I’ve had a few conversations in my clinic lately that start something like, “Doc, what’s the deal with hallucinogens?” Maybe you’ve heard about them – drugs that can really shift how you see and experience the world. It’s a topic that can feel a bit murky, with lots of different names and stories floating around. So, let’s chat about it, just like we would in an exam room.
What Exactly Are Hallucinogens?
At their core, hallucinogens, sometimes called psychedelics, are substances that mess with your awareness of what’s around you. They don’t just stop there; they can change your thoughts and how you’re feeling, too. Some of these are cooked up in labs (synthetic), while others grow naturally in certain plants or fungi. You know, like mushrooms.
The big thing with hallucinogens is that they can cause, well, hallucinations. These are sensations – seeing, hearing, or feeling things – that seem incredibly real but actually aren’t there. It can sometimes feel like you’re out of control, or even disconnected from your own body or surroundings. When someone’s under the influence, folks often say they’re “tripping.” This experience can be positive, a “good trip,” or really quite frightening, a “bad trip.”
People have used these substances for ages, sometimes in religious ceremonies or for healing. These days, some use them recreationally. Now, from a medical standpoint, we don’t generally consider any recreational use of these drugs safe. However, and this is interesting, scientists are taking a fresh look at some hallucinogens. They’re exploring if, under very careful medical supervision, they might help with tough conditions like depression or anxiety.
How Do Hallucinogens Work in the Brain?
So, what’s happening upstairs when someone takes a hallucinogen? Think of your brain as a complex network of chemical messengers. These drugs disrupt the normal flow of communication.
For example, some hallucinogens interfere with a brain chemical called serotonin. Serotonin is a busy little neurotransmitter; it helps manage:
- Sleep
- Hunger
- Your mood
- Body temperature
- How you perceive things through your senses
Others throw a wrench in the works of glutamate, another neurotransmitter. Glutamate is involved in:
- Emotions
- How we feel pain
- Learning and memory
- Our responses to what’s happening around us
A Look at Different Types of Hallucinogens
There are quite a few different kinds of hallucinogens out there. Let’s break down some of the common ones.
LSD (Lysergic Acid Diethylamide)
You’ve probably heard of LSD, or “acid.” It’s one of the most potent mind-altering chemicals. It actually comes from lysergic acid, found in a fungus that can grow on grains like rye. It usually looks like a clear or white substance, often soaked onto small squares of paper called “acid tabs” that people swallow. Sometimes it’s a tablet or capsule.
The effects? They can be pretty dramatic, making someone feel like they’re losing touch with reality. They might have what feel like mystical visions, or their senses might get jumbled – like smelling sounds or hearing colors. An LSD trip can last a good while, often 9 to 12 hours.
It’s not typically considered addictive in the way some other drugs are, meaning it doesn’t usually cause that uncontrollable craving. But, a person can build up a tolerance, needing more to get the same effect.
Peyote (Mescaline)
Peyote is a small cactus, and its main active ingredient is mescaline. This is a naturally occurring psychedelic. People usually use the top part of the cactus, these little “buttons,” which they might chew or soak in water to make a drink.
A hallucinogenic dose of mescaline is about 0.3 to 0.5 grams, and the effects can hang around for about 12 hours. It’s known to be quite bitter, so sometimes it’s brewed into a tea.
Peyote is one of the oldest psychedelics we know of, with a long history of use in Native American cultures. The experience can vary a lot, but common effects include:
- Vivid mental pictures
- A changed sense of time and space
- Feeling like your body is distorted
- Losing your grip on reality
Psilocybin (Magic Mushrooms)
Psilocybin comes from certain types of mushrooms, often called “magic mushrooms” or “’shrooms.” You find these in tropical and subtropical areas. They contain psilocybin and a bit of another hallucinogenic substance called psilocin.
People might eat these mushrooms raw, cook them, or brew them into a drink. To cover the bitter taste, sometimes they’re mixed with chocolate – psilocybin chocolate.
The effects can be a real mixed bag, from feeling like your senses are super sharp to having your judgment impaired. A “bad trip” on psilocybin can mean scary hallucinations, intense fear, depression, or panic attacks.
PCP (Phencyclidine)
PCP, or phencyclidine (you might hear it called angel dust), comes in different forms like liquids, powders, or tablets. People might swallow, snort, inject, or even smoke it.
Interestingly, PCP was developed back in the 1950s as a general anesthetic. But doctors stopped using it because of serious side effects.
PCP can create a strong out-of-body feeling. As it wears off, people can become agitated and irrational. High doses are really dangerous and can lead to seizures, coma, and even death, often from accidents or suicide while intoxicated.
Ketamine
Ketamine is another anesthetic, used in surgery for both people and animals. A lot of the ketamine used illicitly is actually stolen from veterinary clinics. It’s often snorted as a powder or taken as a pill, but can also be injected.
Like PCP, ketamine can cause an out-of-body sensation. For some, it’s pleasant; for others, it’s terrifying.
Salvia (Salvia Divinorum)
Salvia is a plant from Mexico and Central/South America. People might chew the leaves, drink its extracted juices, or smoke the dried leaves.
The effects can include visions and hallucinations, sometimes feeling like you’re floating or time-traveling. Weird, right?
DMT (Dimethyltryptamine)
DMT is a chemical found in some Amazonian plants. It’s often brewed into a tea called ayahuasca. DMT can also be made synthetically in a lab, usually appearing as a white powder that’s smoked.
What About the Downsides? The Adverse Effects of Hallucinogens
It’s really important to understand that using hallucinogens isn’t without risks. Unpleasant side effects are common. The intensity often depends on how much is taken. Some things we see include:
- Dilated pupils (your pupils get really big)
- Increased body temperature
- Faster heart rate and higher blood pressure
- Lots of sweating (hyperhidrosis) and flushing
- Loss of appetite
- Trouble sleeping or feeling very drowsy
- Dry mouth (xerostomia)
- Tremors
- Clumsiness or uncoordinated movements (ataxia)
- Muscle weakness or relaxation
- Nausea and vomiting
PCP is particularly notorious for a wide range of nasty effects. Even at lower doses, it can make your breathing faster, and your blood pressure and pulse can shoot up. You might also get:
- Shallow breathing
- Flushing and heavy sweating
- Numbness in your arms and legs
- Loss of coordination
At high doses, PCP can cause:
- A drop in blood pressure, pulse, and breathing rate
- Nausea and vomiting
- Blurred vision
- Eyes flickering up and down
- Drooling
- Loss of balance
- Dizziness
People on PCP often end up in the emergency room, either from an overdose or because the psychological effects are so severe. They can become violent or suicidal, making them a danger to themselves and others. As I mentioned, high doses can lead to seizures, coma, and death.
When Things Go Wrong: Treatment for Hallucinogen Issues
Sometimes people need medical help because of hallucinogen use, especially during a “bad trip” where they might be at risk of hurting themselves.
Treatment is usually supportive. We’d try to create a calm, quiet environment with as little stimulation as possible. If someone is extremely agitated or having seizures, a medication like a benzodiazepine (you might know brand names like Xanax®) might be given.
For long-term issues like substance use disorder (SUD) related to hallucinogens, there aren’t specific medications to “cure” it. However, behavioral therapies and sometimes inpatient treatment programs can be very helpful, just as they are for other types of substance use disorders. We’ll discuss all options for you or your loved one if this is a concern.
A Couple More Common Questions
Is Weed a Hallucinogen?
That’s a question I get sometimes. Researchers do classify cannabis (weed) as a hallucinogen. While it doesn’t always cause hallucinations, it can, especially in high doses.
Can Hallucinogens Be Used as Medicine?
This is where things are evolving. Psychedelic research is slowly making a comeback. There have been quite a few clinical studies showing that psilocybin, for example, holds promise for treating certain mental health conditions like depression, anxiety, and other mood disorders. Researchers are also looking into whether psilocybin could help with:
- Cluster headaches
- Phantom limb pain
- Chronic pain
It’s early days for much of this research, but it’s an area we’re watching closely.
Take-Home Message on Hallucinogens
This is a lot to take in, I know. If you’re trying to understand hallucinogens, here are the key things to remember:
- Hallucinogens are drugs that significantly alter perception, thoughts, and feelings.
- They work by disrupting chemical communication in the brain, primarily affecting serotonin and glutamate systems.
- Effects vary widely depending on the drug, dose, and individual, ranging from altered sensory experiences to severe psychological distress (“bad trips”).
- Common types include LSD, peyote, psilocybin, PCP, and ketamine, each with unique characteristics and risks.
- Adverse effects can be serious, including physical symptoms like increased heart rate and blood pressure, and psychological effects like panic, paranoia, and even psychosis, especially with drugs like PCP.
- While most hallucinogens are not considered safe for recreational use, there’s growing research into the therapeutic potential of some, like psilocybin, for specific mental health conditions under strict medical supervision.
- If you or someone you know is struggling with hallucinogen use, please reach out. Help is available.
It’s a complex topic, and if you have more questions, or if any of this hits close to home, please don’t hesitate to talk to a healthcare professional. You’re not alone in figuring this out.