Skeptoid - Skeptoid #912: Kambo: Let It Go
Aired: 2023-11-28
Duration: 18:54


=== Amazon's Combo: Poison or Cure (08:37) ===

[00:00:03]  There's a new all-natural drug in town, and whether it's a poison or a miracle cure is in the eye of the person taking it.
[00:00:10]  It's called combo, and it comes from the Amazon.
[00:00:14]  If your shaman gives you some, it might just make you an all-around better, smarter, and healthier person.
[00:00:21]  Or it might do nothing more than make you vomit all over the place.
[00:00:24]  Which one is it?
[00:00:25]  Well, we'll find out right now.
[00:00:27]  On Skeptoid.
[00:00:35]  A quick reminder for everyone, you're listening to Skeptoid, revealing the true science and true history behind urban legends every week since 2006.
[00:00:46]  With over a thousand episodes, we're celebrating 20 years of keeping it focused and keeping it brief.
[00:00:53]  And we couldn't have done it without your curiosity leading the way.
[00:00:57]  And now we're even offering a little bit more.
[00:00:59]  If you become a premium member, supporting the show with a monthly micropayment of as little as $5, you get more Skeptoid.
[00:01:08]  The premium version of the show is not only ad-free, it has extended content.
[00:01:13]  These episodes are a few minutes longer.
[00:01:16]  We get rid of the ads and we'll replace them with more Skeptoid.
[00:01:21]  The Extended Premium Show available now.
[00:01:24]  Come to Skeptoid.com and click Go Premium.
[00:01:34]  You're listening to Skeptoid.
[00:01:35]  I'm Brian Dunning from Skeptoid.com.
[00:01:39]  Combo.
[00:01:40]  Let it go.
[00:01:43]  Welcome to the show that separates fact from fiction, science from pseudoscience, real history from fake history, and helps us all make better life decisions by knowing what's real and what's not.
[00:01:56]  Today we're going to have a look at an alternative wellness therapy plagiarized from an indigenous Amazonian ritual practice and today sold profitably to gullible Westerners intent on blending the ever popular ancient wisdom with the modern wellness fad.
[00:02:14]  It's called combo.
[00:02:16]  In Brazilian Portuguese, it's more like kumbo, but since I can't pronounce that very well, I'm going to say it in the common American way, which is combo.
[00:02:24]  Combo is a paste made from the secretions of poisoned tree frogs, and when a very small dose is spread into a break in the skin, it causes severe vomiting, diarrhea, and other adverse and potentially dangerous reactions.
[00:02:40]  Consequently, it has quickly become a favorite method of virtue signaling, a way to shout, look at how enlightened I am, participating in an indigenous Amazonian ritual, among a very select demographic in the United States and other comfortable Western nations.
[00:02:58]  But regardless of the social implications, combo is still pharmacologically active, and that means that it may indeed provide the benefits its devotees believe it does.
[00:03:09]  And it also might mean that it's deadly.
[00:03:14]  The process of taking combo is as follows.
[00:03:17]  A number of different frog species are used, all of the genus Philomedusa, most common of which is the brightly colored giant monkey frog.
[00:03:27]  Sticks are jammed into the ground, to which the frog's limbs are tied to stretch it out spread eagle in the air.
[00:03:33]  This painful stretching stresses the frog and activates its defense mechanism, which is to secrete poison from its skin.
[00:03:41]  The secretions are scraped from the frog, collected, and dried into a powder.
[00:03:46]  The frogs are released.
[00:03:50]  Sessions to administer the combo are sometimes one-on-one between a practitioner and a participant.
[00:03:57]  Usually in the United States, where it's sold as a wellness therapy, sessions are with a single practitioner administering to a large group of participants, typically adorned with ceremonial or ritualistic trappings, and with the practitioner often assuming a title such as shaman or priest.
[00:04:15]  They refer to it not as poison, but as medicine, in keeping with the new age habit of regarding anything that comes from nature as wholesome and healing.
[00:04:25]  In fact, frog poison is no more medicine than is rattlesnake venom, or box jellyfish neurotoxin.
[00:04:35]  The powdered secretions are mixed with the practitioner's saliva to create a paste.
[00:04:41]  Gross.
[00:04:42]  The participants take off most of their clothes, both to expose their skin to receive the poison and to avoid soiling their clothes with vomit and diarrhea.
[00:04:52]  The practitioner heats a stick, needle, or blade and burns a series of cuts or punctures in the participant's skin, then smears a bit of the poisonous paste onto each burn.
[00:05:05]  For some people, the poison takes effect immediately.
[00:05:08]  For others, it can take several minutes, sometimes even up to an hour.
[00:05:12]  The main effects are tachycardia, vomiting, and diarrhea.
[00:05:17]  The face typically swells noticeably.
[00:05:20]  Participants are encouraged to drink a lot of water throughout to increase the vomiting.
[00:05:26]  More severe reactions, which are fortunately rare, include infections at the burn marks, psychosis, renal failure, toxic hepatitis, seizures, and more.
[00:05:38]  A number of people have died from causes such as cardiac arrhythmia and cerebral edema.
[00:05:44]  But for most people, it's an hour of non-stop vomiting and dry heaves, a severe bout of diarrhea, and a hypertension headache.
[00:05:55]  So the obvious question to ask is, why?
[00:05:58]  Why would anyone willingly subject themselves to this, and moreover, pay money to do it?
[00:06:04]  Prices I found online for the privilege of this lovely experience range from about $100 to $400 for a one to two hour session.
[00:06:13]  Well, the answer is that in its use among indigenous cultures in the Amazon, nobody pays.
[00:06:18]  It's a cultural thing.
[00:06:20]  It's used to increase fertility, to bring good luck, to expel evil spirits, and to boost strength.
[00:06:27]  There's no evidence that it actually does any of these things, but that's what some believe.
[00:06:32]  But in the United States and other Western countries that have appropriated the practice as a for-profit wellness treatment, claims are all over the map.
[00:06:41]  It's one of those things that are claimed to treat everything.
[00:06:45]  The basic claim is a detoxifying cleanse, and as with all detoxification treatments, the alleged toxins are never identified.
[00:06:55]  It's pretty much the full suite of the usual pseudoscientific claims of New Age, balancing chakras, removing negative energy, increasing spiritual awareness.
[00:07:06]  And just about every wellness claim is made too.
[00:07:09]  Combo will cure depression, addiction, fatigue, and chronic pain.
[00:07:14]  It helps you sleep better and confers strength and energy and mental clarity.
[00:07:19]  It makes you a better manager, a better communicator, better at your job, and better at relationships.
[00:07:25]  If anyone wants it, guaranteed there's a combo practitioner somewhere selling it.
[00:07:32]  Beginning around 1994, a few Brazilians brought combo out of the Amazon and into the major cities, where they began offering it as an alternative therapy.
[00:07:42]  From there, its growth was slow, but it suddenly went ballistic around 2020 in Silicon Valley, California, when a number of tech execs began using it and loudly proclaiming its virtues and crediting it for their success.
[00:07:58]  The stereotypical Silicon Valley people have a reputation for being gullible and for buying into every new age fad that comes along, no matter how ridiculous.
[00:08:08]  But combo takes it to a whole new level.
[00:08:10]  Watching videos of their group vomiting sessions made me suspect that this had to be a put-on.
[00:08:17]  Someone had to have challenged themselves to come up with the most insane, disgusting, painful, and horrible ordeal, and then see if they could sell it to rubes with more money than cents.
[00:08:28]  People writhing, groaning, sobbing with pain, some struggling to carry their vomit buckets as they try to stumble to a bathroom, others lying on their sides so they could squirt from both ends simultaneously.

=== The Gullible Silicon Valley Trap (02:12) ===

[00:08:40]  It's really quite a show.
[00:08:42]  In one video I watched, a practitioner described projectile diarrhea.
[00:08:52]  Hey everyone, I want to remind you about a truly unique and once-in-a-lifetime adventure.
[00:08:58]  Join me and Mediterranean archaeologist Dr. Flint Dibble for a skeptoid sailing adventure through the Mediterranean Sea aboard the SV Royal Clipper, the world's largest full-rigged sailing ship.
[00:09:12]  This is also the only opportunity you'll have to hear Flint and I talk about our experiences when we both went on Joe Rogan to represent the causes of science and reality against whatever it is that you get when you're thrown into that lion pit.
[00:09:26]  We set sail from Malaga, Spain on April 18th, 2026 and finished the adventure in Nice, France on April 25th.
[00:09:35]  You'll enjoy a fascinating skeptical mini-conference at sea.
[00:09:39]  You'll visit amazing ports along the Spanish and French coasts and Flint will be our exclusive onboard expert sharing the real archaeology and history about every stop.
[00:09:50]  We've got special side quests and extra skeptical content planned at each port.
[00:09:55]  This is a true sailing ship.
[00:09:57]  You can climb the rat lines to the crow's nest, handle the sails.
[00:10:01]  You can even take the helm and steer.
[00:10:04]  This is a real bucket list adventure you don't want to miss.
[00:10:07]  But cabins are selling fast and this ship does always sell out.
[00:10:11]  Act now or you'll miss this once-in-a-lifetime opportunity.
[00:10:15]  Get the full details and book your cabin at skeptoid.com slash adventures.
[00:10:21]  Hope to see you on board.
[00:10:23]  That's skeptoid.com slash adventures.
[00:10:32]  The scars created by the contaminated burns sometimes fade, sometimes don't.
[00:10:38]  Among some user, proudly displaying those scars, lots of little dots in neat rows, is a status symbol, much like athletes who use cupping and are sure to show off their dark round hickeys.

=== Zero Benefits, Double the Risk (08:01) ===

[00:10:52]  The poison has to be purchased and shipped from the Amazon.
[00:10:56]  And you might wonder, why not just bring some of the frogs up here and have your own unlimited supply?
[00:11:02]  The reason is that wouldn't work.
[00:11:04]  The toxicity of the poison secreted by the frogs comes from certain things they eat in their native Amazonian habitat.
[00:11:11]  If you transplanted the frogs here and fed them regular frog diets, their poison would lose its toxicity.
[00:11:18]  So for now, the powder has to be purchased from Brazil, where paradoxically it's illegal to sell it.
[00:11:25]  Combo is totally unrestricted in the United States and most other countries, with the notable exception of Australia, where several deaths prompted the Therapeutic Goods Administration to ban it.
[00:11:38]  So somehow, creative sellers are getting it out of Brazil.
[00:11:41]  And now it's easy enough to find and buy online.
[00:11:45]  Though of course as an unregulated substance, there are no standards at all for purity or potency.
[00:11:52]  California shamans, beware.
[00:11:56]  But participants need to beware even more.
[00:11:59]  These combo practitioners are completely unregulated.
[00:12:03]  Some of them have created their own training and certification programs, but they have no legitimacy outside their own little club.
[00:12:10]  There is no such thing as board certification or accreditation outside of what they make up themselves.
[00:12:17]  A practice intended only to deceive gullible participants into a risky for-profit ritual.
[00:12:26]  How risky?
[00:12:28]  Some of the risks are fairly obvious, and all of them have resulted in at least some deaths or hospitalizations.
[00:12:35]  Drug interactions are one.
[00:12:37]  As combo is pharmacologically active, it's possible for it to interact harmfully with any drug, not just pharmaceutical drugs, but recreational and herbal drugs as well.
[00:12:48]  There's insufficient data to even make specific warnings.
[00:12:53]  Hyponatremia, aka water intoxication, is another.
[00:12:58]  Participants are told to drink a lot of water before and during the ritual, and this throws your electrolytes out of balance, causing your cells to hold too much water, potentially causing fatal swelling of the brain.
[00:13:10]  All sorts of cardiac problems can be triggered by the tachycardia that combo induces.
[00:13:16]  It's absolutely a terrible idea for anyone with any cardiovascular condition, including hypertension.
[00:13:24]  This has sent more combo participants to the morgue than anything else.
[00:13:30]  Searching for articles on combo in medical journals is sobering.
[00:13:35]  From Toxicology Reports, 2022, COMBO, Natural Drug or Potential Toxic Agent, a literature review of acute poisoning cases.
[00:13:47]  From Integrative Cancer Therapies, 2021, yes, some people do try to treat cancer with it.
[00:13:54]  Combo-induced systemic inflammatory response, a case report of acute disease progression of cholangiocarcinoma.
[00:14:02]  From the Corius Journal of Medical Science, 2020, Combo Frog Poison as a case of esophageal rupture.
[00:14:10]  This was the most common cause for hospitalizations that I came across in my research.
[00:14:15]  From Clinical Toxicology, 2018, prolonged toxicity from Combo Cleansing Ritual.
[00:14:23]  And so on and so on and so on.
[00:14:27]  As far as any journal articles finding positive effects, none.
[00:14:32]  Zip.
[00:14:33]  Zero.
[00:14:34]  Much of the reason for this, I expect, is that there has never been a medical claim made that is specific and consistent enough to be testable.
[00:14:44]  Each practitioner you hear talk about it gives a different list of things they say it will treat and or wellness effects it will bring.
[00:14:52]  And when you hear interviews with participants, they all give totally different and random reasons why they're doing it.
[00:14:58]  Some of these beliefs for what benefits combo provides may be more common than others, but none of them are agreed upon, and certainly none of them are supported by evidence.
[00:15:10]  Should this change tomorrow and the results of some clinical trial are published finding that combo does indeed have some medical benefit that exceeds placebo, that still won't be any reason to get excited.
[00:15:23]  It's almost certain that whatever that hypothetical benefit is, it can be obtained much more safely and effectively through some other treatment already on the market.
[00:15:32]  and moreover, without the severe vomiting, diarrhea, tachycardia, pain, disgusting mess, and high price tag.
[00:15:42]  Combo is the classic case of risks exceeding benefits.
[00:15:46]  There are numerous known risks and zero known benefits.
[00:15:51]  Logically, there's no reason to take combo at all.
[00:15:54]  It certainly can't be argued that it's fun, unless you have a very strange notion of fun.
[00:16:00]  And to endure it to receive some benefit, you have to be deep into cognitive dissonance.
[00:16:06]  Keep your lunch in your tummy.
[00:16:08]  Keep your money in your pocket.
[00:16:11]  And keep combo off your skin.
[00:16:16]  In the ad-free and extended premium feed, we'll add a quick sidebar about charlatans selling combo ceremonies to the mentally ill.
[00:16:24]  To access it, become a supporter at skeptoid.com slash go premium.
[00:16:36]  A great big Skeptoid shout out to our premium supporters, including James Ever Hopeful, Stephen Sanderson, Pete Tuckerman from beautiful Canton, North Carolina, and Felipe Ramos from Portugal.
[00:16:50]  Sustainability is a popular theme in science, and the support from these premium members is what pays the bills of our nonprofit and makes Skeptoid sustainable.
[00:17:00]  Please join them by becoming a member for just $5 a month at skeptoid.com and click GoPremium.
[00:17:09]  And did you know that you could have Skeptoid come to you?
[00:17:13]  I love doing live shows, either at meetup clubs, university groups, and conferences.
[00:17:19]  I can show one of our movies like Science Friction or The UFO Movie, or do a live podcast, or just give one of my popular presentations.
[00:17:28]  For more information, come to skeptoid.com and click on live shows.
[00:17:35]  You're listening to Skeptoid, a listener-supported program.
[00:17:39]  I'm Brian Dunning from Skeptoid.com.
[00:17:47]  Hello, everyone.
[00:17:48]  This is Adrienne Hill from Skookum Studios in Calgary, Canada, the land of maple syrup and mousse.
[00:17:57]  And I'm here to ask you to consider becoming a premium member of Skeptoid for as little as $5 per month.
[00:18:05]  And that's only the cost of a couple of Tim Horton's double doubles.
[00:18:09]  And that's Canadian for coffee with double cream and sugar.
[00:18:14]  Why support Skeptoid?
[00:18:16]  If you are like me and don't like ads, but like extended versions of each episode, Premium is for you.
[00:18:22]  If you want to support a worthwhile nonprofit that combats pseudoscience, promotes critical thinking, and provides free access to teachers to use the podcast in the classroom via the Teacher's Toolkit, then sign up today.
[00:18:36]  Remember that skepticism is the best medicine.
[00:18:40]  Next to giggling, of course.
[00:18:42]  Until next time, this is Adrienne Hill.
[00:18:53]  From PRX.