HALLUCINOGENS
PREPARED BY:
JOVITO LEO LOBIGAN
OLIVER FORTADES
CHRISTIAN NIEL PARAJES
What are Hallucinogens?
These are Hallucinogenic substances that are
characterized by their ability to cause
changes in a person's perception of reality.
Persons using hallucinogenic drugs often
report seeing images, hearing sounds, and
feeling sensations that seem real, but do not
exist. In the past, plants and fungi that
contained hallucinogenic substances were
abused. Currently, these hallucinogenic
substances are produced synthetically to
provide a higher potency.
Hallucinogens
ALSO KNOWN AS: Acid, Peyote, Mighty Quinn,
Mescal, Ibogaine, Window Panes, MDMA, Gelatin,
Pearly Gates, Owsley Acid, Mind Detergent,
Bufotenine, California Triple Dip, Sandoz’s, Sunshine,
Lysergic Acid Diethylamide, Mescaline, Cube, Salvia
Divinorum, Blue Cheers, Vacation, Hawk, LSD,
Wedding Bells, Adams, Phenethylamines, Psilocybin
Analogs, Brown Dot, Lucy in the Sky with Diamonds,
Strawberries, Blotter, Pink Wedge, Psilocybin,
Mushrooms, ‘Shrooms, Ayahuasca, and other
names.
Hallucinogens
Hallucinogens are a diverse group of drugs that
cause an alteration in perception, thought, or mood.
A rather heterogeneous group, these compounds
have different chemical structures, different
mechanisms of action, and different adverse effects.
Despite their name, most hallucinogens do not
consistently cause hallucinations, which are defined
as false perceptions that have no basis in reality.
Often, they are more likely to cause changes in
mood or in thought than actual hallucinations.
SIGNS/EFFECTS OF USE
As the name suggests, hallucinogens are drugs that
cause hallucinations. A hallucination may involve one
or more of the five senses – touch, taste, vision,
sound, or smell. In some cases, the hallucinations
may involve a sensory crossover; for example, the
user may perceive a sound when seeing a certain
object. This is called synesthesia. Some
hallucinations are based in reality, but the user
perceives that an object or experience is somehow
different from what they are accustomed to when, in
fact, it is not. In other cases, the hallucinations are in
no way based in reality.
SIGNS/EFFECTS OF USE
Sometimes users understand that what they are experiencing
is a result of the drug. This is called a pseudo-hallucination.
Other uses may not realize that the hallucination is a result of
drug use, and they may become frightened and paranoid. Still
others will develop a false sense of invincibility and may
engage in dangerous behaviors as a result of this belief.
Hallucinogens may increase the intensity of the emotion or
emotions that the user is experiencing at the time of use. For
example, if the user is feeling sad or depressed before using a
hallucinogen, these feeling may become more profound.
Others may feel extreme agitation or fear as the result of a
“bad trip”. In this way, some hallucinogen users have
committed suicide as a result of the emotions they
experienced while on the substance.
SIGNS/EFFECTS OF USE
Hallucinogens cause their effects by
disrupting the interaction of nerve cells
and the neurotransmitter serotonin.
Distributed throughout the brain and
spinal cord, the serotonin system is
involved in the control of behavioral,
perceptual, and regulatory systems,
including
mood,
hunger,
body
temperature, sexual behavior, muscle
control, and sensory perception.
SIGNS/EFFECTS OF USE
Hallucinogens can produce physiological
effects including elevated heart rate,
increased blood pressure, and dilated
pupils. These drugs are often
unpredictable and a user may experience
different effects compared to other users
or past usage. Users often experience
changes in perception, thought, and
mood.
History of use
Hallucinogenic substances are among the oldest drugs used by
humankind, as hallucinogens naturally occur in mushrooms, cacti,
and a variety of other plants. Numerous cultures worldwide have
endorsed the use of hallucinogens in medicine, religion and
recreation, to varying extents, and some cultures have regulated
or outright prohibited their use. In most developed countries
today, the possession of many hallucinogens, even those found
commonly in nature, is considered a crime punishable by fines,
imprisonment or even death. In some countries, such as the
United States and the Netherlands, partial deference may be
granted to traditional religious use by members of indigenous
ethnic minorities such as the Native American Church and the
Santo Daime Church. Recently the União do Vegetal, a Christianbased religious sect whose composition is not primarily ethnicitybased, won a United States Supreme Court decision authorizing
its use of ayahuasca.
Main Groups of Hallucinogens
•Lysergamides
•Phenylethylamines
•Piperidines
•Indolealkylamines
•Cannabinols
Lysergamides
The lysergamides include LSD-"lysergic acid
diethylamide" and lysergic acid hydroxyethylamide,
which is a naturally occurring psychedelic found in
morning glory seeds. LSD was initially derived from
the ergot alkaloids produced by the fungus Claviceps
purpurea, a contaminant of wheat and rye flour. LSD
is the most potent psychoactive drug, with doses as
low as 1-1.5 mcg/kg capable of producing
psychedelic effects. Despite its potency, LSD has a
very large safety margin; no deaths associated with
isolated LSD ingestion have been reported, despite
ingestions of several thousand mcg.
Lysergamides-LSD
A tasteless, colorless, odorless liquid, LSD is usually
sold as liquid-impregnated blotter paper, gelatin
squares (window panes), or tiny tablets (microdots).
Although usually ingested in blotter form, LSD can
also be taken via intranasal, sublingual, parenteral,
inhalational, or even conjunctival (ie, eyedrops)
routes. LSD has dozens of street names, many
referring to the pattern printed on the blotter paper,
including acid, 'cid, sorcerer's apprentice, paper
acid, Lucy in the Sky with Diamonds, Beavis and
Buttheads, Bart Simpsons, and Sandoz.
Lysergamides-LSD
LSD acts on serotonin and dopamine receptors in the brain.
The neurotransmitter serotonin modulates mood, pain,
perception, personality, sexual activity, and other functions.
The hallucinogenic activity of LSD is thought to be mediated
by LSD's effect on serotonin-2 receptors. LSD acts
postsynaptically to inhibit serotonin release and increase
retention of serotonin at serotonin-2 receptors. Its net effect
is that of a serotonin agonist. The onset of psychological
effects occurs approximately 30-60 minutes after ingestion
of LSD, and they last for approximately 12 hours. Effect
peaks at approximately 5 hours. The psychological effects
vary both with the individual taking the drug and the physical
environment surrounding the user.
Lysergamides-LSD
A transient depression may occur after LSD
use. Acute psychosis after LSD use has been
reported, and an underlying or undiagnosed
schizophrenia may worsen. An unusual aspect
of LSD use is the occurrence of "flashbacks,"
or hallucinogen persisting perception disorder
(HPPD), months to years after LSD use. These
are observed most commonly in persons who
have used LSD more than 10 times. During a
psychotic episode, danger of suicide and
homicide exists.
Lysergamides-LSD
In addition to the psychological effects, LSD also produces
sympathomimetic effects. Increases in heart rate, blood
pressure, and, occasionally, temperature may occur.
Mydriasis usually occurs and appears to parallel the
intensity of the trip, with pupils returning to normal when
the patient returns to a non–drug-induced mental state.
Rarely, LSD can produce life-threatening symptoms.
Hyperthermia (particularly with monoamine oxidase
[MAO] use), hypertension, coma, respiratory arrest, and
bleeding have been reported. However, users remain more
at risk from behavior-related trauma than they do from
the toxic effects of the LSD.
Lysergamides-LSD
Lysergamides are also found naturally in
several species of morning glory (Rivea
corymbosa, ololiuqui) and Hawaiian
woodrose (Ipomoea violacea). The seeds
of these plants contain lysergic acid
hydroxyethylamide,
which
has
approximately one tenth the potency of
LSD.
Phenylethylamines
Phenylethylamine derivatives include mescaline and
several hallucinogenic amphetamines. Mescaline is
the psychogenic amphetamine found in the peyote
cactus, Lophophora williamsii. Native Americans
have used peyote for more than 8000 years. Use
continues today; members of the Native American
Church are still permitted to use the drug in religious
ceremonies. Mescaline is thought to induce
hallucinations by an amphetaminelike action,
although the precise mechanism is unknown.
Phenylethylamines
After ingestion of 6-12 peyote buttons (the
dried bitter fleshy tops of the cactus), the user
first begins to feel effects in 30 minutes to 2
hours. Nausea, vomiting, diaphoresis, and
ataxia precede the hallucinogenic effects,
which may last 8-12 hours. Mescaline also
may be sold as pills containing ground peyote
or a synthetic congener, but the prohibitively
high cost of the raw materials often leads
many dealers to simply substitute PCP.
Phenylethylamines- hallucinogenic amphetamines
The hallucinogenic amphetamines, also
known as enactogens (ie, enabling the user to
"touch within"), are structural analogs of
mescaline and amphetamine. Most were
derived from their parent compounds in an
effort to avoid US Drug Enforcement Agency
prosecution (so-called designer drugs). They
all have similar psychogenic effects and
toxicity. They include MDMA, MDA, MDEA,
and MMDA.
Phenylethylamines- hallucinogenic amphetamines
MDMA, also known as ecstasy, is perhaps the most well
known of these compounds. First synthesized in 1914,
MDMA is presently the drug of choice at "raves," ie, all-night
dance parties popular in the United States and the United
Kingdom.
MDMA
appears
to
affect
serotonin
neurotransmission at presynaptic and postsynaptic sites.
Although it usually does not cause hallucinations, it causes
changes in mood and the perception of music, reputedly
increases interpersonal communication, and fosters feelings
of intimacy and empathy. Despite these positive-sounding
attributes, concern is growing that ecstasy use may cause
permanent neural damage to its users.
Phenylethylamines- hallucinogenic amphetamines
In terms of complications and overdoses, the hallucinogenic
amphetamines do not seem as benign as other psychedelic
drugs. Many of their toxicities are identical to those of
amphetamines. Sympathomimetic effects predominate,
with hypertension and tachycardia being quite common.
Hyperthermia is a common and occasionally serious
complication. The combination of sympathomimetic effect,
strenuous physical activity, dehydration, and high ambient
temperatures found at raves all contribute to severe
hyperthermia. This also may be accompanied by
rhabdomyolysis, myoglobinuric renal failure, and
disseminated intravascular coagulation (DIC).
Piperidines
Piperidine derivatives include PCP (phencyclidine)
and ketamine. PCP was developed in the late 1950s
as a dissociative anesthetic/analgesic agent initially
marketed under the brand name Sernylan. It was
soon withdrawn from use because of severe adverse
psychological reactions following its use; severe
dysphoria, agitation, and psychotic behavior were
all noted routinely. It was used in veterinary
medicine in the 1960s and soon became a popular
drug of abuse, first observed in San Francisco.
During a psychotic episode, danger of suicide and
homicide exists.
Piperidines-PCP
Dubbed the PeaCe Pill, or PCP for short (also known as
angel dust), its dysphoric effects and erratic absorption
initially limited its appeal. However, its popularity
eventually increased as dealers misrepresented the cheap
and
easy-to-synthesize
drug
as
delta-9tetrahydrocannabinol (THC), mescaline, LSD, or
amphetamines. PCP continues to be marketed in place of
other harder-to-obtain drugs. Use peaked in the late
1970s, declined in the 1980s, but seems to have made a
resurgence in the 1990s. PCP goes by several street
names, including angel dust, killer weed, elephant
tranquilizer, rocket fuel, and hog.
Piperidines-PCP
The onset of effects occurs in 2-5 minutes after
ingestion or smoking of PCP (often it is sprinkled on
marijuana cigarettes). Peak effect occurs by 15
minutes. The duration of action is as long as 16
hours (some users report effects persisting as long
as 24-48 h). PCP antagonizes the action of
glutamate at the N-methyl-D-aspartate receptor,
blocking the influx of calcium and inhibiting
neurotransmitter release. Depending on the dose,
PCP may cause either CNS excitation or depression.
Sympathomimetic effects are prominent.
Piperidines-PCP
The onset of effects occurs in 2-5 minutes after
ingestion or smoking of PCP (often it is sprinkled on
marijuana cigarettes). Peak effect occurs by 15
minutes. The duration of action is as long as 16
hours (some users report effects persisting as long
as 24-48 h). PCP antagonizes the action of
glutamate at the N-methyl-D-aspartate receptor,
blocking the influx of calcium and inhibiting
neurotransmitter release. Depending on the dose,
PCP may cause either CNS excitation or depression.
Sympathomimetic effects are prominent.
Indolealkylamines
The indolealkylamine group includes the 2
mushroom-derived hallucinogens (ie, psilocybin,
psilocin), DMT (Dimethyltryptamine) , and
bufotenine. They all appear to cause their
psychogenic effects through activity at the
serotonin receptor. Psilocybin is found in the
following 3 major genera of mushrooms: Psilocybin,
Conocybe, and Panaeolus. Often growing on cow
dung, they are found in most areas of the United
States, with the exception of arid regions. Several
drug-oriented magazines advertise home cultivation
kits that include live mycelia.
Indolealkylamines
The effects of psilocybin last approximately
4-6 hours. Hallucinations are common. The
mushrooms cause fewer adverse reactions
than LSD, although cases of hyperthermia,
seizures, and coma have been reported.
Misidentification of the mushrooms in the
wild and on the street is common; only one
third of "magic mushrooms" bought on the
street contain psilocybin. Many are simply
store-bought mushrooms laced with PCP.
Indolealkylamines-DMT
DMT is a potent psychedelic with a brief
duration of action (15-60 min). This has
earned it the nickname "businessman's
trip." It is found naturally in the bark of
trees of the genus Virola, which grows in
the Amazon basin. DMT is only active
when smoked or snorted. It causes more
visual
hallucinations
and
more
sympathetic effects than LSD.
Indolealkylamines-DMT
Several species of toads produce venom that
has psychoactive properties. Members of the
genus Bufo, particularly Bufo marinus and
Bufo alvarius, contain bufotenine and 5-MeODMT. The compound 5-MeO-DMT is firmly
established as a hallucinogen, whereas the
role of bufotenine has not yet been
established. The toads are either licked or
milked for their venom, which may then be
ingested or smoked. Their dried skin also may
be smoked.
Cannabinols
Marijuana is the leaf or flower of the plant
Cannabis sativa and is commonly known as
pot, grass, or weed. It contains the
psychoactive substance THC. Although
usually grouped with other hallucinogens,
marijuana rarely causes hallucinations. Acute
effects from smoking marijuana include an
alteration in perception or mood, laughing,
increased appetite, conjunctival injection,
tachycardia, and mild CNS depression.
SYMPTOMS
Hallucinogens powerfully affect the brain. The
drugs induce a distorted sense of sight,
hearing and touch, changing the users'
impressions of time and space, and the user
may feel that his or her body is changing
shape. On some trips, users experience
sensations that are enjoyable and mentally
stimulating with a sense of heightened
understanding.
SYMPTOMS
Bad trips, however, include terrifying
thoughts, nightmarish feelings of
anxiety and despair that include fears of
insanity, death or losing control. Users
are also prone to flashbacks—unsolicited
repetitions of the drug experience up to
one year after no further intake of the
drug. People who use hallucinogen
drugs may show symptoms of:
SYMPTOMS
•Difficulty concentrating, communicating or distinguishing between
reality and illusion
•Panic attacks at the height of the drug experience.
•Distorted perceptions, impaired judgment and body-wide anesthetic
with enhanced sensations, which may induce panic reactions and violent
defensive behaviors
•Agitation, paranoia
•Perceptual distortions
•Auditory, visual and sensory hallucinations
•Psychosis similar to schizophrenia
•Cardiac arrhythmias, seizures, muscle rigidity, acute renal failure and
death
•Feelings of euphoria, mania, spirituality and superiority to feelings of
anxiousness, sadness, depression and terror simultaneously
SYMPTOMS
Physical symptoms that include:
•Diluted pupils
•Rapid mood and behavior fluctuations from anxious, agitated and
combative behavior to being somnolent, sedated and having a
sense of relaxation and well-being
•Mydriasis, particularly with LSD use
•Tachycardia, tachypnea
•Mild-to-moderate elevated heart rate and blood pressure
•Hyperthermia, specifically during an episode of extreme exertion,
combative behavior, infection
•Degrees of cognitive distortions or deficits
•Traumatic injuries caused by altered perceptions of reality or
during combative or destructive behavior
SYMPTOMS
LSD users may also show additional
symptoms of:
•Agitation and psychosis
•Confusion and disorientation
•Physical symptoms such as mydriasis,
tachycardia and tachypnea
•Nausea, loss of appetite and dry mouth
•Heightened sensation
•Trembling and tremors
SYMPTOMS
PCP and ketamine users show typical hallucinogen symptoms, and may
show additional symptoms of :
•flushing, sweating and dizziness.
•numbness to touch, pain or injury; hence, user may be vulnerable to
potential life-threatening injuries.
•mixed nystagmus. Rotatory nystagmus strongly suggests PCP
intoxication.
•confusion and poor memory.
•violent or self-destructive behavior.
•bizarre behavior that can lead to death from drownings, burns, falls
(sometimes from high places), and automobile accidents.
•prolonged psychotic behavior and inability to speak.
•episodes of severe depression and schizophrenia.
•paranoia, fearfulness and anxiety for days.
SYMPTOMS
Psilocin and psilocybin (from magic
mushrooms) users may experience
symptoms similar to those of LSD and
mescaline, and may manifest additional
symptoms of:
•hyperreflexia, anxiety and drowsiness.
•adverse gastrointestinal (GI) reactions
associated with ingestion, including
abdominal cramping, diarrhea and nausea
and vomiting.
SYMPTOMS
Mescaline users may have the typical hallucinogen symptoms, and may
also show:
•intoxication that generally lasts 6 to 8 hours, usually followed by
somnolence.
•adverse GI distress associated with ingestion, which includes abdominal
cramping, nausea and vomiting.
•perspiration.
•hallucinations of all forms. but mostly intense visual images of bright
colors and geometric patterns.
•adverse perceptions of self, anxiety or depression.
•a sense of superiority and tremendous power.
•physical injury that may have occurred because of dysphoria and sense
of power, though less common than with PCP.
•mild reflex bradycardia.
TREATMENT
•If someone is going through a bad trip or an adverse reaction while using
hallucinogens, it is very important that they receive professional help as
soon as possible. Quick responses can save lives. In the meantime,
•focus on preventing the user—and all those around them—from harm
and on keeping them safe.
•decrease stimulation and agitation.
•calm the user. Move and speak in a reassuring and confident manner.
•address them by name. Remind them of who they are.
•tell them who you are.
•if possible, don't leave them alone. This may mean staying with them for
several hours.
•if physical restraint is necessary, use a team approach—at least five
people is best—to quickly subdue the user and minimize risks of injury to
both the user and rescuers.
•call an ambulance. Don't delay.
TREATMENT
•stay with the person until the ambulance arrives. Ask if anyone at
the scene knows mouth-to-mouth resuscitation or
cardiopulmonary resuscitation (CPR).
•ensure adequate air by keeping crowds back and opening
windows. Loosen tight clothing.
•if the person is unconscious, don't leave them on their back—they
could choke. Turn them on their side and into the recovery
position. Gently tilt their head back so their tongue does not block
the airway.
•If breathing has stopped, give mouth-to-mouth resuscitation. If
there is no pulse, apply CPR.
•Provide the ambulance officers with as much information as you
can: what hallucinogens were taken, when they were taken, any
preexisting medical conditions known.
END