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Hallucinogens Overview

Information about hallucinogens, identifying signs of addiction, and recovery.

Understanding Hallucinogens as a Drug

Hallucinogens are psychoactive substances that alter perception, mood, and cognitive processes, often causing hallucinations. They are categorized into classic hallucinogens, like LSD, psilocybin (magic mushrooms), and DMT, and dissociative drugs, such as PCP and ketamine. Historically used in spiritual rituals, hallucinogens became popular in the 1950s and 1960s for recreation and research.

Despite their potential therapeutic uses, most hallucinogens are illegal due to abuse risks and unpredictable effects. Experiences vary but often include altered sensory perception, changes in thought patterns, and a distorted sense of time. While some users report positive effects like increased creativity, risks include acute psychological distress, dangerous behavior, and long-term mental health issues.¹

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Understanding Hallucinogens

The use of hallucinogens dates back thousands of years, with evidence of their use in ancient civilizations and indigenous cultures worldwide. Many hallucinogens are naturally occurring substances found in plants, fungi, and animals. For example, psilocybin is found in certain species of mushrooms, while DMT is present in various plants and can also be produced naturally in the human body. Other hallucinogens, such as LSD and MDMA, were synthesized more recently in laboratories. LSD was first synthesized by Swiss chemist Albert Hofmann in 1938, and its psychoactive properties were discovered in 1943. MDMA was first synthesized in 1912 but did not become widely used as a recreational drug until the 1970s and 1980s. The use of hallucinogens in Western society became more prevalent in the 1950s and 1960s, as researchers began exploring their potential therapeutic applications and they gained popularity as recreational drugs associated with the counterculture movement.²

Hallucinogens come in various forms, depending on the specific substance. Classic hallucinogens like LSD are often found as small squares of paper (blotter paper) that have been infused with the drug, or as tiny pellets or tablets known as microdots. Psilocybin mushrooms have a distinctive appearance, with long, slender stems and caps that can range in color from pale brown to golden or even blue-tinted. DMT is typically a white, crystalline powder but can also be found in various plant materials. Dissociative drugs like PCP and ketamine are usually found as white or off-white powders, but PCP can also be found as a liquid or in capsule form. It is important to note that the appearance of a substance does not guarantee its identity or purity, as many hallucinogens can be mixed with other substances or misrepresented entirely.

The smell of hallucinogens can vary depending on the specific substance and form. Many of the classic hallucinogens, such as LSD and psilocybin, have little to no odor in their pure forms. However, psilocybin mushrooms may have a slightly earthy or musty smell. DMT, when vaporized or smoked, has been described as having a distinct, harsh, plastic-like odor. Dissociative drugs like PCP and ketamine may have a slightly sweet or chemical smell when in powder form. It is important to note that the smell of a substance is not a reliable indicator of its identity or purity, as odors can be masked or altered by adulterants or other substances.

Hallucinogens can be ingested in various ways, depending on the specific substance and form. Classic hallucinogens like LSD are often taken orally, either by swallowing blotter paper or tablets or by placing them under the tongue for sublingual absorption. Psilocybin mushrooms are typically eaten fresh or dried, sometimes brewed into a tea. DMT is often smoked or vaporized but can also be snorted or injected. Dissociative drugs like PCP and ketamine are commonly snorted, smoked, or injected, although they can also be taken orally in pill or liquid form. The method of ingestion can influence the onset, intensity, and duration of the drug’s effects, as well as the potential risks and adverse reactions.

The paraphernalia associated with hallucinogen use varies depending on the specific substance and method of ingestion. For classic hallucinogens like LSD and psilocybin mushrooms, there may be little to no specific paraphernalia involved, as these substances are often ingested orally. However, some users may employ scales or microdosing equipment to measure out precise doses. For DMT, which is often smoked or vaporized, users may use glass pipes, vaporizers, or other smoking devices. Dissociative drugs like PCP and ketamine, when snorted, may involve the use of straws, rolled-up bills, or small spoons. When these drugs are smoked, users may employ glass pipes or foil for vaporization. Injecting hallucinogens requires syringes, needles, and other injection equipment. It is important to note that sharing paraphernalia, particularly injection equipment, can increase the risk of transmitting infectious diseases.

Identifying Hallucinogens

Identifying hallucinogens can be challenging, as they come in various forms and may be difficult to distinguish from other substances. LSD blotter paper may be marked with distinctive designs or logos, but this is not always a reliable indicator of the drug’s presence or purity. Psilocybin mushrooms have a characteristic appearance, but they can be easily confused with other, potentially poisonous mushroom species. DMT, PCP, and ketamine in powder form may be indistinguishable from other white powders. The most reliable way to identify a hallucinogen is through laboratory testing, such as gas chromatography-mass spectrometry (GC-MS) or high-performance liquid chromatography (HPLC). Reagent testing kits, which are available commercially, can provide a preliminary indication of the presence of certain hallucinogens but cannot definitively identify all substances or guarantee purity.³

Facts About Hallucinogens

Microdosing Hallucinogens

Microdosing involves taking very small doses of a hallucinogen, typically LSD or psilocybin, on a regular basis to experience subtle effects on mood, creativity, and cognitive function. Proponents of microdosing claim that it can enhance productivity, alleviate symptoms of depression and anxiety, and foster a greater sese of well-being. However, the scientific evidence supporting these claims is limited, and the long-term effects of microdosing are not well understood. Additionally, the illegal status of most hallucinogens and the lack of regulation surrounding microdosing raise concerns about safety, purity, and potential legal consequences.⁴

Hallucinogens and Psychotherapy

There has been renewed interest in the potential therapeutic applications of hallucinogens, particularly in the treatment of mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD). Clinical trials have shown promising results for the use of psilocybin-assisted psychotherapy in treating depression and anxiety in terminally ill patients, as well as for the use of MDMA-assisted psychotherapy in treating PTSD. These studies suggest that hallucinogens, when used in a controlled clinical setting with appropriate support and integration, may have valuable therapeutic potential. However, more research is needed to fully understand the risks and benefits of hallucinogen-assisted psychotherapy and to establish safe and effective treatment protocols.

Hallucinogen Persisting Perception Disorder (HPPD)

Hallucinogen Persisting Perception Disorder (HPPD) is a rare but potentially distressing condition that can occur after hallucinogen use. HPPD is characterized by persistent visual disturbances, such as seeing halos or trails attached to moving objects, experiencing flashbacks to previous hallucinogen experiences, or perceiving static or geometric patterns in the visual field. These symptoms can last for months or even years after the last use of a hallucinogen and can cause significant distress and impairment in daily functioning. The exact causes of HPPD are not well understood, but factors such as the frequency and intensity of hallucinogen use, as well as individual vulnerability factors, may play a role. Treatment for HPPD typically involves a combination of medications, such as antipsychotics or antiepileptics, and psychotherapy to help individuals manage their symptoms and cope with the associated distress.

Cultural and Spiritual Use of Hallucinogens

Hallucinogens have a long history of use in cultural and spiritual contexts, particularly among indigenous communities in the Americas and other parts of the world. Substances like psilocybin mushrooms, ayahuasca (a brew containing DMT), and peyote (a cactus containing mescaline) have been used in religious and healing rituals for centuries. In these contexts, hallucinogens are often viewed as sacred medicines that facilitate spiritual growth, self-discovery, and connection with the divine. The use of hallucinogens in these settings is typically guided by experienced shamans or healers and is governed by specific cultural norms and practices. The globalization of ayahuasca tourism and the increasing interest in the therapeutic potential of hallucinogens have raised complex questions about cultural appropriation, safety, and the commodification of indigenous knowledge and practices.

Set and Setting in Hallucinogen Use

The concepts of “set” and “setting” are considered crucial factors in shaping the hallucinogen experience. “Set” refers to an individual’s mindset, expectations, and psychological preparation before taking a hallucinogen, while “setting” refers to the physical and social environment in which the experience takes place. A positive set and supportive setting are thought to increase the likelihood of a beneficial and meaningful hallucinogen experience, while a negative set or challenging setting can contribute to a difficult or distressing “bad trip.” Factors such as the presence of a trusted guide or sitter, a comfortable and safe physical environment, and a clear intention or purpose for the experience are often emphasized in harm reduction approaches to hallucinogen use. The recognition of the importance of set and setting has also informed the design of clinical trials investigating the therapeutic potential of hallucinogens, which often take place in carefully controlled and supportive environments.

Hallucinogens and Neuroplasticity

Recent research suggests that hallucinogens, particularly classic psychedelics like LSD and psilocybin, may promote neuroplasticity, which is the brain’s ability to form new neural connections and adapt to new experiences. Studies using brain imaging techniques have shown that psychedelics can increase functional connectivity between different brain regions and reduce activity in the default mode network, which is associated with self-referential thinking and rumination. These changes in brain function are thought to underlie the profound psychological experiences and therapeutic benefits reported by some hallucinogen users. The promotion of neuroplasticity may also explain why psychedelics have shown promise in treating conditions such as depression, addiction, and PTSD, which are characterized by rigid patterns of thought and behavior. However, more research is needed to fully understand the mechanisms by which hallucinogens influence neuroplasticity and to determine the long-term effects of these substances on brain function and mental health.

Recovering From Hallucinogen Addiction

While hallucinogens are not typically considered to be physically addictive in the same way as substances like opioids or stimulants, regular use can lead to psychological dependence and negative consequences. Overcoming problematic hallucinogen use often involves a combination of behavioral therapies, peer support, and lifestyle changes. Cognitive-behavioral therapy (CBT) can help individuals identify and change the thought patterns and behaviors that contribute to their hallucinogen use, while motivational interviewing can help them explore their ambivalence about change and strengthen their commitment to recovery. Joining support groups, such as SMART Recovery or Narcotics Anonymous, can provide a sense of community and accountability throughout the recovery process. Developing healthy coping mechanisms, such as exercise, mindfulness practices, or creative pursuits, can help individuals manage stress and find fulfillment without relying on hallucinogens. It is also important to address any underlying mental health concerns or trauma that may have contributed to problematic hallucinogen use. Seeking professional help from a mental health provider experienced in treating substance use disorders can be a crucial step in the recovery process.

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The Stages of Hallucinogen Addiction

The stages of hallucinogen use can vary depending on the individual, the specific substance, and the context of use, but a general progression may be observed. The first stage typically involves experimentation or initiation, where an individual tries a hallucinogen for the first time, often out of curiosity, peer influence, or a desire for novel experiences. The next stage may involve more frequent or regular use as the individual seeks to repeat or intensify the hallucinogenic experience. At this stage, use may still be primarily recreational or exploratory, but it may begin to interfere with other aspects of life. As use continues, some individuals may develop a psychological dependence characterized by a perceived need to use hallucinogens to cope with stress, escape reality, or maintain a sense of spiritual or creative inspiration.
In some cases, this stage may be accompanied by a tolerance to the effects of the substance, leading to higher doses or more frequent use. The final stage may involve problematic or compulsive use, where hallucinogen use becomes a central focus of the individual’s life, leading to neglect of responsibilities, strained relationships, and potential mental health issues. It is important to note that not all individuals who use hallucinogens will progress through these stages, and some may be able to maintain moderate or controlled use without developing significant problems. However, recognizing the potential risks and seeking help if use becomes problematic is crucial for preventing adverse consequences and maintaining overall well-being.⁵

FAQs About Hallucinogens

What are the effects of hallucinogens?
The effects of hallucinogens can vary widely depending on the specific substance, dose, and individual factors, but common experiences include:
Altered sensory perception, such as visual distortions, enhanced colors, or synesthesia (mixing of senses)
Changes in thought patterns and cognitive processes, such as increased introspection, creativity, or paranoia
Intense emotional experiences, ranging from euphoria and feelings of connectedness to anxiety and fear
Distorted sense of time and space
Increased heart rate, blood pressure, and body temperature
Nausea, dizziness, or tremors

Are hallucinogens addictive?
Hallucinogens are not considered to be physically addictive in the same way as substances like opioids or stimulants, as they do not typically lead to the development of tolerance and withdrawal symptoms. However, regular use of hallucinogens can lead to psychological dependence, where individuals feel a strong desire to continue using the substance despite negative consequences. Some people may also develop a tolerance to the effects of hallucinogens over time, requiring higher doses to achieve the desired experience.

What are the risks associated with hallucinogen use?
The risks associated with hallucinogen use can include:
Acute psychological distress or “bad trips,” which can involve intense anxiety, paranoia, or panic
Dangerous behavior during intoxication, such as wandering into traffic or attempting to fly
Exacerbation of pre-existing mental health conditions, such as schizophrenia or bipolar disorder
Hallucinogen Persisting Perception Disorder (HPPD), which involves persistent visual disturbances
Increased heart rate and blood pressure, which can be dangerous for individuals with cardiovascular conditions
Unintentional ingestion of poisonous plants or substances misrepresented as hallucinogens

Can hallucinogens have therapeutic benefits?
While most hallucinogens are currently illegal and not approved for medical use, there is growing interest in the potential therapeutic applications of these substances. Clinical trials have shown promising results for the use of psilocybin-assisted psychotherapy in treating depression, anxiety, and addiction, as well as for the use of MDMA-assisted psychotherapy in treating post-traumatic stress disorder (PTSD). However, these studies are still in the early stages, and more research is needed to fully understand the risks and benefits of hallucinogen-assisted therapy and to establish safe and effective treatment protocols. It is important to note that the use of hallucinogens outside of a controlled clinical setting, without proper preparation, support, and integration, can be dangerous and is not recommended.

Sources

[1] Hallucinogens | DEA.gov
[2]Hallucinogens Fact Sheet | DEA.gov
[3]Hallucinogens| Cleveland Clinic
[4]The popularity of microdosing of psychedelics: What does the science say? | Harvard.edu
[5]Hallucinogen use is associated with mental health and addictive problems and impulsivity in university students | NIH

CLINICALLY REVIEWED

Faz Yar Khan, MD FACP

Medical Director

Dr. Faz Yar Kahn, our Medical Director, is an American Board of Internal Medicine-certified physician. He graduated from the Medical University of the Americas and completed his residency at Mercy Hospital in Chicago. With expertise in primary care, hospitalist medicine, critical care, and addiction medicine, along with ACLS certification, Dr. Kahn leads our team in providing exceptional substance abuse treatment.

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