What is Lysergic Acid Diethylamide Toxicity (LSD trip)?
D-lysergic acid diethylamide, better known as LSD, is a chemical that can cause intense hallucinations. It was first made in 1938 by a scientist named Albert Hofmann, who was trying to create a drug that could stimulate the brain. He didn’t realize LSD’s hallucinatory effects until 1943, when some of it unintentionally got absorbed through his skin. A few days after that accident, Hofmann intentionally consumed an estimated 250 micrograms of the drug, marking the first known ‘LSD trip.’ Ever since then, numerous people have taken different doses of LSD and reported a wide variety of effects. Everyone seems to agree, though, that LSD can cause profound experiences.
In the past, LSD sparked a lot of interest because of its effects. It was the most researched hallucinogen, a drug that can cause hallucinations. The U.S. Central Intelligence Agency conducted a study in the 1950s called MK-ULTRA in which they tried to use LSD and other drugs to create so-called ‘truth serums.’ Later studies confirmed that LSD has a strong effect on serotonin, a chemical that helps transmit messages in the brain. LSD appears to target several receptors in your brain that respond to serotonin. The smallest dose of LSD known to have an effect is usually around 15 micrograms, while a large dose might be around 300 micrograms. As the dose gets bigger, the effects of the drug become more intense.
When examining any drug, it’s important to know how toxic it is. However, no deaths have been directly linked to the effects of taking LSD. Earlier in the 20th century, scientists conducted studies on using LSD for therapeutic purposes, but today, those studies would not be considered sufficient under modern standards.
What Causes Lysergic Acid Diethylamide Toxicity (LSD trip)?
LSD, also known as ‘acid’, was officially declared illegal in the U.S. on October 24, 1968, through an update to the Federal Food, Drug, and Cosmetic Act of 1938. The last study into LSD allowed by the U.S. Food and Drug Administration occurred in 1980. Currently, LSD is classified as a ‘Schedule I’ drug, a category that also includes various other hallucinogens and stimulants like DMT, GHB, heroin, marijuana, MDMA, mescaline, and psilocybin.
Because of its controversial nature and legal restrictions, it’s difficult to organize clinical trials around LSD. However, there are ongoing research projects in countries such as Spain, Israel, and the U.S. investigating the potential benefits of psilocybin and MDMA-assisted psychotherapy for addressing conditions like post-traumatic stress disorder, anxiety, and cancer-related depression.
Alexander Shulgin, a famous chemist and psychopharmacologist, in his book “Tryptamines I Have Known and Loved (TiHKAL)”, outlined how LSD can be made from another substance called lysergic acid (a Schedule III controlled substance). He stated that the LSD molecule is delicate and should be kept away from air and light to stay stable. He also listed three groups of LSD analogs which are essentially different versions of LSD that have been modified slightly.
A study from 2016 examined the prospect of using new antipsychotic drugs to treat LSD-induced psychosis. The researchers found that LSD interacts with multiple neural systems, suggesting that its use affects a wide range of brain functions.
LSD is usually taken orally, most commonly as small decorated paper squares, known as blotter paper. It can also come in pill form (microdot) or as a liquid solution. It’s mostly absorbed by our bodies when taken orally, with effects starting from a dose as small as 15 μg. The effects of LSD can last from 8 to 12 hours, with some residual effects potentially lasting up to 48 hours. Despite being known as a “club drug,” many users prefer to take it in a more controlled, relaxed environment at home.
Risk Factors and Frequency for Lysergic Acid Diethylamide Toxicity (LSD trip)
A study in 2013 aimed to find out how common the use of psychedelic drugs like LSD, psilocybin, mescaline, or peyote was in people’s lifetimes. They got their information from a 2010 US survey that asked random people aged 12 and above about their use of substances and mental health. The survey found that 23 million US residents had used LSD at least once. It was interesting to find that the age groups of 50 to 64 years and 21 to 49 years had a similar rate of usage. However, the highest rate of psychedelic use was among 30 to 34-year-olds. Recreational LSD use was most common during the 1960s and 1970s.
Another study in 2003 focused on the use of LSD among young women. Over 900 women aged 14 to 26, who were sexually active were surveyed at university health clinics. Of these women, 13% had used LSD at least once while 58% had used marijuana at least once. This study further revealed that those who got drunk at least 10 times in the last year, smoked half a pack of cigarettes during the same period, and were categorized as “high-sexual-risk takers” were more likely to have used LSD or cannabis. It also found that LSD users compared to non-users were more often white, under the age of 17, and more likely to have a history of physical abuse and severe depression symptoms.
Signs and Symptoms of Lysergic Acid Diethylamide Toxicity (LSD trip)
When someone has taken too much LSD, they often seek medical help because they are having a frightening experience, known as a “bad trip”. In other cases, people may come to a hospital or clinic unaware that they have ingested a large amount of LSD.
The quality of information that healthcare providers can get from the patient largely depends on how alert they are and how much the LSD is affecting their perception. It may be necessary to involve the patient’s friends or family if the patient can’t give a full medical history. Important information to gather includes the main problems or symptoms, how much LSD was taken, when and where it was taken, the patient’s familiarity with the drug, any previous experiences with LSD, any other symptoms or use of additional substances, and general health information.
The potential physical signs of LSD use may include:
- Vital signs: temperature can be normal to high, high blood pressure, fast heart rate, rapid breathing, oxygen levels can be either higher or lower than usual.
- General appearance: altered mental state, excessive sweating, unkempt look, no appetite.
- Head, ears, eyes, nose, throat: pupils dilated, dry mouth, involuntary eye movements.
- Respiratory: rapid breathing.
- Cardiovascular: fast heart rate, high blood pressure.
- Skin: excessive sweating.
- Neurologic: poor coordination.
- Psychiatric: hearing and seeing things that aren’t there, panic, psychosis, feeling paranoid, hearing, seeing, tasting, smelling or feeling things in ways they typically wouldn’t (synesthesia), a distorted sense of time, quickly changing moods, aggression, feeling detached from oneself, thoughts of suicide, strong religious feelings, depression.
Testing for Lysergic Acid Diethylamide Toxicity (LSD trip)
If a doctor suspects that a patient is experiencing intoxication from LSD (a type of drug), they will primarily use their clinical expertise to diagnose this. They will need a detailed account of the person’s symptoms and their physical health. Although other tests may also be required, the main focus will be on understanding the patient’s health status. If the situation is complicated, such as when the person is experiencing seizures or a condition called neuroleptic malignant syndrome, the doctor might need to do specific blood tests to check the body’s blood clotting abilities and the balance of electrolytes (salts and minerals that carry an electric charge).
Imaging studies, like an x-ray or ultrasound, might be needed to rule out other conditions that might explain the symptoms. An electrocardiogram (ECG), which checks the heart’s rhythm and electrical activity, may be used to investigate heart conditions like slow or fast heartbeat and irregular heart rhythms. However, these conditions may not be directly caused by the LSD, but by other strong stimulants that the person might have taken, such as MDMA (a synthetic drug that alters mood and perception).
A standard drug test cannot detect LSD. But interestingly, a 2015 study tried to measure the levels of LSD and its main product after breakdown in the body (known as its “metabolite”), O-H-LSD, in the blood and urine samples of patients, mostly in emergency situations. Although this method was accurate and could measure the expected concentrations in people intoxicated by LSD, it has not been widely adopted in clinical practice.
A study in 2013 attempted to measure LSD levels in the blood using a method called ultra-performance liquid chromatography. They found that about 24 hours after patients took a dose of LSD, there were still measurable amounts of the drug in their blood. However, due to the complexities of this method, it has not been adopted universally.
Treatment Options for Lysergic Acid Diethylamide Toxicity (LSD trip)
The Substance Abuse and Mental Health Services Administration (SAMHSA), a U.S. mental health agency, updated their guidelines in 2006 for the best treatment methods for patients suffering from the effects or withdrawal of specific substances. When dealing with hallucinogenic toxicity, such as Lysergic Acid Diethylamide (LSD), their suggestion is to create a calm and quiet environment for the patient that is free from any unnecessary stimulation. They also recommend one-to-one supervision to ensure the patient does not harm themselves or others.
The guidelines indicate that, in some cases, a small dosage of a drug called a benzodiazepine can be helpful in managing feelings of anxiety. If a person has taken a high dose of LSD, they are at increased risk of enduring psychotic symptoms. In these instances, the administration of antipsychotic medication may be necessary if the symptoms arise and continue to be a problem.
Treatment primarily involves supporting the individual affected by LSD, as well as managing symptoms as they occur.
Key Steps in Managing LSD intoxication:
1. Assessment and Stabilization: Address life-threatening conditions immediately, treat any problems with the airway or heart and check for low blood sugar.
2. Supportive Care: Provide a calm and supportive environment, using effective communication techniques for reassurance.
3. Symptom Management: Administer benzodiazepines, such as lorazepam or diazepam for severe agitation or anxiety and consider using antipsychotics (like haloperidol) for severe hallucinations.
4. Fluid and Electrolyte Management: Keep an eye on fluid levels and provide appropriate hydration and correct any imbalances of electrolytes.
5. Psychological Support: Use non-judgmental and supportive communication. It may be useful to involve mental health professionals at this point.
6. Observation and Monitoring: It’s crucial to continuously monitor vital signs and mental status to watch for potential complications such as hyperthermia.
7. Collaborative Care: Consult with toxicology specialists or medical toxicologists and engage psychiatry or mental health services.
8. Planning For Discharge: This should involve providing appropriate discharge instructions, educating the patient about the risks of LSD, and arranging referrals for support.
What else can Lysergic Acid Diethylamide Toxicity (LSD trip) be?
When doctors are trying to identify whether someone has been intoxicated by LSD, it’s also important for them to consider the possibility of other drugs being involved. These other drugs can include:
- MDMA (3,4-Methylenedioxymethamphetamine)
- MDA (3,4-Methylenedioxyamphetmine)
- DMT (N,N-dimethyltryptamine)
- Psilocybin
- PCP (Phencyclidine)
- Cocaine and other types of amphetamines
- Alcohol (ethanol)
- Benzodiazepines
- Barbiturates
- GHB (Gamma-hydroxybutyrate)
In addition to these drugs, it’s also crucial for doctors to consider that mental health conditions like psychosis or schizophrenia could be responsible for the patient’s condition. In some cases, it could be infections or tumors within the brain that are causing the symptoms. It’s also possible that an altered mental state could be down to other causes, such as imbalances in the body’s salt and mineral levels (electrolyte abnormalities).
What to expect with Lysergic Acid Diethylamide Toxicity (LSD trip)
The outlook is generally positive for patients under the influence of LSD, provided that other diagnoses are ruled out, and no complications occur. Since the treatment mainly involves providing support to the patient, successful results can be expected, as long as the healthcare team follows the guidelines provided by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Possible Complications When Diagnosed with Lysergic Acid Diethylamide Toxicity (LSD trip)
Complications from using LSD (or acid) can arise in several ways. Firstly, the environment where the drug is taken can create risks. If the location isn’t safe, the person using the drug could unintentionally cause harm to themselves or others, leading to injuries.
Taking high doses of LSD can also cause severe psychological symptoms. People often describe their experiences or “trips” on LSD as deeply changing. In some cases, those who experience particularly intense and unrealistic trips may struggle to return to normal even after the drug’s effects have faded.
One possible complication from using hallucinogenic drugs like LSD is a condition known as persisting perception disorder. According to the DSM-5, a widely-used guide for diagnosing mental disorders, this condition is when people experience symptoms similar to their past hallucinogenic experiences, even though they’re not currently using the drug. These symptoms must cause significant distress and interfere with regular social and work activities. They can include mainly visual disturbances like geometric hallucinations, seeing halos around objects, changes in how movement is perceived, floaters, and flashbacks to images seen during the previous drug experience.
When symptoms like high or low blood pressure, irregular heartbeat, and high body temperature are left untreated, they can also cause serious problems.
Common Complications:
- Accidental self-injury or injury to others
- Persistent severe psychological symptoms
- Persisting perception disorder
- Visual disturbances
- Untreated symptoms of hypertension (high blood pressure), hypotension (low blood pressure), arrhythmias (irregular heartbeat), and hyperthermia (high body temperature)
Preventing Lysergic Acid Diethylamide Toxicity (LSD trip)
It’s important to emphasize education on the hazards associated with taking LSD, to prevent accidental consumption and overdosing. Often, individuals experiment with new substances without fully understanding what they’re taking. This can result in unpleasant experiences and even hospital stays that could have been avoided. As LSD is classified as a Schedule I drug, there are serious legal consequences for possessing or distributing it. It’s essential that people are not only made aware of these potential punishments, but also understand how the drug works and the kind of effects it can produce.
