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Substance Use Disorders
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Hallucinogens principally alter sensory perceptions, mood, and thought patterns. On occasion neuropsychiatric symptoms may be unpleasant (i.e., “bad trip”) and rarely hallucinogen intoxication may lead to psychosis. Vital sign abnormalities are uncommon but may include increased blood pressure and heart rate. Most symptoms are mild and self-limited, but cases of hyperthermia and serotonin syndrome have been reported.
Missed Opportunities? Beneficial Uses of Illicit Drugs
Published in Ross Coomber, The Control of Drugs and Drug Users, 2020
Lester Grinspoon, James B. Bakalar
The most common adverse effect is a bad trip, or hallucinogen hallucinosis, which occasionally produces a true psychotic reaction. Another common effect is the flashback, a spontaneous transitory recapitulation of drug-induced experience in a drug-free state. Prolonged adverse reactions, which are considerably less common, include anxiety reactions, depressive reactions, and psychoses. They are most likely to occur in schizoid and prepsychotic personalities with barely stable egos who cannot cope with the mind alterations produced by the drug trip. There is a close resemblance between people hospitalized for LSD reactions and those hospitalized for psychoses unrelated to drugs (Strassman, 1984; Grinspoon & Bakalar, 1979). Like any probing psychotherapy, psychedelic drug therapy presents the danger that material will come up and cannot be accepted and integrated. Psychosis and even suicide have been reported in the course of psychedelic drug treatment. On the other hand, some people who have worked with psychedelic drugs consider them more likely to prevent suicide than to cause it, and most studies questioning psychiatrists about adverse reactions to psychedelic drugs in experimental or therapeutic research have revealed a low rate of serious complications (Clark et al., 1975; Cohen, 1960; Malleson, 1971).
Hallucinogens and Phencyclidine
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
Patterns of hallucinogen use tend to be sporadic and quite irregular, unlike most other abused drugs. These drugs are rapidly absorbed orally, and though there is a substantial first-pass effect, the rapid development of tolerance requires dose adjustment by chronic users to obtain the desired effect. These drugs are absorbed by nasal insufflation and faster but erratically by smoking. There is rapid development of tolerance and cross tolerance for other drugs of the group. There are several reasons that use is usually limited to fairly short periods of time. Only the chemically synthesized LSD and PCP are readily available in pure form; other agents are hard to come by and are irregular in potency. There is a limited margin of safety between a good trip and a bad trip with serious psychosis; few patients can continue use without experiencing bad trips. Tolerance is rapid in onset, requiring dose, adjustment to get a good trip. Nearly all users also abuse other substances both simultaneously and sequentially.
Investigational drugs for assisting psychotherapy for posttraumatic stress disorder (PTSD): emerging approaches and shifting paradigms in the era of psychedelic medicine
Published in Expert Opinion on Investigational Drugs, 2022
Lynnette A. Averill, Chadi G. Abdallah
gh we hold great excitement for these interventions, it must be noted that psychoplastogens and assisted therapies are not a panacea nor a golden bullet and not without limitations and challenges, just as is the case for every intervention in psychiatry and medicine more broadly. They will not work for everyone and are neither appropriate nor safe for everyone. There is no one-size-fits-all. Concerns about abuse potential have been expressed; however, neither research nor clinical anecdotes suggest this is a major concern. Further, generally when there are reports of an individual having a negative experience or a “bad trip,” these are in the context of individual use, without clear knowledge of drug purity or potency, no intention for the use, no support established to monitor for safety, aid with anxiety or distress, or to process the experience and often very ‘heavy’ content that comes out of these sessions, and so on. The potential here is not only to effectively reduce symptoms of PTSD, to not only save lives, but through safe administration of these psychedelic medicines, with appropriate medical/psychiatric clearance, appropriate dosing with clear knowledge of purity and potency of these drugs, trained mental health professionals to walk people through the experience and provide psychedelic-assisted therapy, we will not only be saving lives but helping people to build a foundation to create lives they truly want to live.
Motives for Recreational Cannabis Use among Mental Health Professionals
Published in Journal of Substance Use, 2021
All participants described risks related to cannabis use and six out of seven stated they had encouraged clients to reduce or stop using at some point. The impact of cannabis on mental health was discussed across all seven interviews, with emphasis on potential for development or exacerbation of psychosis, anxiety, social anxiety, depression, impulsivity, suicidal ideation, self-harm, and absent-mindedness. Cannabis intake could reportedly result in a “bad trip” or be used as a means to “avoid painful emotions.” Cannabis-impaired driving was a concern for six out of seven participants. Five discussed the potential for cannabis to negatively impact employment and/or academic functioning. Four indicated consumption could harm adolescent brain development and/or contribute to relational challenges, particularly between youth and parents. Three respondents discussed the “very real” risk for dependence. Concerns regarding cannabis and memory, motivation, stigma, dosing, and physical health problems were also noted.
Hallucinogen persisting perception disorder: A literature review and three case reports
Published in Journal of Addictive Diseases, 2018
Valentin Yurievich Skryabin, Maria Vinnikova, Anna Nenastieva, Vladislav Alekseyuk
Many patients suffering from HPPD experience a high level of anxiety, obsessive-compulsive disorder, hypochondria, and paranoia. Several studies have evaluated patients with psychotic disorders comorbid with HPPD.25,28,29 Cross-sectional studies compared patients with schizophrenia who had used LSD in the past and who had developed HPPD (49 patients) with patients suffering from schizophrenia who had no HPPD (57 patients). These studies did not reveal any statistically significant differences between two groups of patients in terms of demographics, age of psychotic disorder onset, age of substance use onset, and type of substance use. Patients with schizophrenia and HPPD reported negative experiences on LSD, the so-called “bad trip.” Also, 67% of these patients were able to differentiate between perceptual distortions and hallucinations, and 9 out of 12 patients were able to detect early signs of perceptual distortion (substance-induced signals, situational signals, and mental signals).