Kambo Deaths – How Can We Avoid Them?

Image from AnnuTara.co.uk

Image from AnnuTara.co.uk

Kambo, or kambô, is an unusual natural medicine. Also known as sapo, it is the poisonous secretion of a tree frog that, when applied to burns on the skin, induces an intense experience involving nausea, dizziness, pain, and disorientation.

Kambo originates from the Amazon, where multiple indigenous groups use the secretion to treat illnesses, to strengthen the body’s defences, and to improve hunting abilities. It is also sometimes used for divination or shamanic shapeshifting.

It has since been taken beyond the territories of the Amazon, achieving popularity in Western spiritual circles. Some people use it as part of ayahuasca ceremonies, helping to purge the body as part of the dieta – while others use it alone in dedicated healing ceremonies.

Kambo has been suggested to treat a number of psychospiritual issues including addiction, and health issues like chronic inflammation; but there have not yet been any large investigations into its healing potential.

Kambo Toxicity

Kambo is a secretion of the Phyllomedusa bicolor tree frog, also known as the giant leaf frog. The kambo secretion is collected by causing the frog stress and then scraping the milky substance from its back.

The secretion is then applied to small burns on the skin, to allow it to enter the bloodstream. The effects are felt after a few minutes, and last up to an hour. Usually people will vomit or defecate within the first few minutes, and the nausea and disorientation will continue for some time afterwards.

The kambo secretion is potentially poisonous to humans. It can cause vomiting, a drop in blood pressure, an increase in heart rate, and a boost of adrenaline. There have been cases of liver toxicity, seizures, psychosis, and prolonged vomiting after kambo use (da Silva et al, 2019).

Most concerning, there have been several recorded deaths directly linked to kambo use. Could these deaths have been avoided? And if so, how can you choose a safe kambo facilitator?

Kambo Deaths

There have been four high-profile deaths linked with kambo in Western ceremonies, and probably more that have not gone reported.

The first was in 2008, when a 52-year-old Brazilian man died at a private kambo ceremony. He had taken kambo several times before over the course of the previous few months, to treat a health condition. This time, he went to the bathroom unobserved, and was later found not breathing on the floor, and could not be resuscitated.

Then in 2016, a 22-year-old man in Florida died during a joint ayahuasca and kambo ceremony at an event run by the controversial Soul Quest church. After the ayahuasca ceremony, the man was given a kambo dose, and organizers did not notice that he was in distress until it was too late. He died from a fatal imbalance in sodium levels, a known risk of kambo.

Next came in 2017, when a 42-year-old man was found dead at his house in Italy, alone and surrounded by kambo paraphernalia. He had suffered a heart attack, and coroners did not find any drugs in his system other than the kambo toxins.

Most recently was in 2019, when a 39-year-old Australian woman had a fatal heart attack at a private ceremony, thought to have involved kambo. She had taken kambo several times before, and was herself a certified IAKP (International Association of Kambo Practitioners) facilitator. This case garnered a lot of publicity, and led to the Australian government banning two unrelated kambo practitioners from serving the medicine for 12 weeks.

A number of kambo insiders have shared with us that two additional fatalities have occurred as a result of hyponatremia: an imbalance in sodium caused by drinking too much water following a kambo ceremony. In these cases the hyponatremia was made worse by the victims having recently been on ayahuasca dietas, as kambo facilitator Caitlin Thompson explains:

“I think no one should be receiving kambo within three days of drinking ayahuasca because the combination of the no salt dieta, exhaustion, dehydration and electrolyte depletion puts people at risk for hyponatremia – a very avoidable, yet potentially lethal condition.”

Could These Deaths Have Been Avoided?

Kambo deaths involving people who are left unattended (such as the case in Brazil in 2008) are likely due to poor facilitation, and could possibly have been avoided. Similarly, when people are allowed to drink too much water after a ceremony, this indicates a facilitator who has failed to educate and care for their participants.

But the case is less clear when apparently healthy people, who have taken kambo many times, suffer heart attacks.

Does this mean that kambo is unpredictable and potentially deadly without warning? Is there anything facilitators can do to avoid unexpected deaths?

Kambo facilitator Benjamin Mudge, who runs ceremonies in London, believes that most of the documented kambo deaths have been caused by a disconnect from indigenous traditions. Mudge suggests that the Westernized practice of applying dots directly to the chest area may increase the risk of heart attack, and that indigenous wisdom cautions against this. Mudge says:

“The most urgent issue that needs to be addressed, in my humble opinion, is that people are dying at kambo ceremonies which are facilitated by non-indigenous people who are not following the traditional indigenous methodology. My argument is that the deaths are happening precisely because the traditions are being ignored.”

Similarly, Caitlin Thompson suggests that almost all kambo fatalities can be avoided:

“There are a number of very simple safety protocols that make a tremendous difference in reducing the risk of accidents related to kambo. The biggest risks of kambo are hyponatremia and the participant potentially fainting and injuring themselves. Proper screening for contraindications such as heart disease, specific water protocol and education, performing a test point and assisted walking to the bathroom are the best ways that practitioners can ensure safety.

These things aren’t hard to do, it’s just that most people administering kambo have no proper training and don’t have any idea what the risks are to serving this medicine. Many if not all of the accidents associated with kambo could have been easily prevented by having an educated and responsible practitioner.”

What are the Risk Factors with Kambo?

Since kambo affects heart rate and blood pressure, people with conditions related to the heart should avoid taking it. Heart or blood pressure medications should not be combined with it. Facilitators should ideally be trained in CPR.

The effects of kambo can induce panic, or distress. People with anxiety disorders, or PTSD, should be especially cautious using kambo, as it may induce trauma or panic attacks. Experienced facilitators may still be able to look after you, but make sure to do your research!

Pregnant people should not take kambo, as it has abortive properties. It is even used traditionally to end pregnancies – and it is not a pleasant process.

Other risk factors are Addison’s disease, epilepsy, or a weak immune system. People on immuno-suppressants, or any medications that heavily strain the liver, should avoid kambo.

There is a slight risk of allergic reaction, so facilitators should apply a test dot first, and have an epipen ready.

People who have just taken ayahuasca, and been on the no-salt dieta, are at an increased risk of hyponatremia following kambo. To reduce the risks of hyponatremia, facilitators must avoid giving their participants too much water (under two litres is safe).

An alternative way to approach the risk of hyponatremia is to provide electrolytes to balance sodium levels. Some traditional facilitators will give participants a salted root vegetable drink called Caiçuma, greatly reducing the risk of hyponatremia.

Ultimately, we don’t know enough yet about kambo to fully understand its risks. It is possible that it poses a risk of heart attack even in seemingly healthy people. Therefore a decision to take kambo should not be taken lightly – and every effort should be taken to choose a trustworthy and experienced facilitator.

How Do You Select a Safe Kambo Facilitator?

Finding a good kambo facilitator is essential to minimizing the risks of the experience. Kambo not only has severe physical effects; it can also be a trying psychological experience.

You should be in the hands of someone who can guide and care for you appropriately. Remember that kambo also leaves permanent scars, so you truly are putting your body in the hands of your facilitator.

At a very basic level, your facilitator must ask about your medical history, and be aware of any health conditions that could make kambo especially dangerous for you. They must know the risks, and have a plan for medical emergencies.

Ask your prospective facilitator how they would handle an emergency, and how they screen out unsuitable participants. A facilitator without a screening process or an emergency procedure may not be trustworthy.

Check that your practitioner will be doing a test point on you, will limit your water consumption following the application of kambo, and will monitor you throughout the ceremony. Have a high standard while researching facilitators – there are many out there, and if a practitioner does not fulfil all of these requirements then they don’t deserve to be working with the medicine.

Should I Choose a Western or Indigenous Facilitator?

There choice between Western or indigenous facilitators is not straightforward and depends on what exactly you’re looking for.

Some Western facilitators have little or no indigenous training. Even modern qualifications, such as those offered by the IAKP, do not necessarily confer trustworthiness with a medicine we know so little about.

Indigenous facilitators are likely to understand how to guide people through the kambo experience in some depth, and will probably have a good anticipation of what dose is appropriate for you. They will likely have spent years training with kambo and other plant medicines, including going on challenging dietas. Some indigenous facilitators will be experienced shamans, who understand how to work with a number of plant medicines in addition to kambo.

On the flipside, while a Western facilitator may lack the wisdom and experience of an indigenous facilitator, they could have the benefit of knowing more about contraindicated medications and health conditions.

In the end, a safe facilitator has to be someone who is willing to answer your questions, and who you feel comfortable with. They should take your wellbeing as a priority, and be honest with you about the risks and how they will work to minimize them.

Why Take Kambo?

If kambo is a potentially fatal substance, even in seemingly healthy people, why should anyone risk it?

Well, the benefits drastically outweigh the risks, says Caitlin Thompson:

“Despite the handful of unfortunate and preventable incidents, kambo is an incredibly safe substance with a tremendous track record. Thousands and thousands of people have received kambo around the world, many by reckless and naive “practitioners” and yet they still come out of it unharmed. […] Activities such as snowboarding, horseback riding, or even prescription drugs have higher rates of injury and death then kambo does. I think it’s important to put that into perspective.

Many people have received profound physical, spiritual and emotional healing from kambo. Many people who were failed by conventional medicine found relief from this medicine. I’ve worked with many chronically ill people, and I’ve never seen a modality work as effectively as kambo.

All medicines have to be evaluated for the potential risks and benefits to the individual. In this way, kambo is no different than any other conventional or alternative therapy.”

As Caitlin highlights, compared to other activities (and substances like alcohol) kambo has relatively low risk. It’s possible to administer kambo relatively safely, to make the most of its healing benefits.

If we want to keep kambo legal, and make sure that everyone has access to its healing benefits, we must minimize avoidable deaths. If authorities get the impression that facilitators can’t manage the risks, it’s likely that this ancestral medicine will find itself restricted and stigmatized.

If you are looking for a kambo ceremony, search for an educated and responsible facilitator who will take your safety and wellbeing as a priority. This will not only maximize the chances of you having a positive experience, but will also raise standards of kambo facilitation and help the medicine become available to all.

About Patrick Smith

Patrick Smith is a biologist and writer who has been working in the psychedelic community for several years. Twitter: @rjpatricksmith

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