Drugs that Cause (Pseudo) Hallucinations
- Main Hallucinogens: (mescaline, psilocybin mushrooms, LSD, DMT)
- Club Drugs: MDMA (Ecstasy), Ketamine (Special K), methamphetamines
- Dissociative drugs include PCP (Angel Dust) and Ketamine
Hallucinogens distort reality rather than causing true hallucinations (e.g. schizophrenia), which can be appealing or problematic depending on the user. While some are being studied for treating mental health conditions like depression, anxiety, and PTSD, they are often misused in unregulated settings and labeled as “gateway drugs.” Misuse can lead to side effects, which should be carefully considered.. Information about their side effects:
About Hallucinogenics
Short-Term Effects: Classic hallucinogens can cause users to see images, hear sounds, and feel sensations that seem real but do not exist. The effects generally begin within 20 to 90 minutes and can last as long as 12 hours in some cases (LSD) or as short as 15 minutes in others (synthetic DMT). Hallucinogen users refer to the experiences brought on by these drugs as “trips.” If the experience is unpleasant, users sometimes call it a “bad trip.”
Along with hallucinations, other short-term general effects include: increased heart rate, nausea, intensified feelings and sensory experiences (such as seeing brighter colors), changes in sense of time (for example, the feeling that time is passing by slowly)
Specific short-term effects of some hallucinogens include: increased blood pressure, breathing rate, or body temperature, loss of appetite, dry mouth, sleep problems, spiritual experiences, feelings of relaxation, uncoordinated movements, excessive sweating, panic, paranoia—extreme and unreasonable distrust of others, psychosis—disordered thinking detached from reality, bizarre behaviors
Long-Term Effects: Two long-term effects have been associated with the use of classic hallucinogens, although these effects are rare:
- Persistent Psychosis—a series of continuing mental problems, including visual disturbances, disorganized thinking, paranoia, mood changes
- Hallucinogen Persisting Perception Disorder (HPPD)—recurrences of certain drug experiences, such as hallucinations or other visual disturbances. These flashbacks often happen without warning and may occur within a few days or more than a year after drug use. These symptoms are sometimes mistaken for other disorders, such as stroke or a brain tumor.
Both conditions are seen more often in people who have a history of mental illness, but they can happen to anyone, even after using hallucinogens one time. For HPDD, some antidepressant and antipsychotic medications can be used to improve mood and treat psychosis. Behavioral therapies can be used to help people cope with fear or confusion associated with visual disturbances.
About Dissociative Drugs
Short-Term Effects: Dissociative drug effects can appear within a few minutes and can last several hours in some cases; some users report experiencing drug effects for days.
Effects depend on how much is used. In low and moderate doses, dissociative drugs can cause: numbness
disorientation and loss of coordination, hallucinations, increase in blood pressure, heart rate, and body temperature
In high doses, dissociative drugs can cause the following effects: memory loss, panic and anxiety
seizures, psychotic symptoms, amnesia, inability to move, mood swings, trouble breathing
Long-Term Effects of Dissociative Drugs: more research is needed on the long-term effects of dissociative drugs. Researchers do know repeated use of PCP can result in addiction. Other long-term effects may continue for a year or more after use stops, including speech problems, memory loss, weight loss, anxiety, depression, and suicidal thoughts
Medication Management for Hallucinogen Use
Mechanism and Effects:
- Hallucinogens primarily act on serotonin receptors and may affect additional systems when taken in large doses.
- They do not cause physical dependence or withdrawal but may lead to psychological dependence.
- Excessive use, such as with LSD, can result in emergency situations.
Acute Treatment:
- Environmental Management: Reduce sensory stimuli by placing the individual in a dark, quiet room.
- Medical Interventions:
- Focus on ABCs (Airway, Breathing, Circulation).
- Use benzodiazepines as the first line for agitation.
- Administer antipsychotics if needed, avoiding physical restraints, which can make a person MORE aggressive.
- Flashbacks: Provide verbal reassurance and emotional support.
Outpatient Management:
- Education: Discuss hallucinogen effects and risks, including potential contamination with dangerous substances like fentanyl.
- Behavioral Guidance: Address psychological dependence often linked to mood improvement attempts or depression.
- Treatment Reevaluation: Review and adjust medications or treatment plans, and rule out other substance use or alcohol issues.
Additional Major Risks:
- Ketamine/MDMA: High doses can cause rhabdomyolysis (rare).
- GHB: Can lead to vomiting, loss of consciousness, and seizures.
- Ketamine “K-hole”: Temporary perception of separation from the body.
- Flunitrazepam: Rarely used as a “date rape” drug, with risks similar to GHB.
- Psychological and physiological effects vary but are typically short-term.
Effective management emphasizes reducing harm, addressing psychological dependence, and educating patients about risks. Like most of our medications, hallucinogens come from plants and they may/may not be illegal. Some of these things can be bought online or hidden in the ingredients such as teas, incense, seeds, pills…etc Also, don’t forget some of these plants have cultural implications. Continue to express empathy and greatly educate. Common street names and origins:
- LSD (AKA: Acid, blotter, cubes, microdot, yellow sunshine, blue heaven, Cid): an odorless, colorless chemical that comes from ergot, a fungus that grows on grains.
- Mushrooms (Psilocybin) (AKA: Simple Simon, shrooms, silly putty, sherms, musk, boomers): psilocybin is the hallucinogenic chemical found in approximately 190 species of edible mushrooms.
- Mescaline (AKA: Cactus, cactus buttons, cactus joint, mesc, mescal, mese, mezc, moon, musk, topi): occurs naturally in certain types of cactus plants, including the peyote cactus.
