Hallucinogens (Psychedelics) Chapter 12

1. Hallucinogens(Psychedelics)Chapter 12

2. Hallucinogens • Hallucinogens are substances that alter sensory processing in the brain, causing perceptual disturbances, changes in thought processing, and depersonalization. • Depersonalization is an anomaly of the mechanism by which an individual has self-awareness. It is a feeling of watching oneself act, while having no control over a situation. Sufferers feel they have changed, and the world has become less real, vague, dreamlike, or lacking in significance. It can be a disturbing experience, since many feel that, indeed, they are living in a "dream". 1 • Sometimes described as causing a spiritual-like experience. 1Source: http://en.wikipedia.org/wiki/Depersonalization

3. History of Hallucinogens • Have been used for centuries for religious purposes. • There are many indications that medicine men, priests, and other mystics have use herbs and drugs that caused experiences that are know today as hallucinations. • Abuse of hallucinogens became a problem in the United States in the 1960s

4. History of Hallucinogens • The Native American Church • Because the hallucinogen mescaline plays a central role in ceremonies of Native Americans, Congress passed legislation allowing its use for religious ceremonies. • The American Indian Religious Act (1978)was an attempt by Congress to allow the Native American Church access to Peyote due to constitutional guarantees of religious freedom. The 1994 amendment clarified that the peyote was only to be used for religious ceremonies

5. History of Hallucinogens • Timothy Leary and the League of Spiritual Discovery: • Tim Leary, after being fired from Harvard in 1963 undertook a constitutional strategy intended to retain legitimate access to LSD (Lysergic acid diethylamide). He began a religion called the League of Spiritual Discovery. LSD was the Sacrament. The orientation manual was called The Psychedelic Experience (textbook online). In 1969, Federal authorities sentenced Leary to 20 years imprisonment (he was released in 1976)

6. The Nature of Hallucinogens(see Signs and Symptoms of Hallucinogens, p.354) • Many drugs can exert hallucinogenic effects: • Traditional hallucinogens (LSD-types) • Phenylethylamines (Ecstasy, amphetamines) • Anticholinergic agents (Jimsonweed and other natural products) • Cocaine • Steroids

7. Nature of Hallucinogens • Because of the nature of hallucinogens they can produce varied responses. Hallucinogens have been described as: • Psychedelic • Psychotogenic = Inducing psychosis • Psychotomimetic = pertaining to, characterized by, or producing symptoms similar to those of a psychosis

8. Nature of Hallucinogens The features of Hallucinogens that distinguish them from other drug groups are their ability to alter perception, thought, and feeling in such a manner that does not normally occur except in dreams or during experiences of extreme religious exaltation.

9. Sensory and Psychological Effects of Hallucinogens • Typical users will experience several stages of sensory experiences (some or all of below): • Heightened, exaggerated senses • Loss of control • Self-reflection • Loss of identity and a sense of cosmic merging

10. Sensory and Psychological Effects of Hallucinogens Altered senses • Heightened Colors, Object distortions, Change in the sense of time and distance • Synesthesia – a cross-over phenomenon between the senses. Sound develops visual dimensions, and visual objects develop sound dimensions (ex. “See sounds” and “Hear Colors”).

11. Sensory and Psychological Effects of Hallucinogens Loss of control • The LSD user cannot determine if the “trip” will be pleasant or a “bad trip” with recollections of hidden fears and suppressed anxieties can precipitate neurotic or psychotic responses. • “Bad Trips” can include feelings of panic, confusion, fear, helplessness, and total lack of control.

12. Sensory and Psychological Effects of Hallucinogens Loss of control • Flashbacks – Recurrences of the frightening experiences (Bad trips) can occur at a later time, even though LSD has not been taken again. These occurrences are called “flashbacks”.

13. Sensory and Psychological Effects of Hallucinogens • Self Reflection • One becomes aware of thoughts and feelings that are hidden beneath the surface of consciousness (ie. forgotten or repressed feelings). • It is possible that the effects of LSD may be used treat emotional problems such as depression in cancer patients, obsessive-compulsive disorders, and end-of-life anxiety. However, the unpredictability of human response to these drugs creates a challenge for therapeutic use.

14. Sensory and Psychological Effects of Hallucinogens Loss of identity and a sense of cosmic merging • A “mystical-spiritual” aspect of the drug experience. The Hallucination gives one the experience of “blending with the surroundings and being in totality with the universe”. • The loss of identity and personal boundaries caused by the hallucinations is not necessarily a pleasant experience for these individuals with rigid highly organized personalities. The experience can cause panic and anxiety, even suicide.

15. Traditional Hallucinogens: LSD and Other Types of Agents (possible mechanisms of LSD activity) • LSD (lysergic acid diethylamide) • Similar to ergot alkaloids (see also ergotism), synthesized by experimentation with ergot compounds. Albert Hoffman created slight chemical modifications to lysergic acid creating LSD. • LSD induced psychosis and was initially studied to investigate the symptoms of schizophrenia. Interest in the use of LSD declined as it became generally accepted that LSD effects differed from natural psychosis. • LSD has been tried in psychotherapy in treatment of alcoholism, paranoia, schizophrenia.

16. Traditional Hallucinogens: LSD Types of Agents (continued) • Physical properties of LSD • Synthesis of LSD requires about one week, and requires the skills of a trained chemist • In pure form: colorless, odorless, tasteless • Comes in several forms: Tiny tablets = microdots, capsules, thin squares of gelatin “window panes”, and applied to paper as “blotter acid” and cut up into 0.25 inch squares ….One gram of LSD can provide 10,000 individual doses

17. Traditional Hallucinogens: LSD Types of Agents (continued) • Physiological Effects – LSD is very potent (20-30 mcg) • LSD is particularly concentrated in the brain at the hypothalamus and limbic system, and the auditory and visual reflex centers. • The Limbic system undergoes an “electric storm” of activity which may correlate with the synesthesia reported by the user. • Physical signs (sympathetic) include increase in body temperature, heart rate, blood pressure and hyperhidrosis, with concomitant dilation of the pupils. (30-90 min. activation)

18. Traditional Hallucinogens:LSD Types of Agents (continued) • Physiological effects continued: • Parasympathetic nervous system (increase in salivation and nausea). • Individuals do not become physically dependent, but psychological dependency can occur. • Tolerance develops very quickly and to repeated doses because of a change in sensitivity of the target cells in the brain rather than a change in the metabolism of LSD

19. Traditional Hallucinogens: LSD Types of Agents (continued) • LSD Behavioral effects: • Creativity and insight – Perhaps it is just the belief that one is more creative or less restricted by “normal” boundaries. • Adverse psychedelic effects – there is no typical response to LSD. The experience varies as a function of the users set and setting. User may “freakout” on a bad trip. • Perceptual effects -

20. Traditional Hallucinogens: LSD Types of Agents (continued) • LSD Behavioral effects (continued): • Perceptual effects – LSD alters both visual and auditory perception. In some cases, LSD alters perceptions to the extent that people feel (believe) that they can walk on water or fly through the air. • The user may experience flashbacks that are pleasant or unpleasant. There are three categories of unpleasant flashbacks: 1) Body trip – recurrence of an unpleasant physical sensation; 2) Mind trip – distressing thought or emotion, and; 3) Altered Visual Perception – the most frequent type of recurrence consisting of seeing dots, flashes, trails of light, halos, motion in the peripheral field, and other sensations.

21. Traditional Hallucinogens: LSD Types of Agents (continued) • LSD Behavioral effects (continued): • Flashbacks are disturbing because they come unexpectedly – most subside within weeks or months after taking LSD, and the duration is usually a few minutes to several hours. • The precise mechanism of flashbacks is unknown – possible because of the altercation on the brain via neurotransmitters effected by LSD use. • Treatment of flashbacks includes reassurance that the condition will go away and the use of sedatives to treat anxiety and panic associated with the recurrent flashbacks

22. Other LSD Types of Agents • Mescaline (Peyote) • Mescaline is the most active drug in peyote; it induces intensified perception of colors and euphoria. • Effects include dilation of the pupils, increase in body temperature, anxiety, visual hallucinations, alteration of body image, vomiting, muscular relaxation. • The last effect is a type of hallucination in which parts of the body may disappear or be distorted. They may have a “two people experience” within themselves • Users report that they lose all sense of time • Like LSD, users may experience synesthesia

23. Other LSD Types of Agents • Mescaline (Peyote) • Within 30-120 minutes, mescaline reaches a maximum concentration in the brain. • Effects may last 9-10 hours, hallucinations up to two hours, depending on the dosage. • Like LSD, mescaline probably exerts much of its hallucinogenic effects by altering serotonin systems. • (Scene from “Young Guns”)

24. Other LSD Types of Agents(continued) • Psilocybin • Principle source is the Psilocybe mexicanamushroom. • It was first used by natives of Central America more than 200 years ago • The active ingredient of the Psilocybe mexicana mushroom was extracted by Albert Hoffman in 1958. • Hallucinogenic effects similar to LSD. • Cross-tolerance among psilocybin, LSD, and mescaline, suggesting they have similar mechanisms of action • Stimulates autonomic nervous system, dilates the pupils, increases body temperature.

25. Other LSD Types of Agents(continued) Psilocybin (cont) • The effects of caused by psilocybin vary by dosage. Up to four mg cause a pleasant experience, relaxation, and some body sensation. Higher doses may cause perceptual and body image changes, accompanied by hallucinations. • It may be possible that psilocybin can be used to treat depression, but the possible adverse affects include mental problems and induce the first stages of schizophrenia-like psychosis. • Like other hallucinogens, psilocybin apparently causes no apparent dependence

26. Tryptamines (class of drugs) • Tryptamines • a. These compounds resemble the serotonin molecule and exist naturally in herbs, fungi, animals, and even in minute amounts in the human brain • b. Most of these compounds are abused for their hallucinogenic/psychedelic actions and are classified as Schedule I drugs • Dimethyltryptamine (DMT) • Foxy • Nutmeg

27. Other LSD Types of Agents (continued) • Dimethyltryptamine (DMT) • A short-acting hallucinogen found in seeds of trees native to the West Indies and parts of South America, and prepared synthetically. • Trace amounts are found naturally in the human body. • It is inhaled and is similar in action to psilocybin. • Its effects occur rapidly and last less than one hour • Like other hallucinogens, DMT does not cause physical dependence

28. Other LSD Types of Agents(continued) • Foxy • Relatively new hallucinogen (scheduled cat 1 by DEA, 2004). • Lower doses: euphoria. • Higher doses: similar to LSD causing hallucinations and psychedelic experiences • Nutmeg • Myristica oil responsible for physical effects. Myristica blocks the release of serotonin from neurons in the brain. • The exterior covering of the nutmeg seed also contains the hallucinogenic compound of myristicin • High doses can be quite intoxicating. • Often causes unpleasant trips (rapid heartbeat, dry mouth, thirst, agitation, apprehension, and feelings of impending doom – effects may last up to 12 hours, with a sense of unreality for days)

29. Phenylethylamine Hallucinogens • The phenylethylamine drugs are chemically related to amphetamines. • They have varying degrees of hallucinogenic and CNS stimulant effects. • LSD-like: predominantly release serotonin; dominated by their hallucinogenic action. • Cocaine-like: predominantly release dopamine; dominated by their stimulant effects.

30. Phenylethylamine Hallucinogens (continued) • Dimethoxymethylamphetamine (DOM or STP) • A powerful hallucinogen that works like mescaline and LSD and like other hallucinogens not considered to be particularly addicting • “Effects of this drug include substantial perceptual changes such as blurred vision, multiple images, vibration of objects, visual hallucinations, distorted shapes, enhancement of details, slowed passage of time, increased sexual drive and pleasure, and increased contrasts. It may also cause (pupil) dilation and a rise in systolic blood pressure.”1 • 1Source : http://en.wikipedia.org/wiki/Dimethoxymethylamphetamine

31. Phenylethylamine Hallucinogens (continued) • “Designer” amphetamines (review information from Chapter 10) • 3,4-Methylenedioxyamphetamine (MDA) • Methylenedioxymethamphetamine(MDMA, Ecstasy) • Include drugs such as MDA and MDMA (Ecstasy), which enhance the sense of touch; these drugs are sometimes referred to as entactogens. • These drugs are popular and typically used by young adults because of their combination of entactogenic and stimulant effects. The use of these drugs is often associated with raves and dance clubs.

32. Phenylethylamine Hallucinogens (continued) • “Designer” amphetamines (review information from Chapter 10) • 3,4-Methylenedioxyamphetamine (MDA) • Methylenedioxymethamphetamine(MDMA, Ecstasy) • There is some debate as to their ability to cause addiction and dependence. It is likely that MDMA is significantly less addicting than potent psycho-stimulants such as methamphetamine and cocaine due to its preferential ability to activate serotonin over dopamine systems.

33. Anticholinergic Hallucinogens • The anticholinergic hallucinogens include naturally occurring alkaloid substances that are present in plants and herbs. • The potato family of plants contains most of these mind-altering drugs. • Three potent anticholingergic compounds in these plants: • Scopolamine • Hyoscyamine • Atropine

34. Naturally Occurring Anticholinergic Hallucinogens Anticholinergic Hallucinogens They can cause drowsiness and conditions similar to psychosis. 1. Atropa Belladonna: The Deadly Nightshade Plant 2. Mandragora Officinarum: The Mandrake 3. Hyoscyamus Niger: Henbane 4. Datura Stramonium: Jimsonweed

35. Naturally Occurring Anticholinergic Hallucinogens Anticholinergic Hallucinogens (cont) • Atropa Belladonna: The Deadly Nightshade Plant • The name of the genus, Atropa, is the origin of the name atropine. • Atropos – One of the three fates in Greek mythology, whose duty it was to cut off life when the time came • Bella Donna “beautiful woman” atropa placed in the eyes cause pupil dilation

36. Naturally Occurring Anticholinergic Hallucinogens Anticholinergic Hallucinogens (cont) 2. Mandragora Officinarum: The Mandrake • Contains several active psychedelic alkaloids: hyoscyamine, scopolamine, atropine, and mandragorine. • In ancient medicine was used to treat nervous disorders, and relieve pain

37. Naturally Occurring Anticholinergic Hallucinogens Anticholinergic Hallucinogens (cont) 3. Hyoscyamus Niger: Henbane • A plant that contains both hyoscyamine and scopolamine. • It was frequently used to cause sleep, although producing hallucinations and included in “witches brew” • “ It was historically used in combination with other plants, such as mandrake, deadly nightshade, as an anaesthetic potion, as well as for its psychoactive properties in "magic brews."These psychoactive properties include visual hallucinations and a sensation of flight.” • Source = http://en.wikipedia.org/wiki/Hyoscyamus_niger

38. Naturally Occurring Anticholinergic Hallucinogens Anticholinergic Hallucinogens (cont) 4. Datura Stramonium: Jimsonweed • The principal active drug in this group is scopolamine, and also contains atropine. • Historically used as a hallucinogen by many societies. • Jimsonweed grows freely and is sometimes used in “stews”. Jimsonweed produces many bad side effects in addition to hallucinations including confusion, dilated pupils, and tachycardia.

39. Other Hallucinogens • Phencyclidine (PCP) • Considered by many experts as the most dangerous of the hallucinogens although it has a host of other effects as well. • It was developed as an intravenous anesthetic but was found to have serious adverse side effects.

40. Other Hallucinogens (continued) • Phencyclidine (PCP) physiological effects • Hallucinogenic effects, stimulation, depression, anesthesia, analgesia • Large doses can cause coma, convulsions, and death • PCP psychological effects • Feelings of strength, power, invulnerability, perceptual distortions, paranoia, violence, and psychoses and users appear like schizophrenics

41. Other Hallucinogens (continued) • Ketamine(general anesthetic; PCP-like) • It is used as a general anesthetic for veterinarian procedures • Considered a club drug with effects similar to PCP but more rapid and less potent • Dextromethorphan(cough suppressant) • High doses cause PCP-like effects • An active ingredient in many OTC cough medications, but when consumed in high doses it can cause hallucinogenic effects including symptoms such as confusion, numbness, and disorientation • Abuse is generally by teenagers and may be referred to as “roboing.” Recreational use of cough medicine by high school seniors in 2010 was 6.6%.

42. Other Hallucinogens (continued) • Salvia divinorum • Comes from a Mexican herb • Can cause intense hallucinations and short-term memory loss • Outlawed in some, but not all states • Some studies suggest that the ingredient salvinorum may be useful in the treatment of chronic pain and some mental disorders. End of Presentation