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: LSD, , , and PCP

Hallucinogenic compounds found in • Psilocybin (4-phosphoryloxy-N,N- some and (or their dimethyltryptamine) is obtained extracts) have been used—mostly from certain types of mushrooms during religious —for centuries. that are indigenous to tropical and Almost all hallucinogens contain subtropical regions of South America, and are classified as . , and the United States. Many hallucinogens have chemical These mushrooms typically contain structures similar to those of natural less than 0.5 percent psilocybin plus (e.g., -, trace amounts of , another -, or catecholamine-like). hallucinogenic substance. While the exact mechanisms by • PCP () was developed which hallucinogens exert their effects in the 1950s as an intravenous remain unclear, research suggests that . Its use has since been these work, at least partially, discontinued due to serious adverse by temporarily interfering with effects. action or by binding to their sites. This InfoFacts will discuss four common types of How Are Hallucinogens hallucinogens: Abused? • LSD (d-lysergic diethylamide) is The very same characteristics that led one of the most potent mood-changing to the incorporation of hallucinogens chemicals. It was discovered in 1938 into ritualistic or spiritual traditions and is manufactured from lysergic have also led to their propagation acid, which is found in , a as drugs of abuse. Importantly, and that grows on rye and other grains. unlike most other drugs, the effects of hallucinogens are highly variable and • Peyote is a small, spineless in unreliable, producing different effects which the principal active ingredient in different people at different times. is . This has been used This is mainly due to the significant by natives in northern Mexico and the variations in amount and composition southwestern United States as a part of of active compounds, particularly religious ceremonies. Mescaline can in the hallucinogens derived from also be produced through chemical plants and mushrooms. Because of synthesis.

June 2009 Page 1 of 7 their unpredictable nature, the use • PCP is a white crystalline powder that of hallucinogens can be particularly is readily soluble in water or . It dangerous. has a distinctive bitter chemical taste. PCP can be mixed easily with dyes • LSD is sold in tablets, capsules, and, and is often sold on the illicit occasionally, liquid form; thus, it market in a variety of , capsule, is usually taken orally. LSD is often and colored powder forms that are added to absorbent paper, which is normally snorted, smoked, or orally then divided into decorated pieces, ingested. For , PCP is often each equivalent to one . The applied to a leafy material such as , often referred to as mint, , , or marijuana. “trips,” are long; typically, they end Depending upon how much and by after about 12 hours. what route PCP is taken, its effects can • Peyote. The top of the peyote cactus, last approximately 4–6 hours. also referred to as the crown, consists of disc-shaped buttons that are cut How Do Hallucinogens from the roots and dried. These buttons are generally chewed or soaked in Affect the Brain? water to produce an intoxicating LSD, peyote, psilocybin, and PCP liquid. The hallucinogenic dose of are drugs that cause , mescaline is about 0.3 to 0.5 grams, which are profound distortions in a and its effects last about 12 hours. person’s of reality. Under Because the extract is so bitter, some the influence of hallucinogens, people individuals prefer to prepare a by see images, hear sounds, and feel boiling the cacti for several hours. sensations that seem real but are not. Some hallucinogens also produce rapid, • Psilocybin. Mushrooms containing intense emotional swings. LSD, peyote, psilocybin are available fresh and psilocybin cause their effects by or dried and are typically taken initially disrupting the interaction of orally. Psilocybin (4-phosphoryloxy- nerve cells and the neurotransmitter N,N-dimethyltryptamine) and its serotonin.1 Distributed throughout the biologically active form, psilocin brain and spinal cord, the serotonin (4-hydroxy-N,N-dimethyltryptamine), system is involved in the control of cannot be inactivated by cooking or behavioral, perceptual, and regulatory freezing preparations. Thus, they may systems, including mood, hunger, body also be brewed as a tea or added temperature, sexual behavior, muscle to other to mask their bitter control, and sensory perception. On the flavor. The effects of psilocybin, which other hand, PCP acts mainly through a appear within 20 minutes of , type of in the brain last approximately 6 hours. that is important for the perception of

June 2009 Page 2 of 7 , responses to the environment, and a condition known as - learning and memory. induced persisting perceptual disorder (HPPD). There have been no properly controlled research studies on the specific effects Most users of LSD voluntarily decrease of these drugs on the , but or stop its use over time. LSD is not smaller studies and several case reports considered an addictive drug since have been published documenting some it does not produce compulsive drug- of the effects associated with the use of seeking behavior. However, LSD does hallucinogens. produce tolerance, so some users who take the drug repeatedly must • LSD. Sensations and feelings change take progressively higher doses to much more dramatically than the achieve the state of intoxication that physical signs in people under the they had previously achieved. This influence of LSD. The user may feel is an extremely dangerous practice, several different at once given the unpredictability of the drug. or swing rapidly from one In addition, cross-tolerance between to another. If taken in large enough LSD and other hallucinogens has been doses, the drug produces delusions reported. and visual hallucinations. The user’s of time and self is altered. • Peyote. The long-term residual Experiences may seem to “cross psychological and cognitive effects of over” different , giving the user mescaline, peyote’s principal active the feeling of hearing colors and ingredient, remain poorly understood. seeing sounds. These changes can A recent study found no evidence of be frightening and can cause panic. psychological or cognitive deficits Some LSD users severe, among Native Americans that use terrifying and feelings of peyote regularly in a religious setting.2 despair, fear of losing control, or fear It should be mentioned, however, that of insanity and while using LSD. these findings may not generalize to those who repeatedly abuse the LSD users can also experience drug for recreational purposes. flashbacks, or recurrences of certain Peyote abusers may also experience aspects of the drug experience. flashbacks. Flashbacks occur suddenly, often without warning, and may occur • Psilocybin. The active compounds within a few days or more than a year in psilocybin-containing “magic” after LSD use. In some individuals, mushrooms have LSD-like the flashbacks can persist and cause and produce alterations of autonomic significant distress or impairment in function, motor reflexes, behavior, social or occupational functioning, and perception.3 The psychological

June 2009 Page 3 of 7 consequences of psilocybin use emergency rooms because of PCP- include hallucinations, an altered induced problems—related to use perception of time, and an inability within the past 48 hours—report to discern fantasy from reality. Panic significant elevations in reactions and also may symptoms.4 occur, particularly if a user ingests a o People who have abused PCP for large dose. Long-term effects such as long periods of time have reported flashbacks, risk of psychiatric illness, memory loss, difficulties with speech impaired memory, and tolerance have and thinking, , and been described in case reports. weight loss. These symptoms can • PCP. The use of PCP as an approved persist up to one year after stopping anesthetic in humans was discontinued PCP abuse. in 1965 because patients often o : PCP is addictive—its became agitated, delusional, and repeated abuse can lead to craving irrational while recovering from and compulsive PCP-seeking its anesthetic effects. PCP is a behavior, despite severe adverse “ drug,” meaning that it consequences. distorts of sight and sound and produces feelings of detachment (dissociation) from the environment What Other Adverse Effects and self. First introduced as a street Do Hallucinogens Have on drug in the 1960s, PCP quickly gained Health? a reputation as a drug that could cause bad reactions and was not Unpleasant adverse effects as a result worth the risk. However, some abusers of the use of hallucinogens are not continue to use PCP due to the feelings uncommon. These may be due to the of strength, power, and invulnerability large number of psychoactive ingredients as well as a numbing effect on the in any single source of hallucinogen.3 that PCP can induce. Among the • LSD. The effects of LSD depend adverse psychological effects reported largely on the amount taken. LSD are— causes dilated ; can raise body o Symptoms that mimic , temperature and increase heart rate such as delusions, hallucinations, and pressure; and can cause , disordered thinking, and profuse sweating, loss of appetite, a sensation of distance from one’s sleeplessness, dry mouth, and tremors. environment. o Mood disturbances: Approximately 50 percent of individuals brought to

June 2009 Page 4 of 7 • Peyote. Its effects can be similar to and others. High doses of PCP can those of LSD, including increased also cause , , and death body temperature and heart rate, (though death more often results from uncoordinated movements (), accidental injury or during profound sweating, and flushing. The PCP intoxication). Because PCP can active ingredient mescaline has also also have effects, interactions been associated, in at least one report, with other central to fetal abnormalities.5 , such as alcohol and , can also lead • Psilocybin. It can produce muscle to coma. relaxation or weakness, ataxia, excessive dilation, , , and drowsiness. Individuals What Treatment Options who abuse psilocybin mushrooms also Exist? risk poisoning if one of many existing Treatment for hallucinogen (such varieties of poisonous mushrooms is as psilocybin) intoxication—which is incorrectly identified as a psilocybin mostly symptomatic—is often sought as . a result of bad “trips,” during which a • PCP. At low to moderate doses, patient may, for example, hurt him- or physiological effects of PCP include herself.6 Treatment is usually supportive: a slight increase in breathing rate provision of a quiet room with little and a pronounced rise in blood sensory stimulation. Occasionally, pressure and pulse rate. Breathing benzodiazepines are used to control becomes shallow; flushing and profuse extreme agitation or seizures. sweating, generalized numbness of There is very little published data on the extremities, and loss of muscular treatment outcomes for PCP intoxication. coordination may occur. Doctors should consider that acute At high doses, blood pressure, pulse adverse reactions may be the result of rate, and respiration drop. This may drug synergy with alcohol.7 Current be accompanied by nausea, vomiting, research efforts to manage a life- blurred vision, flicking up and down threatening PCP overdose are focused of the eyes, drooling, loss of balance, on a passive immunization approach and dizziness. PCP abusers are often through the development of anti-PCP brought to emergency rooms because antibodies.8 There are no specific of overdose or because of the drug’s treatments for PCP abuse and addiction, severe untoward psychological effects. but inpatient and/or behavioral While intoxicated, PCP abusers may treatments can be helpful for patients become violent or suicidal and are with a variety of , including therefore dangerous to themselves that to PCP.

June 2009 Page 5 of 7 How Widespread Is the National Survey on Drug Use † Abuse of Hallucinogens? and Health In 2007, more than 22.7 million persons According to the National Survey on † aged 12 or older reported they had Drug Use and Health (NSDUH), there used LSD in their lifetime (9.1 percent); were approximately 1.1 million persons however, fewer than 620,000 had used aged 12 or older in 2007 who reported the drug in the past year. There was no using hallucinogens for the first time change between 2006 and 2007 in the within the past 12 months. number of past-year initiates of LSD.

LSD Peyote and Psilocybin

Monitoring the Future Survey†† It is difficult to gauge the extent of use of There were no significant changes in these hallucinogens because most data LSD use from 2007 to 2008 for most sources that quantify drug use exclude prevalence periods among the 8th-,10th-, these drugs. The the Future and 12th-graders surveyed; however, survey†† reported in 2008 that 7.8 there was a significant increase in past- percent of high school seniors had month use of LSD among 12th-graders. used hallucinogens other than LSD—a Perceived risk of harm from taking LSD group that includes peyote, psilocybin, regularly decreased among 12th-graders and others—at least once in their (from 67.3 percent in 2007 to 63.6 lifetime. Past-year use was reported to percent in 2008). No other changes were be 5 percent. significant, but longer term trends indicate a steady decline in perceived harmfulness PCP of LSD in all three grades. Such changes Monitoring the Future Survey†† in attitude could signal a subsequent In 2008, 1.8 percent of high school increase in use, an outcome that would seniors reported lifetime††† use of PCP; be of great concern after the large past-year use was reported by 1.1 decreases seen since the mid-1990s, percent of seniors; and past-month use when LSD use peaked among youth. was reported by 0.6 percent. Data on PCP use by 8th- and 10th-graders are LSD Use by Students not available. 2008 Monitoring the Future Survey 8th Grade 10th Grade 12th Grade ††† Lifetime 1.9% 2.6% 4.0% Past Year 1.3% 1.8% 2.7% Past Month 0.5% 0.7% 1.1%

June 2009 Page 6 of 7 National Survey on Drug Use Other Information Sources and Health† For more information on Hallucinogens, In 2007, 6.1 million persons aged 12 please visit www.clubdrugs.org and or older reported that they had used PCP www.teens.drugabuse.gov. in their lifetime (2.5 percent), although only 137,000 persons in the same age For street terms searchable by drug group reported use in the past year—this name, street term, cost and quantities, represents a decrease from 187,000 drug trade, and drug use, visit persons in 2006. www.whitehousedrugpolicy.gov/ streetterms/default.asp.

† NSDUH (formerly known as the National Household Survey on Drug Abuse) is an annual survey of Americans age 12 and older conducted by the and Mental Health Services Administration. Copies of the latest survey are available at www.samhsa.gov and from NIDA at 877–643–2644. †† These data are from the 2008 Monitoring the Future survey, funded by the National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, and conducted annually by the University of Michigan’s Institute for Social Research. The survey has tracked 12th-graders’ illicit drug use and related attitudes since 1975; in 1991, 8th- and 10th-graders were added to the study. The latest data are online at www.drugabuse.gov. ††† “Lifetime” refers to use at least once during a respondent’s lifetime. “Past year” refers to use at least once during the year preceding an individual’s response to the survey. “Past month” refers to use at least once during the 30 days preceding an individual’s response to the survey. References 1 Fantegrossi WE, Murnane KS, Reissig CJ. The behavioral of hallucinogens. Biochem Pharmacol 75(1):17–33, 2008. 2 Halpern JH, Sherwood AR, Hudson JI, Yurgelun-Todd D, Pope HG Jr. Psychological and cognitive effects of long-term peyote use among Native Americans. Biol 58(8):624–631, 2005.

3 Cunningham N. Hallucinogenic plants of abuse. Emerg Med Australas 20(2):167–174, 2008. 4 Yago KB, Pitts FN, Burgoyne RW, Aniline O, Yago LS, Pitts AF. The urban epidemic of phencyclidine (PCP) use: Clinical and laboratory evidence from a public psychiatric hospital emergency service. J Clin Psychiatry 42:193–196, 1981. 5 Gilmore HT. Peyote use during pregnancy. S D J Med 54(1):27–29, 2001. 6 Attema-de Jonge ME, Portier CB, Franssen EJ. Automutilation after consumption of hallucinogenic mushrooms. Ned Tijdschr Geneeskd 151(52):2869–2872, 2007. 7 Schwartz RH, Smith DE. Clin Pediatr (Phila) 27(2):70–73, 1988.

8 Kosten T, Owens SM. for the treatment of drug abuse. Pharmacol Ther 108(1):76–85, 2005.

National Institutes of Health – U.S. Department of Health and Human Services This material may be used or reproduced without permission from NIDA. Citation of the source is appreciated.

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