Dissociative Drugs



Short-Term Effects

Dissociative drug effects can appear within a few minutes and can last several hours in some cases; some users report experiencing drug effects for days.

Effects on a Developing Fetus

While the effects of most hallucinogens on the developing fetus are unknown, researchers do know that mescaline in peyote may affect the fetus of a pregnant woman using the drug.

Effects depend on how much is used. In low and moderate doses, dissociative drugs can cause:

  • numbness
  • disorientation and loss of coordination
  • hallucinations
  • increase in blood pressure, heart rate, and body temperature

In high doses, dissociative drugs can cause the following effects:

  • memory loss
  • panic and anxiety
  • seizures
  • psychotic symptoms
  • amnesia
  • inability to move
  • mood swings
  • trouble breathing 

Long-Term Effects of Dissociative Drugs

More research is needed on the long-term effects of dissociative drugs. Researchers do know repeated use of PCP can result in addiction. Other long-term effects may continue for a year or more after use stops, including:

  • speech problems
  • memory loss
  • weight loss
  • anxiety
  • depression and suicidal thoughts

Can a person overdose on hallucinogens?

It depends on the drug. An overdose occurs when a person uses enough of a drug to produce serious adverse effects, life-threatening symptoms, or death. Most classic hallucinogens may produce extremely unpleasant experiences at high doses, although the effects are not necessarily life-threatening. However, serious medical emergencies and several fatalities have been reported from 251-NBOMe.

Overdose is more likely with some dissociative drugs. High doses of PCP can cause seizures, coma, and death. Additionally, taking PCP with depressants such as alcohol or benzodiazepines can also lead to coma. Benzodiazepines, such as alprazolam (Xanax), are prescribed to relieve anxiety or promote sleep.

However, users of both classic hallucinogens and dissociative drugs also risk serious harm because of the profound alteration of perception and mood these drugs can cause.

  • Users might do things they would never do in real life, like jump out of a window or off a roof, for instance, or they may experience profound suicidal feelings and act on them.
  • With all drugs there is also a risk of accidental poisoning from contaminants or other substances mixed with the drug.
  • Users of psilocybin also run the risk of accidentally consuming poisonous mushrooms that look like psilocybin. Taking poisonous mushrooms can result in severe illness or possible death.

Are hallucinogens addictive?

In some cases, yes. Evidence suggests that certain hallucinogens can be addictive, and that people can develop a tolerance to them.

For example, LSD is not considered an addictive drug because it doesn't cause uncontrollable drug-seeking behavior. However, LSD does produce tolerance, so some users who take the drug repeatedly must take higher doses to achieve the same effect. This is an extremely dangerous practice, given the unpredictability of the drug. In addition, LSD produces tolerance to other hallucinogens, including psilocybin.

The misuse and addiction potential of DMT is currently unknown. Unlike other hallucinogens, DMT does not appear to lead to tolerance. There is also little evidence that taking it in the form of ayahuasca tea can lead to addiction.

On the other hand, PCP is a hallucinogen that can be addictive. People who stop repeated use of PCP experience drug cravings, headaches, and sweating as common withdrawal symptoms.

More research is needed on the tolerance or addiction potential of a variety of hallucinogens. 

Tolerance vs. Dependence vs. Addiction

Long-term use of prescription opioids, even as prescribed by a doctor, can cause some people to develop a tolerance, which means that they need higher and/or more frequent doses of the drug to get the desired effects.

Drug dependence occurs with repeated use, causing the neurons to adapt so they only function normally in the presence of the drug. The absence of the drug causes several physiological reactions, ranging from mild in the case of caffeine, to potentially life-threatening, such as with heroin. Some chronic pain patients are dependent on opioids and require medical support to stop taking the drug.

Drug addiction is a chronic disease characterized by compulsive, or uncontrollable, drug seeking and use despite harmful consequences and long-lasting changes in the brain. The changes can result in harmful behaviors by those who misuse drugs, whether prescription or illicit drugs.

How is a hallucinogen addiction treated?

There are no FDA-approved medications to treat addiction to hallucinogens. While behavioral treatments can be helpful for patients with a variety of addictions, scientists need more research to find out if behavioral therapies are effective for addiction to hallucinogens.

Could hallucinogens be medicines?

Potentially. Some hallucinogens have been studied for possible therapeutic benefits in treating mental disorders such as depression.

Ketamine was approved many years ago as an anesthetic for painful medical procedures. In March 2019, the medicine esketamine (called “Spravato” by the manufacturer) was approved by the Food and Drug Administration as a treatment for severe depression in patients that do not respond to other treatments. Esketamine is closely related to the drug ketamine which is used illicitly and so there are concerns about the potential for abuse of this newly approved medication. In response, esketamine will be limited to administration in medical facilities.

Unlike a prescription that can be taken home and might be diverted into recreational use, esketamine will be administered in a medical office as a nasal spray. Patients must wait at least 2 hours under medical supervision to ensure proper management of potential side effects. It is a rapid acting medication, so improvements may be seen immediately or within the first few weeks of treatment (unlike most other antidepressants which can take weeks to begin to show an effect). Traditional antidepressants target the neurotransmitters serotonin, norepinephrine or dopamine. Esketamine affects the receptor for a different brain chemical called glutamate and so it represents a new approach to treating depression.

Evidence has also mounted in recent years that psilocybin may be effective in treating depression, and this is currently being studied in clinical trials. Psilocybin is not approved by the Food and Drug Administration (FDA), but in 2018, the FDA granted “Breakthrough Therapy” designation to one pharmaceutical company to facilitate clinical trials for its psilocybin-assisted therapy for treatment-resistant depression; the trials will determine the most optimal dose of the drug. It has also been studied as a possible treatment for depression and anxiety suffered by people with terminal illnesses.


Source:

National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.