LSD Addiction and Abuse


Lysergic acid diethylamide (LSD) is a powerful hallucinogenic chemical typically synthesized from a chemical extracted from ergot, a fungus that grows on grains.1 The DEA lists LSD as a Schedule I substance, meaning the drug has no recognized medical benefits and a high potential for abuse. Possession and distribution of LSD is illegal;2 however, in 2019, the Substance Abuse and Mental Health Administration estimated that 0.9% of Americans over 12 years old used LSD within the past year.3

Synthesizing LSD is a complicated process that requires chemistry knowledge and laboratory experience.4 LSD is clear or white and odorless liquid.1

Common street names for LSD are:5

  • Acid.
  • Blotter.
  • Hits.
  • Windowpane.
  • Sugar cubes.
  • Sunshine tabs.

Read on to learn more about this powerful hallucinogen.

How is LSD Used?

LSD is usually taken orally;6 however, it can also be snorted, injected,5 and even absorbed through the skin.7 Only a very small amount is needed to produce strong effects. On average, an effective oral dose is between 20 to 80 micrograms.4

The illicit drug is available:5

  • In liquid form.
  • Saturated onto small sheets of paper or sugar cubes.
  • In tablets or capsules.

How Long is an Acid Trip?

People commonly refer to being under the influence of LSD as “tripping.” The effects of LSD are normally felt within 20-30 minutes after taking an oral dose and within 10 minutes when injected. The experience usually peaks at 2 to 4 hours, though LSD effects are felt for up to 12 hours.5

The subjective and psychological effects of LSD include:8

  • Visual distortions and illusions, such as shapes shifting, “seeing sounds” or “hearing colors.”
  • Feelings of depersonalization or derealization.
  • Extreme mood changes.
  • Altered perception of time, as if it is speeding up or slowing down.
  • Transient magical thinking.
  • Delusional ideas.
  • Enhanced emotional empathy and trust of, or closeness to, others.
  • A loss of control.

How To Help Someone on a Bad LSD Trip

During an LSD trip, a person may maintain their ability to delineate between subjective experience and real world. This often results in a perceived clarity of the mind, euphoria, and fearlessness, and can be described as a “good trip.”8

However, some people experience the other end of the spectrum—a “bad trip”—after taking LSD. During a bad trip, fear is amplified and distorted thoughts and sensory illusions are interpreted as intrusive and terrifying, causing anxiety, panic and despair.8 A person may experience both positive and negative interpretations at different times of use.9

While there’s no way to guarantee someone will have a good trip on LSD, there are some ways to reduce the likelihood of a bad trip and to mitigate someone’s negative experience should one occur:10

  • The location should be safe and comfortable as possible. Whether an LSD experience is positive or negative is largely dependent environment.
  • LSD should only be taken with a trusted friend that knows how strong it is and what to expect.
  • No one should take LSD if they are feeling upset or self-conscious; LSD can amplify these feelings.
  • People that take LSD and don’t feel its effects should avoid taking another dose as it may take a long time for these effects to be felt and they can be stronger than expected.

If someone starts having a bad trip, a trusted friend should take them to a calm, safe space, away from other people and visual and auditory stimulation. Speaking calmly and assuring them that the experience is temporary may make them feel better. In extreme cases where the situation seems unsafe, medical attention may be needed.

How Long Does LSD Stay in Your System?

The length of time that LSD can be detected in someone’s body depends on the type of test that is administered. The amount of LSD taken also plays a significant factor in how long the drug can be detected through various methods.11 Because only a low dose of the drug is needed to produce its effects, drug testing for LSD is challenging.12

A blood test can detect LSD for about 6-12 hours after it was taken. LSD is detectable in urine samples for about 2-4 days.10 Tests performed on hair follicles can detect LSD for a much longer period of time, but the actual length of time is highly variable.13

LSD is not part of the Substance Abuse and Mental Health Services Administration (SAMHSA)-5 drug test panel, nor is it part of most expanded drug testing panels.14

Adverse Effects of LSD

LSD alters the mind by strongly binding to serotonin receptors and changing two major signaling pathways within cells.14 Serotonin is a brain chemical that is associated with regulating:1

  • Sensory perception.
  • Body temperature.
  • Sleep.
  • Hunger.
  • Sexual behavior.
  • Mood.

Physical effects of LSD, with the exception of dilated pupils, occur inconsistently, meaning they tend to not be significant, and a person may experience none, some, or all of the following:8

  • Slight increase or decrease in heart rate.
  • Minimal increase or decrease in body temperature and blood sugar.
  • Increased sweat and saliva production.
  • Constriction of the blood vessels.
  • Nausea and vomiting.
  • Decrease or increase in blood pressure.
  • Chills, tremor, and trembling.10

Long Term Effects of Acid

There is no evidence that LSD causes lasting damage to the organs or long-lasting neuropsychological deficits even at higher doses.8 Some people who take LSD experience longer-lasting effects. These are typically a result of a particularly traumatic “bad trip.” Lingering effects may include:

  • Depression and anxiety symptoms.10
  • Hallucinogen Persisting Perception Disorder (HPPP). This causes people to experience the effects of the drug long after the substance leaves their system. Sometimes it manifests as “flashbacks” that can cause someone to feel certain qualities of the trip for months after the experience.6

A bigger risk is when individuals on LSD exhibit erratic and dangerous behavior as a result of the intense subjective experience.10

Is Acid Addictive?

LSD effects on the brain have been studied extensively.7 Despite this, researchers are still largely baffled by how LSD effects on the brain are caused.15

Research has not shown LSD to be addictive, as it is not reliably reinforcing—and its highly variable subjective effects can also be aversive. Studies have confirmed that a tolerance to LSD develops quickly, limiting the impact of whatever rewarding effects it has.8

Many studies have been conducted to observe potential therapeutic properties in treating a variety of mental disorders, Alzheimer’s, and severe migraines. However, there are currently no approved indications for LSD-assisted therapy.9

Microdosing

Recently, the concept of microdosing—taking low doses of LSD or other hallucinogens (so only threshold effects are felt)—as a means to improve mood and cognitive function has been gaining attention. This has led some researchers to speculate whether a controlled version of this methodology might be useful in treating depression. So far, research has yet to prove or disprove this hypothesis.16

Sources

  1. National Institute on Drug Abuse. (2019). Hallucinogens drugFacts.
  2. Drug Enforcement Administration. Drug scheduling.
  3. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  4. U.S. Department of Justice. (2004). LSD trafficking and abuse. Product No. 2004-L0424-026.
  5. U.S. National Library of Medicine. (2018). Substance use – LSD.
  6. Drug Enforcement Administration. (2020). Drug Fact Sheet: LSD.
  7. Baquiran M. & Al Khalili Y. (2020). Lysergic Acid Diethylamide (LSD, Entactogen) Toxicity. Treasure Island (FL): StatPearls Publishing.
  8. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  9. Hwang K.A.J. & Saadabadi A. (2020). Lysergic Acid Diethylamide (LSD). Treasure Island (FL): StatPearls Publishing.
  10. University of California Santa Cruz. (2019).
  11. Emrich, Hinderk M., Halpern, John H., Hintzen, A. Passie, T. & Stichtenoth, Dirk O. (2008). The pharmacology of lysergic acid diethylamide: a review. CNS Neuroscience & Therapeutics (14), 295–314.
  12. Allorge, D., Gaulier, J., Richeval, C. & Vanhoye X. (2017). LSD detection and interpretation in hair. Current Pharmaceutical Design 23(36), 5496.
  13. Foltz R.L., Kikura R., Mieczkowski T., Nakahara Y., & Takahashi K. (1996). Detection of LSD and metabolite in rat hair and human hair. Journal of Analytical Toxicology 20(5), 323-9.
  14. Substance Abuse and Mental Health Services Administration. (2020). Drug testing.
  15. National Institutes of Health. (2017) Protein structure reveals how LSD affects the brain.
  16. Bershad, A.K., Bremmer, M.P., de Wit, H., Lee, R., & Schepers, S.T. (2019). Acute subjective and behavioral effects of microdoses of lysergic acid diethylamide in healthy human volunteers. Biological Psychiatry 86(10), 792-800.



About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


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