
Hallucinogens
are drugs that cause hallucinations - profound distortions in a person's
perceptions of reality. Under the influence of hallucinogens, people see images,
hear sounds, and feel sensations that seem real but do not exist. Some
hallucinogens also produce rapid, intense emotional swings.
Hallucinogens cause their effects by disrupting the interaction of nerve cells
and the neurotransmitter serotonin. Distributed throughout the brain and spinal
cord, the serotonin system is involved in the control of behavioral, perceptual,
and regulatory systems, including mood, hunger, body temperature, sexual
behavior, muscle control, and sensory perception.
LSD, an abbreviation of the German words for "lysergic acid diethylamide," is
the drug most commonly identified with the term "hallucinogen" and the most
widely used in this class of drugs. It is considered the typical hallucinogen,
and the characteristics of its action and effects described below apply to the
other hallucinogens, including mescaline, psilocybin, and ibogaine.
Hallucinogenic drugs have played a role in human life for thousands of years.
Cultures from the tropics to the arctic have used plants to induce states of
detachment from reality and to precipitate "visions" thought to provide mystical
insight. These plants contain chemical compounds, such as mescaline, psilocybin,
and ibogaine, that are structurally similar to serotonin, and they produce their
effects by disrupting normal functioning of the serotonin system.
Historically, hallucinogenic plants were used largely for social and religious
ritual, and their availability was limited by the climate and soil conditions
they require. Mescaline comes from a cactus called peyote. And certain
mushrooms, also known as magic mushrooms, are hallucinogens.
After the development of LSD, a synthetic compound that can be manufactured
anywhere, abuse of hallucinogens became more widespread, and from the 1960s it
increased dramatically. All LSD manufactured in this country is intended for
illegal use, since LSD has no accepted medical use in the United States.
What Are Dissociative Drugs?
Drugs such as
PCP (phencyclidine) and ketamine, which were initially developed as general
anesthetics for surgery, distort perceptions of sight and sound and produce
feelings of detachment - dissociation - from the environment and self. But these
mind-altering effects are not hallucinations. PCP and ketamine are therefore
more properly known as "dissociative anesthetics." Dextromethorphan, a widely
available cough suppressant, when taken in high doses can produce effects
similar to those of PCP and ketamine.
The dissociative drugs act by altering distribution of the neurotransmitter
glutamate throughout the brain. Glutamate is involved in perception of pain,
responses to the environment, and memory. PCP is considered the typical
dissociative drug, and the description outlined below of PCP's actions and
effects largely applies to ketamine and dextromethorphan as well. What Are The
Facts About Dissociative Drugs?
PCP's forms
and effects PCP, developed in the 1950s as an intravenous surgical anesthetic,
is classified as a dissociative anesthetic: Its sedative and anesthetic effects
are trance-like, and patients experience a feeling of being "out of body" and
detached from their environment. PCP has been used in veterinary medicine but
was never approved for human use because of problems that arose during clinical
studies, including delirium and extreme agitation experienced by patients
emerging from anesthesia.
During the 1960s, PCP in pill form became widely abused, but the surge in
illicit use receded rapidly as users became dissatisfied with the long delay
between taking the drug and feeling its effects, and with the unpredictable and
often violent behavior associated with its use. Powdered PCP - known as "ozone,"
"rocket fuel," "love boat," "hog," "embalming fluid," or "superweed" - appeared
in the 1970s. In powdered form, the drug is sprinkled on marijuana, tobacco, or
parsley, then smoked, and the onset of effects is rapid. Users sometimes ingest
PCP by snorting the powder or by swallowing it in tablet form. Normally a white
crystalline powder, PCP is sometimes colored with water-soluble or
alcohol-soluble dyes.
When snorted or smoked, PCP rapidly passes to the brain to disrupt the
functioning of sites known as NMDA (N-methyl-D-aspartate) receptor complexes,
which are receptors for the neurotransmitter glutamate. Glutamate receptors play
a major role in the perception of pain, in cognition - including learning and
memory - and in emotion. In the brain, PCP also alters the actions of dopamine,
a neurotransmitter responsible for the euphoria and "rush" associated with many
abused drugs.
At low PCP doses (5 mg or less); physical effects include shallow, rapid
breathing, increased blood pressure and heart rate, and elevated temperature.
Doses of 10 mg or more cause dangerous changes in blood pressure, heart rate,
and respiration, often accompanied by nausea, blurred vision, dizziness, and
decreased awareness of pain. Muscle contractions may cause uncoordinated
movements and bizarre postures. When severe, the muscle contractions can result
in bone fracture or in kidney damage or failure as a consequence of muscle cells
breaking down. Very high doses of PCP can cause convulsions, coma, hyperthermia,
and death.
PCP's effects are unpredictable. Typically, they are felt within minutes of
ingestion and last for several hours. Some users report feeling the drug's
effects for days. One drug-taking episode may produce feelings of detachment
from reality, including distortions of space, time, and body image; another may
produce hallucinations, panic, and fear. Some users report feelings of
invulnerability and exaggerated strength. PCP users may become severely
disoriented, violent, or suicidal.
Repeated use of PCP can result in addiction, and recent research suggests that
repeated or prolonged use of PCP can cause withdrawal syndrome when drug use is
stopped. Symptoms such as memory loss and depression may persist for as long as
a year after a chronic user stops taking PCP.
LSD is a
clear or white, odorless, water-soluble material synthesized from lysergic acid,
a compound derived from a rye fungus. LSD is the most potent mood- and
perception-altering drug known: oral doses as small as 30 micrograms can produce
effects that last 6 to 12 hours.
LSD is initially produced in crystalline form. The pure crystal can be crushed
to powder and mixed with binding agents to produce tablets known as "microdots"
or thin squares of gelatin called "window panes"; more commonly, it is
dissolved, diluted, and applied to paper or other materials. The most common
form of LSD is called "blotter acid" - sheets of paper soaked in LSD and
perforated into 1/4-inch square, individual dosage units.
Variations in manufacturing and the presence of contaminants can produce LSD in
colors ranging from clear or white, in its purest form, to tan or even black.
Even uncontaminated LSD begins to degrade and discolor soon after it is
manufactured, and drug distributors often apply LSD to colored paper, making it
difficult for a buyer to determine the drug's purity or age.
The precise
mechanism by which LSD alters perceptions is still unclear. Evidence from
laboratory studies suggests that LSD, like hallucinogenic plants, acts on
certain groups of serotonin receptors designated the 5-HT2 receptors, and that
its effects are most prominent in two brain regions: One is the cerebral cortex,
an area involved in mood, cognition, and perception; the other is the locus
ceruleans’, which receives sensory signals from all areas of the body and has
been described as the brain's "novelty detector" for important external stimuli.
LSD's effects typically begin within 30 to 90 minutes of ingestion and may last
as long as 12 hours. Users refer to LSD and other hallucinogenic experiences as
"trips" and to the acute adverse experiences as "bad trips." Although most LSD
trips include both pleasant and unpleasant aspects, the drug's effects are
unpredictable and may vary with the amount ingested and the user's personality,
mood, expectations, and surroundings.
Users of LSD may experience some physiological effects, such as increased blood
pressure and heart rate, dizziness, loss of appetite, dry mouth, sweating,
nausea, numbness, and tremors; but the drug's major effects are emotional and
sensory. The user's emotions may shift rapidly through a range from fear to
euphoria, with transitions so rapid that the user may seem to experience several
emotions simultaneously.
LSD also has dramatic effects on the senses. Colors, smells, sounds, and other
sensations seem highly intensified. In some cases, sensory perceptions may blend
in a phenomenon known as synesthesia, in which a person seems to hear or feel
colors and see sounds.
Hallucinations distort or transform shapes and movements, and they may give rise
to a perception that time is moving very slowly or that the user's body is
changing shape. On some trips, users experience sensations that are enjoyable
and mentally stimulating and that produce a sense of heightened understanding.
Bad trips, however, include terrifying thoughts and nightmarish feelings of
anxiety and despair that include fears of insanity, death, or losing control.
LSD users quickly develop a high degree of tolerance for the drug's effects:
After repeated use, they need increasingly larger doses to produce similar
effects. LSD use also produces tolerance for other hallucinogenic drugs such as
psilocybin and mescaline, but not to drugs such as marijuana, amphetamines, and
PCP, which do not act directly on the serotonin receptors affected by LSD.
Tolerance for LSD is short-lived it is lost if the user stops taking the drug
for several days. There is no evidence that LSD produces physical withdrawal
symptoms when chronic use is stopped.
Two long-term effects persistent psychosis and hallucinogen persisting
perception disorder (HPPD), more commonly referred to as "flashbacks," have been
associated with use of LSD. The causes of these effects, which in some users
occur after a single experience with the drug, are not known.
The effects of LSD can be described as drug-induced psychosis-distortion or
disorganization of a person's capacity to recognize reality, think rationally,
or communicate with others. Some LSD users experience devastating psychological
effects that persist after the trip has ended, producing a long-lasting
psychotic-like state. LSD-induced persistent psychosis may include dramatic mood
swings from mania to profound depression, vivid visual disturbances, and
hallucinations. These effects may last for years and can affect people who have
no history or other symptoms of psychological disorder.
Some former
LSD users report experiences known colloquially as "flashbacks" and called
"HPPD" by physicians. These episodes are spontaneous, repeated, sometimes
continuous recurrences of some of the sensory distortions originally produced by
LSD. The experience may include hallucinations, but it most commonly consists of
visual disturbances such as seeing false motion on the edges of the field of
vision, bright or colored flashes, and halos or trails attached to moving
objects. This condition is typically persistent and in some cases remains
unchanged for years after individuals have stopped using the drug.
Because HPPD symptoms may be mistaken for those of other neurological disorders
such as stroke or brain tumors, sufferers may consult a variety of clinicians
before the disorder is accurately diagnosed. There is no established treatment
for HPPD, although some antidepressant drugs may reduce the symptoms.
Psychotherapy may help patients adjust to the confusion associated with visual
distraction and to minimize the fear, expressed by some, that they are suffering
brain damage or psychiatric disorder.