Hallucinogens

Hallucinogen Abuse - A Medical Perspective

Hallucinogens are a very popular psychoactive substance of abuse, especially at parties. Hallucinogens when consumed cause alterations in perception, feeling, and experiences making you see, hear, and feel things that are not real. Hallucinogens are also known as dissociatives.

Hallucinogens can even cause intense mood swings that can lead to violence and even suicide.

Hallucinogen addiction and overdose are generally low compared to most other substances, however, individuals may still become dependent on the effects of these drugs.

How Hallucinogens Work

Proper perception of senses such as sign, hearing, touch, and smell occur as a result of the accurate transmission of signals from the sensory organs such as eyes, nose, and skin to the brain where it is processed.

Disruption of these pathways by mind-altering hallucinogens causes alterations in the perception of stimuli.

Hallucinogens are also known to stimulate the release of the neurotransmitter serotonin which is responsible for moods, sex drive, sleep, and sensory perception. This is why, most users report increase feelings of happiness, touch, and sexual pleasure.

However, over time the brain becomes dependent on the external stimulating drug so much that it craves it, even to feel normal.

Types Of Hallucinogens

1. Phencyclidine (PCP)

PCP is also known as angel dust, hog, love boat, and peace pill. It is often found mixed with meth, LSD, and marijuana. PCP was originally used as an anesthetic agent but was discontinued due to its dissociative properties.

It produces what is known as an “out of body” experience.

2. Lysergic Acid Diethylamide (LSD)

LSD, also known as acid, dots, blotter acid, mellow yellow, yellow sunshine, and windowpane is known for its potent psychedelic effects. LSD is made from a chemical found in a fungus that grows on rye and grains. LSD is mostly used illegally in parties by teens and those in their 20s. LSD is consumed orally as a powder, liquid, or pill and it causes elevations of mood known as ‘trips’.

3. Psilocybin

Psilocybin is another drug developed from psychedelic mushroom derivatives and also known as Magic Mushrooms, or Shrooms. These mushrooms have long slender stems and the caps contain dark gills on the underside, in contrast to edible mushrooms. Psilocybin produces hallucinations, an inability to differentiate reality from fantasy, panic attacks, and even psychoses in overdoses.

4. Gamma-Hydroxybutyric Acid (GHB)

GHB also is known as liquid ecstasy, roofies, goop, easy lay is a central nervous system depressant that is also found naturally in the human body. GHB produces a sense of euphoria, decreased inhibitions, sleepiness, disorientation, and loss of coordination.

5. Peyote (Mescaline)

Peyote is a small spineless cactus containing the potent psychedelic mescaline. Also known as buttons, cactus, and mesc. It is known to cause illusions and hallucinations, altered perception of space and time, and an altered body image.

Other hallucinogens

DMT (N, N- dimethyltryptamine)
251-NBOMe
Ketamine
Dextromethorphan (DXM)
Salvia (Salvia divinorum)

Effects Of Hallucinogens

Short term effects

Visual, auditory, tactile hallucinations
Distortion of time
Dry mouth
Anxiety or paranoia
Intensified feelings and sensory experience
Increased heart rate

Long term effects

Speech and memory problems from PCP overuse
Ketamine use can lead to bladder ulcers and other urinary tract problems
Visual disturbances
Mental problems
Paranoia
Persistent Psychosis - continued mental problems including visual disturbances, disorganized thinking, paranoia, and mood changes.
Hallucinogen Persisting Perception Disorder (HPPD) - Recurrences of drug experiences, flashbacks.

Managing Hallucinogen Addiction

Managing a hallucinogen addiction follows the same modalities as other substances of abuse. There are no approved medications to treat hallucinogen addiction per se, however, the main goals revolve around

1. Abstaining or gradual withdrawal from the drug.

Complete cessation of the drug is difficult for an addict. So this step requires strong motivation and controlling social cues that would encourage drug use. This includes cognitive behavioural therapy, support from family and friends, and abstaining from going to places such as parties.

In-patient and outpatient treatment centres are available to treat addictions and co-morbidities.

2. Treating the effects of the drug.

This is mostly required in an acute emergency setting, in cases of an overdose.

3. Managing withdrawal symptoms.

Withdrawal symptoms can occur upon cessation of the drug. It is important to provide the necessary motivation to prevent relapses. Craving to use the drug may be severe, therefore support from family and friends is important to keep in check.

4. Treating co-morbidities

Severe co-morbidities require an inpatient setting. However, most other co-morbidities should be diagnosed early and managed early.

5. Preventing relapses

The sudden cravings may occur after stopping the drug. Cravings may occur even years later, when the patient comes to a similar social setting, or when an easy opportunity presents itself. Therefore, the patient and those close to him/her must be educated on the possibility of a recurrence even years later.

References

Hallucinogens DrugFacts | National Institute on Drug Abuse. (2020). Retrieved 21 November 2020, from https://www.drugabuse.gov/publications/drugfacts/ hallucinogens

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Health risks of problematic to dependent use of hallucinogens

Hallucinogens are chemical compounds that alter the thought and behaviour of a person and the perception of their surroundings. Hallucinogenic drugs are used by almost all age groups(except for older people). These are used for medical as well as recreational purposes. As far as the recreational parties concerned, These drugs are mostly used by the tourist, and university and college students.

Mechanism of action

Hallucinogens act on the synaptic clefts in the brain where they activate specific receptors, which are also activated by serotonin, so they mainly work by altering the 5-HT2A receptors and serotonin interaction.

Types of hallucinogens

There are two types of hallucinogens:

1.Classical hallucinogens

2.Dissociative hallucinogens

As the name suggests, hallucinogens cause hallucinations. A person using hallucinogens sees images and sensations without a real external stimulus. Additionally, dissociative hallucinogens can cause dissociative symptoms. Dissociative symptoms make a user feel like he is not connected to his body.

Sources of hallucinogens:

There are two sources of hallucinogens:

1.Natural hallucinogens are extracted from plants.

2.Man-made hallucinogens

Plants that cause hallucinations:

Many plants produce hallucinations; these are known as psychoactive plants. Humans have been using these plants for a long time, for spiritual and recreational purposes.

The important ones are:

• Peyote Cactus: These are vision-inducing intoxicants. These are still used for religious purposes in Mexico.

• Ololiuqui: These also cause visual effects.

• Ebena: These are inhaled.

Routes of administration of hallucinogens:

1.Inhalation In the form of smoking

2.Swallowing as tablets

3.Swallowing as drinks

4.Snorting

5.Injection

Different types of hallucinogens are taken from various routes, such as LSD, taken by mouth.

Important hallucinogens:

• LSD: Lysergic acid diethylamide.

• Ketamine: Most commonly used in anesthesia.

• DXM: dextromethorphan.

• PCP: phencyclidine.

• DMT: dimethyltryptamine

• Salvia

• psilocybin (magic mushrooms).

Magic mushrooms and LSD are the most widely used recreational drugs among hallucinogens.

Health risks of hallucinogens: Hallucinogens are recreational drugs that mainly affect the brain while having fewer effects elsewhere.

Mental health problems
Physical health problems
Social problems

Mental health problems:

Hallucinogens act by disrupting the chemical system in the brain and spinal cord. The primary effect is on the serotonin receptors and the serotonin hormone, which are generally responsible for mood changes, sexual activity, perception of the environment, temperature, sleep, and hunger.

Short term effects:

The effects usually begin within 20 to 90 minutes after taking the drug. It may last for up to 12 hours in case of long-acting Hallucinogens such as LSD. Effects in short-acting Hallucinogens such as DMT while it may be over within 15 minutes.

• Visual hallucinations.

• Auditory hallucinations.

• Tactical hallucinations

• Impulsive and rapid emotional shifts.

• Numbness, weakness, and tremors.

• Feelings and sensory experiences are exaggerated (colours appear vibrant)

• The sense of time is also changed. For example, a person feels that time is passing slowly.

• Feeling of euphoria.

• The blurring of vision.

• Sense of relaxation.

• Dizziness.

• Panic.

• Paranoia: A condition in which a person distrusts others.

• Psychosis: Psychosis can be defined as disorder thinking not related to reality.

The users of hallucinogens use the term “the trip” for the acute experiences after taking the drug.

Long term effects:

• Persistent psychosis: These are a series of continuing mental problems like visual disturbance, disorganized thinking, change in perception, chronic mood changes, and paranoia.

• Flashbacks/Hallucinogen persistent perception disorder:(HPPD) These are recurrence of individual drug experiences, weeks, or years after taking the drug.

• Depression.

• Speech problems.

• Suicidal thoughts.

• Tolerance: Hallucinogens can have a tolerance effect. The user is compelled to take an increased amount of a drug to produce the desired results. This can be very dangerous as these drugs (LSD) are known for their unpredictability.

• Addiction: It is not generally found in hallucinogen users.

• Dependence: This is rare in the case of hallucinogens.

Bad trip:

Hallucinogens do not always cause euphoria or pleasant effects; sometimes, persons using them experience unpleasant sensations; this is called a bad trip. This includes fear, anxiety, paranoia, and unpleasant/intense hallucinations.

Physical health problems:

Apart from affecting the brain and bringing about change in perception, hallucinogens also affect other organs and parts of the body.

• Increase energy and heart rate.

• Increasing temperature.

• Increase in blood pressure.

• Increase in the breathing rate.

• Nausea and vomiting.

• Excessive sweating.

• Uncoordinated movement.

• Ataxia

• Decrease in appetite

• Dry mouth

• Seizures, coma, and death.

• Trauma: Incoordination and visual disturbances are the main reasons behind injury.

Social problems:

Like every other recreational drug, Hallucinogens are packed with a lot of social problems:

• Legal problems

• Crimes: A person intoxicated with Hallucinogens can commit various crimes because he is unaware of his actions.

• Interpersonal relationships: Users of hallucinogens do not enjoy good relations with their significant other. This is mostly due to violent tendencies in users.

• Social stigma: Like all other drug users, hallucinogen users are also subjected to various social stigmas

• A decline in work capacity: Although hallucinogens do not cause addiction, they cause harmful long-term effects on the brain, thus declining the working ability of a person.

• Financial problems: Decrease in the word capacity eventually leads to financial difficulties.

• Family problems.

• RTA: Just like alcohol, driving under the influence of Hallucinogens can cause road traffic accidents. This is mainly because hallucinogens make a person unaware of his/her surroundings.

• Loss of life: As a person is unaware of his surroundings and emotions, it has been reported that he often commits suicide or even harms others.

References

Book: DAVIDSON’s principle and practice of medicine.

https://emedicine.medscape.com/article/293752-overview

https://www.sciencedaily.com/releases/2007/01/070131135536.htm

https://covenanthillstreatment.com/blog/how-hallucinogens-affect-the-body/

https://www.mydr.com.au/addictions/hallucinogens-what-are-the-effects/

United States Department of Agriculture.