HallucinogensHallucinogens

HallucinogensHallucinogens

• • Hallucinogens are substances Hallucinogens are substances that alter sensory processing in that alter sensory processing in the brain,the brain,

causing perceptual disturbances,causing perceptual disturbances,

changes in thought processing, changes in thought processing, and depersonalization and depersonalization

Modern Day History of Modern Day History of HallucinogensHallucinogens

Vietnam War Vietnam War

Timothy Leary Timothy Leary

Harvard professorHarvard professor

The Psychedelic Experience The Psychedelic Experience

The Nature of Hallucinogens The Nature of Hallucinogens

• • Many drugs can exert hallucinogenic effects Many drugs can exert hallucinogenic effects related to neurotransmitters:related to neurotransmitters:

SerotoninSerotonin: LSD, psilocybin, DMT: LSD, psilocybin, DMT

NorepinephrineNorepinephrine: amphetamine related, : amphetamine related, mescaline, MDMAmescaline, MDMA

AcetylcholineAcetylcholine: atropine, scopolamine: atropine, scopolamine

Dissociative anestheticsDissociative anesthetics: PCP, ketamine: PCP, ketamine

Names for HallucinogensNames for Hallucinogens

Psychedelic Psychedelic

Psychotogenic Psychotogenic

Psychotomimetic Psychotomimetic

Sensory and Psychological Effects Sensory and Psychological Effects

Altered perception.Altered perception.- Synesthesia: blending of the - Synesthesia: blending of the senses. Perceptual changes.senses. Perceptual changes.Self-reflection Self-reflection - “Make conscious the - “Make conscious the unconscious” unconscious” Loss of identity and cosmic Loss of identity and cosmic merging merging - “Mystical-spiritual aspect of the - “Mystical-spiritual aspect of the drug experience” drug experience” Aldous Huxley: Aldous Huxley: Doors of Doors of Perception.Perception.

                                    

       

LSD class drugsLSD class drugs

LSD, mescaline, LSD, mescaline, psilocybin, DMT, bufoteninepsilocybin, DMT, bufoteninePrimarily act on Serotonin receptorsPrimarily act on Serotonin receptorsFrontal cortex and limbic systemFrontal cortex and limbic systemAlso act on raphe nucleus which functions Also act on raphe nucleus which functions to filter incoming sensory stimulito filter incoming sensory stimuliDisrupts the sorting processDisrupts the sorting processFlood of sensations and perceptionsFlood of sensations and perceptions

LSD-class HallucinogensLSD-class Hallucinogens

LSD Types of Agents LSD Types of Agents

These drugs cause These drugs cause predominantly predominantly psychedelic effects.psychedelic effects.

Of high school seniors Of high school seniors sampled: sampled:

- 1999—12.2% had used - 1999—12.2% had used LSD sometime during life LSD sometime during life

- 2002—8.4% had used - 2002—8.4% had used LSD sometime during lifeLSD sometime during life

Albert Hofmann and LSD model

LSD Physical EffectsLSD Physical Effects

LSD Types of Agents LSD Types of Agents Physiological effects: Physiological effects: - Massive increase in neural - Massive increase in neural activity in some brain regions activity in some brain regions - Activates sympathetic - Activates sympathetic nervous system (rise in body nervous system (rise in body temperature, heart rate, and temperature, heart rate, and blood pressure) blood pressure) - Parasympathetic nervous - Parasympathetic nervous system (increase in salivation system (increase in salivation and nausea) and nausea)

LSD TimelineLSD Timeline

• • About half of the About half of the substance is cleared from substance is cleared from the body within 3 hours, the body within 3 hours, and more than 90% is and more than 90% is excreted within 24 hours. excreted within 24 hours. Effects of this Effects of this hallucinogen can last 2–hallucinogen can last 2–12 hours.12 hours.Tolerance to the effects Tolerance to the effects of LSD develops very of LSD develops very quickly.quickly.

PsilocybinPsilocybin

• • Psilocybin—its principal source is the Psilocybin—its principal source is the Psilocybe mexicana mushroom.Psilocybe mexicana mushroom.It is not very common on the street. It is not very common on the street. Hallucinogenic effects produced are quite Hallucinogenic effects produced are quite similar to LSD. similar to LSD. Cross-tolerance among psilocybin, LSD, Cross-tolerance among psilocybin, LSD, mescaline. mescaline. Stimulates the autonomic nervous system, Stimulates the autonomic nervous system, dilates the pupils, increases the body dilates the pupils, increases the body temperaturetemperature

Psilocybe MushroomsPsilocybe Mushrooms

Small brown Small brown mushrooms that stain mushrooms that stain blue to the touchblue to the touch

Illicit cultivation but Illicit cultivation but also foraged from also foraged from temperate climatestemperate climates

Psilocybe Mushrooms:Psilocybe Mushrooms:Religious UseReligious Use

Religious use continues in Oaxaca, Mexico

Dimethyltryptamine (DMT)Dimethyltryptamine (DMT)

Dimethyltryptamine (DMT) Dimethyltryptamine (DMT) - A short-acting hallucinogen - A short-acting hallucinogen - Found in seeds of certain leguminous trees - Found in seeds of certain leguminous trees and prepared synthetically. and prepared synthetically. - It is inhaled and similar action as psilocybin. - It is inhaled and similar action as psilocybin. - High doses can be quite intoxicating.- High doses can be quite intoxicating.- Can also cause unpleasant reactions/\. - Can also cause unpleasant reactions/\.

DMT…it’s as common as DMT…it’s as common as crabgrass… crabgrass…

““Canary” grass; Canary” grass; Phalaris aquatica, P. Phalaris aquatica, P. arundinacea, P. canariensis, P. tuberosaarundinacea, P. canariensis, P. tuberosa

Desmanthus illinoensis; Desmanthus illinoensis; Prairie Prairie BundleflowerBundleflower

Many other sources; mostly S. America.Many other sources; mostly S. America.

Phalaris (DMT source)Phalaris (DMT source)

Desmanthus illinoesis (DMT Source)Desmanthus illinoesis (DMT Source)

Bufo Frogs…Bufo Frogs…

Contains bufontinin but intoxication Contains bufontinin but intoxication primarily from 5-Meo-DMTprimarily from 5-Meo-DMT

The toad is NOT licked but glands are The toad is NOT licked but glands are milked for poisonmilked for poison

Amphetamine ClassAmphetamine Class

MescalineMescaline

Synthetic amphetamine derivatives (DOM, Synthetic amphetamine derivatives (DOM, MDA, MDMA)MDA, MDMA)

Act on dopamine and serotoninAct on dopamine and serotonin

Amphetamine HallucinogensAmphetamine Hallucinogens

Drugs are chemically related to amphetamines. Drugs are chemically related to amphetamines.

They have varying degrees of hallucinogenic They have varying degrees of hallucinogenic and CNS stimulant effects. and CNS stimulant effects.

- Release serotonin are dominated by their - Release serotonin are dominated by their hallucinogenic action hallucinogenic action

- Release dopamine are dominated by their - Release dopamine are dominated by their stimulant effectsstimulant effects

Amphetamine Hallucinogens Amphetamine Hallucinogens

MescalineMescaline

““Designer” amphetamines Designer” amphetamines

3,4 3,4 MMethyleneethyleneddioxyioxyaamphetamine (MDA) mphetamine (MDA)

MMethyleneethyleneddioxyioxymmethethaamphetamine mphetamine

(MDMA, Ecstasy) (MDMA, Ecstasy)

Ephedra of the USEphedra of the USE. trifurcaE. trifurca, , E. viridisE. viridis, , E. torreyana,E. torreyana, E. nevadensis E. nevadensis and and E. E.

californicacalifornica

100 gm dried ephedra could contain anywhere 100 gm dried ephedra could contain anywhere from 0 to 2.6 gm of ephedrine.from 0 to 2.6 gm of ephedrine.

Ephedra grows in the deserts Ephedra grows in the deserts of the Southwestof the Southwest

MescalineMescaline

- Mescaline is the most active drug in - Mescaline is the most active drug in peyote cactuspeyote cactus; it induces ; it induces intensified perception of colors and intensified perception of colors and euphoria euphoria - Effects include dilation of the - Effects include dilation of the pupils, increase in body pupils, increase in body temperature, anxiety, visual temperature, anxiety, visual hallucinations, and alteration of hallucinations, and alteration of body image, vomiting, muscular body image, vomiting, muscular relaxation.relaxation.Very high doses may cause death.Very high doses may cause death.- Street samples are rarely - Street samples are rarely authentic.authentic.

PeyotePeyote

Lophophoria williamsiiLophophoria williamsii contains 1.5% mescaline (contains 1.5% mescaline (--3,4,5-trimethoxyphenethylamine3,4,5-trimethoxyphenethylamine))3mg/kg3mg/kg potent intoxication potent intoxicationUp to 8 to 10 hour durationUp to 8 to 10 hour durationContinued religious use in Continued religious use in North AmericaNorth AmericaOther cacti used in South Other cacti used in South America and also…America and also…

Harvesting PeyoteHarvesting Peyote

Natural Range of PeyoteNatural Range of Peyote

The Peyote CeremonyThe Peyote Ceremony

Stewart OC. Stewart OC. Peyote ReligionPeyote Religion. Norman, OK: . Norman, OK: University of Oklahoma Press, 1987.University of Oklahoma Press, 1987.

Aberle DF. Aberle DF. The Peyote Religion Among the NavahoThe Peyote Religion Among the Navaho. . Chicago, IL: Aldine Publishing Co., 1966.Chicago, IL: Aldine Publishing Co., 1966.

MDMA (‘Ecstasy’)MDMA (‘Ecstasy’)

PsychostimulantsPsychostimulants

The most common psychostimulants (cocaine, The most common psychostimulants (cocaine, MDMA and amphetamine) act on the synapse MDMA and amphetamine) act on the synapse to increase the activity of dopamine, to increase the activity of dopamine, noradrenaline and serotonin.noradrenaline and serotonin.

Cocaine Cocaine blocks blocks pre-synaptic pre-synaptic reuptakereuptake

A synthetic amphetamine derivative, usually sold as small A synthetic amphetamine derivative, usually sold as small tablets or capsulestablets or capsules

Many tablets sold as ecstasy also contain other chemicals Many tablets sold as ecstasy also contain other chemicals including: ketamine, GHB, amphetamine, caffeine.including: ketamine, GHB, amphetamine, caffeine.

A recent study (Baggott et al 2000) found that:A recent study (Baggott et al 2000) found that: 63% contained MDMA63% contained MDMA 29% contained other substances (e.g. caffeine, 29% contained other substances (e.g. caffeine,

psuedoephedrine) psuedoephedrine) 8% contained no MDMA8% contained no MDMA

MDMA (‘Ecstasy’)MDMA (‘Ecstasy’)

Immediate sought after-effects, 4-6 hours in durationImmediate sought after-effects, 4-6 hours in duration

euphoria, increased confidence, increased perception euphoria, increased confidence, increased perception

of closeness to others, visual hallucinationsof closeness to others, visual hallucinations

Negative effectsNegative effects

jaw clenching, anxiety, paranoia, insomnia, dry jaw clenching, anxiety, paranoia, insomnia, dry

mouth, increased body temperaturemouth, increased body temperature

MDMA (‘Ecstasy’): EffectsMDMA (‘Ecstasy’): Effects

Party drug cultureParty drug culture

High levels of activity: hydration and High levels of activity: hydration and hyperthermiahyperthermia

Poly-drug use, illicit and misuse of Poly-drug use, illicit and misuse of prescribed substances:prescribed substances: Viagra used primarily within the gay communityViagra used primarily within the gay community Anti-depressants and benzodiazepines thought to Anti-depressants and benzodiazepines thought to

increase the ‘high’ or relieve the ‘come down’ increase the ‘high’ or relieve the ‘come down’ associated with party drug useassociated with party drug use

Risks of EcstasyRisks of Ecstasy

Toxicity: MDMA overdose is rareToxicity: MDMA overdose is rare associated with intense sympathomimetic responses and associated with intense sympathomimetic responses and

active hallucinations as well as thermoregulatory, neurologic, active hallucinations as well as thermoregulatory, neurologic, cardiovascular, hepatic and electrolyte disturbances (Gowing cardiovascular, hepatic and electrolyte disturbances (Gowing et al 2002).et al 2002).

Risks of adulterantsRisks of adulterants

Dependence syndrome (occasionally)Dependence syndrome (occasionally)

Some evidence of cognitive impairment as a result of long term Some evidence of cognitive impairment as a result of long term use (Kalant, 2001)use (Kalant, 2001)

Association between long-term MDMA use and emotional Association between long-term MDMA use and emotional disturbance (depression).disturbance (depression).

AnticholinergicsAnticholinergics

Attach to Ach receptors and act as Attach to Ach receptors and act as antagonistsantagonists

Found in Belladonna, Nightshade, Found in Belladonna, Nightshade, Jimsonweed and Mandrake plantsJimsonweed and Mandrake plants

Ach AntagonistsAch Antagonists

Plants containing scopolaminePlants containing scopolamineLow doses produce amnesia, fatigue, Low doses produce amnesia, fatigue, mental confusion, dreamless sleep and loss mental confusion, dreamless sleep and loss of attentionof attentionHigh doses: Hallucinations, paralysis of High doses: Hallucinations, paralysis of respiratory system, coma, and death. respiratory system, coma, and death. Side Effects: increase in sympathetic activitySide Effects: increase in sympathetic activityHot as a hare, dry as a bone, red as a beet, Hot as a hare, dry as a bone, red as a beet, and mad as a henand mad as a hen

Datura stramoniumDatura stramonium

Leaves typically cut and smokedLeaves typically cut and smoked

Contains atropine, scopalomineContains atropine, scopalomine

Ancient ceremonial use in the U.S.Ancient ceremonial use in the U.S.

Occasional report of death by Occasional report of death by ingestion of rootingestion of root

Many other sources for atropine Many other sources for atropine

and scopalomineand scopalomine

Member of Nightshade familyMember of Nightshade family

““Jimson weed”Jimson weed”

Dissociative DrugsDissociative Drugs

PCP (phencyclidinePCP (phencyclidine))

Ketamine Ketamine

DextromethorphanDextromethorphan

Dissociative DrugsDissociative Drugs

• • Phencyclidine (PCP)Phencyclidine (PCP)

It was developed as an intravenous anesthetic, It was developed as an intravenous anesthetic,

but found to have serious adverse side effects. but found to have serious adverse side effects.

It differs from the other traditional hallucinogens. It differs from the other traditional hallucinogens.

It is a general anesthetic in high doses. It is a general anesthetic in high doses.

It causes incredible strength and extreme violent It causes incredible strength and extreme violent behavior.behavior.

Management of the severe psychological reactions Management of the severe psychological reactions requires drug therapy.requires drug therapy.

PCP physiological effects PCP physiological effects

- - Hallucinogenic effects, stimulation, depression, Hallucinogenic effects, stimulation, depression, anesthesia, analgesia anesthesia, analgesia - Large doses can cause coma, convulsions, - Large doses can cause coma, convulsions, and death. and death. PCP psychological effects PCP psychological effects - Feelings of strength, power, invulnerability; - Feelings of strength, power, invulnerability; perceptual distortions, paranoia, violence, perceptual distortions, paranoia, violence, Potential for psychotic break.Potential for psychotic break.

Ketamine (“Special K”)Ketamine (“Special K”)

Anesthetic developed to replace PCP, manufactured by Pfizer

Used in human and veterinary medicine

Injected or dried and snorted

Feelings of floating, or sometimes terrifying “bad trip” called “K hole”

“Vitamin K”

“K”

“Bump”

DXM DXM (dextromethorphan)(dextromethorphan)

Cough suppressant

(Also used to boost effects of analgesics for severe pain)Typical dose 15-30 mg. for cough4 or more ounces may cause distorted visual

perceptions, similar effects to PCP and Ketamine“Robo”Internet groups to discuss “Robo-ing”

National Survey on Drug Use and National Survey on Drug Use and Health Health (2004 & 2005)(2004 & 2005)

Monitoring the Future (National Monitoring the Future (National Survey) Survey) (2005)(2005)

Drug Abuse Warning Network Drug Abuse Warning Network (DAWN)(DAWN)

Statistics on UseStatistics on Use

NSDUH Hallucinogen StatisticsNSDUH Hallucinogen Statistics

Percentages of Past Year Hallucinogen Use among Persons Aged 12 or Older, by Age Group: 2004 and 2005

Monitoring the Future Hallucinogens 2005Monitoring the Future Hallucinogens 2005

8th8th 10th10th 12th12th

PsychedelicsPsychedelics 2.42.4 4.04.0 5.55.5

LSDLSD 1.21.2 1.51.5 1.81.8

OthersOthers 2.02.0 3.53.5 5.05.0

Hallucinogens in ER Visits, 2005Hallucinogens in ER Visits, 2005

DrugDrugDrug-Related ER Drug-Related ER

Visits DAWN Visits DAWN HospitalsHospitals

CocaineCocaine 448, 481448, 481

HeroinHeroin 164, 572164, 572

KetamineKetamine 275275

LSDLSD 1,8641,864

PCPPCP 7,5357,535

Misc. hallucinogensMisc. hallucinogens 3,7923,792

AAPCC Annual Report 2005AAPCC Annual Report 2005

SubstanceSubstance Number of human exposures reported to Number of human exposures reported to US Poison Control CentersUS Poison Control Centers

Hallucinogenic mushroomsHallucinogenic mushrooms 849849

Muscarine mushroomsMuscarine mushrooms 1919

Hallucinogenic plantsHallucinogenic plants 355355

Solanine plants (nightshade family)Solanine plants (nightshade family) 1,1661,166

KetamineKetamine 161161

Dextromethorphan (APA/ASA)Dextromethorphan (APA/ASA) 67,038.0067,038.00

Hallucinogens (general, various)Hallucinogens (general, various) 1,9241,924

Mescaline/peyoteMescaline/peyote 102102

PCPPCP 662662

2005 Annual Report of the American Association of Poison Control Centers’ National Poisoning and Exposure Database. Clinical Toxicology, 44:803-932, 2006