine's process, and anticoagulant use raises risk with forceful purging

Why it matters: The MAOIs in ayahuasca block the enzyme that clears serotonin from your system. Combined with anything else that raises serotonin, this can trigger serotonin syndrome, a medical emergency involving dangerously high fever, seizures, and cardiac instability. Most SSRIs and SNRIs need a supervised taper of several weeks before ceremony, not a same week stop.

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BUFO (5-MeO-DMT) (potent, fast acting serotonergic and cardiovascular effect, hypertensive and serotonin risk)

Contraindicated medications:

• MAOIs: the combination is considered especially dangerous and is never appropriate

• SSRIs / SNRIs: same serotonin syndrome mechanism as above

• Lithium

• Stimulants of any kind, prescribed or otherwise

Why it matters: 5-MeO-DMT produces a rapid, intense spike in blood pressure and heart rate alongside its serotonergic effects. This makes it contraindicated for anyone with cardiovascular disease, uncontrolled hypertension, or a history of stroke or aneurysm, independent of medications. We screen for cardiac history as carefully as we screen for medications.

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PSILOCYBIN (serotonergic, generally gentler pharmacology, seizure and blunting risk)

Contraindicated medications:

• Lithium: case reports of seizures with this combination, considered a hard contraindication

• Tramadol: lowers seizure threshold in combination

• MAOIs

• SSRIs / SNRIs: usually not dangerous in the way ayahuasca combinations are, but they commonly blunt or block the experience entirely, and still warrant medical guidance before stopping

Why it matters: Psilocybin's risk profile is milder than ayahuasca or bufo, but it is not risk free. Lithium combinations in particular have a well documented seizure risk. Long term SSRI use also changes serotonin receptor sensitivity, which is why abrupt stopping isn't the same as a safe taper.

 

HAPÉ (RAPÉ) (tobacco based, nicotine and alkaloid effect, cardiovascular risk)

Contraindicated conditions and substances:

• Pregnancy: nicotine exposure is contraindicated outright

• Nicotine sensitivity or history of nicotine related illness

• Asthma or other respiratory conditions: the forceful application can trigger respiratory irritation or spasm

 

GENERAL HEALTH CONTRAINDICATIONS

Across all of these medicines, certain conditions raise the risk regardless of what's on your medication list.

• Pregnancy or breastfeeding. Contraindicated across all medicines offered here.

• Cardiovascular disease. Uncontrolled hypertension, arrhythmia, recent heart event, aneurysm history, or an implanted device such as a pacemaker.

• Psychotic disorders. Schizophrenia, schizoaffective disorder, or a first degree relative with either.

• Bipolar disorder. Particularly with a history of mania or psychosis.

• Epilepsy or seizure disorder. Including any recent seizure activity, regardless of cause.

• Recent surgery, stroke, or head injury. Needs individual medical review before clearance.

• Diabetes. Especially insulin dependent diabetes, given fasting requirements and the length of ceremony; blood sugar management needs to be discussed at intake.

• Liver or kidney disease. These medicines are metabolized through the liver and kidneys, and impaired function changes how they're processed.

• Glaucoma. Some of these medicines increase eye pressure.

• Autoimmune conditions on immunosuppressive therapy, or recent organ transplant. These require individual medical clearance.

• Recent chemotherapy or serious ongoing illness. Needs individual medical review before clearance.

• History of disordered eating or being significantly underweight. Fasting and dietary requirements around ceremony can be harmful without individual guidance.

• Active substance use. Alcohol or recreational drugs must be fully cleared, confirmed via screening.

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