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Journal of Criminal Law and Criminology

Volume 63 | Issue 3 Article 10

1973 Psychotoxic or Psychedelic G. R. Nakamura

N. Adler

Follow this and additional works at: https://scholarlycommons.law.northwestern.edu/jclc Part of the Criminal Law Commons, Criminology Commons, and the Criminology and Criminal Justice Commons

Recommended Citation G. R. Nakamura, N. Adler, Psychotoxic or Psychedelic, 63 J. Crim. L. Criminology & Police Sci. 416 (1972)

This Criminology is brought to you for free and open access by Northwestern University School of Law Scholarly Commons. It has been accepted for inclusion in Journal of Criminal Law and Criminology by an authorized editor of Northwestern University School of Law Scholarly Commons. THE JOURNAL or CRIMINAL LAW, CRIMINOLOGY AND POLICE SCIENCE Vol. 63, No. 3 Copyright C 1972 by Northwestern University School of Law Printedin U.S.A.

PSYCHOTOXIC OR PSYCHEDELIC?

G. R. NAKAMUJRA AN N. ADLER*

George R. Nakamura Ph.D. is head toxicologist of the Los Angeles County Department of Chief Medical Examiner-Ceroner, Los Angeles, California. He was formerly employed as a forensic chemist with the U. S. Department of Justice, Bureau of & Dangerous and with the U. S. Treasury Department, Internal Revenue Service in the , & Firearms Laboratory, San Francisco. Dr. Nakamura is the author of a number of papers dealing with forensic analyses and has previously contributed to this Journal. Nathan Adler Ph.D. is a lecturer at the School of Criminology and in the Department of Psychology, University of California, Berkeley. He is also a private consultant and author of a number of papers in the psycho-sociological aspects of drug abuse.

The current epidemic of drug abuse in the replace "" with one which would search for means to alter is only one be "euphonious" and not connote a sick but of the many ways of altering or transcending expand and open the mind to man's own nature to states of awareness (1, 2).1 Many other spiritual increase his understanding and awareness. He exercises in , hypnosis, parachute jumping, indicated that specific beneficial goals could be or rock climbing are a few of the possible examples reached by "unhabitual " through of the ways known to alter and thought and psychedelic drugs. The word "psychedelic" was to orientation. In the search for the effects of the imply good and beneficial effects ... from the use "trips," many substances have of compounds like LSD. been explored-, furniture polish,, aerosol LSD was an accidental discovery of an extraor- freezers, glue, and other bizarre agents. dinary sort. Its profound and specific hallucino- The word, "psychedelic," coined by Osmond (5) genic action led to eager research in many labora- reifies the "mind-manifesting" process known for tories in hope that such studies with psychotomi- millenia and grants a new prestige and a scientific metics would elucidate the psychotic processes. It aura for what is a psychotoxic process. Man has led also to a popular mechanics and popular inhaled carbonated air emitted from the earth, medicine by those not qualified. Too many young rotated thongs in the pectoral muscles until they people have played with the physical and psycho- wore out. Yoga, with its transcendental logical effects with no capacity to control or techniques, was an attempt to achieve the psy- evaluate the and its consequence. chedelic state. is construed as a path While LSD has not been found to be lethal, its for "turning-out" without drugs (3). DeRopp (4) uncontrolled use has subverted many individuals, devised a parlor game which describes a "pathway and has created an abusiveness in which meaning- to Beyond the Drug Experi- ful research into its potentials as a psychotherapeu- ence." Schizophrenics may experience biochemical agent is not possible. changes which many of the psychotomimetic drugs The popular cult of has been ex- are presumed to model. Respiratory failure ploited by the mass media to embrace an antimo- (anoxia) due to lack of in body circulation nian ideology and hair styles, jewelry, and argot. may cause and so will electric stimu- The of the drug is only one aspect of lation (6). the transvaluation of values and a reorientation Osmond (5) originally sought a word in 1957 to of the individual who seeks to vitalize his life * The authors are indebted to Milton H. Joffee, anew. Ph.D., National Institute of , Division Tolan and Linge (6) have compared the syn- of and Drug Abuse, and E. Leong Way, Ph.D., University of California San Francisco, drome of toxic due to inhalation Department of , for reading the manu- with the so-called "model psychosis" evoked by script and suggesting improvements. , LSD, and . These "psy- I Numbers in parentheses refer to references following this article. chotomimetic effects" have also been observed by 19721 PSYCHOTOXIC OR PSYCHEDELIC?

Press and Done (7) in deliberate inhalation. Osmond (14) defined psychedelic as a compound Visual hallucination and are among the "like LSD or mescaline which enriches the mind desired effects sought by glue-sniffers, and these and enlarges the vision. It is this kind of experience subjective responses have been noted in a large which provides the greatest possibility for examin- number of medical case reports. ing those areas to and which has pro- What criteria must a substance fulfill psycho- vided men down the ages with they have pharmacologically to be called a psychedelic? Is considered valuable above all others." While psy- "psychedelic" a valid differentiation scientifically chotomimetic refers to psychological changes re- merited or is it merely a public relation labelling sembling, more or less, experiences like those found operation? It appears worthwhile to examine some in psychotic illnesses, psychedelic implies a benefi- of the terms used interchangeably. While hallucino- cial change and the description of a positive value; 2 gens include only those drugs which produce however, the word tells more about attitudes , a more general term describing a towards drugs than about the effect of the sub- whole range of toxic effects on the cerebrum are stance. called psychotoxic or psychotogenic. These may The net effect from LSD trips, after all the not only include "trips" accommodated by the confusional experiences have been swept away, exogenous drugs such as mescaline, LSD, Can- has not elicited any profound revelation. The nabis, and , but also by a wide range overt behavioral change produced by LSD trips of and commercial organic . A appears to be minimal or non-existent in most lack of air and in toxic amounts may also be cases. A variety of bizarre, subjective experiences considered psychotoxic. has been described, but there appears to be no new In comparison to the terms psychotoxic and insight or true revelations. psychotogenic, the terms psychotropic and psycho- active have also been used to cover the spectrum PHARMACOLOGICAL BASIS OF COMPAuSON of drugs and chemicals having an affinity for Since its discovery by Hofmann in 1943, LSD cerebral processes without invidious inferences. ( iethylamide) has remained the "Psychotomimetics" was introduced by Gerard chemical vehicle (9) and applied to those agents reproducing for "model psychosis." Its effects have been used as a basis for comparison with other characteristics of functional psychosis. To be substances producing potentials for causing "con- classed as a psychotomimetic, the drug must only scious alteration." mimic the syndromes of a psychiatric illness and LSD belongs to a group of substituted "its action must be both readily reversible and of alkylamines. Others in the group include such limited duration" (10). psychotomimetics as dimethyltryptamine (DMT), Psychotomimetic agents have been described as (DET), bufotenine, , being capable of effecting changes in perception, psilocybin, , and . Current reviews emotion, thought, and ego function (11). These by Hofmann (12) Hoffer and Osmond (14), Down- changes are differentiated from the effects ing (15, 16), Crossland (17), Jacobson (18), and elicited by alcohol, , , and Cohen (11) more than adequately cover the atropines since these latter compounds tend to chemistry and pharmacology of LSD and other cloud consciousness and exhibits other serious indole . disability of the autonomic (12); A cursory examination of the basic structure the definition of psychotomimetics therefore also of these compounds would reveal excludes anesthetics, , and . their amazing similarity to , or 5-hydroxytryptamine Ilett and Parfitt (13) categorized the psychoto- (Fig. 1), an endogenous chemical putatively mimetics into four groups: phenylethylamines, called an "inhibitory transmitter" acting between (e.g., mescaline), (e.g., LSD, bufotenine), nerve cells. The presence of serotonin has been theorized (e.g., phenycyclidine), and to suppress the cells from becoming (for marihuana). over- excited and resulting in hallucination and other 2See Comprehensive Drug Abuse Prevention and behavioral aberrations. Control Act of 1970, 21 U.S.C. §§801-966 (1970), in which 17 hallucinogens, including LSD, mescaline, The specificity of LSD compounds at the nerve marihuana, MDA, DMT, psilocybin, are specifically sites introduces another dimensional listed as controlled drugs. interest to the above hypothesis. The brominated G. R. NAKAMURA AND N. ADLER [Vol. 63

OH

Bufotenine Psilocin

Serotonin

C0H 2

CHO 3 NH 2

Mescaline LSD FIGURE 1 Serotonin, a putative chemical nerve transmitter, compared with hallucinogenic drugs. LSD, psiocin and bufotenine possess the same indole ring structure (in bold lines). Mescaline has structure resembling an indole ring. derivative of LSD (2-brom LSD), although having , which have been used by Mexican the same serotonin antagonism action, was found Indians in elaborate for at least 3000 years, to be devoid of psychotomimetic effects. Moreover, exert hallucinogenic effects. At high dosage, the levo-rotatory of LSD is relatively mystical or religious experiences are reported by inactive in comparison to the d-form with respect subjects. That these experiences are different from to serotonin inhibition and devoid of psychotomi- what non-Indians report is probably due to a metic actions. Only the d-LSD form of LSD com- learning process. One visualizes what one is pre- pounds, therefore, is of interest here. pared to see or hear or experience. Also in corroboration to the similarity of the The correlation of chemical structure and psychotomimetic activity of indoles is the observa- psychotomimetic activities of the indoles such as tion that psilocybin and psilocin, the simplest psilocybin and psilocin and LSD with those of the chemical forms of indoles yield effects most important phenylethylamine, mescaline, similar to that of mescaline or LSD. The similarity found in the are frequently cited in of the effects of LSD and psiocybin or psilocin the literature. supported the idea that these two drugs possess Mescaline, a phenylalkylamine-type compound, perhaps some common metabolic mechanisms in is not a serotonin antagonist nor is it an indole-type causing psychic changes. compound that LSD and psilocybin and psilocin Psilocybin and psilocin found in are. Yet it produces in man similar schizophrenic- 19721 PSYCHOTOXIC OR PSYCHEDELIC? like reactions and also the strange effect of de- by the setting in which the drugs are consumed, personalization3 with which LSD is characterized. by his prior desires, his traits, his mood, and other On closer examination, the chemical structure of accidental factors. The phantasy of his "psyche- mescaline, 3, 4, 5-dimethoxyphenylethylamine, re- delic" experience may largely depend on suggested sembles closely those of indolds (see Figure 1). expectations (4). Hypothesis has arisen that mescaline is a precursor to indolic compounds in its eventual action in the MARIUANA the excretory products from body (13), however, The compilation of bibliography on marihuana, mescaline use has not been shown to contain an its chemistry, its ethnopharmacology, and its indole compound (19). social and legal implications, is a major under- The alteration of mescaline molecule to a 3- taking (28, 29, 30, 31), so voluminous have been methoxy-4,5-methylene dioxy compound results the published papers. in MDA, another psychotomimetic which bears Polemics and partisanship appear still to be resemblance to . The psychotomimetic dominant, and ideological issues contaminate an effect of nutmeg was suggested by Shulgin (in 20) objective assessment. Some natural and social to be due to myristicin. scientists claim that the "weed" is merely a mild is an isopropylphenethylamine intoxicant or euphoriant while others find it whose pharmacological action on the CNS is sufficiently psychoactive to be described as a attributed in part to the free . It induces psychotomimetic associated with some of the psychotropic effects if taken in large doses, and effects derived from LSD, mescaline, and psilocy- this response is attributed perhaps to the preven- bin. The various effects are primarily -related. tion of a putative nerve transmitter called norepi- The fact that the active chemical constituents, nephrine from a re-uptake following its release THC ( ) are non- from the nerve cells. nitrogenous and structurally unrelated and that That , which is normally present no cross-tolerance exists between 1-delta-9 tetra- in the brain, possesses a chemical structure similar hydrocannabinol (from marihuana) and LSD in to such psychotomimetic drugs as mescaline and man (32), as the latter with mescaline, suggests tempts speculations as to its role in that the mechanism of psychotomimetic actions abnormal in early . For produced by marihuana and LSD are not funda- reasons, the psychotomimetics have been these mentally the same. Like LSD, the hallucinogenic valuable in the study of the biochemical function phenomena elicited by must be directed, of the nervous system. motivated or situation set, as demonstrated in brief discussion of the action of, The foregoing controlled experiments by Weil et al (33). psychotomimetic drugs has been presented so that The problem of characterizing marihuana's a basis of comparison can be made with the effects is in the determination of its the inhalation of solvents used in industrial from active constituents. The and household agents with those of LSD. (THC) which were only recently synthesized have The "psychedelic" syndromes of LSD ingestion been tentatively assigned the principal active role, has been widely documented and reviewed in thus opening the door to controlled studies (34, journals and exploited in popular literatures (14, 35). The delta-i isomer of THC is considered the 19, 22, 23, 24, 25, 26, 27). Since LSD syndrome is only important psychotomimetic agent in mari- essentially the same as those for mescaline, psilocin, and psilocybin it is used as a point of huana; the other active THC is called delta-6 reference in this discussion. THC contained in the marihuana in a quantity ten Table I lists some of the more important sub- times less from that of the delta-i isomer. THC is jective effects of LSD in man. It is difficult to extracted from marihuana as an oily -soluble catalog subjective responses since these are idio- substance. Recent research activities suggest that syncracies and are influenced by the individual set, THC exerts its action in the animal body as a hydroxy THC (36). 3The subject feels that he has two forms, an in- more polar metabolite such as tellectual and emotionless form which is able to ob- In man, li-hydroxyl THC and possibly other serve the second form, a fantastic being of and polar metabolites of THC appeared to be present fantasy (13). Spectator and actor in the self, agent and agency appear fragmented and disintegrated. upon administration of THC (37). THC acts in the G. R. NAKAMURA AND N. ADLER [Vol. 63

Table I EFFECTS OF LSD EXPERIENCE OBSERVED IN INHALATION*

LSD-type Symptoms Glue Solvents [ Gasoline

§OMATIC Dizziness & weakness Present Present Present, with vomit- Present, with vomit- Present, with vomit- ting ting ting Drowsiness Present Present Present Present, rare Blurred vision Double visions Present Indicated Indicated Amnesia PERCEPTUAL Altered shape and color Present Altered shape only Present Sharpened of hearing (rare) PSYCHIC Sense of lightness, of Same as in glue Same as in glue spinning, moving, floating, and mag- netic pull Distorted time & space Space distortion Space distortion Space distortion Difficulty in expressing Present Present Present thought Not indicated Not indicated Not indicated Dreamlike feeling Present Present Present tac- Visual hallucination Also auditory & tac- Also auditory & tac- Also auditory & tile tile tile Present Present Present Euphoria Present Present Present Micropsia Micropsia Micropsia Ideational, delusional misin- Grandiosity Grandiosity Grandiosity terpretation Altered mood, happy, sad & Loneliness Loneliness Loneliness irritable

* From references 6, 7, 56, 61, 65, 71, 72, 73, 74, 75, 76, 77, 78, LSD syndrome according to 79. manner of other fat soluble substances such as obtained it must be categorized on its own. No and alcohol but as a steric specific chemical. other drug agent, nevertheless, has a more intimate Hollister et al (38) tested THC in man and association with the "psychedelic" community as observed clinical effects resembling those of psy- has marihuana. chotomimetics such as LSD, but differing in a Marihuana ultimately must be evaluated by its longer euphoria, a more pronounced dreamlike active constituents than by the subjective reports sequence and a prominent sedation. For these of behaviors elicited on crude reasons, THC action has been related to that of material. Smoking crushed marihuana plant ma- alcohol as as to LSD. Unlike alcohol, however, terial is analogous to smoking crushed marihuana does not induce even at high poppy pods, both are chemically crude plant tissue doses. The dosage level used ranged from 30 to 70 materials containing less than 0.5% active chemical milligrams, with a median of 50 milligrams; LSD constituents. The concentrated extracts from dosage, to obtain desired euphoric effects, is about opium poppy and marihuana on the other hand 0.02 to 0.2 milligrams. These and other investiga- are what we know as opium and . tions have shown that THC induces effects of both On application of heat, the , in- alcohol and LSD, but until more information is cluding THC, volatilize and then condense on a 19721 PSYCHOTOXIC OR PSYCHEDELIC? cool surface. In a simulated smoking experiment ingested about 2 tablespoons of grated nutmeg and much of the THC has been shown to be trapped whose clinical symptoms involved exhilaration and unchanged in the smoking machine (39). One of the intoxication followed by a persistent feeling of un- present writers, working in a government testing reality for 48 to 60 hours. Payne noted that no laboratory, has detected large amounts of can- hallucination appeared evident; "the effect is nabinoids in the ashes of burnt and in fairly well known among alcoholic patients and the stems of smoking pipes indicating that much of narcotic addicts whose regular supplies are ex- the active constituents of marihuana are trapped hausted." in the smoking paraphernalia, and it is presumed Farnsworth (43) suggested that the psychotomi- that only about a half of the active material finds metic substance must be contained in the volatile its way into the body. of nutmeg, but he doubted, based on lack of Ecological factors may also determine the responses in human experiments, that myristicin is strength of marihuana. Plants grown in a warm, the major psychoactive agent. humid climate seem to have a greater THC con- At the present time, most writers categorize tent than those grown in a temperature zone. Two nutmeg as "a psychedelic" rather than as an genotypes of marihuana, however, have been intoxicant (44) and have indicated that its action suggested (40), one variety is of the "drug type" does differ appreciably from that of marihuana having a higher THC to ratio than (45). Again, we are faced with the situation where the "fiber type" having a lower ratio value of the active principles must be isolated and fully THC. characterized. It should also be noted that much of the seized' marihuana examined in laboratories contains stalk, SEEDS twigs, and seed fragments all of which dilute and Its abuse was reported by Fink, et al (46) who attenuate the psychotropic action of marihuana. noted the similarity to the effects induced by Mold, mildew growth, and insect infestations are LSD. D-Lysergic acid monoethyl amide and d-iso- also common. The status of marihuana as a lysergic acid monoethylamide are the principal psychoactive agent must await a less ambiguous components of morning glory seeds and their examination of the active principles derived from comparative effects with LSD (d-lysergic acid information that does not depend on studying the diethylamide) have been delineated by Barron effect of smoking crushed plant materials. The (26), Hofman (47) and others. Their psychotomi- availability of synthetic THC affords a chemically metic effects are somewhat less than those of LSD. pure product for scientific study and makes possible an assessment of the full impact of the AND Toxic PsycaosEs effect of marihuana in man. The search for euphoria and escape has led NmiG sniffing adolescents to sniff glue solvents, gasoline, lighter fluids, shoe polish, lacquer, deodorants, The active constituent of nutmeg remains a 4 , laughing (), etc. speculative matter. It has been commonly ascribed The social background of glue-sniffing is noted in to myrlsticin which has been characterized as a an American Social Health Association leaflet by inhibitor like tranyl- Winick and Goldstein (48) as well as in a study cypromine and . Its action is presumed to conducted in the slums by Preble and increase the level of 5-hydroxytryptamine (sero- Laury (49). An extensive bibliography on glue- tonin) in the brain and thus perhaps to exert its sniffing and other inhalants has been prepared by narcotic property of inducing stupor (20). Kupperstein and Susman (50) who have also Weil (41) describes reactions from nutmeg included newspaper reports. "Ether drinking" (51) ingestion that range from no change to full-blown has a historical reference for the "drug abuse" of hallucinogenic experiences like those caused by hashish or LSD. Visual hallucination, distortion of the 1890's. Cherkins (52) looks back to 1799 when time and space perception, and body image dis- the poets Southey and Coleridge used laughing- tortions have been reported. Feelings of deperson- 4There is a suggestion of the perverted ingestion known as to be considered here as drug users alization and unreality have been reported too. persist in a smorgasbord of compulsive promiscuous Payne (42) reported on 2 male college students who and indiscriminate pill-popping. G. R. NAKAMURA AND N. ADLER [Vol. 63 gas, and Sir Humphrey Davey documented a and other undesirable side-effects. It is conceivable vivid description of his experience with laughing that other low molecular weight alcohol such as gas that appears to be similar to that elicited by propanol and butanol used in model airplane complex molecules such as LSD and mescaline. It cements would exert similar psychic effects on the appears, therefore, that much of the acute effects of CNS, the higher with lower the inhalants are the consequence of a general would be relatively weaker. Toluene and , CNS . common ingredients of glue and rubber cements Case reports (49, 53, 54, 55, 56, 57, 58, 59, 60) products, are also shown to induce euphoria. and studied works and reviews (6, 7, 61, 62) indi- Diplopia (double visions) was added to the list of cate transitory but apparent effects resembling the effects since a number of writers have reported euphoric, hallucinatory, and other psychic effects them in glue-sniffing. All in all, the present litera- of psychotomimetic drugs. ture lacks psychopharmacological studies of indi- Although Von Oettringen (63) listed a few of vidual solvents. A description of the toxic mecha- these psychic responses obtained from a number nism of aromatic , such as toluene of industrial chemicals, ranging from to found commonly in glue, deserves some attention extremely toxic tetrachloride, the literature here. is devoid of the psychopharmacological discussion Toluene is an example of a simple aromatic on industrial solvents. We must therefore rely on which qualifies as a suitable the subjective responses reported retrospectively in since its is not disagreeable, and it has suffi- "glue-sniffing" and other deliberate inhalation of cient vapor pressure to effect a rapid onset of vapor from a limited number of common organic CNS depressant effect. solvents. The factor of anticipation appears to play Contrary to LSD and morphine, the selectivity a dominant role in the individual's quest for the or specificity of action of the arematic hydro- particular desired effect to obtain certain at the CNS site is dependent on the num- or grandiose power through the use of these ber of molecules present at the particular moment psychoactive agents. rather than the type of molecule. Such physical The common agents of purposeful inhalation effects as the vapor pressure of the solvents in the include aromatic hydrocarbons (e.g., toluene), cells determine the quality of their action. There- hydrocarbons (e.g., ), halogenated hydro- fore, the depressant action of the alkylbenzenes carbons (e.g., ), ketones (e.g., ), (e.g., toluene, ) have much in common with esters (e.g., ethyl acetate), glycols (e.g., those of alcohol, ketones, ether, and esters. glycol), and alcohol (e.g., ethyl alcohol). In- Benzene compounds with long alkyl chains, gredients used in some airplane model cements were such as having 4 or 5 carbons in the chain, have listed by Barman, et al (64), Glaser (65), and in the little or no CNS depressant action because of low bulletin on "Glue-Sniffing" issued by the National . Toluene thus is a fast but short acting Clearinghouse for Poison Control Centers (66); agent while such compounds as n-butylbenzene some of the pathological effects of ingredients are slow and long acting. Those with a longer chain tricresyl phosphate, xylene, toluene, and acetone, (e.g., phenyldodecane) are less volatile, like were described. The active component of lighter oil, and have no narcotic potency. fluid is generally , mixed with other The depressant action remains as long as the aliphatic hydrocarbons. Ether, chloroform, and hydrocarbons are present in the nerve cells, but, nitrous oxide in judicious amounts have been used as soon as these are removed, normal metabolic as anesthetics, however, undesirable side effects activity is restored. Chronic use of these solvents have been present. The difficulty of evaluating eventually to the degeneration of nerve cells, commercially prepared solvents such as glue, particularly in the brain, since these compounds gasoline, and lighter fluid lies in the fact that they are fat solvents. During the distribution of these are mixtures, and the subjective effects can not be solvents in the body, the red cells absorb attributed to one particular component. them readily because of their high lipid content, Ethanol, or ethyl alcohol, may be one of the and there is an accompanying destruction of blood best inhalants for psychic purposes since it affords building tissues and a depletion of oxygen supply. euphoria and mental well-being on prescribed In chronic cases and in overdoses, the brain re- dosage without the relatively rapid onset of toxic ceives an inadequate supply of oxygen which 1972] PSYCHOTOXIC OR PSYGHEDELIC?

results in severe injury. It appears that narcosis perceptual disturbances, and impaired motor and oxygen depletion go hand in hand. (Narcosis activity. All seems to be characterized by clouding can occur also with adequate oxygenation.) of consciousness and mental disorientation. We As in LSD and marihuana experiences, there are mindful also of the effects of hypoxia in addi- are the suggestions of sexual stimulation associated tion to the direct effect of solvent inhalation; with solvent inhalation. Ackerley and Gibson (67) Noguchi (70) noted that oxygen is usually excluded reported autoerotic and homosexual activity in a by methods sniffers use. Another possible effect is 10-year old boy while under lighter fluid induced that from rising induced from euphoria. Gwozdz (68) reported a bizarre case of deep breathing, if there is re-breathing, it was the death of a 21-year old male who hanged himself stated. with a plastic bag and cotton saturated with glue LSD and mescaline appear to be exceptions and over his head during masturbation. One need not are distinguishable because they may model a assume a pharmacological or physiologic base for psychotic state in that there is relatively lower effects. These may be consequences of impairment of cognitive functions, consciousness, the lowering of inhibition, the "dissolution" of the memory, or comprehension. Remarkable is the superego, or other psychogenic factors. highly specific and sensitive nature of LSD reaction Glaser (65) discussed a number of materials and since as little as 20 micrograms, or 0.02 gram, can techniques used in inducing what he called "in- initiate a train of hallucinatory, euphoric, illu- halation psychosis". He noted that possibly "in sionary reactions with a minimum of mind-cloud- some cases, at least, inhalation psychoses may be a ing. The LSD effect is long-lived, lasting as long as deliriant similar to that induced by barbiturates 12 hours on a single dose. and alcohol". If this is so, it is important to infer In short, the toxic inhalants are rapidly absorbed that the responses from inhalant experiences differ into the bloodstream, the onset of psychic effect is from the "psychoses induced by LSD and related rapid, and lasts as long as solvent effect occurs. compounds, which is not felt to be a and Exhilaration, euphoria, and intoxication are the which can be differentiated from deliria both initial "desirable" effects, but these are rapidly objectively and subjectively". displaced by , dizziness, impaired motor Glaser remarks that in inhalation psychosis, the coordination, nausea, and . Sustained LSD and schizophrenic syndromes may occur only use may to and unconsciousness. Doubt- in individuals "whose psyche was in precarious lessly, there is a parallel between inhalants and balance prior to delirium". Those symptoms de- alcohol drinking with one notable difference being scribed by inhalers as auditory, visual, and tactile the rapidity with which such solvents as benzene hallucinations and spatial distortions, macropsia, and toluene as well as with general anesthetics in micropsia, and body image distortions may not contrast with alcohol reach the CNS. In general, develop in all cases. most inhalants act similar to the anesthetics by Gleason et al (69) in Clinical Toxicology of causing disinhibition and general CNS . Commercial Products discuss delirium attributed Table I represents some of the subjective reac- to drugs and chemicals and note that certain doses tions observed in glue sniffing, paint thinners, and of LSD, mescaline, , quinacrine, and gasoline and are compared to those from LSD especially the amphetamine group produce a expeiaeces. Since the effects of inhalation psycho- heightening of perception and awareness rather sis are gleaned mostly from case reports which in than a reduction of awareness. However, they themselves are dependent on subjective recollec- indicate that "in the late stages of severe poisoning tions, some of the somatic and psychological with cerebral exhaustion, these toxic psychoses responses may have not been accounted for. While (from LSD type drugs) are not distinguishable there are general agreements, such somatic experi- from the delirium induced by the commoner seda- ences as parasthesia probably went unreported in tive drugs". glue and thinner sniffing. For the subjective re- Acute toxic psychosis is caused by a host of sponses, the element of expectancy is of profound drugs and other noxae including heavy metal importance to the extent that it is said that if the poisoning, hormones, oxygen depletion, water in subject is skeptical of the drug effects, he may toxic amount as well as glue solvents; they produce suppress all sensory responses. The adolescents one or more of these disorders: mental clouding, and those from economically impoverished families, G. R. NAKAMURA AND N. ADLER [Vol. 63

Table II CHARACTERISTIC DIFFERENCES BETWEEN Toxic INHALANTS AND PsYcaTomrMIMETIc DRUGS

Effects Toxic Inhalants (glue solvents, gasoline, Psychotomimetic Drugs (LSD, mescaline, paint thiner, etc.) psilocybin, etc.)

Odor or taste Present None Action on tissue Lipid solvent No destructive action Respiratory failure Possible Not indicated Specificity of bio- None Highly chemical action Narcosis & coma Possible Not indicated Clouding of conscious- Present, Impairment of cognitive Relatively none, high order of percep- ness function tion and alertness Duration of action Acute effect, shortlived Long (6 to 12 hours) Deliria Present, & disorientation Not present Behavior Restless, stuporous, irrational, etc. Passive-usually, but may exhibit panic reaction seeking escape from reality may, on the other hand, LSD-like effect may include DMT (dimethyl- lend themselves to hypersuggestibility of grandiose ), DET (diethyltryptamine), bufoten- illusions. This may be why true hallucination is ine, psilocybin, psilocin, and possibly tetrahydro- said to be of rare occurrence. (marihuana). It is of interest to note that the inhalant symp- In contrast, the effect of organic solvents, in- toms do not include depersonalization, the out-of- cluding the alcohols, is that of intoxication at first the body experience, which is invariably reported but is followed by degenerative action on the nerve in LSD experiments. There appears to be no tissues leading to delirium, coma, etc. Gerade (80) significant differences in symptoms derived from has observed endothelial (fat linings) injuries in the inhalation of the three solvents. the kidney, liver, spleen, bladder, and thymus as Table II shows the distinctions between the well as in the brain and spinal cords due to aromatic effects of psychedelic drugs and of glue solvents, 'hydrocarbon inhalation. Toxic overdose of the gasoline, and paint thinners. While the two groups belladonnas, for example, induces symptoms of share some of the psychic phenomena, the solvents disorientation and deliria. do not exhibit the level of consciousness, the The term "psychedelia" is now used loosely and heightened perception, and the hyperalertness of in a figurative sense as a label invoking the prestige the LSD experiences. Solvent inhalation leads to a of modern science. -It has suggested factors that state of mental deterioration. These features differ from those previously known to us as psycho- appear to differentiate the "psychedelic" drugs toxic. But as we have noted, the physiological and from the others. behavioral responses subsumed under both the While some LSD effects overlap those of other psychedelic and the psychotoxic labels overlap in types of drugs such as the , atropines, part. The term "psychedelic" has no justified barbiturates, and cocaine, LSD appears not to operational basis, and its use in the place of such induce other deleterious effects of toxic psychoses. words as psychoactive or psychotropic and hallu- The specific effect of the various chemicals on the cinogenic or psychotoxic belong more to the world brain is poorly understood, but the variety of of public relations than to that of science. Whether psychological reactions obtained by drugs of the state of "psychedelia" is purportedly achieved different structural configurations indicate that by solvent inhalation or by drug ingestion, it there are probably specific locations in the brain appears quite doubtful if there is a drug or any even on a cellular or molecular basis which certain other agents which "enriches" the mind and exogenous agents stimulate or depress. Evidently, "enlarges" vision. Succinctly stated by Freedman LSD affects areas in which the level of conscious- (81), "these (psychedelic) drugs do allow the mind ness is not diminished, i.e., the cognitive function is to expand upon and vivify sensations; they shrink relatively unimpaired. Other compounds possessing that part of the mind which exerts logical control". 19721 PSYCHOTOXIC OR PSYCHEDELC?

SUMMARY Hospital at Asilomar Conference, February 17, 1970). 1. The meaning of various terms used to describe 3. HOFFER, A. ANm OsmoNm, H., THE CHEMICAL BASIS oP CmCAL PSYCHIATRY, (1960). psychopharmacological drugs were compared with 4. DEROPP, R. S., THE MASTER GME (1969). particular reference to the term "psychedelic", 5. Osmond, H., A Review of the Clinical Effects of Psychotomimetic Agents, 66 ANNALS, N.Y. ACA- proposed by . Terms such as DEmY OF SCIENCES, 418 (1957). psychotropic, psychotoxic, psychotogenic, psycho- 6. Tolan, E. J., and Lingl, F. A., Model Psychosis active, psychotomimetic, and hallucinogenic have by Inhalation of Gasoline Fumes, 120 Aae J. oF PsYcmA., 757 (1964). been used interchangeably to describe the same 7. Press, E. and Done, A. K., Solvent Sniffing, 39 group of drugs affecting the . Pediatrics, 451 (1967); 39 ibid, 611 (1967). Psychedelic was introduced -in preference to 8. 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