Hallucinogens

DEFINITION: Substances that cause alterations of perception, including but not limited to changing what users see, hear, feel, taste, smell, and experience about themselves and their relationship to the world and others.

SIGNIFICANCE: Hallucinogenic drugs are widely used in the United States, despite the fact that such use can be dangerous and even life threatening. Law enforcement agencies expend significant resources in efforts to reduce the illegal manufacture, sale, and use of such drugs.

Hallucinogenic drugs, or hallucinogens, are capable of altering the perceptions of those who ingest them. Historically, some hallucinogens have been important parts of cultural rituals, particularly spiritual ceremonies and developmental rites of passage, and their use has been socially sanctioned because of these associations. Most use in the United States, however, is recreational in nature.

Effects

As the name implies, hallucinations—internal perceptions that separate the individual from reality and that are not perceptible to others—are common effects of hallucinogen usage. The hallucinatory experiences associated with these drugs may include increased awareness of surroundings and perceptual distortions, such as perceived heightened visual ability or changes in the way motion is perceived. Any and all of the senses may be affected simultaneously, creating often illogical and nonlinear observations. Some users of hallucinogens have reported experiencing synesthesia, a phenomenon in which one sense overlaps with another. For instance, the notes, melodies, and harmonies of music may be perceived both as sounds and as colors.

Users of hallucinogens may also experience a different sense of themselves as persons, with the drugs affecting their perceptions of consciousness and their bodies in relationship to others. Some experience greatly increased empathy and feelings of connection to others and the environment. In fact, in some users, the perceived dissolution of personal boundaries may proceed to such an extent that they cannot perceive any sense of self—in essence, they feel they become their surroundings.

The experience of taking a hallucinogen is often referred to as a trip. Some trips are brief; others are long. Experiences can vary substantially from one use session to the next in terms of length of time a person is affected, the quality of the experience (pleasurable or upsetting), the number of senses affected, and so on. Some of this variation may be accounted for by the specific drugs used, the dosages taken, the quality or purity of the drugs, and the physical and environmental circumstances or contexts under which the drugs are taken.

Substances

Hallucinogens include human-made drugs, such as psychedelic “club drugs,” as well as substances derived from certain plants and fungi. In the United States, these substances are classified as having no medical uses, although this is a matter of some debate. Some have argued that particular hallucinogens may be useful for treating trauma,psychopathology , and even conditions such as headaches.

Common hallucinogens include lysergic acid diethylamide (LSD), 2,5-dimethoxy-4-methylamphetamine (known as DOM or STP), and 3,4-methylenedioxymethamphetamine (also known as MDMA or ecstasy). Also popular are psilocybin, a hallucinogen derived from mushrooms (sometimes known as magic mushrooms), and peyote. Peyote, which is derived from the mescal cactus and contains mescaline, has a long history of being used in Native American spiritual ceremonies. Dimethyltryptamine (DMT), another substance found in plants and seeds but that also may be synthesized, is used for its hallucinogenic properties.

Users seeking hallucinogenic properties in their recreational drugs of choice also sometimes abuse substances that were originally seen as anesthetics, such as ketamine (known as special K) and (known as or angel dust). These drugs’ dissociative properties lead users to experience feelings of being detached from themselves or their experiences.

Associated Problems

The experiences, or trips, that individuals have when they take hallucinogens can be pleasant or unpleasant. When pleasant, a trip can be a memorable experience, but when unpleasant, it can be like living trapped in a nightmare. Either circumstance can be dangerous, particularly if the individual under the influence is unsupervised. When experiencing pleasant hallucinations, users of hallucinogens may believe they can do things they cannot physically do (such as fly), and this may result in accidental injury or even death. Negative hallucinations may lead to aggression and paranoia that can spur attacks on others or objects, which may result in property damage, injuries, or—in extreme cases—deaths. In addition, users have reported the phenomenon of flashbacks—that is, the reexperiencing of trips well after the drugs’ initial effects have passed. Such unexpected experiences may lead to confusion, aggression, and accidental injury.

Hallucinogen use disorders follow the same pattern of problems as do use disorders associated with other substances of abuse. The use of hallucinogens may lead to daily functioning problems at work, home, or school, as trips and their associated recovery times may be lengthy. Hallucinogens can sometimes exacerbate preexisting psychological problems, and research indicates that they may even cause psychological problems, such as psychosis, in some users.

Like other substances of abuse, hallucinogens pose problems for law enforcement agencies, which must expend significant resources to combat the illegal manufacture, sale, and use of these drugs as well as other crimes that stem from the actions of persons under the influence of hallucinogens. The production and distribution of hallucinogens and their components are particularly noteworthy growing problems, as manufacturers and drug traffickers increasingly conduct their business using the Internet.

Clinical Use

The hallucinogen psilocybin has been illegal in the United States since 1970. In 2016, however, psilocybin trials were underway for depression in cancer patients. The objective of the study is to conclude whether or not this hallucinogen can reduce mental anguish in distressed cancer patients. Researchers think that the effects of psilocybin can interrupt feelings of anxiety that often characterize cancer patients with depression. Although they are looking to use psilocybin as therapy, researchers emphasize that they do not condone its recreational use.

In 2017, the Food and Drug Administration (FDA) approved a trial investigating MDMA as a breakthrough therapy for post-traumatic stress disorder (PTSD). Lykos Therapeutics applied for FDA approval for its MDMA-assisted therapy for PTSD in February 2024, but the FDA rejected Lykos's application that August and requested an additional phase 3 study.

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