Hallucinogens are a class of drugs that cause hallucinations—profound distortions in a person’s perceptions of reality. Hallucinogens can be found in some plants and mushrooms (or their extracts) or can be man-made, and they are commonly divided into two broad categories: classic hallucinogens (such as LSD) and dissociative drugs (such as PCP). When under the influence of either type of drug, people often report rapid, intense emotional swings and seeing images, hearing sounds, and feeling sensations that seem real but are not.
While the exact mechanisms by which hallucinogens and dissociative drugs cause their effects are not yet clearly understood, research suggests that they work at least partially by temporarily disrupting communication between neurotransmitter systems throughout the brain and spinal cord that regulate mood, sensory perception, sleep, hunger, body temperature, sexual behavior, and muscle control.
Some of the classic Hallucinogens include but not limited to:
• LSD (d-lysergic acid diethylamide) -Also known as Acid, Blotter, Doses, Hits, Microdots, Sugar cubes, Trips, Tabs, or Windowpanes.
• Psilocybin (4-phosphoryloxy-N, N-dimethyltryptamine)-Also known as Magic mushrooms, Shrooms, Boomers, or Little smoke
• Peyote (Mescaline)-Also known as Buttons, Cactus, or Mesc
• DMT (Dimethyltryptamine)—Also known as Dimitri
• Ayahuasca—also known as Hoasca, Aya, and Yagé
Let’s break down what each of these are:
LSD– is one of the most potent moods- and perception-altering hallucinogenic drugs. It is a clear or white, odorless, water-soluble material synthesized from lysergic acid; a compound derived from a rye fungus. LSD is initially produced in crystalline form, which can then be used to produce tablets known as “microdots” or thin squares of gelatin called “windowpanes.” It can also be diluted with water or alcohol and sold in liquid form. The most common form, however, is LSD-soaked paper punched into small individual squares, known as “blotters.”
Psilocybin– (4-phosphoryl oxy-N, N-dimethyltryptamine)— is extracted from certain types of mushrooms found in tropical and subtropical regions of South America, Mexico, and the United States. In the past, psilocybin was ingested during religious ceremonies by indigenous cultures from Mexico and Central America. Psilocybin can either be dried or fresh and eaten raw, mixed with food, or brewed into tea, and produces similar effects to LSD.
Peyote- (Mescaline)—is a small, spineless cactus with mescaline as its main ingredient. It has been used by natives in northern Mexico and the southwestern United States as a part of religious ceremonies. The top, or “crown,” of the peyote cactus has disc-shaped buttons that are cut out, dried, and usually chewed or soaked in water to produce an intoxicating liquid. Because the extract is so bitter, some users prepare a tea by boiling the plant for several hours. Mescaline can also be produced through chemical synthesis.
DMT- (Dimethyltryptamine)—is a powerful hallucinogenic chemical found naturally occurring in some Amazonian plant species (see “Ayahuasca”) and also synthesized in the laboratory. Synthetic DMT usually takes the form of a white crystalline powder and is typically vaporized or smoked in a pipe.
Ayahuasca- is a hallucinogenic brew made from one of several Amazonian plants containing DMT (the primary psychoactive ingredient) along with a vine containing a natural alkaloid that prevents the normal breakdown of DMT in the digestive tract. Ayahuasca tea has traditionally been used for healing and religious purposes in indigenous South American cultures, mainly in the Amazon region.
Dissociative Drugs:
• PCP (Phencyclidine)-Also known as zone, rocket fuel, love boat, hog, embalming fluid, or superweed.
• Ketamine- also known as K, Special K, or cat Valium
• DXM (Dextromethorphan)- Also known as robo
• Salvia Divinorum- Also known as diviner’s sage, Maria Pastora, Sally-D, or magic mint
PCP (Phencyclidine)—was originally developed in the 1950s as a general anesthetic for surgery. While it can be found in a variety of forms, including tablets or capsules, it is usually sold as a liquid or powder. PCP can be snorted, smoked, injected, or swallowed. It is sometimes smoked after being sprinkled on marijuana, tobacco, or parsley.
Ketamine—is a dissociative currently used as an anesthetic for humans as well as animals. Much of the ketamine sold on the street has been diverted from veterinary offices. Although it is manufactured as an injectable liquid, ketamine is generally evaporated to form a powder that is snorted or compressed into pills for illicit use. Because ketamine is odorless and tasteless and has amnesia-inducing properties, it is sometimes added to drinks to facilitate sexual assault.
DXM (Dextromethorphan)—is a cough suppressant and expectorant ingredient in some over the counter (OTC) cold and cough medications that are often abused by adolescents and young adults. The most common sources of abused DXM are “extra-strength” cough syrup, which typically contains around 15 milligrams of DXM per teaspoon, and pills and gel capsules, which typically contain 15 milligrams of DXM per pill. OTC medications that contain DXM often also contain antihistamines and decongestants.
Salvia divinorum—is a psychoactive plant common to southern Mexico and Central and South America. Salvia is typically ingested by chewing fresh leaves or by drinking their extracted juices. The dried leaves of salvia can also be smoked or vaporized and inhaled.
How Widespread Is the Abuse of Hallucinogens and Dissociative Drugs?
According to the 2013 National Survey on Drug Use and Health, 229,000 Americans ages 12 and older reported current (past month) use of LSD and 33,000 reported current use of PCP (Substance Abuse and Mental Health Services Administration, 2013). Among high school seniors, salvia was significantly more popular than LSD or PCP when it was added to the Monitoring the Future survey in 2009. Past-year use was reported to be 5.9 percent for salvia, 2.7 percent for LSD, and 1.3 percent for PCP. Fortunately, rates have dropped significantly for saliva—to 1.8 percent in 2014—with LSD and PCP use dropping slightly (Johnston, 2014).
While regular use of hallucinogenic and dissociative drugs, in general, has remained relatively low in recent years, one study reported that the United States ranks first among 36 nations in the proportion of high school students ever using LSD or other hallucinogens in their lifetime (6 percent versus 2 percent in Europe) (Hibell, 2012).
While regular use of hallucinogenic and dissociative drugs in general has remained relatively low in recent years, one study reported that the United States ranks first among 36 nations in the proportion of high school students ever using LSD or other hallucinogens in their lifetime (6 percent versus 2 percent in Europe) (Hibell, 2012).
Additionally, tourism to the Amazon for the purpose of using ayahuasca has become increasingly popular among Americans and Europeans in recent years, and ayahuasca use has also been reported in major cities in Brazil and abroad (Barbosa, 2012; McKenna, 2004). Although DMT is a schedule I drug, plants containing DMT are not scheduled, and there is ambiguity over ayahuasca’s legal status in the United States (McKenna, 2004). Two U.S. Brazilian churches have obtained permission to import and use these plants in their ceremonies.
Why Do People Take Hallucinogenic or Dissociative Drugs?
Hallucinogenic and dissociative drugs have been used for a variety of reasons (Bogenschutz, 2012; Bonson, 2001). Historically, hallucinogenic plants have been used for religious rituals to induce states of detachment from reality and precipitate “visions” thought to provide mystical insight or enable contact with a spirit world or “higher power.” More recently, people report using hallucinogenic drugs for more social or recreational purposes, including to have fun, help them deal with stress, or enable them to enter into what they perceive as a more enlightened sense of thinking or being. Hallucinogens have also been investigated as therapeutic agents to treat diseases associated with perceptual distortions, such as schizophrenia, obsessive-compulsive disorder, bipolar disorder, and dementia.
Classic hallucinogens are thought to produce their perception-altering effects by acting on neural circuits in the brain that uses the neurotransmitter serotonin (Passie, 2008; Nichols, 2004; Schindler, 2012; Lee, 2012). Specifically, some of their most prominent effects occur in the prefrontal cortex—an area involved in mood, cognition, and perception—as well as other regions important in regulating arousal and physiological responses to stress and panic.
How Do Hallucinogens (LSD, Psilocybin, Peyote, DMT, and Ayahuasca) Affect the Brain and Body? How Do Hallucinogens Work?
Classic hallucinogens are thought to produce their perception-altering effects by acting on neural circuits in the brain that use the neurotransmitter serotonin (Passie, 2008; Nichols, 2004; Schindler, 2012; Lee, 2012). Specifically, some of their most prominent effects occur in the prefrontal cortex—an area involved in mood, cognition, and perception—as well as other regions important in regulating arousal and physiological responses to stress and panic.
What Are the Short-Term Effects of Hallucinogens?
Ingesting hallucinogenic drugs can cause users to see images, hear sounds, and feel sensations that seem real but do not exist. Their effects typically begin within 20 to 90 minutes of ingestion and can last 12 hours. Experiences are often unpredictable and may vary with the amount ingested and the user’s personality, mood, expectations, and surroundings.
The effects of hallucinogens like 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. Users refer to LSD and other hallucinogenic experiences as “trips” and to acute adverse or unpleasant experiences as “bad trips.” 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 losing control, insanity, or death.
Like LSD and psilocybin, DMT produces its effects through action at serotonin (5-HT) receptors in the brain (Strassman, 1996). Some research has suggested that DMT occurs naturally in the human brain in small quantities, leading to the hypothesis that release of endogenous DMT may be involved in reports of alien abductions, spontaneous mystical experiences, and near-death experiences, but this remains controversial (Barker, 2012).
Specific short-term effects of LSD, psilocybin, peyote, DMT, and ayahuasca include:
LSD:
• Increased blood pressure, heart rate, and body temperature
• Dizziness and sleeplessness
• Loss of appetite, dry mouth, and sweating
• Numbness, weakness, and tremors
• Impulsiveness and rapid emotional shifts that can range from fear to euphoria, with transitions so rapid that the user may seem to experience several emotions simultaneously.
Psilocybin:
• Feelings of relaxation (similar to effects of low doses of marijuana)
• Nervousness, paranoia, and panic reactions
• Introspective/spiritual experiences
• Misidentification of poisonous mushrooms resembling psilocybin could lead to unintentional, potentially fatal poisoning
Peyote
• Increased body temperature and heart rate
• Uncoordinated movements (ataxia)
• Profound sweating
• Flushing
DMT:
• Increased heart rate
• Agitation
• Hallucinations frequently involving radically altered environments as well as body and spatial distortions
Ayahuasca:
• Increased blood pressure
• Severe vomiting (induced by the tea)
• Profoundly altered state of awareness and perceptions of otherworldly imagery
Short-Term General Effects of Hallucinogens Sensory Effects
• Hallucinations, including seeing, hearing, touching, or smelling things in a distorted way or perceiving things that do not exist
• Hallucinations, including seeing, hearing, touching, or smelling things in a distorted way of perceiving things that do not exist
• Mixed senses (“seeing” sounds or “hearing” colors)
• Changes in sense or perception of time (time goes by slowly)
Physical Effects
• Increased energy and heart rate
• Nausea
LSD users quickly develop a high degree of tolerance to the drug’s effects, such that repeated use requires increasingly larger doses to produce similar effects. The use of hallucinogenic drugs also produces tolerance to other drugs in this class, including psilocybin and peyote.
The use of classic hallucinogens does not, however, produce tolerance to drugs that do not act directly on the same brain cell receptors. In other words, there is no cross-tolerance to drugs that act on other neurotransmitter systems, such as marijuana, amphetamines, or PCP, among others.
Furthermore, tolerance for hallucinogenic drugs is short-lived—it is lost if the user stops taking the drugs for several days—and physical withdrawal symptoms are not typically experienced when chronic use is stopped.
LSD users quickly develop a high degree of tolerance to the drug’s effects, such that repeated use requires increasingly larger doses to produce similar effects. The use of hallucinogenic drugs also produces tolerance to other drugs in this class, including psilocybin and peyote. Use of classic hallucinogens does not, however, produce tolerance to drugs that do not act directly on the same brain cell receptors. In other words, there is no cross-tolerance to drugs that act on other neurotransmitter systems, such as marijuana, amphetamines, or PCP, among others.
Furthermore, tolerance for hallucinogenic drugs is short-lived—it is lost if the user stops taking the drugs for several days—and physical withdrawal symptoms are not typically experienced when chronic use is stopped.
What Are the Long-Term Effects of Hallucinogens?
LSD users quickly develop a high degree of tolerance to the drug’s effects, such that repeated use requires increasingly larger doses to produce similar effects. The use of hallucinogenic drugs also produces tolerance to other drugs in this class, including psilocybin and peyote.
The use of classic hallucinogens does not, however, produce tolerance to drugs that do not act directly on the same brain cell receptors. In other words, there is no cross-tolerance to drugs that act on other neurotransmitter systems, such as marijuana, amphetamines, or PCP, among others. Furthermore, tolerance for hallucinogenic drugs is short-lived—it is lost if the user stops taking the drugs for several days—and physical withdrawal symptoms are not typically experienced when chronic use is stopped.
The long-term residual psychological and cognitive effects of peyote remain poorly understood. Although one study found no evidence of psychological or cognitive deficits among Native Americans who use peyote regularly in a religious setting, those findings may not generalize to those who repeatedly abuse the drug for recreational purposes (Halpern, 2005).
The long-term effects of DMT use and abuse and addiction liability are currently unknown. Unlike most other hallucinogens, DMT does not appear to induce tolerance (Winstock, 2013). ed, in at least one report, with fetal abnormalities (Gilmore, 2001).
Overall, two long-term effects—persistent psychosis and HPPD—have been associated with the use of classic hallucinogens (see text box below). Although the occurrence of either is rare, it is also unpredictable and may happen more often than previously thought, and sometimes both conditions occur together. While the exact causes are not known, both conditions are more often seen in individuals with a history of psychological problems but can happen to anyone, even after a single exposure.
There is no established treatment for HPPD, in which flashbacks may occur spontaneously and repeatedly although less intensely than their initial occurrence. Some antidepressant and antipsychotic drugs can be prescribed to help improve mood and treat psychoses, however. Psychotherapy may also help patients cope with fear or confusion associated with visual disturbances or other consequences of long-term LSD use.
More research on the causes, incidence, and long-term effects of both disorders is being conducted.
Overall, two long-term effects—persistent psychosis and HPPD—have been associated with the use of classic hallucinogens (see text box below). Although occurrence of either is rare, it is also unpredictable and may happen more often than previously thought, and sometimes both conditions occur together. While the exact causes are not known, both conditions are more often seen in individuals with a history of psychological problems but can happen to anyone, even after a single exposure.
Psychotherapy may also help patients cope with fear or confusion associated with visual disturbances or other consequences of long-term LSD use. More research on the causes, incidence, and long-term effects of both disorders is being conducted.
There is no established treatment for HPPD, in which flashbacks may occur spontaneously and repeatedly although less intensely than their initial occurrence. Some antidepressant and antipsychotic drugs can be prescribed to help improve mood and treat psychoses, however. Psychotherapy may also help patients cope with fear or confusion associated with visual disturbances or other consequences of long-term LSD use. More research on the causes, incidence, and long-term effects of both disorders is being conducted.
As with some other hallucinogens, there is little information to suggest that ayahuasca use creates lasting physiological or neurological deficits, especially among those using the brew for religious activities.
Long-Term Effects of Hallucinogens- Persistent psychosis
• Visual disturbances
• Disorganized thinking
• Paranoia
• Mood disturbances
Hallucinogen Persisting Perception Disorder (HPPD):
• Hallucinations
• Other visual disturbances (such as seeing halos or trails attached to moving objects)
• Symptoms sometimes mistaken for neurological disorders (such as stroke or brain tumor)
What Are the Effects of Common Dissociative Drugs on the Brain and Body? How Do Dissociative Drugs Work?
Laboratory studies suggest that dissociative drugs, including PCP, ketamine, and DXM, cause their effects by disrupting the actions of the brain chemical glutamate at certain types of receptors—called N-methyl-D-aspartate (NMDA) receptors—on nerve cells throughout the brain (Morgan, 2012; Morris, 2005). Glutamate plays a major role in cognition (including learning and memory), emotion, and the perception of pain (the latter via activation of pain-regulating cells outside of the brain).
PCP also alters the actions of dopamine, a neurotransmitter responsible for the euphoria and “rush” associated with many abused drugs.
Salvia divinorum works differently. While classified as a dissociative drug, salvia causes its effects by activating the kappa opioid receptor on nerve cells (Cunningham, 2011; MacLean, 2013). These receptors differ from those activated by commonly known opioids like heroin and morphine.
What Are the Short-Term Effects of Dissociative Drugs?
Dissociative drugs can produce visual and auditory distortions and a sense of floating and dissociation (feeling detached from reality) in users.
The use of dissociative drugs can also cause anxiety, memory loss, and impaired motor function, including body tremors and numbness. These effects, which depend on the amount of the drug taken, are also unpredictable—typically beginning within minutes of ingestion and lasting for several hours, although some users report feeling the drug’s effects for days. See text box for general effects of dissociative drugs.
Low to Moderate Doses:
• Numbness
• Disorientation, confusion, and loss of coordination
• Dizziness, nausea, vomiting
• Changes in sensory perceptions (such as sight, sound, shapes, time, and body image)
• Hallucinations
• Feelings of detachment from self and environment
• Increase in blood pressure, heart rate, respiration, and body temperature
High Doses:
• Hallucinations
• Memory loss
• Physical distress, including dangerous changes in blood pressure, heart rate, respiration, and body temperature
• Marked psychological distress, including feelings of extreme panic, fear, anxiety, paranoia, invulnerability, exaggerated strength, and aggression
• Use with high doses of alcohol or other central nervous system depressants can lead to respiratory distress or arrest, resulting in death
• In addition to these general effects, different dissociative drugs can produce a variety of distinct and dangerous effects. For example, at moderate to high doses, PCP can cause seizures or severe muscle contractions, become aggressive or violent, or experience psychotic symptoms like schizophrenia. At moderate to high doses, ketamine can cause sedation, immobility, and amnesia. At high doses, ketamine users also report experiencing terrifying feelings of almost complete sensory detachment likened to a near-death experience (called a “K-hole,” similar to a bad LSD trip). Salvia users report intense but short-lived effects—up to 30 minutes—including emotional mood swings ranging from sadness to uncontrolled laughter.
• DXM, which is safe and effective as a cough suppressant and expectorant when used at recommended doses (typically 15 to 30 milligrams), can lead to serious side effects when abused. For example, the use of DXM at doses from 200 to 1,500 milligrams can produce dissociative effects similar to PCP and ketamine and increase the risk of serious central nervous system and cardiovascular effects such as respiratory distress, seizures, and increased heart rate from the antihistamines found in cough medicines.
While the long-term use of most dissociative drugs has not been investigated systematically, research shows that repeated use of PCP can lead to tolerance and the development of a substance use disorder that includes a withdrawal syndrome (including a craving for the drug, headaches, and sweating) when drug use is stopped. Other effects of long-term PCP use include persistent speech difficulties, memory loss, depression, suicidal thoughts, anxiety, and social withdrawal that may persist for a year or more after chronic use stops.
What Are the Long-Term Effects of Dissociative Drugs?
While the long-term use of most dissociative drugs has not been investigated systematically, research shows that repeated use of PCP can lead to tolerance and the development of a substance use disorder that includes a withdrawal syndrome (including craving for the drug, headaches, and sweating) when drug use is stopped. Other effects of long-term PCP use include persistent speech difficulties, memory loss, depression, suicidal thoughts, anxiety, and social withdrawal that may persist for a year or more after chronic use stops.
IN CLOSING: To learn more about hallucinogens and other drugs of abuse, visit the NIDA website at www.drugabuse.gov or contact the DrugPubs Research Dissemination Center at 877-NIDA-NIH (877-643-2644).
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