HALLUCINOGENS ADDICTION •Tryptamines – Psilocin in psilocybe mushrooms; Ayahuasca •Lysergic acid – LSD – synthesized from alkaloids of ergot fungus (discovered in 1930s by Albert Hofmann, at first used as a freely accessible drug. Tested in 1950-60s for military potential military use and consequently made illicit in 70s) •Phenylalkylamines – Mescaline in Peyote •All these are alkaloids found naturally in some plants •All are serotonin agonists although precise way of function is not completely understood data:image/jpeg;base64,/9j/4AAQSkZJRgABAQAAAQABAAD/2wCEAAkGBxITEhUTExMWFhUXGB4aGRcYFx0dIBoeHh0YGCAZ IB0aHyggGBomHRoeITEhJikrLi4uFx8zODMtNygtLisBCgoKDg0OGxAQGy0lHyY1LS0tLS0tLS0vLS0tLS0tLS0tLS0tLS0tLS0 tLS0tLy0tLS0tLS0tLS0tLS0tLS0tLf/AABEIAMkA+wMBIgACEQEDEQH/xAAbAAADAQEBAQEAAAAAAAAAAAAEBQYDAgEHAP/EAE UQAAIBAgQEAwYEAwYEBAcAAAECEQMhAAQSMQVBUWEicYEGEzKRobFCwdHwUnLhIzM0grLxFBVicyRDktIWNURTorPC/8QAGQEAA wEBAQAAAAAAAAAAAAAAAQIDAAQF/8QAJBEAAgICAgICAgMAAAAAAAAAAAECEQMhEjEiQRNRBHEygaH/2gAMAwEAAhEDEQA/AM6l SXkH4Lnv2xJ/8qzArroQBSzXLAAA3vJxQZtYkBoHlM4Fz+ZBEKfOTiMpN3RXXsfcNoKlMA7g35iefnjt6gQsZHKPL/fEvwnMVWQ +FyVMTpN+/fA2d4k4YBgRNoIwOTWqIy7GHGeKC8WGCPZHJVQrVdBGo21Wt94wRwngKgB6t3NwNwv6nDLMZp6Rh9uot8xyxSK9sU 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fever •Psychological •All psychedelic drug changes perception and cognition •Massively context and expectancy dependent effects. Right mental set and environmental setting is absolutely crucial – have positive and supportive background (trip sitters) and have a positive mood •Merges consciousness and subconsciousness – hidden and suppressed hopes, fears, moods,… are magnified • effects •Positive effects •mental and physical stimulation, mood lift •sensory enhancement (taste, smell, visuals, etc), closed- and open-eye visuals, including trails, colour shifts, brightening, etc., feelings of flying •Profound life-changing spiritual experiences or personal revelations •therapeutic psychological reflection – can help even to treat addictions •feeling of oceanic connectedness to the universe; blurring of boundaries between self and other •Negative •anxiety, paranoia, fear, and panic – most hallucinogens can produce schizophrenia like states of mind •dissolved sense of self •delusions, delusional thinking, unwanted or unexpected life-changing spiritual experiences or personal revelations •insomnia •unwanted and overwhelming feelings •Flashbacks • • • addiction •No addiction as hallucinogens do not have any effect on dopamine levels in reward circuits (except for MDMA, cannabis, ketamine) •No physical dependency •No withdrawal symptoms •But hallucinogens users are often multi-drug users and thus are sometimes addicted to other drugs •No deaths report because of overdose •Overdose may happened and had destructive effect on psyche – hallucination flashbacks returning the whole life •No physiological or psychological addiction and dependency •Short-term tolerance – e.g. three LSD papers taken within a week have no effect • • • Risk factors •Hallucinogens are rarely drug of the first choice •Average age of the fist intake is higher (above 20) – except for MDMA that is about 16. •Data about problems associated with taking hallucinogens are often data on MDMA only - typically problems resulting from substance impurities, combination with other substances (alcohol), dehydration •High association with personality disorders – antisocial, paranoid, histrionic, schizoid (in this order) and potential link with psychosis •Link with suicidality, common accidents while on trip •Because of the polydrug use, it is hard to attribute the negative effect to specifically to hallucinogens •Since the prevalence of use is very low, hallucinogens are often listed together with „hard“ illicit drugs which spreads unnecessary bad reputation • •Positive use of these substances are promising for use in therapy – PSD, depression, addictions Illicit drugs with hallucination properties •Cannabis •MDMA •Dissociative anaesthetics - ketamine • data:image/jpeg;base64,/9j/4AAQSkZJRgABAQAAAQABAAD/2wCEAAkGBxISDw8QEBAREhIQEA8QDxAQFRAQEBUWFRUWFxUV FRUYHSggGBolHRUVITEhJSktLi4uFx8zODMtNygtLysBCgoKDg0OGhAQFy4dHR0tLS0tKy0rLS0tKy0tKy0tLSstKy0rLS0rKys tLS0tKy0tKysrLS0rLS0tKy0tKy03Lf/AABEIAKgBLAMBIgACEQEDEQH/xAAcAAACAgMBAQAAAAAAAAAAAAAAAQIFAwQGBwj/xA 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Sometimes used as unofficial antidepressant and anti-asthma. As a drug used since 80s. •Used as a pill, liquid, powder, solution in injections •Effects are very similar to other hallucinogens •Extra psychological effect – tantra-like sexual feeling; passivity; lethargy •Extra physiological effect – relaxes muscles (especially of rectum) Addiction and risks •Ketamine can be addictive – confirmed also from animal studies •Overdose has been reported (ketamine does not have know overdose reversal agent) •Withdrawal symptoms include anxiety attacks, palpitations, shaking •Most risk comes from the setting – danger of accidents, injuries •Spreading of transmitted diseases •Risk of rape and use in sexual slavery •Ketamine is usually found at the same places as MDMA •