An Examination of LSD Abuse & Treatment Options

What Is LSD?

LSD (D-lysergic acid diethylamide) is a potent, man-made hallucinogen manufactured from a lysergic acid compound found on the ergot fungus. In its various forms, LSD is also known as:¹

• Acid.
• Blotter.
• Dots.
• Windowpane.
• Purple haze.
• Electric Kool-Aid.
• Sugar cubes.
• Yellow Sunshine.

LSD is a Schedule I substance, meaning it has no accepted medical use and a high potential for abuse.² People typically use LSD orally, either in liquid form, capsules, or tablets. The most common form is small squares of paper soaked in LSD.

Nearly 5% of high school seniors report having used LSD.³ Among adults aged 26 and older, about 10% report that they have used LSD at some point in their lives.³

Is LSD Use Dangerous?

LSD is a synthetic, hallucinogenic drug that causes what users often refer to as a “trip” because of the unusual sensory experiences it produces. LSD can profoundly alter a person’s sense of reality, and many users find the sensations it elicits to be exciting, enjoyable, and even potentially therapeutic.

The effects of the drug are unpredictable, however, and can lead people to feel extremely anxious, frightened, or totally out of control. People can develop a tolerance to LSD quickly, even when used just a few days in a row. Even periodic use, however, is not without risks, as it can lead to dangerous situations and is associated with some adverse health effects. For those whose use has become problematic, a substance abuse treatment program can help.

How Does It Affect the Brain?

LSD users typically feel the drug’s effects within 30–90 minutes after ingesting it, experiencing sensory changes and alterations in smells, sights, and sounds that can last up to 12 hours.¹ While on an LSD trip, someone may feel disconnected from their body and physical reality. In addition, users can lose all concept of what’s real and take physical risks, such as driving a car or jumping from high places, without understanding the danger involved.

People can develop a tolerance to LSD quickly, even when used just a few days in a row.

Even though LSD has been used recreationally for decades, scientists have only recently begun to understand how it impacts the human brain to create its hallucinogenic effects. A 2017 study revealed that LSD interacts with a protein in the brain that is a receptor for the chemical transmitter serotonin.⁴ Serotonin is a neurotransmitter that impacts mood and behavior, affects regulatory systems (such as those that control body temperature), and can alter the perception of external stimuli. Changes in serotonin can affect a person’s mood, sexual drive, temperature, and muscle control.

The psychedelic effects of LSD include:¹

• Visual hallucinations such as flashes of light, colors, shapes, or complete distortions of reality.
• Intensified sensations of sounds or smells.
• Distorted sense of time.
• A subjective greater understanding of the universe.
• Feelings of having a mystical or religious experience.
• Feeling a disconnect between mind and body.
• Synesthesia, or the blending of senses (being able to “hear colors” or “see music”).

Users typically experience some physical side effects of LSD, which can include:¹

• Dilated pupils.
• Increased blood pressure.
• Nausea.
• Weakness.
• Tremors.
• Elevated blood sugar levels.
• Increased heart rate.
• Chills.
• Dizziness.
• Blurred visions.
• Tingling in fingers and toes.
• Dry mouth.
• Sweating.
• Increased body temperature.
• Loss of appetite.
• Insomnia.
• Extreme mood changes.

What Is a Bad Trip?

Not everyone experiences an LSD trip the same way. While some people report experiencing pleasant sensory effects and a sense of euphoria, others have frightening hallucinations that make them feel panicked and disoriented. This is what is sometimes referred to as a bad trip.

A bad trip on LSD may result in:¹

• Extreme anxiety.
• Panic.
• Delusions.
• Paranoia.
• Intense mood swings.
• Feeling a loss of identity or of disappearing into nothingness.
• Seizures.

These frightening effects can lead users to participate in violent or dangerous behaviors, including self-mutilation, suicide, or homicide.¹

History

First developed in 1938 by a Swiss chemist who was looking for a circulatory and respiratory stimulant, LSD gained renewed interest years later when its hallucinogenic properties were accidentally discovered.¹ Pharmaceutical companies marketed LSD as a way to treat mental illness, such as schizophrenia, as well as alcoholism and various criminal and sexual behaviors.

The drug was extensively researched—and experimented with—by psychiatric students and teachers trying to gain a better understanding of schizophrenia. By the 1960s and 70s, LSD became part of the counterculture movement popularized by prominent Harvard professor Timothy Leary and others who celebrated the drug’s mind-altering effects.¹

Scientific study of the drug officially ended in the 1980s, and LSD has since become a popular recreational drug at dance clubs and music festivals, often mixed with other drugs like ecstasy or ketamine.¹

What Is Microdosing?

Microdosing is a recent trend in which users of LSD advocate for using it in small amounts. Proponents believe that the drug has legitimate medical uses and advocate for the use of very low doses to heighten creativity, alertness, and energy. Users claim that it reduces stress and anxiety, increases the quality of sleep, and enhances well-being.

To date, there is little scientific evidence to support the anecdotal claims. LSD continues to be classified as a Schedule I drug by the DEA, which diminishes the potential for legitimate scientific study of any therapeutic capacity for the drug. Microdosing advocates claim that using very low doses of LSD does not cause hallucinogenic effects, despite LSD’s classification as an unregulated poison by the FDA.⁵

One potential danger of microdosing is that LSD is not subjected to the rigorous quality control or regulatory oversight that FDA-approved drugs are. Therefore, it is impossible to know the potency or purity of LSD from batch to batch. Experimenting with the drug, even in small amounts, could expose the user to potentially serious side effects and negative reactions. People seeking therapeutic benefits from LSD should talk to their doctor about safer—and legal—alternatives.

Long-Term Effects

Perhaps the best-known consequence of LSD is the potential for a bad trip, but in certain rare cases, the effects of a bad trip can trigger prolonged psychiatric reactions and episodes of psychosis.⁶ Even researchers who believe LSD has therapeutic medical benefits note that the use of LSD should occur in a controlled environment in which the dosage is carefully measured.⁶

For some, flashbacks can be intense and frequent enough to affect daily functioning. 

Another documented side effect of LSD is Hallucinogen Persisting Perception Disorder (HPPD), better known as flashbacks.⁷ Some users have reported experiencing LSD flashbacks years after their last drug use. With HPPD, a person spontaneously sees sensory disturbances reminiscent of those experienced while on an LSD trip.

For some, flashbacks can be intense and frequent enough to affect daily functioning. Symptoms can sometimes be mistaken for other conditions, such as a brain tumor or stroke.⁷ One case study reported an instance in which HPPD was triggered by use of anti-depressants, decades after the patient stopped using LSD.⁸

Other long-term side effects of LSD use can include:⁹

• Anxiety.
• Sleep disturbances.
• Mental and emotional instability.

Health Consequences

Because LSD raises blood pressure, heart rate, and disrupts other body functions, users with conditions such as cardiovascular disease may experience severe complications from LSD use.⁵ However, most accidental deaths associated with LSD use are the result of hallucinations that lead to panic attacks and feelings of terror.⁶ There have been reports of people who commit suicide, mutilate themselves, attack others, or perform dangerous activities because they do not understand their physical limitations.¹

LSD use resulted in nearly 5,000 emergency room visits in 2011, which is relatively low compared with other drugs with hallucinogenic properties like PCP (more than 75,000 visits) or synthetic cannabinoids (more than 28,000 visits).¹⁰ The 2011 number was up from 2010, when less than 4,000 people were admitted for LSD use.¹⁰ LSD accounted for 0.4% of all emergency room visits involving illicit drugs in 2011.¹⁰

People frequently consume LSD with other drugs, including alcohol, so it is difficult for emergency physicians to know when LSD is the sole cause of adverse effects.

Tolerance and Addiction

Tolerance to LSD is different than with other drugs more commonly associated with substance abuse and addiction.

Typically, people who develop a tolerance to a drug will take increasingly larger amounts of the drug to achieve the same desired results they once did. Drug tolerance usually develops with regular drug use over time, and can lead a person to develop drug dependence and, ultimately, addiction.

Tolerance to LSD, however, develops very rapidly, so taking more and more LSD does not help the user overcome the tolerance to achieve the desired high.¹ Additionally, strong hallucinations and the potential for negative reactions, along with the inconsistency in experience from one usage to the next, often prompt people to take LSD only sporadically and recover to full sobriety in between trips.

For these reasons, LSD users don’t typically develop the compulsive, drug-seeking behaviors that characterize addiction.¹ Although LSD is not considered physically addictive, frequent use can put people at greater risk for bad trips, dangerous situations, encounters with law enforcement, and health complications. Just because the drug isn’t considered addictive in the traditional sense shouldn’t stop you from seeking help for yourself or a loved one for whom LSD has become a problem.

Treatment Options

Numerous treatment options are available to help people struggling with LSD abuse. An inpatient program might be necessary if someone is abusing multiple drugs, has underlying medical or co-morbid psychiatric conditions, or has been using drugs for a long time. The person’s severity of drug abuse and history of failed attempts at outpatient treatment are also factors in deciding whether they need inpatient treatment.

Inpatient rehab programs require patients to live at the facility full-time for a period of 30–90 days while receiving treatment. This intensive atmosphere allows patients to focus 100% of their energy on recovery and provides a supportive network of clinicians, staff, and other patients in various stages of their own recovery.

The intensive inpatient experience is not for everyone, and many people opt to receive substance abuse treatment on an outpatient basis. Outpatient programs vary in duration and intensity of the services provided. Programs may last 3–6 months. Some require patients to attend treatment session once per week, while others require 3 or 4 sessions per week, with sessions lasting anywhere from 1 to 4 hours.

Methods used to treat LSD abuse include:

• Cognitive-behavioral therapy (CBT): CBT is the most common form of drug abuse treatment and it works by helping to change the thinking patterns that led to substance abuse. Through therapy sessions, patients learn to develop new ways of managing stress or other negative emotions that do not involve drugs. CBT helps people find ways to cope with triggers—people, places, and things that lead a person to want to use LSD or other drugs.
• Motivational interviewing (MI): Many people who abuse drugs have no real desire to change, but attend treatment simply to please a family member, keep a job, or comply with court-ordered probation. Others may feel ready to quit drugs but are hesitant to make the necessary lifestyle changes. In the MI approach, a person’s readiness to change is thoroughly evaluated and their personal barriers to change are then approached in an individualized plan. The goal is to help them move to the next level of readiness so they can gradually move from resistance, to a desire to change, and then to a point where they actually start making the necessary changes. This approach is often used in the early stages of treatment or in people who have made many attempts to complete treatment but continue to relapse.

Regardless of the drug(s) a person may abuse, the treatment programs available at professional rehab facilities can lead them to sobriety and help develop strategies to prevent relapse.

Recovery

Recovery from drug abuse and addiction is possible. With treatment and ongoing support, the journey from LSD abuse to health and recovery is achievable.

Recovery is a life-long process, and rehab is just the first step. Ongoing participation in aftercare and recovery-focused activities is necessary. Many inpatient programs for drug addiction provide a step-down service into outpatient programs to enhance the skills learned in inpatient treatment.

Support groups and group therapy sessions keep those in recovery in touch with their peers and counselors. Many rehab facilities offer a weekly aftercare group for people who successfully complete the program. In addition, 12-step programs, such as Narcotics Anonymous (NA) and Alcoholics Anonymous (AA), give people in recovery a place to continue to receive long-term support in their recovery efforts.

The idea of weeks of treatment and years of ongoing 12-step participation may seem overwhelming, but making a phone call to explore treatment options is an easy step to help you achieve sobriety.

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References:

1. University of Maryland Center for Substance Abuse Research. (2013). LSD.
2. Drug Enforcement Administration. (n.d.). Drug Fact Sheet: LSD.
3. National Institute on Drug Abuse. (2014). Hallucinogens: Brief Description.
4. National Institute of Mental Health. (2017). Revealed: LSD Docked in its Human Brain Target.
5. U.S. Food & Drug Administration. (n.d.) FDA Poisonous Plant Database.
6. Das, S., Barnwal, P., Ramasamy, A., et. al. (2016). Lysergic acid diethylamide: A drug of ‘use’?Therapeutic Advances in Psychopharmacology. 6(3):214–228.
7. National Institute on Drug Abuse. (2016). Hallucinogens: What are hallucinogens?
8. Goldman, S., Galarneau, D., & Friedman, R. (2007). New onset LSD flashback syndrome triggered by the initiation of SSRIs. The Ochsner Journal. 7(1):37–39.
9. Roth, E. (2011). The Post-LSD Syndrome: Diagnosis and Treatment. Bloomington, IN: AuthorHouse.
10. Substance Abuse and Mental Health Services Administration. (2011). Drug Abuse Warning Network: National estimates of drug related emergency department visits.