The psychedelics are capable of producing a wide range of subjective and objective effects. However, there is apparently no reaction that is distinctive for a particular drug. Subjects are unable to distinguish among LSD, mescaline, and psilocybin when they have no prior knowledge of the identity of the drug ingested.
These drugs induce a physiological response that is consistent with the type of effect expected of a central-nervous-system stimulant. Usually there is elevation of the systolic blood pressure, dilatation of the pupils, some facilitation of the spinal reflexes, and excitation of the sympathetic nervous system and the brain.
There is considerable difference in the potency of these drugs. A grown man requires about 500 milligrams of mescaline or 20 milligrams of psilocybin or only 0.1 milligram of LSD for full clinical effects when the substances are ingested orally. The active principle in the seeds of the morning glory is about one-tenth as potent as LSD.
There are also differences in the time of onset and the duration of effects. Psilocybin acts within 20 to 30 minutes, and the effects last about five to six hours. LSD acts within 30 to 60 minutes, and the effects usually last eight to 10 hours, although occasionally some effects persist for several days. Mescaline requires two to three hours for onset, but the effects last more than 12 hours.
All psychedelics presumably are lethal if taken in quantities large enough, but the effective dose is so low compared with the lethal dose that death has not been a factor in experimental studies. Physiological tolerance for these drugs develops quite rapidly—fastest for LSD, somewhat more slowly and less completely for psilocybin and mescaline.
The effects for a particular dose level of LSD are lost within three days of repeated administration, but the original sensitivity is quickly regained if several days are allowed to intervene. Cross-tolerance has been demonstrated for LSD, mescaline, psilocybin, and certain of the lysergic acid derivatives. Tolerance to one of the drugs reduces the effectiveness of an equivalent dose of a second drug, thus suggesting a common mode of action for the group.
Most persons regard the experience with one of these drugs as totally removed from anything ever encountered in normal everyday life. The subjective effects vary greatly among individuals and, for a particular person, even from one drug session to the next.
The variations seem to reflect such factors as the mood and personality of the subject, the setting in which the drug is administered, the user’s expectation of a certain kind of experience, the meaning for the individual of the act of taking the drug, and the user’s interpretation of the motives of the person administering the drug. Nevertheless, certain invariant reactions experienced by hallucinogen users stand out.
The one most easily described by users is the effect of being “flooded” with visual experience, as much when the eyes are closed as when they are open. Light is greatly intensified; colours are vivid and seem to glow; images are numerous and persistent, yielding a wide range of illusions and hallucinations; details are sharp; perception of space is enhanced; and music may evoke visual impressions, or light may give the impression of sounds.
A second important aspect, which people have more difficulty describing, involves a change in the feelings and the awareness of the self. The sense of personal identity is altered. There may be a fusion of subject and object; legs may seem to shrink or become extended, and the body to float; space may become boundless and the passage of time very slow; and the person may feel completely empty inside or may believe that he is the universe.
This type of reaction has been called depersonalization, detachment, or dissociation. Increased suspiciousness of the intentions and motives of others may also become a factor. At times the mood shifts. Descriptions of rapture, ecstasy, and an enhanced sense of beauty are readily elicited; but there can also be a “hellish” terror, gloom, and the feeling of complete isolation. For some people the experience is so disturbing that psychiatric hospitalization is required.
Studies of performance on standardized tests show some reduction in reasoning and memory, but the motivation of the subject probably accounts for much of the performance decrement, since many people are uncooperative in this type of structured setting while under the influence of a drug.
Interest in these drugs was routinely scientific for the first few years following the discovery of LSD, but in the 1950s some professional groups began to explore the use of the psychedelics as adjuncts to psychotherapy and also for certain purposes of creativity. It was at this juncture, when the drugs were employed to “change” people, that they became a centre of controversy. LSD is not an approved drug in most countries; consequently, its therapeutic applications can only be regarded as experimental.
In the 1960s LSD was proposed as an aid in the treatment of neurosis with special interest in cases recalcitrant to the more conventional psychotherapeutic procedures. LSD was being given serious trial in the treatment of alcoholism, particularly in Canada, where experimentation was not heavily restricted. LSD has been employed to reduce the suffering of terminally ill cancer patients. The drug was also under study as an adjunct in the treatment of narcotic addiction, of autistic children, and of the so-called psychopathic personality, and the use of various hallucinogens was advocated in the experimental study of abnormal behaviour because of the degree of control that they offer.
LSD can be dangerous when used improperly. Swings of mood, time and space distortion, “hallucinations,” and impulsive behavior are complications especially hazardous to an individual who is alone. Driving while under the influence of one of these drugs is particularly dangerous. Acts of aggression are rare but do occur. The recorded suicide rate was not high in the various investigational (legal use) groups, but the rate of serious untoward psychological effects requiring psychiatric attention climbed steadily.
These drugs do induce psychotic reactions that may last several months or longer. Negative reactions, sometimes called bad trips, are most apt to occur in unstable persons or in other persons taking very large amounts of a drug or taking it under strange conditions or in unfamiliar settings. So far as is known, these drugs are nontoxic, and there are no permanent physical effects associated with their use.
There is no physical dependence or withdrawal symptom associated with long-term use, but certain individuals may become psychologically dependent on the drug, become deeply preoccupied with its use, and radically change their lifestyle with continued use.
Prior to the mid-1960s, LSD-type drugs were taken by several different types of persons including many who were respected, successful, and well-established socially. Intellectuals, educators, medical and mental health professionals, volunteer research subjects, psychiatric patients, theological students, and participants in special drug-centre communities were some of the first users of these hallucinogenic substances. Beginning in 1966, experimentation in most countries was severely restricted, and subsequent use was almost entirely of a black market type.
LSD use has declined substantially, since the drug was replaced largely by cannabis and the amphetamines. Most users tend to be of the middle class—either college-educated young persons or people who have drifted to the fringe of society. Drug initiation is typically by way of a personal friend or acquaintance. Employers or teachers also have a powerful influence over subordinates and students in terms of drug acceptance.
The user of LSD seems often to have an almost fanatic need to proselytize others to drug use. Those who have taken a hallucinogenic substance generally have had experience with other drugs prior to the LSD experience, and there is also a tendency on the part of those who take these drugs to repeat the drug experience and to experiment with other drugs.
The special language, method of proselytizing, and psychological dependence surrounding the use of psychedelics bear striking resemblance to the context of narcotics addiction. The chronic LSD user tends to be introverted and passive. Motives for LSD use are many: psychological insight; expansion of consciousness; the desire to become more loving, more creative, open, religious; a desire for new experience, profound personality change, and simple “kicks.”
Barbiturates, stimulants, and tranquilizers
There are many sanctioned uses for drugs that exert an effect on the central nervous system. Consequently, there are several classes of nonnarcotic drugs that have come into extensive use as sleeping aids, sedatives, hypnotics, energizers, mood elevators, stimulants, and tranquilizers.
Sedatives and hypnotics differ from general anesthetics only in degree. All are capable of producing central-nervous-system depression, loss of consciousness, and death.
The barbiturates, bromides, chloral hydrate, and paraldehyde are well-known drugs—with the barbiturates being of greatest interest because of the increasing number of middle- and upper-class individuals who have come to rely on them for immediate relaxation, mild euphoria, and an improved sense of well-being. But alcohol has been and continues to be the drug of choice for these same effects.
Of the drugs that excite the nervous system, nicotine, caffeine, the amphetamines, and the potentially addicting cocaine are well known. The use of stimulants to facilitate attention, sustain wakefulness, and mask fatigue has made the amphetamines an increasingly popular drug for students and those who engage in mental work.
Originally the drug of truck drivers, amphetamine is now a common cause of arrest among teenagers and young adults who commit drug offenses. Cocaine has always been a potentially dangerous drug, and it has become especially popular among the middle and upper classes. Stimulants do not create energy, and the energy mobilized by these drugs is eventually depleted with serious consequences.
The tranquilizers are a heterogeneous group, as are the behaviours that they are employed to alter. In general, tranquilizing drugs reduce hyperactivity, agitation, and anxiety, which tend to cause a loss of behavioral control. Tranquilizing drugs do not characteristically produce general anesthesia, no matter what the dose; this attribute tends to distinguish tranquilizing drugs from the barbiturates.
All the barbiturates, stimulants, and tranquilizers are widely prescribed by physicians, and all these drugs are available through nonmedical (illegal) sources. Most of these drugs are classified as “habit-forming.” The minor tranquilizers are commonly associated with habituation and may induce physical dependence and severe withdrawal symptoms.
The amphetamines and cocaine intoxicate at high dosages, and both are capable of inducing serious toxic and psychotic reactions under heavy use. The barbiturates are the leading cause of death by suicide. They are judged to be a danger to health by both the World Health Organization Expert Committee and the United Nations Commission on Narcotic Drugs, which have recommended strict control on their production, distribution, and use.
The nonnarcotic drugs in widespread use among middle- and upper-class citizenry manifest considerable untoward consequences for the individual and for society when abused—thus placing their problem in a different perspective than that normally associated with the opiates, LSD, and marijuana.