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
This is a quirky situation. “hallucinogens” don’t technically cause hallucinations but they can cause a distortion of reality, which a person may or may not like. So although hallucinogens can cause problems, some of these substances are currently being studied and used to treat depression, anxiety, and PTSD. However, hallucinogens are frequently misused and unregulated, especially in social scenes, hence they’re also considered “gateway drugs”. Here’s some information about the side effects:
About Hallucinogenic Drugs
Short-Term: 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
It’s believed that hallucinogens act on the serotonin receptors (i.e. positive schizophrenia symptoms) but of course, when the patient took a handful of pills, it can act on additional systems. Hallucinogens do not cause physical dependence or withdrawals, but there is a psychological dependence. And too much of a good thing like LSD can whisk a person to the ER.
Acute Treatment: try to place the person in a dark quiet room (decrease the stimuli). ABCs and benzodiazepines are first-line for agitation. Use antipsychotics as needed and avoid restraints. With “flashbacks” talk down via verbal reassurance and offer emotional support.
Outpatient: I have patients that would try to microdose shrooms i.e. but thankfully most people don’t use party drugs for a long time and hallucinogens are very short-acting. I generally try to educate about the effects and major risks. Warn how anything off the street can be laced with Fentanyl or something dangerous. The psychological dependence is usually a result of the patient trying to improve the mood or depressive symptoms, so reevaluate the medications or treatment plan and r/o other issues like substance abuse, ETOH, etc..
Major Risks: Ketamine and MDMA at high doses can induce rhabdomyolysis but is rare, GHG (date r@pe/rx) at high doses can cause vomiting, LOC, and SZ, Ketamine causes a perception of separation (K-hole) but the effects don’t last as long as PCP. Flunitrazepam is also used as a date r@pe/rx but is rare. The major short and long-term effects are listed above.
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.
- 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.
