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Lysergic acid diethylamide, also known as LSD, or “acid,” is considered the best-known and most researched psychedelic or hallucinogenic drug. [footnoteRef:1] It is made from a lysergic acid compound found in ergot, a fungus that grows on grains. [1: Passie,Torsten , John H. Halpern, Dirk O.Stichtenoth, Hinderk M. Emrich, and Annelie Hintzen. 'The Pharmacology of Lysergic Acid Diethylamide: A Review.' CNS Neuroscience & Therapeutics 14, no. 4 (2008): 295-314. doi:10.1111/j.1755-5949.2008.00059.x.]
Today’s recreational users of LSD often include people in their late teens and early twenties, who are involved in the psychedelic music scene. In the 1990’s, LSD was among the ranks of “club drugs” that, along with MDMA and ketamine, were found at dance clubs and large underground parties known as raves.[footnoteRef:2] [2: National Drug Intelligence Center. (April 2001). Information Bulletin: Raves]
In 2014, 0.3% of the 16,875 adolescent respondents (12 to 17year-olds) in the US were considered to be current users of LSD, 0.3% of the 11,643 young adult respondents (18 to 25), and 0.1% of 33,750 adult respondents aged 26 or older.[footnoteRef:3]
In 1938, Albert Hofmann, a Swiss chemist working at Sandoz Laboratories, discovered LSD. He later became the first person to experience the drug’s psychoactive effects „after he accidentally ingested a small amount in 1943. The effects Hofmann reported included, “restlessness, dizziness, a dreamlike state and an extremely stimulated imagination.” [footnoteRef:4] [3: Krebs, Teri S., and Pål-Ørjan Johansen. 'Over 30 Million Psychedelic Users in the United States.' F1000Research, 2013. doi:10.12688/f1000research.2-98.v1.] [4: Hofmann, Albert. LSD -- My Problem Child. New York: McGraw-Hill, 1980]
In the 1950s, intellectuals, such as Aldous Huxley experimented with the drug for its alleged ability to induce a state of “cosmic consciousness.”[footnoteRef:5]
A lot of experiments with LSD led to a better understanding of how LSD affected consciousness by interacting with the brain’s serotonin neurotransmitter system. Nowadays, LSD is in Schedule I of the Controlled Substances Act of 1970[footnoteRef:6], the most heavily criminalized category for drugs. Schedule I drugs are considered to have a “high potential for abuse” and no currently accepted medical use – though when it comes to LSD there is significant evidence to the contrary on both counts. [5: Centre for Addiction and Mental Health https://www.camh.ca/-/media/files/guides-and-publications/dyk-lsd.pdf] [6: Controlled Substances Act https://legcounsel.house.gov/Comps/91-513.pdf]
LSD produces distortions of visual perceptions, that some people find awesome and fascinating but for another ones its effects can be frightening and terrifying. This is the drug, which is effective in extremely small doses, is a direct agonist for postsynaptic 5-HT2A receptors in the forebrain.[footnoteRef:7] [7: Neil R. Carlson; “Physiology of Behavior”’; 11th edition; pp. 120; 625]
LSD is a highly potent synthetic hallucinogen. The hallucinogens are a chemically diverse class, but are characterized by their ability to produce distortions in sensations, and to markedly alter mood and thought processes. The hallucinations are most often visual, but can affect any of the senses, as well as the individual’s perception of time, the world, and the self.[footnoteRef:8]
Pure LSD is a white, crystalline powder that dissolves in water. It is odorless and has a slightly bitter taste. An effective dose of the pure drug is too small to see (20 to 80 micrograms). [8: World health organization Geneva. Neuroscience of psychoactive substance use and dependence. 2004. https://www.who.int/substance_abuse/publications/en/Neuroscience.pdf]
LSD is usually packaged in squares of LSD-soaked paper (“blotters”), miniature powder pellets (“microdots”) or gelatin chips (“window pane”). Blotters are sometimes printed with illustrations of cartoon characters. Users usually chew or swallow them, allowing the drug to be absorbed through the gastrointestinal tract. It also is inhaled or injected.
LSD has a high affinity for a range of different neurotransmitter receptors, but its characteristic psychological effects are thought to be mediated by serotonin 2A receptor (5-HT2AR) agonism. A neurophysiological research with LSD is limited to electroencephalography (EEG) studies in the 1950s and 1960s. These reported reductions in oscillatory power, predominantly in the lower-frequency bands and an increase in the frequency of alpha rhythms.[footnoteRef:9] LSD structurally resembles serotonin, which is an inhibitory neurotransmitter. Serotonin does not directly stimulate the brain but is essential for regulating mood and balancing excessive excitatory neurotransmitter firing in the brain. Serotonin has been found to be connected to many different types of behaviors in humans, including appetitive, emotional, motor, cognitive and autonomic behavior. It is involved in the control of perceptual, and regulatory systems, such as mood, hunger, body temperature, sexual behavior, and muscle control. LSD’s impact on serotonin also affects an area of the brain that detects external stimuli from all over the body, making it more responsive to input from the environment.[footnoteRef:10] [9: Neural correlates of the LSD experience revealed by multimodal neuroimaging. 2016 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855588/] [10: Carson-Dewitt, R., MD (editor). (2001). Encyclopaedia of Drugs, Alcohol, & Addictive Behaviour, 2nd edition]
LSD is known to combine with the serotonin pathway by binding and activating the 5-hydroxytryptamine sub-type 2A (5-HT2A) receptor. Activation of the 5-HT2A receptor is a common characteristic of serotonergic hallucinogens.[footnoteRef:11] [11: Halberstadt, A.L. (2015). Recent advances in the neuropsychopharmacology of serotonergic hallucinogens. Behavioural Brain Resources. 277: 99-120. http://www.ncbi.nlm.nih.gov/pubmed/25036425]
Slang terms for LSD: “Acid, boomers, doses, Yellow Sunshine, battery acid, blotter, microdots, dots, electric Kool-Aid, window pane, pane, purple haze, sugar cubes, cubes, Elvis, tabs, hits, blue cheer.'
After ingestion users feel the effects of LSD within 30 to 90 minutes, and these effects may last as long as 12 hours. The LSD experience, usually referred to as a “T R I P”, differs widely and is unpredictable. Individual reactions to the drug can range from ecstasy to terror, even within a single drug-taking experience. People who have used the drug before and had a positive experience, may have a negative experience, if they take it again.
Two factors that influence the way people feel when they take LSD are their “mindset”—their expectations, experience and mood at the time they take the drug— and the setting, or place where they are. For those who use the drug, the possibility of an adverse reaction, or “B A D T R I P,” may be reduced by taking the drug only when already in a positive state of mind, in a relaxed environment and with supportive friends. The ability of LSD to cause schizophrenic-like actions and perceptual disturbances may lead to a “bad trip,” which can potentially be dangerous to the mental and physical well-being of the user. Characteristics of Bad Trip are Intense anxiety; panic; delusions; the sense that one is losing his/her identity; paranoia; rapid mood swings; violent or hazardous behavior leading to accidental fatalities, homicides, self-mutilation, or suicide; some users may experience seizures.[footnoteRef:12] [12:]
LSD can have 2 kinds of effects: Short term and long-term effects. Short term effects[footnoteRef:13], itself is dividing in physical and psychedelic effects. Physical effects can be: Dilated pupils; raised body temperature; rapid heartbeat and elevated blood pressure; increased blood sugar; salivation; dry mouth; tingling fingers and toes; weakness; tremors; palpitations; facial flushing; chills and gooseflesh; sweating; nausea; loss of appetite; dizziness; blurred vision; sleeplessness. [13: Beck, F., & Bonnet, N. (2013). The substance experience, a history of LSD. http://www.ncbi.nlm.nih.gov/pubmed/23621940.]
Psychedelic effects are: [footnoteRef:14]Visual hallucinations, colors seem to become more intense, halos or rainbows may appear around objects, and shapes may become fluid in form. Besides this, according, to the Centre for Neuropsychopharmacology in London, the LSD modulates music-induced imagery via changes in Para hippocampal connectivity.[footnoteRef:15]
Rapidly changing, brightly colored geometric patterns and other images may be seen, whether the eyes are open or shut. These visual alterations are referred to as “pseudo-hallucinations”, because people know that what they are seeing is not real and is due to the effect of the drug. Strengthening of smells, sounds, and other sensations; Sense of heightened understanding; Distorted sense of time; Distorted perception of body and a sense of “depersonalization” in which the one feels one’s mind has left one’s body; [14: Darke, I. (1996). Postulated Mechanisms of LSD. Harry Mudd College. https://www.cs.hmc.edu/~ivl/writing/non_fiction/lsd/#1] [15: Effects of LSD and music on brain activity. 2016. https://www.researchgate.net/publication/309596938_Effects_of_LSD_and_music_on_brain_activity]
Synesthesia-a blending of sensory perception (i.e. “hear” colors or “see” sounds); It is the involuntary or automatic sensation of a sensory modality that occurs when another sensory modality is stimulated;[footnoteRef:16]The sense that one is undergoing a profound mystical or religious experience. [16: Alfra, P. (2015). Auditory Synesthesias. Handbook of Clinical Neurology. 129:389-407. https://www.ncbi.nlm.nih.gov/pubmed/25726281.]
Long-term effects of LSD use include Hallucinogen Persisting Perception Disorder (HPPD) and persistent psychosis. Drug-induced Psychosis: For some people, even those with no history or symptoms of psychological disorders, a distorted ability to recognize reality, think rationally, or communicate with others caused by LSD may last years after taking the drug. Hallucinogen Persisting Perception Disorder (HPPD): Known familiarly to LSD users as “FLASHBACKS” HPPD episodes are spontaneous, repeated recurrences of some of the sensory distortions originally produced by LSD. The flashback experience may contain visual disturbances, such as halos or trails attached to moving objects or seeing false motions in the peripheral vision.
More recently, the first case of Alice in Wonderland Syndrome (AIWS) associated with LSD use was reported. Alice in Wonderland Syndrome (AIWS), is same as Todd’s Syndrome, is an HPPD that is characterized by: macropia, micropsia, pelopsia and teleopsia, which are neurological conditions that affect human visual perception by creating the illusion that things are: bigger, smaller, closer than they actually are.[footnoteRef:17] [17: Lerner, A., & Lev-Ran, S. (2015). LSD-associated ‘Alice in Wonderland Syndrome’ (AWIS): A Hallucinogen Persisting Perception Disorder (HPPD) Case Report.” The Israel Journal of Psychiatry and Related Sciences. http://www.ncbi.nlm.nih.gov/pubmed/25841113.]
Additionally, some people who use LSD frequently feel compelled to take it. The drug takes on an exaggerated importance in their lives, leading to emotional and lifestyle problems. People who use LSD regularly do not experience physical withdrawal symptoms when they stop taking the drug. However, regular use of LSD will produce “tolerance” to the effects of the drug. This means that if LSD is taken repeatedly over a period of several days, it no longer has the same effect. After several days of not taking the drug, it becomes effective once again.[footnoteRef:18] [18: Centre for Addiction and Mental Health; LSD; 2010. https://www.camh.ca/-/media/files/guides-and-publications/dyk-lsd.pdf ]
According to above findings, we can say that hallucinogenic drugs referred-hallucinogens have the primary effect of altering the sensory perceptions of individuals who use them in a manner that significantly distorts objects in the real world or results in the individual having sensory experiences that produce perceptions of objects or events that are not exist in the real world (hallucinations). Unlike drugs classified as opioids, benzodiazepines, amphetamines, and others, LSD is not considered to have addictive properties.
Sometimes people who take the drug feel that the experience gets out of control. They may feel they are losing their identity; such a reaction can lead to a state of panic. They may try to escape from the situation, or become paranoid and frightful and shout at the people around them. People experiencing a dangerous reaction to LSD should be kept as calm as possible. Taking extremely high amounts of LSD alone can produce potentially fatal effects. Several research studies have documented mortalities as a result of overdoses of hallucinogenic drugs like LSD that were taken in combination with other potentially dangerous drugs (e.g., alcohol, prescription pain medications, stimulants, etc.). If their distress continues, they should receive treatment at a hospital emergency room.
The drug has made people feel that they could fly, or that they could walk through traffic, and this has resulted in accidental injuries and deaths. In some people, LSD may release underlying psychosis or aggravate anxiety or depression.
To sum up, the best way to avoid an overdose with LSD, its adverse/side effects is to never take the drug in the first place. It is unpredictable and dangerous—a person can use LSD many times without serious problems, and then suddenly experience aggression, self-harm, psychosis, or other adverse side effects.
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