April 12 Hallucinogens

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April 12 - Hallucinogens
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I. Psychedelics and Hallucinogens A.
Definitions Psychedelic effects alterations in
the perception of real objects, in cognition, or
in mood alongside an otherwise clear
sensorium Hallucinations perception of things
that are not really there B. 4 Classes of
Psychedelic Drugs Serotonergic hallucinogens
LSD, DMT, psilocybin Catecholaminergic (NE or DA,
also SE) drugs mescaline DOM
MDA Glutamatergic anesthetics PCP
Ketamine Anticholinergic drugs atropine and
scopolamine in BellaDonna, Datura Mandrake
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II. Serotonergic Hallucinogens A. members LSD
lysergic acid diethylamide DMT dimethyl
tryptamine Bufotenine 5-hydroxy dimethyl
tryptamine Psilocybin 4-phosphoryl dimethyl
tryptamine Psilocin 4-hydroxy dimethyl
tryptamine Morning Glory Seeds - lysergic acid
amide Hawaiian Baby Woodrose lysergic acid
amide Yage (ya-hay) Ayahuasca mixture of
plants from Amazon rain forest, containing
harmine harmaline, and DMT
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• B. Pharmacodynamic Actions
• Multiple actions at serotonergic receptors
  produce effects on mood pleasure anxiety
  thermoregulation perception.
• Agonist at 5HT2A receptors throughout cortex,
  especially visual cortex and other sensory
  cortex also limbic areas
• Actions in the Rostral pathway for Serotonin (one
  particular path among 5)- rostral Raphe neurons
  to sensory cortex
• LSD has higher affinity for 5HT2A receptors than
  do other serotonergic hallucinogens and affinity
  correlates with activity
• Directly and indirectly activates norepinephrine
  sympathetic effects

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• C. LSD
• 1. Source and uses
• ergot alkaloid derived from a poisonous fungus
  that grows on rye, other grains, and wild grasses
• moldy grain
• accidental poisonings dubbed ergotism
• St. Anthonys Fire monks cared for the
  afflicted
• Ergot can be used to induce labor use in 1500s
  for this, but also causes uncontrolled muscle
  contractions
• Today, Methergine, a drug used after childbirth
  to increase muscle tone of the uterus, stop
  bleeding, stabilize blood flow

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• C. LSD
• 2. History
• Albert Hoffman, chemist at Sandoz got exposed in
  1943
• The world was if newly created. All my senses
  vibrated in a condition of highest sensitivity,
  which persisted for the entire day
• users vividly recall their experiences
• 1950s formal studies of LSD effects as model
  psychosis
• Army and CIA tried using it as an aid to
  interrogation, but too unpredictable
• 1960 Timothy Leary, Clinical psychologist and
  lecturer at Harvard first touted praises of
  mushrooms then LSD

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• C. LSD
• 2. History
• 1960 Timothy Leary, Clinical psychologist and
  lecturer at Harvard first touted praises of
  mushrooms then LSD
• Leary fired in 1963 (more related to mushroom
  advocacy) due to media personality as psychedelic
  drug advocate
• 1964 66 LSD made a misdemeanor
• peak use 1967-68 Summer of Love
  Haight-Ashbury, San Francisco
• 1968 sale became a felony

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• 1. Source and uses
• 2. History
• 3. Recreational use
• taken orally in 20-80 microgram doses very
  potent
• (vs 100-200 microgram doses of 60s-70s)
• tablets gelatin cubes impregnated paper
• effects begin 30-90 min later and last 5-12
  hours
• unpredictable, variable, and phase-based effects
• not addictive no craving-based drug-seeking
• some tolerance though leads to increasing doses
  when taken more frequently than once/week(may
  require gt 300 mcg to get effects)
• 1997 use , 13.6 of high school seniors

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1. Source and uses 2. History 3. Recreational
use 4. Dose and Time-related LSD effects 25
micrograms mild euphoria mild
stimulation altered time perception rise in
heart rate and blood pressure increased body
temperature some sweating uterine and
visceral sensations At this dose, more like a
stimulant than a psychedelic.
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50-200 micrograms prior plus illusions and
hallucinations Phase 1 first 1-3 hours In 20
min-1 hour - altered sensation, perception, and
mood abnormal color perception space and
time distortions visual illusions glowing
objects, auras around objects, visual
trails, vibration synesthesia hear colors
see sounds as lights and forms 1-3 hours
hallucinations begin like a movie or slide
show pulsating moving forms with lots of
color geometric illusions and hallucinations -
lattice patterns honeycomb patterns
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50-200 micrograms above plus illusions and
hallucinations Phase 1 first 1-3 hours Phase 2
- rapid images 10/second emotional component
opening up emotionally may become a
part of hallucinated scenes and actions may
feel meaningful spiritual transcendant may be
terrifying loss of control, panic,
depersonalization boundary between reality and
unreality is unclear out-of-body
experiences may occur Phase 3 6-12 hours
variable length period of reflection and
insight
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50-200 micrograms above plus illusions and
hallucinations Phase 3 6-12 hours variable
length period of reflection and insight 4
categories of LSD experience based on
retrospective interpretations 1. Sensory
distortions allowed a new understanding of basic
experience freshening of experience 2.
Recollective/analytical experiences allowed new
self-understanding new perception of ones own
personaility 3. Symbolic images led to new
interpretations of experience in line with
mythical or ancient connections 4. Experiences
caused a renewed sense of unity with god,
spiritual self, or universe
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• 4. Side effects and safety
• very safe physically (Therapeutic Index of
  300-600) death would result from respiratory
  arrest
• worst effects are not medical, but psychological
  from bad trip
• bad trip panic and paranoid reactions
• steps of talk-down therapy
• create atmosphere of acceptance, trust,
  confidence
• get user into a quiet, non-threatening
  environment
• reassure them that it is a bad trip, they are
  safe, will be okay
• help them relax talk in a calm voice no quick
  movements
• discuss peaceful, non-threatening subjects
  avoid any that worsen anxiety

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• 5. Chronic effects
• psychotic reactions mimic SZ-like paranoia
• flashbacks illusions/hallucinations that occur
  weeks years after use
• persistent hallucinogen perceptual disorder
  alteration in perception whereby vision is
  affected light trails, afterimages, humming
  noise, discoloration of visual field (purple
  haze)
• unexplained origin

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• D. Psilocybin mushrooms
• 75 different species of mushrooms from genera
  Psilocybe, Panaeolus, and Conocybe
• grow wild in North, Central, South America
  Mexico
• cultural/religious use to get in contact with
  spirit world, have visions, treat illness, solve
  problems
• in Pacific NW, USA, 15 species
• active ingredients are psilocybin and psilocin
  (structure similar to LSD)
• not as potent as LSD
• 10-60 mg dose has 5-6 hours of psychedelic
  effects
• individual mushrooms vary in potency one may be
  as strong as 10 others combined
• usually eaten or made into tea may be smoked
  for shorter duration of effects
• street supplies may be regular mushrooms with
  LSD on them

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• D. Psilocybin mushrooms
• Effects
• physical effects are similar to LSD -rise in
  heart rate and blood pressure increased body
  temperature some sweating
• may be initial nausea
• lots of visceral sensations
• altered sensory perception
• less likely to experience panic or dissociation
  than is the case for LSD
• flashbacks and prolonged psychotic reactions are
  also more rare than for LSD

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• History
• religious ceremonial use in many cultures
• In US, Timothy Leary (Boston) was major advocate
  and researcher
• The Good Friday Experiment Leary gave
  psilocybin mushrooms to 10 theology students at a
  Good Friday service 9 reported an intense
  religious experience.
• Concord Prison Experiment Leary investigated
  use in psychotherapy (1961-1963) gave mushrooms
  to 32 prisoners in context of group
  psychotherapy. Leary argued for its merits and
  that it reduced the number of these prisoners
  that returned to crime/prison upon release.
• 1998 followup published when Leary got
  fired, etc, prisoners did not get follow-up
  support as promised. Recidivism not reduced.

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• E. DMT dimethyltryptamine
• can be plant-derived or synthetic
• in South American ritual usage, bark of plant is
  dried, then powdered, the smoked.
• purchased as crystals/powder known as The
  Substance Dimitri, DMT
• commonly smoked, but can be snorted or injected
• when smoked, effects begin immediately, last 20
  min, then disappear over a 1 hour period
  (Businessmans Special)

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II. Serotonergic Hallucinogens A. members LSD
lysergic acid diethylamide DMT dimethyl
tryptamine Bufotenine 5-hydroxy dimethyl
tryptamine Psilocybin 4-phosphoryl dimethyl
tryptamine Psilocin 4-hydroxy dimethyl
tryptamine Morning Glory Seeds - lysergic acid
amide Hawaiian Baby Woodrose lysergic acid
amide Yage (ya-hay) Ayahuasca mixture of
plants from Amazon rain forest, containing
harmine harmaline, and DMT
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• III. Catecholaminergic Hallucinogens
• Members
• Mescaline 3,4,5-trimethoxy-phenethylamine
• DOM 2,5-dimethoxy-4-methylamphetamine
• MDA 3,4 methylenedioxyamphetamine
• MDMA methylenedioxy-n-methylamphetamine
• B. Mescaline
• Naturally derived from the peyote cactus
• Also sold in synthetic form

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• III. Catecholaminergic Hallucinogens
• B. Mescaline
• Structurally resembles norepinephrine, however
  psychedelic effects result from 5HT2A affinity
• Naturally derived from the peyote cactus
• Also sold in synthetic form
• From natural, button is cut from cactus and dried
  into a hard disk eat this
• Sacramental use in Native American Church of
  North America

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• IV. Glutamatergic Anesthetics Dissociative
  Anesthetics
• General
• Members are Ketamine and Phencyclidine
• Ketamine Special K Super-K Ketalar
  (prescription)
• Phencyclidine PCP angel dust ozone rocket
  fuel
• PCP is a prescription drug as veterinary
  anesthetic not allowed for humans.
• Sold as powder or tablets snorted, smoked, or
  eaten
• 4 of high school users report having tried it
• Most dont like it some do (enjoy emotional
  blunting)
• Act differently from the hallucinogens previously
  discussed no direct effects on NE or SE and may
  be addictive
• Act by blocking NMDA receptors for Glutamate
  prevent Ca influx following GLU binding, so no
  response to GLU

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• IV. Glutamatergic Anesthetics Dissociative
  Anesthetics
• General
• Acute Effects
• Euphoria and Mind-Body Dissociation
• Drunken stupor intoxicant sedative
• Disinhibition
• Numbed sensation -gt Analgesia
• Still and staring -gt catatonic and unable to
  speak -gt coma
• Mental confusion -gt Psychosis
• Amnesia for event
• Exagerrated, distorted, possibly violent
  reactions to stimuli
• High dose - Respiratory depression, increased
  blood pressure, seizures possible death. More
  typically death by suicide or injury.

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Dose difference between effects versus toxic
reaction is narrow. Effects at 10-15 mg may be
somewhat desirable like drunkenness for some
but toxic for others confusion, agitation,
paranoia Effects at 20 mg toxic for all
catatonic, coma, seizures, respiratory
depression, cardiac instability Low dose effects
last 1-2 hours High dose bad effects may last 48
hours Gets stored in fat flashbacks possible
due to actual recirculation of drug
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• IV. Glutamatergic Anesthetics Dissociative
  Anesthetics
• General
• Acute Effects
• Chronic effects
• Memory loss
• Cognitive effects
• Effects on speech
• Mood disorders
• Psychosis