Hallucinogens

Hallucinogens

The main types of hallucinogens are:

Classic hallucinogens – LSD (lysergic acid diethylamide), psilocybin (magic mushrooms), DMT (dimethyltryptamine)

Dissociative hallucinogens – PCP (phencyclidine), ketamine, DXM (dextromethorphan)

Deliriants – atropine, scopolamine

Modern synthetic hallucinogens were developed later. For example:

MDMA (ecstasy) – first synthesized in 1914

LSD (lysergic acid diethylamide) – was created in 1938

Ketamine and PCP – in the 1950s

Fascination – the desire to discover new sensations and an unreal world.

Blurring the boundaries between reality and illusion – the person can no longer tell where reality ends and hallucination begins.

Psychological dependence – when a person constantly seeks out similar experiences, overshadowing their interest in real life.

Possible psychosis or depersonalization – a condition in which the individual has difficulty maintaining an adequate connection with the outside world.

The effects of hallucinogens are determined by their distinct mechanisms of action on the brain.

Classical hallucinogens affect serotonergic neural connections. Serotonin plays an important role in regulating mood, sensory perception, and physiological processes.

Dissociative substances partially suppress the activity of the neurotransmitter glutamate, which affects cognition, emotions, and the perception of pain.

Signs of dependence:

Signs of dependence appear over a period of at least 12 months:

Persistent thoughts about the drug and planning its use.

More frequent use and higher doses.

Social, occupational, or academic problems caused by substance use.

Persistent anxiety, depression, or paranoia when not using the substance.

Tries to stop, but is unable to.

Ignoring physical or psychological side effects and continuing use.

A marked interest in “spiritual experiences” or “altering reality” that is believed to be unattainable without hallucinogens.

The most common classic hallucinogens

LSD

It is one of the most powerful hallucinogens.

It is available in the form of tablets, liquid, or small pieces of paper.

It causes intense hallucinations and altered perception.

Psilocybin ("magic mushrooms")

It can be taken raw, dried, or brewed as a tea.

Its effects are similar to LSD – it causes hallucinations and sensory disturbances.

Ecstasy (MDMA, "molly")

It is a synthetic substance that is available in tablet form.

It combines hallucinogenic and stimulant effects, which makes it popular in club settings.

DMT

It is a naturally occurring hallucinogen that has been used for thousands of years in various rituals.

It can be used by smoking, inhalation, or in a drink.

It produces strong psychoactive effects that last for 30–45 minutes.

The most common dissociative hallucinogens

PCP (angel dust)

It is a synthetic drug that is available in liquid, powder, or pill form.

It alters the perception of pain, produces euphoria, but can also lead to aggression.

Ketamine

It may be available in tablet, powder, or liquid form.

It is used as a medication, but it is frequently misused.

It causes a sense of disconnection from reality.

Dextromethorphan (DXM)

It is found in medications used to treat coughs and colds.

In high doses, it can cause hallucinations and euphoria.

Possible consequences of hallucinogen use:

Psychological and emotional:

Hallucinations and paranoia

Intensified anxiety and panic attacks

Depersonalization (a feeling of being detached from reality)

Post-hallucinogen perceptual disorder (HPPD) – hallucinations may continue even after you stop using the substance

Triggering of psychotic disorders (especially in highly sensitive individuals)

Physical consequences:

Nausea, dizziness

High or low blood pressure

Rapid heartbeat

Insufficient dose to be lethal, but indirect risks (traffic accidents, self-injury)

Long-term use of dissociative substances can also lead to:

amnesia (memory loss)

suicidal thoughts

speech difficulties

Possible risk factors:

Mental health conditions such as schizophrenia, bipolar disorder, and PTSD increase the risk of psychotic reactions.

Social and environmental factors – peer pressure and access to hallucinogens.

Genetic predisposition – neurobiological factors that influence the regulation of neurotransmitters.

Treatment methods:

Psychotherapy

Cognitive-behavioral therapy (CBT) – identifying obsessive thoughts and distorted perceptions.

Medication treatment

Antipsychotic medications for psychosis or agitation caused by hallucinations.

Antidepressants or benzodiazepines to reduce anxiety or depression.

Support groups and relapse prevention

Psychoeducational programs

Creating a safe environment and avoiding triggers

Relapse prevention

Coping and support

Set a primary goal: to stay substance-free.

Avoid risky situations: remind yourself that even a single dose is very dangerous, because one often leads to another.

Reach out to your loved ones for support: acknowledge that willpower alone is not enough to overcome this. Ask a family member or friend to help you follow through with your treatment plan.

Know and avoid your triggers: identify the situations or feelings that create an urge to use, and try to keep your distance from them.

Preparing for your visit with the doctor

What you can do before your appointment:

Write down all your feelings and thoughts: note what triggers your urge to use, whether you have tried to resist it, and how the use of hallucinogens has affected your life.

Write down your personal information: include the main stressors or life changes that may be affecting your behavior.

List all medications: provide information about every medicine, vitamin, herbal product, and supplement you are taking, including their dosages.

Recall any other health problems: write down your physical or mental health conditions and how they are being treated.

Questions for your doctor: prepare a list of questions so you can use your appointment time as effectively as possible.

Source: NIDA — Hallucinogens.