“One pill makes you larger/and one pill makes you small

But the ones that mother gives you/don’t do anything at all

Go ask Alice/when she’s ten feet tall”

–from “White Rabbit,” as sung by Jefferson Airplane

People who abuse drugs such as alcohol or narcotics are often trying to escape reality, but those who take hallucinogens sometimes do it to distort their ordinary reality and transcend it. From the peyote used in Native American ceremonies to psychedelic mushrooms used in Mexico, hallucinogens have been used for centuries to create an alternate world in which people have visions or hallucinations that they view as profoundly spiritual or enlightening. The term “hallucinogen” is actually somewhat of a misnomer, because outright visual hallucination is a rare part of the overall experience. But make no mistake: These drugs can radically change your mental state and sensory experience.

Intriguing as it may sound, a trip into the world of hallucinogens can be dangerous. They can be psychologically addictive, and despite their reputation as “peace pills,” users sometimes become violent towards themselves or other people. How hallucinogens will affect particular people is unpredictable, and depends partly on their psychological state, surroundings, and previous use of psychedelics. There are no known medical uses for hallucinogens, and all are illegal in the United States. With the exception of PCP, or phencyclidine, most are considered by the Drug Enforcement Agency to be Schedule I drugs, which means they have no apparent medical use and a high potential for abuse. Extremely large doses of any hallucinogen may lead to convulsions, ruptured blood vessels in the brain, and even irreversible brain damage, according to the National Clearinghouse for Alcohol and Drug Information. The most commonly used psychedelics are:

LSD (acid)

LSD (lysergic acid diethylamide) is also called acid. It is a semi-synthetic hallucinogen derived from a substance found in ergot, a fungus that grows on rye and other grains. Swiss chemist Albert Hofmann discovered LSD’s unusual hallucinogenic effects by accident in 1938. During the 1950s, the drug was tested widely in the hope that it might offer insight into the nature of mental problems such as schizophrenia. During the 1960s and ’70s, many young Americans took LSD, then known as dropping acid; they believed the drug could expand their minds and unlock the “doors of perception.” Inspired by cult heroes such as drug guru Timothy Leary, author and acid pioneer Ken Kesey and the Merry Pranksters, and rock band The Grateful Dead, “tripping” on LSD reached its peak during this era.

One of the more potent hallucinogens, acid used to be very popular, especially among 18-to 25-year-olds. During 1993, 13.2 million Americans used LSD at least once, an increase of more than 60 percent from 1985, contradicting a conception that acid use had steadily declined since its heyday. Today, however, LSD use among teens and young adults has significantly declined. In 2008, 4 percent of high school seniors reported using the drug at least once in their lifetime and 2.7 percent had used it in the past year. This is down from 12.6 percent and 7.6 percent respectively a decade ago.

Pure LSD is a white powder, but it is generally sold on small, decorated squares of paper blotted with liquid LSD, hence the nickname “blotters.” It also comes in capsules, tablets, or in liquid form. While it is usually taken orally, LSD can also be snorted or injected. Users usually pay about $5 per “hit” or dose. The drug begins to take effect 30 to 90 minutes after ingestion, and the “trip” can last anywhere from two to 12 (or more) hours.

The experience of using LSD is highly unpredictable. One person may find the experience pleasurable, while another may have terrifying hallucinations that can cause extreme and irrational reactions, known as a “bad trip” — hallucinogens’ most common adverse effect and the reason for most visits to the emergency room. Someone might also have a pleasant experience on one trip but a horrible experience on a different occasion. The recommended treatment is a safe, quiet environment and “talk down” supportive therapy. While an LSD overdose is nearly impossible, some disoriented users have had fatal accidents or committed suicide. In addition, LSD is known to aggravate preexisting psychiatric problems. And as with any synthetic drug, there is always the danger that it has been mixed too strong or “laced” with another harmful drug, such as speed.

A small number of people who use LSD experience “flashbacks,” which are vivid recollections of a past intoxication. While flashbacks can occur days or years later, they most typically occur soon after the period of intoxication and decrease in frequency and intensity over time. For a small percentage of people, however, the frequency and intensity do not decrease and they continue to have persistent and unpleasant flashbacks.
Users quickly develop a tolerance to LSD, but there is no evidence of physical addiction and withdrawal, even with chronic use.

Mushrooms (psilocybin)

These aren’t your average spinach-salad-variety mushrooms. Some species of mushrooms that grow in the wild contain a psychedelic substance called psilocybin, which is chemically related to LSD. “Magic mushrooms,” or “shrooms,” are usually dried and eaten raw, though they may also be ground and sold in capsules. Pure psilocybin is sometimes sold in white crystalline form. (Some people have mistaken poisonous mushrooms for psilocybin and died after ingesting them.)

The drug begins to take effect about 30 minutes after ingestion, and the trip can last several hours. Small doses can cause relaxation, mood changes, and distorted perception (especially visual), and users often report profound spiritual or religious experiences. Larger doses can produce nausea, dizziness, stomach cramps, shivering, and more intense hallucinations similar to those experienced with LSD. In general, psilocybin is much less potent than LSD.

Peyote (mescaline)

A small cactus that contains the hallucinogen known as mescaline, peyote grows in the southwest United States and northern Mexico and has been a central part of Native American religious practices for centuries. The federal government and several states permit peyote’s sacramental use in the Native American Church of North America ceremonies.

Peyote “buttons,” cut from the cactus crown, are dried and then chewed or sometimes soaked in liquid that is then used as a drink. Peyote can also be ground and taken in a capsule, smoked or (rarely) injected. Mescaline can also be extracted from the peyote cactus and produced synthetically. Inexperienced users or users taking large doses can experience nausea and vomiting, making overdose with additional complications extremely rare. Intoxication occurs approximately 30 minutes after ingestion, reaches peak levels after several hours, and can last 12 or more hours. The effects are similar to those of LSD, with visual illusions, including bright lights, and geometric patterns.

Ecstasy (“X,” MDMA)

Ecstasy is a psychoactive drug similar to both the stimulant amphetamine and the hallucinogen mescaline (above). It is also called “Adam” and “Lover’s speed” because it reportedly enhances sexual experiences and makes people feel unusually compassionate and empathetic. In recent years, ecstasy has become the drug of choice at “raves,” all-night dance parties, in part because the amphetamine element keeps users awake. MDMA (Methylenedioxymethamphetamine), as well as a similar drug called MDA (Methylenedioxyamphetamine), are sold as tablets or capsules and taken orally. Their effects last about three to six hours. While all hallucinogens act on the serotonergic system, MDMA is the only one that has been shown to damage the neurons that release serotonin, possibly resulting in depression and memory loss down the road. Becoming dehydrated while taking MDMA at raves can lead, in rare cases, to kidney failure, heart attacks, strokes, seizures, and possibly death.

PCP (phencyclidine)

PCP (phencyclidine) was developed as an anesthetic in 1956, but was quickly discontinued when doctors found that patients became agitated, delusional, and even hallucinatory while recovering from its effects. The bizarre street names for the now illegal drug — “angel dust,” “rocket fuel,” “wack,” and “ozone” — attest to its potency. PCP is sold as a powder or in pills and can be taken orally, snorted, injected, or smoked, often mixed with marijuana. (PCP, along with amphetamines, is frequently found in ‘ecstasy’ sold at raves.)

PCP is unpredictable and highly dangerous. People taking low doses act as if they have been drinking heavily, showing poor coordination, slurred speech, and may experience fever, sweating, muscle rigidity, and sometimes nausea and vomiting. In addition to the illusions caused by other hallucinogens, PCP has pain-killing properties, and also frequently causes paranoia and mood instability. This combination of effects, especially being unaware of physical pain, can occasionally bring on violent and psychotic behavior. Users may damage property, harm other people, and even become suicidal. Effects usually last four to six hours. Flashbacks have also been reported. Overdosing on PCP is not uncommon as a dose only 5 times the usual dose can result in seizures, coma and death. Unlike most psychedelics, PCP is physically addictive (monkeys self-administer the drug in laboratory tests). People in withdrawal crave the drug and experience anxiety, tremors, gastrointestinal problems, and cold sweats. PCP was popular in the 1960s through the 1980s, but is not used widely as a single agent today.

What signs do I look for if I suspect someone is taking hallucinogens?

The signs to watch for when someone is on psychedelics vary according to the drug. In general, however, the physical signs include:

  • dilated pupils (except among PCP and MDMA users)
  • increased body temperature
  • a rapid heart rate
  • high blood pressure
  • sweating, dizziness, loss of appetite, dry mouth, and/or tremors
  • anxiety, sleeplessness, and poor muscular coordination
  • sudden violence and aggression in response to sensory input (unique to PCP users)

How can I or someone I know get help?

Perhaps because most psychedelics aren’t as addictive as such drugs as alcohol or heroin, there aren’t many support groups or organizations aimed at these users. But Narcotics Anonymous has long been dedicated to helping anyone battling the “disease of addiction,” regardless of the type of drug or severity of their problem, and it has chapters around the country (see below for contact information).


National Institute on Drug Abuse. NIDA InfoFacts: LSD.

Johnston L, et al. Monitoring the Future: National Results on Adolescent Drug Use, Overview of Key Findings 2008. National Institute on Drug Abuse.

Image credit: Shutterstock

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