1. 1
Psychedelics
Neal Deot & Amir Hakimi

2. 2
Psychedelics
Psychedelic comes from the Greek words “psyche” (soul) and “delein” (to manifest) = soul-manifesting
Often compared to non-ordinary forms of consciousness: dreaming, religious ecstasy, near death experiences

3. Seems to date back thousands of years!!!3
Traditional Use
Traditional use in medicine/religion
Aztecs in Mexico – 1400's
Mentioned in the Rig Veda (Hindu Holy Book)
Seems to date back thousands of years!!!

4. Psychedelics Different types Examples: LSD, Shrooms, Molly, DMT, etc.
Act on Serotonin
Serotonin effects mood and hallucinations

5. Aka Shrooms, Mushies, Boomers
Magic Mushrooms
Aka Shrooms, Mushies, Boomers

6. Mushrooms Chemical psilocin cause hallucinations
Same founder as LSD (Albert Hoffman)
Most illegal class (Schedule 1)
Different part of mushroom = different feeling/effects

7. Pharmacokinetics Predominantly ingested
Fresh mushroom, dried, powdered, encapsulated
Slower onset compared to smoking, injecting
10-40 min onset
Longer lasting compared to smoking, injecting
Lasts 3-8 hours

8. Acute Effects Elevated senses (auditory, visual, emotions)
Hallucinations
Euphoria at lower doses
Anxiety at higher doses (bad trip)
Limited dopamine release

9. Mode of Action Same receptor as LSD
Causes Tolerance (need more to get high)
Increase serotonin release in synapse

10. Withdrawal Insignificant “comedown”
Hallucination Persisting Perception Disorder (HPPD)
Flashbacks

11. Treatment Acute (right away, for overdose) Chronic (long term)
Can’t undo “bad trip”
Wrong mushroom = DEATH!
Benzos (eg. Xanax) can remove some anxiety
Chronic (long term)
Considered not addictive
Low dopamine = low addictiveness

12. LSD
In the 1930's, when amphetamine's CNS stimulant properties and use as a respiratory stimulant were discovered, it was marketed as an inhaler for nasal congestion (Benzedrine)
Edeleanu called amphetamine “phenylisopropylamine”

13. Origins of LSD
1938: Lysergic Acid Diethylamide first found by Swiss chemist Albert Hofmann to help with breathing and circulation (analeptic)
Dr. Hofmann “accidentally” consumes LSD and experiences hallucinogenic effects
In the 1930's, when amphetamine's CNS stimulant properties and use as a respiratory stimulant were discovered, it was marketed as an inhaler for nasal congestion (Benzedrine)
Edeleanu called amphetamine “phenylisopropylamine”

14. Proposed Benefits Anxiety Depression Addiction
In the 1950s-60s, medical professionals recommended LSD as a treatment for:
Anxiety
Depression
Addiction

15. Statistics: Rise in Use...and Abuse
1960's: Street use of LSD reaches its peak
1967: Approximately 40% or more of students at Stanford University were using hallucinogenic drugs like LSD
1990's: Resurgence of LSD possibly due to emergence of rave/club culture

16. Famous LSD Users Ray Charles Dock Ellis Steve Jobs Eminem
“Made the blind man see”
Dock Ellis
70's no hitter against Padres
Steve Jobs
“Doing LSD was one of the most important things of my life”
Eminem
Created alias
“Slim Shady”

17. LSD Deaths
“Flew out the window thinking she could fly”

18. Oral Administration
Most common method of recreational use
Only need to take around 25 micrograms (around a few grains of salt)
Trip begins within 1 hour, peak at around halfway into trip, and can last up to 12 hours
Oral administration requires no preparation, making it the easiest option in many cases. It is common for users to modify extended release forms to receive the full dose at once by removing the beads from the capsule and crushing them to destroy the mechanism that causes the extended release
While oral administration is the safest method, it also produces a less intense (longer lasting) effect

19. How Does It Work? LSD looks like serotonin (5HT)
LSD binds to many serotonin receptors, causing hallucinations
Profound cross-tolerance with other hallucinogens (i.e shrooms, molly)

20. Mechanism
Serotonin!

21. LSD and You
Short term effects
Dilated pupils
Increased blood pressure
High body temperature
Dizziness
Tingling of hands/feet
Long term effects
Psychosis
Prolonged depression
Hallucinogenic Persisting Perception Disorder (HPPD)
Amphetamine stimulates the medullary respiratory centers, which increases the rate of respiration and produces deeper breaths
Amphetamines also bind to the NET which causes the increased vasoconstriction of blood vessels + hypertension, but binding to DAT = primary target

22. The “Trip” Differing perception of reality Colors look more vibrant
Spiritual ecstasy
Religious enlightenment
Objects become alive
Paranoia

23. Addictiveness/Dependence
Not considered an addictive substance
Very little risk of physical dependence, no documented evidence of physical withdrawal symptoms

24. Consequences of LSD Use
About 50% of patients admitted to hospitals for LSD toxicity had actually been given other dangerous substances (not pure LSD!)
Altered perception! Many users accidentally walk in front of cars, get into accidents while driving, or fall from windows/buildings

25. To which Drug Scheduling do you think LSD belongs?
Legality
To which Drug Scheduling do you think LSD belongs?

26. Legality
Does LSD have a high potential of abuse? In other words, is it addictive?

27. Does LSD have any current medical purposes?
Legality
Does LSD have a high potential of abuse? In other words, is it addictive? NO
Does LSD have any current medical purposes?

28. Does LSD have any current medical purposes?
Legality
Does LSD have a high potential of abuse? In other words, is it addictive? NO
Does LSD have any current medical purposes?
NO...not yet

29. Schedule 1: Legal Consequences
First offense simple possession of LSD: imprisonment for not more than one year or fine of $1,000 or both
First offense making/selling LSD (up to 10 grams): 5-40 years in jail and fine of up to $2 million
**LSD offenses number less than 2% of all DEA arrests

30. Treatments Benzodiazepines (Xanax) used to initially manage anxiety
Patient put in quiet, safe room with a low level of sensory stimulation (avoid a bad trip!)
Psychotherapy to discuss consequences/triggers of use