414 CHAPTER 9
are less predictable in their effects, and are more sensitive to the user’s expectations
as well as the context in which the drug is taken.
Hallucinogens are substances that induce sensory or perceptual distortions—
hallucinations in any of the senses. That is, they lead users to think they see, hear,
taste, or feel something that is not actually present or not present in the way it
is perceived. Some hallucinogens also can induce mood swings. Hallucinogens fre-
quently taken for recreational purposes include the following:LSD• (a synthetic hallucinogen),mescaline• (a psychoactive substance produced by some kinds of cacti),- psilocybin (a psychoactive substance present in psilocybin mushrooms, commonly
referred to as “magic mushrooms”), and - marijuana (the dried leaves and fl owers of the hemp plant).
The fi rst three of these drugs are chemically similar to the neurotransmitter sero-
tonin. A single moderate dose of any of these drugs (or a very high dose of mari-
juana) is enough to induce visual hallucinations. Let’s examine the abuse of and
dependence on LSD and marijuana.LSD
All of the Beatles used LSD at one point or another, but John Lennon reported that
he took LSD thousands of times—which surely would constitute abusing the drug.
LSD is a hallucinogen because it alters the user’s visual or auditory sensations and
perceptions; it also induces shifting emotions. Users may also experience synesthe-
sia, a blending of senses that might lead them to “see” musical notes or “hear”
colors. At higher doses, LSD can lead to delusions and distortions of time (NIDA,
2007d). LSD normally has an effect within 30 to 90 minutes of being ingested, and
the effects last up to 12 hours (NIDA, 2001).
However, the effects of LSD can be unpredictable. A “bad trip” (i.e., an adverse
reaction to LSD) can include intense anxiety, fear, and dread; a user may feel as if
he or she is totally losing control, going crazy, or dying. People who are alone when
experiencing a bad trip may get hurt or kill themselves as they respond to the hal-
lucinations. If other people are present, they can talk the user through the effects,
constantly reminding him or her that the trip is actually a temporary, drug-induced
state; alternatively, they may take the person to the emergency room of a hospital.
Two aftereffects can occur from LSD use, even after the pharmacological
effects of the drug have worn off: psychosis (hallucinations and visual distur-
bances) and “fl ashbacks” (termed hallucinogen persisting perception disorder in
DSM-IV-TR, which are involuntary and vivid memories of sensory distortions
that occurred while under the infl uence of the drug). However, such aftereffects
are rare.
Recurrent LSD use can rapidly lead to tolerance, meaning that the user needs
larger doses. Tolerance disappears if the user stops taking the drug, and LSD does
not cause withdrawal symptoms. Unfortunately, LSD abuse can induce enduring
psychotic symptoms in a small number of people (NIDA, 2007d).Marijuana
The Beatles also smoked marijuana, which is the dried leaves and fl owers of the
hemp plant (cannabis sativa). The resin from the hemp plant’s fl owering tops is
made into another, more potent drug, hashish. The active ingredient of marijuana
and hashish is tetrahydrocannabinol (THC). Both marijuana and hashish can be
either smoked or ingested. George Harrison used hashish and was arrested for pos-
sessing it. Paul McCartney and John Lennon were arrested at different times for
possessing marijuana.
Marijuana’s effects are subtler than those of other hallucinogens, creating mi-
nor perceptual distortions that lead a person to experience more vivid sensations
and to feel that time has slowed down (NIDA, 2005b). The user’s cognitive and
motor abilities are also slowed or temporarily impaired, which produces poor driving