Hallucinogen abuse
Hallucinogen abuse refers to the repeated use of hallucinogenic drugs, which significantly alter an individual's perception of reality and ability to meet daily responsibilities. Commonly known hallucinogens include substances like LSD, psilocybin mushrooms, and MDMA. These drugs work by binding to serotonin receptors in the brain, leading to distortions in sensory perception, mood changes, and sometimes euphoric experiences. While many users seek these substances for their consciousness-expanding effects, hallucinogen abuse can lead to serious physical and psychological symptoms, including increased heart rate, anxiety, and even persistent flashbacks known as Hallucinogen Persisting Perception Disorder (HPPD).
The accessibility of these drugs makes them particularly appealing to adolescents and young adults. However, the risks associated with their use, such as triggering latent psychiatric conditions or causing long-lasting cognitive changes, are significant. Treatment options may include immediate care during a "bad trip," long-term psychotherapy, and support groups, especially for those with a history of frequent use. Education on the unpredictable effects and dangers of hallucinogens is vital in preventing abuse, emphasizing the importance of early intervention in schools and communities.
Hallucinogen abuse
- ALSO KNOWN AS: Illusionogenic abuse; psychedelic drug abuse. Common names for these drugs include acid, blotter, fry, mind candy, shrooms, mushrooms, special K, X, and XTC.
DEFINITION: Hallucinogen abuse is the repeated use of hallucinogens, which are drugs that distort a person’s perception of reality after they have caused impairment that undermines the user’s ability to fulfill obligations at home, school, and work.
Causes
The mechanism by which hallucinogens exert their effects is not fully understood. However, it is recognized that hallucinogens bind with 5-HT serotonin receptors in the brain. Serotonin facilitates the transmission of nerve impulses. When a hallucinogen binds with serotonin receptors, it blocks serotonin from these receptor sites, thus altering nerve transmission. Unbound serotonin increases in the brain, contributing to the distortions in vision, hearing, and the perception of time and space, as well as in the alterations in mood and thought processes that occur under the influence of hallucinogens. Individuals who abuse hallucinogens regard this as a consciousness-raising experience that can lead to increased creativity and self-awareness.
Risk Factors
Hallucinogens are easily and cheaply obtained, making them attractive to adolescents who want to experiment with mind-altering drugs. Older adolescents and young adults use them in the party scene to heighten their experiences. The National Institute on Drug Abuse reports that between four and six percent of high school students have tried hallucinogenic mushrooms, lysergic acid diethylamide (LSD, or acid), MDMA (3,4-methylenedioxymethamphetamine or ecstasy), or other hallucinogens at least once. Persons who abuse hallucinogens are also likely to abuse alcohol and marijuana.
Symptoms
Physical symptoms of hallucinogen abuse include increased blood pressure, increased heart rate, nausea, vomiting, diarrhea, dilated pupils, blurred vision, paraesthesia (burning, tingling, or itching skin), and sweating. With MDMA (ecstasy), symptoms include muscle cramping, dehydration, and severe elevations in body temperature.
Psychological symptoms of hallucinogen abuse include distortion of sight, sound, and touch, synesthesia, depersonalization, delusions of physical invulnerability, elation or euphoria, blissful calm or mellowness, reduced inhibitions, poor judgment, increased risk taking, impaired concentration and motivation, anxiety attacks, and paranoia.
Individuals who abuse hallucinogens can experience recurring flashbacks of their drug-induced psychological symptoms long after the immediate experience. These flashbacks are referred to as persisting psychosis, perception disorder, or hallucinogen persisting perception disorder (HPPD). Flashbacks occur in 30 to 50 percent of individuals who frequently use these drugs and far less often in occasional users. Using alcohol or marijuana or experiencing extreme fatigue can trigger flashbacks. Chronic abuse can affect long-term memory and cause personality changes. Frequent abuse can trigger latent psychiatric disorders, such as depression, anxiety, and psychosis. Individuals who frequently abuse hallucinogenics can develop a psychological dependence on hallucinogens.
Screening and Diagnosis
Most persons who are treated for hallucinogenic abuse are experiencing an acute “bad trip.” The key to diagnosis is that their distress will be evident. Routine blood or urine sampling does not detect the use of hallucinogens. Individuals who abuse hallucinogens do not develop a tolerance to the drug that would require more frequent and higher dosing. Frequent or high-dose use indicates a psychological rather than a physiological need. Detectable withdrawal symptoms do not occur when an individual stops using hallucinogens.
Treatment and Therapy
A bad trip can be a frightening and anxiety-provoking experience, as can flashbacks. The immediate goal of treatment in these situations is to prevent the person from harming the self or others. The individual needs to be assured that the experience will pass as the drug wears off.
The effects of LSD, the longest-acting hallucinogen, can last up to twelve hours. The individual should be kept in a quiet, comfortable, and lighted environment and allowed to move around under supervision. An anti-anxiety drug such as lorazepam or another benzodiazepine may be helpful. An individual who abuses ecstasy may develop a dangerously high body temperature, which must be brought controlled.
Persons who have recurrent flashbacks or those with a history of long-term frequent hallucinogen use may require long-term psychotherapy after stopping the drug. Any underlying psychiatric disorders will have to be addressed. Many people find group support or a twelve-step program helpful in the recovery process. Hallucinogen intoxication delirium is a rare syndrome that can occur when a hallucinogen is contaminated with another drug or chemical, such as strychnine.
Though hallucinogen use is addictive and, in most cases, illegal, some substances in this class of drugs have been proposed as treatments for various mental health conditions. MDMA, ketamine, and psilocybin have been used in trials involving individuals with treatment-resistant conditions like post-traumatic stress disorder and for the treatment of addictions like opioid use disorder.
Prevention
Education regarding hallucinogen abuse should begin with children or early adolescents before they experiment with the drugs. People conducting the training or education should stress that the effects of hallucinogens cannot be predicted or controlled. Any user, even a first-time user, is at risk of a bad, even life-threatening, trip and of recurrent, disturbing flashbacks.
As all hallucinogen products are prepared in illegal, unregulated laboratories, there is no guarantee of their potency or purity, furthering the user’s risk of serious consequences. Parents should be alert to the availability and use of hallucinogens in their communities and should keep children from these sources.
Bibliography
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"Drug Fact Sheet: Hallucinogens." Drug Enforcement Administration, Apr. 2020, www.dea.gov/sites/default/files/2020-06/Hallucinogens-2020.pdf. Accessed 20 Sept. 2024.
Julien, Robert M. A Primer of Drug Actions. 15th ed. Worth, 2023.
Kuhn, Cynthia, et al. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. 3rd ed. W. W. Norton, 2008.
Laing, Richard R., ed. Hallucinogens: A Forensic Drug Handbook. Elsevier, 2003.
Lowinson, Joyce W., et al., eds. Substance Abuse: A Comprehensive Textbook. 5th ed. Lippincott, 2011.
“Psychedelic and Dissociative Drugs.” National Institute on Drug Abuse, Apr. 2023, www.nida.nih.gov/infofacts/hallucinogens.html. Accessed 20 Sept. 2024.
Weleff, Jeremy, et al. “From Taboo to Treatment: The Emergence of Psychedelics in the Management of Pain and Opioid Use Disorder.” British Journal of Clinical Pharmacology, 16 Apr. 2024, doi.org/10.1111/bcp.16045.