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Hallucinogens: dependence, symptoms and treatment
Last reviewed: 18.10.2021
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Hallucinogens can cause intoxication with impaired perception and distortion of judgments. Chronic use is increasingly aggravating mental disorders and can lead to the development of depression, anxiety or psychosis.
The hallucinogens include diethylamidersergic acid (LSD), psilocybin and mescaline. Some other drugs, including marijuana, also have hallucinogenic properties. The term "hallucinogens" persists, even if the use of these drugs can not cause hallucinations. Alternative names, such as psychedelics or psychotomimetics, are less suitable for use.
Symptoms of dependence on hallucinogens
Acute use. Hallucinogens cause intoxication in the form of CNS excitation and central vegetative hyperactivity, manifested by changes in perception and mood (usually euphoric, sometimes depressive). True hallucinations are rare.
The reaction to hallucinogens depends on a number of factors, including the expectations of the person who uses, his ability to cope with distortions of perception and surroundings. Unpleasant reactions (anxiety attacks, severe fright, panic state) on LSD are rare. More often these reactions quickly subsided with appropriate treatment in a safe environment. However, in some people (especially after using LSD), violations persist, and patients may be in a state of persistent psychosis. The question remains whether the use of these drugs triggers the development of psychosis with a previously available psychotic potential in the patient or may cause psychosis in previously stable patients.
Chronic use. The main signs of chronic use are psychological effects and violation of judgments, which can lead to dangerous decisions and accidents. A high degree of tolerance to LSD develops and disappears quickly. If the patient has a tolerance to one of these drugs, then there is a cross tolerance to others. Mental dependence varies greatly, but is usually not intensive; There is no evidence of physical dependence when drugs suddenly stop.
Some people, especially those who use hallucinogens for a long time (especially LSD), experience a distinct effect of the drug even after a long period after stopping its use. Such episodes ("flashbacks" - flashbacks) often consist of visual illusions, but can include distortions of any other sensations (including the image of one's own body, the perception of time and space) and hallucinations. Flashbacks can be triggered by the use of marijuana, alcohol or barbiturates, stress or fatigue, or arise for no apparent reason. The mechanisms of "back flashes" are not established. They tend to pass for 6-12 months.
Treatment of dependence on hallucinogens
Acute use. Usually there is enough conviction that bizarre thoughts, visions and sounds are associated with the use of the drug, and not with a nervous breakdown. Phenothiazine antipsychotics should be used with extreme caution because of the risk of hypotension. An anxiolytics, such as chlordia-zepoxide and diazepam, can help in the reduction of anxiety.
Chronic use. Cancellation usually happens easily; some patients may need psychiatric treatment of co-occurring problems. Effective relationships with the doctor are helpful, with the maintenance of frequent contacts.
Persistent psychotic conditions or other mental disorders require appropriate psychiatric care. Transient or not strongly disturbing patient flashbacks do not require special treatment. However, flashbacks associated with anxiety and depression may require treatment similar to acute side effects.
Ketamine
Ketamine (also called "K" or special K) can cause intoxication, sometimes with confusion or catatonic condition. Overdose can cause collapse.
Ketamine is an anesthetic. When used illegally, it is usually inhaled.
Euphoria with dizziness occurs at low doses, then often attacks of anxiety and emotional lability. Higher doses cause states of detachment (dissociation); if the doses are high, dissociation can become serious (known as a "K-hole") with ataxia, dysarthria, muscle hypertension, myoclonic jerking. The cardiovascular system is usually not damaged. At very high doses, coma and severe hypertension can be observed; There are usually no deaths. Acute effects usually fade after 30 minutes.
The patient should be in a calm environment and carefully observed. There is usually no need for further treatment.