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Hallucinogens

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Addiction Medicine

Abstract

Hallucinogenic substances extend back into pre-history as religious sacraments, as shamanic medicines, and as part of some tribal rituals, but the reader is likely most familiar with their recreational, illicit use. Since the most potent hallucinogen, lysergic acid diethylamide, “escaped” the research laboratory and fueled, starting in the 1960s, a popular movement of awareness about the potentials for hallucinogen intoxication, “modern” societies have resisted their acceptance. Despite prohibition, some 35 million Americans are estimated to have tried a hallucinogen at least once in their lifetime and approximately 4 million are active users (at least one use in a year); yet less than 17,000 emergency room visits per year are associated with hallucinogen use. This chapter reviews basic pharmacology, including psychological and physiological effects, and then presents the most common hallucinogen use disorders (with assessment, differential diagnosis, and treatment options) that are likely to be encountered by medical and allied health care providers. The chapter concludes with a brief update on research suggesting that hallucinogens may assist in recovery from other substance abuse and dependence, and a caution for current research to avoid the methodological flaws and excesses that took place some 40–50 years ago.

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References

  1. Abraham HD (1983) Visual phenomenology of the LSD flashback. Arch Gen Psychiatry 40:884–889

    Article  PubMed  CAS  Google Scholar 

  2. Abraham HD, Mamen A (1996) LSD-like panic from risperidone in post-LSD visual disorder. J Clin Psychopharmacol 16:228–231

    Article  Google Scholar 

  3. Abraham HD, McCann UD, Ricaurte GA (2002) Psychedelic drugs. In: Davis KL, Charney D, Coyle JT, Nemeroff C (eds) Neuropsychopharmacology: the fifth generation of progress. Lippincott Williams & Wilkins, Philadelphia, pp 1545–1556

    Google Scholar 

  4. Abramson HA (ed) (1967) The use of psychotherapy and alcoholism. Bobbs Merrill, Indianapolis, Kansas City, New York

    Google Scholar 

  5. Abuzzahab FS, Anderson BJ (1971) A review of LSD treatment in alcoholism. Int Pharmacopsychiatry 6:223–235

    PubMed  Google Scholar 

  6. Alper KR, Lotsof HS, Frenken GMN, Luciano DJ, Bastiaans J (1999) Treatment of acute opioid withdrawal with ibogaine. Am J Addict 8:234–242

    Article  PubMed  CAS  Google Scholar 

  7. American Psychiatric Association (2000) Diagnostic criteria from DSM-IV-TR. American Psychiatric, Washington DC

    Google Scholar 

  8. Anonymous (1966) LSD: the search for definite conclusions. JAMA 196:32–33

    Google Scholar 

  9. Baggott MJ, Erowid E, Erowid F, Robertson LC (2006) Prevalence of chronic flashbacks in hallucinogen users: a web-based questionnaire [Abstract]. Presented at the 68th Annual Meeting of the College on Problems of Drug Dependence, Scottsdale, AZ, 21 June 2006

    Google Scholar 

  10. Boyer EW (2004) Dextromethorphan abuse. Ped Emerg Care 20: 858–963

    Article  Google Scholar 

  11. Cohen S (1960) Lysergic acid diethylamide: side effects and complications. J Nerv Ment Dis 130:30–40

    Article  PubMed  CAS  Google Scholar 

  12. Doering-Silveira E, Grob CS, de Rios MD, Lopez E, Alonso LK, Tacla C, Da Silveira DX (2005) Report on psychoactive drug use among adolescents using ayahuasca within a religious context. J Psychoactive Drugs 37:141–144

    Article  PubMed  Google Scholar 

  13. Dribben B, Wood A (2006) Toxicity, hallucinogens—LSD. eMedicine article topic #2809. http://www.emedicine.com

  14. El-Mallakh RS, Halpern JH, Abraham HD (2008) Substance abuse: hallucinogen- and MDMA-related disorders (chapter 60). In: Tasman A, Maj M, First MB, Kay J, Lieberman JA (eds) Psychiatry, 3rd edn. Wiley, London, pp 1100–1126

    Chapter  Google Scholar 

  15. Fasano A, Barra A, Nicosia P, Rinaldi F, Bria P, Bentivoglio AR, Tonioni R (2008) Cocaine addiction: from habits to stereotypical-repetitive behaviors and punding. Drug Alcohol Depend 96:178–182

    Article  PubMed  CAS  Google Scholar 

  16. Fiorella D, Helsley S, Lorrain DS, Rabin RA, Winter JC (1995) The role of the 5-HT2A and 5-HT2C receptors in the stimulus effects of hallucinogenic drugs. III: the mechanistic basis for supersensitivity to the LSD stimulus following serotonin depletion. Psychopharmacology (Berl.) 121:364–372

    Article  CAS  Google Scholar 

  17. Frosch WA, Robbins ER, Stern M (1965) Untoward reactions to lysergic acid diethylamide (LSD) resulting in hospitalization. NEJM 273:1245–1239

    Article  Google Scholar 

  18. Gamma A, Buck A, Berthold T, Liechti ME, Vollenweider FX (2000) 3,4-Methylenedioxymethamphetamine (MDMA) modulates cortical and limbic brain activity as measured by [H(2)(15)O]-PET in healthy humans. Neuropsychopharmacology 23:388–395

    Article  PubMed  CAS  Google Scholar 

  19. Giannini AJ, Loiselle RH, Giannini MC, Price WA (1987) Phencyclidine and the dissociatives. Psychiatry Med 3:197–217

    Google Scholar 

  20. Giannini AJ, Loiselle RH, Price WA (1984) Antidotal strategies in phencyclidine intoxication. Int J Psychiatry Med 4:513–518

    Google Scholar 

  21. González-Maeso J, Sealfon S (2006) Hormone signaling via G protein-coupled receptors. In: DeGoot LC, Jameson JL (eds) Endocrinology. Elsevier, Amsterdam, pp 177–203

    Google Scholar 

  22. González-Maeso J, Yuen T, Ebersole BJ, Wurmbach E, Lira A, Zhou M, Weisstaub N, Hen R, Gingrich JA, Sealfon SC (2003) Transcriptome fingerprints distinguish hallucinogenic and nonhallucinogenic 5-hydroxytryptamine 2A receptor agonist effects in mouse somatosensory cortex. J Neurosci 23:8836–8843

    PubMed  Google Scholar 

  23. Gouzoulis-Mayfrank E, Schreckenberger M, Sabri O, Arning C, Thelen B, Spitzer M, Kovar KA, Hermle L, Büll U, Sass H (1999) Neurometabolic effects of psilocybin, 3,4-methylenedioxyethylamphetamine (MDE) and d-methamphetamine in healthy volunteers. Neuropsychopharmacology 20:565–581

    Article  PubMed  CAS  Google Scholar 

  24. Grinspoon L, Bakalar JB (1997) Psychedelic drugs reconsidered, 2nd edn. The Lindesmith Center, New York

    Google Scholar 

  25. Grob CS (1994) Psychiatric research with hallucinogens: what have we learned? Yearbook Ethnomedicine Consciousness Res 3:91–112

    Google Scholar 

  26. Grob CS, McKenna DJ, Callaway CJ, Brito GS, Neves ES, Oberlaender G, Saide OL, Labigalini E, Tacla C, Miranda CT, Strassman RJ, Boone KB (1996) Human psychopharmacology of hoasca, a plant hallucinogen used in ritual context in Brazil. J Nerv Ment Dis 184:86–94

    Article  PubMed  CAS  Google Scholar 

  27. Grof S (1975) Realms of the human unconsciousness. Viking, New York

    Google Scholar 

  28. Grof S, Goodman LE, Richards WA, Kurland AA (1973) LSD-assisted psychotherapy in patients with terminal cancer. Int Pharmacopsychiatry 8:129–144

    PubMed  CAS  Google Scholar 

  29. Halpern JH (2000) Hallucinogens, anesthetic agents, and amphetamines. Pharmaceutical News 7:21–29

    CAS  Google Scholar 

  30. Halpern JH (2003) Hallucinogens: an update. Curr Psychiatry Rep 5:347–354

    Article  PubMed  Google Scholar 

  31. Halpern JH (2004) Hallucinogens and dissociative agents naturally growing in the United States. Pharmacol Ther 102:131–138

    Article  PubMed  CAS  Google Scholar 

  32. Halpern JH (2007) Hallucinogens in the treatment of alcoholism and other addictions. In: Winkelman M, Roberts T (eds) Psychedelic medicine: scientific evidence for hallucinogenic substances as treatments, vol 2. Praeger, Westport, CT and London, pp 1–14

    Google Scholar 

  33. Halpern JH, Pope HG Jr (1999) Do hallucinogens cause residual neuropsychological toxicity? Drug Alcohol Depend 53:247–256

    Article  PubMed  CAS  Google Scholar 

  34. Halpern JH, Pope HG Jr (2003) Hallucinogen persisting perception disorder: what do we know after 50 years? Drug Alcohol Depend 69:109–119

    Article  PubMed  Google Scholar 

  35. Halpern JH, Sherwood AR, Hudson JI, Yurgelun-Todd D, Pope HG Jr (2005) Psychological and cognitive effects of long-term peyote use among Native Americans. Biol Psychiatry 58:624–631

    Article  PubMed  Google Scholar 

  36. Halpern JH, Sherwood AR, Passie T, Blackwell KC, Ruttenber AJ (2008) Evidence of health and safety in American Members of a religion who use a hallucinogenic sacrament. Med Sci Monit 14:SR15–SR22

    PubMed  Google Scholar 

  37. Hoffer A, Osmond H (1966) New hope for alcoholics. University Books, New Hyde Park, NY

    Google Scholar 

  38. Hermle L, Funfgeld M, Oepen G, Botsch H, Borchardt D, Gouzoulis E, Fehrenbach RA, Spitzer M (1992) Mescaline-induced psychopathological, neuropsychological, and neurometabolic effects in normal subjects: experimental psychosis as a tool for psychiatric research. Biol Psychiatry 32:976–991

    Article  PubMed  CAS  Google Scholar 

  39. Hintzen A, Passie T (2010) The pharmacology of LSD. Oxford University Press, Oxford, New York

    Google Scholar 

  40. Holland D (2004) Flashback-Phänomene als Nachwirkung von Halluzinogeneinnahme. Hannover: Hannover Medical School Dissertation

    Google Scholar 

  41. Hillebrand J, Olszewksi D, Sedefov R (2006) Hallucinogenic mushrooms: an emerging trend case study. European Monitoring Centre for Drugs and Drug Addiction, Lisbon

    Google Scholar 

  42. Hollister LE (1984) Effects of hallucinogens in humans. In: Jacobs BL (ed) Hallucinogens: neurochemical, behavioral, and clinical perspectives. Raven, New York, pp 19–33

    Google Scholar 

  43. Johnston LD, Bachman JG, O’Malley PM (2006) Monitoring the Future: questionnaire responses from the nation’s high school seniors, 2005. Institute for Social Research, Ann Arbor, MI

    Google Scholar 

  44. Kurland AA, Savage C, Pahnke WN, Grof S, Olsson JE (1971) LSD in the treatment of alcoholics. Pharmakopsychiatrie Neuro-Psychopharmakologie 4:83–94

    Article  Google Scholar 

  45. Leuner H (1962) Die experimentelle psychose. Julius Springer, Berlin, Heidelberg

    Book  Google Scholar 

  46. Lotsof HS (1985) Rapid method for interrupting the narcotic addiction syndrome. U.S. Patent # 4,499,096

    Google Scholar 

  47. Markel H, Lee A, Holmes RD, Domino EF (1994) LSD flashback syndrome exacerbated by selective serotonin reuptake inhibitor antidepressants in adolescents. J Pediatr 125: 817–819

    Article  PubMed  CAS  Google Scholar 

  48. Malleson N (1971) Acute adverse reactions to LSD in clinical and experimental use in the United Kingdom. Br J Psychiatry 118:229–230

    Article  PubMed  CAS  Google Scholar 

  49. Mash DC, Kovera CA, Buch BE, Norenberg MD, Shapshak P, Hearn WL, Sanchz J (1998) Medication development of ibogaine as a pharmacotherapy for drug dependence. Ann NY Acad Sci 844: 274–292

    Article  PubMed  CAS  Google Scholar 

  50. Morehead DB (1997) Exacerbation of hallucinogen-persisting perception disorder with risperidone. J Clin Psychopharmacol 17:327–328

    Article  PubMed  CAS  Google Scholar 

  51. Mottin JL (1973) Drug-induced attenuation of alcohol consumption: a review and evaluation of claimed, potential or current therapies. Q J Stud Alcohol 34:444–472

    PubMed  CAS  Google Scholar 

  52. Nichols DE (2004) Hallucinogens. Pharmacol Ther 101:131–181

    Article  PubMed  CAS  Google Scholar 

  53. Nutt D, King LA, Saulsbury W, Blakemore C (2007) Development of a rational scale to assess the harm of drugs of potential misuse. Lancet 369: 1047–1063

    Article  PubMed  Google Scholar 

  54. O’Brien CP (2005) Drug addiction and drug abuse. In: Brunton L, Lazo J, Parker K (eds) Goodman & Gillman’s the pharmacological basis of therapeutics, 11th edn. McGraw-Hill, New York, pp 607–628

    Google Scholar 

  55. Osmond H (1957) A review of the clinical effects of psychotomimetic agents. Ann NY Acad Sci 66:418–434

    Article  PubMed  CAS  Google Scholar 

  56. Passie T (1997) Psycholytic and psychedelic therapy research: a complete international bibliography 1931–1995. Laurentius, Hannover

    Google Scholar 

  57. Pletscher A, Ladewig D (eds) (1994) 50 Years of LSD: current status and perspectives of hallucinogens. Parthenon, New York & London

    Google Scholar 

  58. Riba J, Romero S, Grasa E, Mena E, Carrio I, Barbanoj MJ (2006) Increased frontal and paralimbic activation following ayahuasca, the pan-Amazonian inebriant. Psychopharmacology (Berl.) 186:93–98

    Article  CAS  Google Scholar 

  59. Roth, BL, Willins DL, Kristiansen K, Kroeze WK (1998) 5-Hydroxytryptamine2-family receptors (5-hydroxytryptamine2A, 5-hydroxytryptamine2B, 5-hydroxytryptamine2C): where structure meets function. Pharmacol Ther 79:231–257

    Article  PubMed  CAS  Google Scholar 

  60. SAMHSA, Office of Applied Studies (2007) Results from the 2006 national survey on drug use and health: national findings. NSDUH Series H-32, DHHS Publication No. SMA 07–4293, Rockville, MD

    Google Scholar 

  61. SAMHSA, Office of Applied Studies (2007) Drug abuse warning network, 2005: national estimates of drug-related emergency department visits. DAWN Series D-29, DHHS Publication No. SMA 07-4256, Rockville, MD

    Google Scholar 

  62. Savage C, McCabe OL (1973) Residential psychedelic (LSD) therapy for the narcotic addict. Arch Gen Psychiatry 28:808–814

    Article  PubMed  CAS  Google Scholar 

  63. Schultes RE, Hofmann A, Rätsch C (2001) Plants of the gods: their sacred, healing and hallucinogenic powers, 2nd edn. Inner Traditions, Vermont

    Google Scholar 

  64. Schwarz CJ (1968) The complications of LSD: a review of the literature. J Nerv Ment Dis 146:174–186

    Article  PubMed  CAS  Google Scholar 

  65. Strassman RJ (1984) Adverse reactions for psychedelic drugs: a review of the literature. J Nerv Ment Dis 172:577–595

    Article  PubMed  CAS  Google Scholar 

  66. Strassman RJ (1995) Hallucinogenic drugs in psychiatric research and treatment: perspectives and prospects. J Nerv Ment Dis 183:127–138

    Article  PubMed  CAS  Google Scholar 

  67. Tacke U, Ebert MH (2005) Hallucinogens and phencyclidine. In: Kranzler HR, Ciraulo DA (eds) Clinical manual of addiction psychopharmacology. American Psychiatric, Washington, DC, pp 211–241

    Google Scholar 

  68. Taylor RL, Maurer JI, Tinklenberg JR (1970) Management of “bad trips” in an evolving drug scene. JAMA 213:422–425

    Article  PubMed  CAS  Google Scholar 

  69. Ungerleider JT, Pechnick, RN (1999) Hallucinogens. In: Galanter M, Kleber HD (eds) Textbook of substance abuse treatment. American Psychiatric, Washington, DC, pp 195–203

    Google Scholar 

  70. Vollenweider FX (2001) Brain mechanisms of hallucinogens and entactogens. Dialog Clin Neurosci 3:265–279

    CAS  Google Scholar 

  71. Vollenweider FX, Leenders KL, Scharfetter C, Maguire P, Stadelmann O, Angst J (1997) Positron emission tomography and fluorodeoxyglucose studies of metabolic hyperfrontality and psychopathology in the psilocybin model of psychosis. Neuropsychopharmacology 16:357–372

    Article  PubMed  CAS  Google Scholar 

  72. Vollenweider FX, Vollenweider-Scherpenhuyzen MF, Babler A, Vogel H, Hell D (1998) Psilocybin induces schizophrenia-like psychosis in humans via a serotonin-2 agonist action. Neuroreport 9:3897–3902

    Article  PubMed  CAS  Google Scholar 

  73. Wasson RG (1961) The hallucinogenic fungi of Mexico: an inquiry into the origins of the religious idea among primitive peoples. Bot Mus Leaflets Harv Univ 19:137–162

    Google Scholar 

  74. Wright D, Sathe N, Spagnola K (2007) State estimates of substance use from the 2004–2005 national surveys on drug use and health (DHHS Publication No. SMA 07-4235, NSDUH Series H-31). Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Rockville, MD

    Google Scholar 

  75. Zinberg NE (1986) Drug, set, and setting: the basis for controlled intoxicant use. Yale University, New Haven, CT

    Google Scholar 

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Acknowledgments

The authors greatly appreciate the editing assistance of medical student Sean Doherty of Cardiff University School of Medicine.

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Authors and Affiliations

  1. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    John H. Halpern

  2. Laboratory for Integrative Psychiatry, Alcohol and Drug Abuse Research Center, Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA, USA

    John H. Halpern

  3. Department of Psychiatry, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    Joji Suzuki

  4. Department of Psychiatry, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Joji Suzuki

  5. Department of Psychiatry, Harvard Medical School, 115 Mill Street, Belmont, MA, 02478, USA

    Pedro E. Huertas

  6. The Laboratory for Integrative Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA

    Pedro E. Huertas

  7. The Laboratory for Neurocognition and Consciousness, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Torsten Passie

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  1. John H. Halpern
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Correspondence to John H. Halpern .

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  1. , Depts Psychiat & Neurobehav Sciences, Me, University of Virginia, Charlottesville, 22908, Virginia, USA

    Bankole A. Johnson

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Halpern, J.H., Suzuki, J., Huertas, P.E., Passie, T. (2010). Hallucinogens. In: Johnson, B. (eds) Addiction Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0338-9_54

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