Emergency Medical Minute12 Aug 2019

Podcast # 496: Hallucinogens

Author: David Holland, MD

Educational Pearls:

Hallucinogenics have been used for a variety of cultural and religious reasons for thousands of years
In the 1960's a Harvard professor began experimenting with psilocybin mushrooms. There was resulting public outcry, eventually leading to all hallucinogens being listed as schedule I drugs
Common hallucinogens include: LSD (acid), Mescaline (peyote), DMT (ayahuasca), Psilocybin (mushrooms), MDMA (ecstacy)
Effects vary by specific drug but may include auditory/visual hallucinations, increased empathy, loss of fear
Physiologic effects often include mydriasis, tachycardia, hyperthermia and hypertension
Recent neuroimaging studies have shown increased neural connectivity in people after administration of hallucinogens
Each hallucinogen has a specific dose and duration, some can last half a day or more

References

Heal DJ, Gosden J, Smith SL. Evaluating the abuse potential of psychedelic drugs as part of the safety pharmacology assessment for medical use in humans.Neuropharmacology. 2018 Nov;142:89-115. doi: 10.1016/j.neuropharm.2018.01.049. Epub 2018 Feb 8. Review. PubMed PMID: 29427652.

Garcia-Romeu A, Kersgaard B, Addy PH. Clinical applications of hallucinogens: A review. Exp Clin Psychopharmacol. 2016 Aug;24(4):229-68. doi: 10.1037/pha0000084. Review. PubMed PMID: 27454674; PubMed Central PMCID: PMC5001686.

Bogenschutz MP, Johnson MW. Classic hallucinogens in the treatment of addictions.Prog Neuropsychopharmacol Biol Psychiatry. 2016 Jan 4;64:250-8. doi: 10.1016/j.pnpbp.2015.03.002. Epub 2015 Mar 14. Review. PubMed PMID: 25784600.

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