CHAPTER 4 Substance Abuse^75
Acute panic and paranoia is a common side effect that can lead to homicidal
thoughts and actions. The toxic effect of LSD causes impaired judgment and
toxic delirium. This results in a stage of exhaustion and feeling of emptiness
where the person is unable to coordinate thoughts. This fall into depression
increases the risk of suicide. Some people who take LSD also enter into a long-
term schizophrenic or psychotic reaction. LSD stimulates the uterus and could
induce contractions in a pregnant woman.
Healthcare providers treat a person who is under the influence of LSD by
using a “talk-down” approach where they talk the patient through the episode in
a quiet, relaxed environment. If this approach fails, drug therapy is employed
using a benzodiazepine such as diazepam (Valium). Drugs should only be used
along with crisis intervention therapy.
Avoid using phenothiazines such as chlorpromazine (Thorazine). These can
exacerbate the patient’s panic reaction and cause postural hypotension (low blood
pressure when standing). Also avoid large doses of tranquilizers, using restraints,
and isolating the patient because these interventions are more traumatic than
therapeutic.
Mescaline
Mescaline is an alkaloid that is extracted from the flowering heads (mescal but-
tons) of the peyote cactus. Mescaline causes subjective hallucinogenic effects
similar to LSD. The extract is a soluble crystalline power that can be dissolved
into tea or placed in capsules for ingestion.
This drug takes effect almost immediately and lasts about six hours before it
reaches its half-life and is excreted into the urine. People taking mescaline expe-
rience anxiety, hyperreflexia, static tremors, and psychic disturbances with vivid
visual hallucinations. They also feel abdominal pain, nausea, and diarrhea.
Psilocybin
Psilocybin is extracted from Mexican mushrooms. It produces a subjective hal-
lucinogenic effect that is similar to mescaline, but of shorter duration. Psilocybin
takes effect in a half hour to an hour after the drug is administered and its effect
can last up to six hours.
People who take this drug experience a pleasant mood although some users
become apprehensive. This results in impaired performance and poor critical
judgment. Some exhibit hyperkinetic (compulsive movements) behavior and
inappropriate laughter. The pupils dilate and the person experiences vertigo