in American Society, 5th, 6th, 7th, and 8th editions, Erich Goode, McGraw-Hill,
1999/2005/2008/2012. Chapters 1 and 9 and Drugs, Society, and Human
Behavior, Ray and Ksir, Mosby, 1999. Chapter 15 (8th ed.)
stare at this too long!)
too. (or this or this)
- Humans have always sought
to expand experience: Aphrodisiacs, Spirituality, Knowledge of "Other
- Plants have been there
- Knowledge of appropriate
ways to use plants to achieve particular effects has been part of human culture(s)
for 1000's of years
- Earliest form of religious
- Spirits are thought to
inhabit: animals, plants, rocks, etc.
- Consume the object and
"inherit" the spirit: Communicate, Special Powers, Knowledge
- Medicine Man, Shaman:
Specialist in plant properties
- Plants and their psychoactive
properties were instrumental in the development of human religions and folklore.
and Religious Experience
in a Name?
- 1931: Category of
drugs associated with the world of fantasy referred to as Phantastica
- 1960's: Psychedelic.
Mind made manifest, "See" more clearly, Transcend cultural limitations.
Aldous Huxley "The Doors of
Perception" (1954). Direct confrontation with reality.
Humphrey Osmund: LSD as a drug with "more than medical
significance." Pro-drug ideology.
- Impact of these drugs:
Hallucinations, Psychotic-like experience=> Psychotomimetic. Induced
state is illusion and undesirable. Anti-drug Ideology. Hallucinogen
A substance that is useful in a therapeutic
General Categories of Hallucinogens
- Substances which contains
the "indole nucleus" which is the basic structure of the neurotransmitter
Serotonin (impact on deep sleep regulation).
- The individual is typically
able to maintain some contact with the "real" world and remember
- Little "acute physiological
toxicity," overdose deaths unlikely.
(this .zip file is a program to download (it will need to be unzipped!) that
will give you a taste of the experience! Contact email@example.com
for more information.
Acid Diethylamide (the "S" comes from the German word
for acid: Saure)
- Odorless, colorless
- LD50 (rats) is about
400x the ED
- Dose for recreational
purposes: 1965-79: 150-250 micrograms, Today: 25-100 micrograms (see, LSD
- Stable use patterns (rather
- Early years: Key to mind
expansion; Today: "Just another drug in the soup"
- Not found in nature,
Semi-synthetic: synthesized from the ergot alkaloids from the ergot fungus
purprea. Mold which grows on grain, typically rye. Causes illness:
timeline). The following is from a 2/15/2000 post the MAPS Discussion
to ergotamine and dihydroergotamine which are used in the treatment of migraines,
the ergot alkaloid methylergonovine is an obstetric agent used to induce
labor and to control excessive uterine bleeding. (I believe these are its
main uses; Im a psychiatrist so thats not the usual end of the
body that I treat.) Also, if Im not mistaken, Hydergine (ergoloid
mesylate) is also a related compound believed by some to improve cognitive
The ergot preparations
used in migraine therapy are potent vasoconstrictors and are metabolized
in the liver by a specific subset (3A) of metabolic enzymes (known as the
cytochrome P450 system). Among the antiretroviral protease inhibitors, ritonavir
and indinavir are particularly potent inhibitors of the cytochrome P450
3A subset (among others). I have run across 3 case reports in which migraine
treatment with ergotamine resulted in severe systemic vasoconstriction when
co-administered with indinavir or ritonavir. According to the PDR, "ergotamine
overdose [may] include the following: numbness, tingling, pain, and cyanosis
of the extremities associated with diminished or absent peripheral pulses;
respiratory depression; an increase and/or decrease in blood pressure, usually
in that order; confusion, delirium, convulsions, and coma; and/or some degree
of nausea, vomiting, and abdominal pain." For dyhydroergotamine the
maximum recommended dose is no more than 4mg administered intranasally over
the course of 7 days (in 0.5mg doses) and for ergotamine no more than 10mg
(in 1mg doses) over the course of a week. Overt ergotism is rare but apparently
may be precipitated by the inhibition of hepatic metabolism of these 2 drugs.
I have found
no references to adverse reactions to Hydergine or methylergonovine in combination
protease inhibitors or other cytochome P450 inhibitors (two common examples
being nefazodone and erythromycin). Additionally there are no reports of
adverse reactions to LSD in individuals taking cyp3A inhibitors. Appologies
for the confusion regarding which drugs I was referring to in the phrase
"these agents" near the end of my previous post.
School of Medicine
of Psychiatry and Behavioral Health
Research Training Program
- St. Anthony's Fire
- Salem Witch Trials: Possessed
- 1938: Albert
Hofmann (Albert Hofmann Foundation) synthesizes
LSD at Sandoz Laboratories
- April 16, 1943:
Hofmann accidentally absorbs a tiny bit through his skin. The first "trip,"
about 3 hours in duration.
- "An uninterrupted
stream of fantastic images of extraordinary plasticity...accompanied by an
intense, kaleidoscope-like play of colors."
- April 19, 1943:
Hofmann deliberately ingests 250 micrograms. Experiences anxiety, but is fine
the next day.
- 1947: Werner
Stoll reports on the mental effects of LSD
- 1952: Charles
Savage reports on the first use of LSD to treat depression
- 1953: LSD clinic
opens in England- Roland Sadison. In USA, CIA's Project
MK-Ultra. An account
of other CIA testing,
- 1955: Conference
on LSD and Mescaline in USA
- 1960: Harvard's
Timothy Leary establishes the Psychedelic
- 1960's Army
experimentation. (account)(local copy)
- 1963: First year
LSD is recorded on the streets. Sugar cubes. Media coverage. Leary fired.
- 1966: Government
- 1967: First "human
be-in" held in San Francisco. "Summer of Love"
- 1970: Dock
Ellis no-hitter for the Pirates
- 1975: End of
- 1976: "Blotter
Acid" emerges as primary type.
- 1979: Hofmann
My Problem Child."
- 1988: Re surfacing
of the "psychedelic movement." Rave scene.
- 2005: Re-evaluation
of the therapeutic potential of LSD
Blotter Acid Art
- Methodology: subjective
- Distinction between therapist
and patient? Therapist use of the drug.
- Unpredictability of effects
- Boundary Problems
- Psychiatry as a young
- Science and spiritualism
- Science and religion
- Government funding
- Drug Wars
- Symbolic aspect of
- Re-study? Problem
with Schedule I substances
- How to study? For
what purpose? Development rational use policies?
information sheet on LSD
. LSD has a way of "doing that!"
- Used by natives of
South, Southwest and Central America(s)
- Teocanacatl: "God's
flesh" or "sacred mushroom"
in 1930: many species identified
- NY banker/ethnobotanist,
Gordon Wasson, first outsider to participate
permits you to travel backwards and forward in time, to enter other planes of
existence. Even (as the Indians say), to know God..."
- Psilocybe mexicana
is species with greatest psychoactive effect. Psilocybin is primary
active ingredient; isolated and synthesized by Albert Hofmann (LSD) in 1958.
- Dried mushrooms: .2-.5%,
psilocybin-- similar to LSD
- Effects: up to 4 mg.:
pleasant, relaxing, "body trip"
- Higher doses: perceptual
changes, distortion of body image and hallucinations
- CNS effect after
changed to psilocin: little in mushroom, half as potent. Psilocybin's
solubility is linked to its greater psychoactive properties.
Friday Study": Tim Leary's follower- investigate as tool to induce
religious experience. 20 seminarians, double blind study, half placebo, 90
minutes prior to religious ceremony. Immediate, one week, and 6 month follow-up.
- Criminalization of
- Can grow in a closet.
Spores available through mail order.
- Use seems to be stable,
popular in the 1990's. Availability is rather sporadic.
- Mexico: ololiuqui,
seeds of the morning glory plant, Rivea corymbosa.
- Alkaloids similar to
LSD, especially d-lysergic Amide, about 1/10 as active as LSD(Albert Hofmann,
- This finding relating
to Morning Glory's is unique since lysergic acid had only been known to exist
in the ergot fungus
- In USA, the species Ipomoea
violacea is most common.
- Seeds are eaten in large
numbers to achieve the psychedelic effect. CAREFUL!! Seeds are coated with
a poisonous herbicide.
- Names of commercial varieties:
Pearly Gates, Flying Saucers, Heavenly Blue.
- Dimethyltryptamine. Also
a variant- DET and DPT
- Not widely used in USA
- But, most important,
naturally occurring hallucinogen (neurotransmitter). Occurs in a wide variety
- Cohoba snuff: S. America
- Must be snuffed, smoked,
- Short duration, ~30-60
minutes: "Businessman's Trip"
Information on DMT
- Similar to indole hallucinogens
- But, different chemical
structure: catechol nucleus, basic structure of the catecholine neurotransmitters;
norepinephrine and dopamine (waking response, REM sleep, and reward centers)
- Also, similar to amphetamines,
although the stimulant effect is not as pronounced.
- Peyote cactus: Lophophora
williamsii. Small, spineless cactus. Subterranean. Rio Grande Valley
and southward. Grayish-pink pincushion like top protrudes above the ground.
- Crown is sliced into
disks: peyote buttons or mescal buttons
- Not the same as mescal
beans or mescal liquor: these come from the agave cactus- contain another
alkaloid, cytisine- highly toxic, effects resemble nicotine.
The Divine Cactus
- Taken orally=>
- High doses required:
passes blood-brain barrier poorly
- Reaches highest concentration
in 30-120 minutes, half removed from body in 6 hours, although some persists
in brain for up to 10 hours.
- Low doses: euphoria;
High doses: Hallucinations.
- Excreted unchanged in
the urine, metabolites not psychoactive.
- Objective effects: dilated
pupils, increase pulse and BP, body temperature elevated. Also elevated EEG
activity. LD50 is about 30x effective dose. Death: convulsions and respiratory
depression. Tolerance develops, and cross-tolerance with LSD.
- Although different chemical
structure, appears to operate similar to LSD. Effects blocked by serotonin
- Evidence as early as
1760 of use in USA, yet wasn't until late 19th Century that peyote cult was
- Today, perhaps 250,000
members. Cross between Christianity and traditional tribal beliefs. Native
American Church chartered in Oklahoma in 1918.
- Peyote used as aid to
prayers, as medicine, and worn as an amulet.
- Use was protected for
many years. (Leary attempted to have LSD recognized as "sacramental"
for the 1960's "The League for Spiritual Discovery").
- 1990 Supreme Court ruled
state of Oregon could prosecute its use. Religious freedom not allowed as
- Federal law and many
states specifically exclude sacramental use of peyote from prosecution, but
the court allows individual states to outlaw.
- Further decisions: "Wait
- June 2004: "Utah
Supreme Court ruled that peyote use in "bona fide" religious ceremonies,
regardless of the race of the participants, is protected under Utah and Federal
Law in Utah. " (Erowid)
- Mescaline isolated
as primary psychoactive agent in peyote in late 19th Century: See: The Heffter Research Institute.
It was synthesized in 1919. It is now known to be one of 30 psychoactive
alkaloids in peyote.
- Early investigator: Dr
I saw. Stars, delicate floating films of color, then an abrupt rush of countless
points of white light swept across my field of view, as if the unseen millions
of the Milky Way were to flow in a sparkling river before my eyes..."
- Huxley, in 1954, suggested
both the up side and down side of the mescaline experience.
- Availability and use
limited today. Often, what is sold as mescaline is a mixture of LSD and/or
group of drugs, due
to substitution on the ring of the catechol nucleus, effects closer to mescaline
(see also DrugText for
- AKA: STP (Serenity,
Tranquility and Peace)
- Similar in effect
to mescaline and LSD. 100x more potent than the former, 1/30 as potent as
- Trips reputed to be extremely
long, but due to the large doses consumed.
- Experience from the Haight-Ashbury
Clinic suggest high incidence of toxic effects
- Wide variety of concoctions
here, also DOET, TMA-2.
- Similar to above in effects,
although MDA seems to be subjectively different
- Designer Drugs
(Photo from Erowid: http://www.erowid.org/)
- Synthesized in 1912
- Extensively used and
tested in therapeutic setting
- Hits streets in USA in
mid 1980's; Today- Rave Scene.
- Effects reported as been
very different from other hallucinogens
- Empathogen, "Closeness,"
"Openness," objects appear luminescent, Serenity,
Noetic (see world in a new, fresh way)
- Objective: heart rate
increase, dryness, jaw clenching, teeth grinding, profuse sweating. Impact
- Not illegal until 1986
Controlled Substance Act which included analogues of other illegal drugs.
- First used as appetite
- 1953: Army tests- massive
doses killed rats
- 1970's Psychiatric use
(though not approved by FDA): 30,000 doses per month
- 1985: Temporary Schedule
I, 1988: Permanent, 1995: Appeals- ?
- Attracts older age group,
- Rosenbaum, Morgan, and
Beck: Controlled Hedonism and young, urban professionals. Extensive planning
goes in to use, Use is occasional==> Mini-Vacation.
- Purpose of use: Euphoria,
use: Opens patient up. Grinspoon: allows individual to "get in touch
with feelings." Rick Ingrasci: (200 patients)- Serves as a catalyst,
speeds up the therapeutic process.
- Norman Zinberg: "No
- BUT, others skeptical:
Ron Siegal (UCLA): "Used to think cocaine was non-problematic."
- Low dose therapeutic
use vs. Street/Rave scene (pills,
- Increasing use in the
1990s--media focus (in 2000, over 1000 stories broadcast on Ecstasy--wild claims):
- Taking over middle-class
- Depicted as comparable
to crack and heroin
- Best studies (on animals):
at levels 2-3x ED50- seems to deplete level of serotonin, with indication
of long-term impact. (see also DrugText
for more information)
- Grinspoon downplays,
but problems of cardiac arrhythmia indicates use may not be appropriate for
Use (Press release, 12/2001 MTF)
Response to Time: The Lure of Ecstasy
Review of the Literature on MDMA (Continuing
concerns over MDMA's effect on serotonin, May 2010, 2009 study).
Lure of Ecstasy ("THE
ELIXIR BEST KNOWN FOR POWERING RAVES IS AN 80-YEAR-OLD ILLEGAL DRUG. BUT IT'S
SHOWING UP OUTSIDE CLUBS TOO, AND ADVOCATES CLAIM IT EVEN HAS THERAPEUTIC
BENEFITS. JUST HOW DANGEROUS IS IT?")
Rising (2004 ABC Primetime Thursday special hosted by Peter Jennings).
is for Ecstasy
Chemicals- Hyperreal Information
the New Prescription Drug? (Washington Post, January 23, 2007)
and PTSD, 2008 (Alter.net)
and psychotherapy (2010): Michael
C. Mithoefer, Mark T. Wagner, Ann T. Mithoefer, Ilsa Jerome and Rick Doblin.
"The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted
psychotherapy in subjects with chronic, treatment-resistant posttraumatic
stress disorder: the first randomized controlled pilot study." Journal
of Psychopharmacology. Published online 19 July 2010. DOI: 10.1177/0269881110378371.
- Potato Family: Solanaceae
- Three genera: Atropa,
Hyoscyamus, Mandragora (Europe); and one worldwide: Datura
Scopolamine and l-hyoscyamine
- These drugs occupy, but
don't activate, the acetylcholine receptor site. They have both peripheral
and central effects: Mucous, saliva, and perspiration levels drop; heart rate
increases (up to 50 beats per minute); body temperature increases; pupils dilate (difficulty focusing).
High doses: confusion, toxic psychosis. No vivid sensory effect.
- Deadly nightshade (atropine)
- Used as a poison throughout
the Middle Ages and before.
- Name refers to "beautiful
woman": dilation of pupils. Used by Roman and Egyptian women. Today we
know that people judge a woman with more dilated pupils to be "pretty."
- Witches and "flying":
Prepare ointment, rub between legs and on stick (phallic symbol)- suggested
as part of the ritual of the Sabbat, or Black Mass
- As a cure for alcoholism
- Significant mention throughout
history, especially: Bible
- Close association with
love and lovemaking
- Root resembles the human
- Very active
- Used primarily as poison
- Used to "poison"
of a cure for alcoholism?
- Ancient Chinese: medicinal
use- for colds
- Associated with the "Buddha"
- Greeks: Delphi Oracle--
- India: Shiva- love potions
- S.W. American Indians
- Algonquin Indians: Adolescent
- Jamestown: Jimsonweed-
Early Spring growth, salads- strange behavior
- Used previously to treat
Parkinson's disease (now L-DOPA)
- Still used for pseudoparkinsonism
- Fly agaric: When flies
ingest the juice-- stuporous for 2-3 hours
- Common poisonous mushroom
- Severe effects: twitching,
raving drunkenness, vivid hallucinations
- Aryan invaders into
India-- 3500 years ago: Soma, sacramental substance. Discover within the past
25 years to be Amanita.
- Ambrosia- fruit of
the god Dionysious
- Even suggested, based
on the paintings representing the "tree of life" found in Roman
catacombs, that this mushroom formed a basis for a cult 2000 years ago which
now goes by the name Christianity.
(local copy) See,
Allegro, J. (1970). The Sacred Mushroom and the Cross: A Study of the Nature
and Origins of Roman Theology within the Fertility Cults of the Ancient Near
East. London: Hodder and Stoughton. More at wikipedia.
Most scholars are a bit skeptical of Allegro's claims.
- Until Russians brought
alcohol, tribes of Siberia had no other intoxicant, its use continues today:
Cost- several reindeer for an effective dose.
- Psychoactive agent
is excreted in the urine and is "reusable"
- Use also associated
with several native American tribes
- Originally the psychoactive
agent was thought to be muscarine: similar to the anticholergics. But,
Also found as secretions on certain toads (genus Bufo). TOADLICKING: an
urban legend. Not a very potent hallucinogen, and toads have a variety of
other toxins. Oakley Ray cautions: "Don't lick strange toads, and be
particularly cautious about believing weird stories about hallucinogenic drugs."
Actually, it's the venom that is harvested, dried, and smoked. See: http://www.erowid.org/archive/sonoran_desert_toad/
- More recent studies:
two other chemicals in the Amanita: ibotenic acid and muscimol.
- Effects strange and different.
Confusion, disorientation in time and space, sensory disturbances, twitching,
fatigue and sleep.
- Parke, Davis and Co.
In the 1950's: New intravenous anesthetic-- Phencyclidine.
- Not a very good product,
but animals did seem to become "disassociated"
- Use in humans: unpredictable
psychological effects-- feelings of unreality, depersonalization, persecution,
depression, and intense anxiety.
- By 1960: seen as useful
as anesthetic for animals; medically safe, but problematic for humans; and
a hallucinogen of a "different sort."
- Used in veterinary
medicine to "stun" animals (not a tranquilizer)
- Similar drug marketed:
- Appears on the streets-
late 1960's-1970's: "Hog," "garbage," "Angel Dust."
- Use to "beef"
up poor quality marijuana, sold as a substitute for just about everything
- Morgan and Kagan:
Media myths and realities. Dangerous, yes- But: with each "new"
drug explosion of negative publicity feed itself to create overblown vision
of danger. Use and "morbidity of PCP declining. Culture has "adjusted."
- Most news coverage
on PCP in aone year: 1978. Narrow focus on individual cases--issuesof violence
and horror. Media "myth" becomes (and remains) popular image.
- Linked to violence,
yes, but level of use is minimal
- 2000 DAWN: .33% of
ER cases. Even in 1970, 20 million instances of use; 6,000 trips to ER.
K," "Vitamin K"): Effects
- Eidetic Imagery: "Eyeball
- Multi-level Reality:
multiple perspectives, molecular view, universal images.
- Subjective Exaggeration:
Number, Size, Details and
Transformation of objects
- Emotional Lability: ups
- Irrationalism: intuition,
organicism. Words, meanings become strange. Impact of subcultural attitudes
and rejection of Western culture.
- Sensory overload
- Metabolized rapidly-
4 hour half life
- Tolerance develops rapidly,
- No physical addiction
- Dilated pupils
- Elevated body temperature,
- ASC effects: serotonin
systems of the brain.
- Panic reactions
- Prolonged psychotic reaction
seem to reflect use patterns and subcultural controls. As use has remained consistent,
perhaps even slight increase; problems associated with use have decreased.
Becker on Subculture
- Over time
the subculture develops
interpretations of drug experience, these take the experience out of the realm
of insanity and place it in a "normal" context.
- Creates approved and
- Ideology of acceptance,
and positive nature
- Sets expectations
- Leads to fewer problems
today, coupled with lower doses
on controlled use.
- All users have bad experiences
- Most handle
- Importance of "cultural
context" for interpreting experience: Middle Ages and ergotism
- Definitions of reality;
- Many cultures successfully
integrate the drug experience into the realm of normalcy and acceptability.
pure LSD- Actual number of "bad" experience small (Joel Fort- 1:1000);
seriously bad- 1:10,000. BUT: Street
- Why risk? Problems can
occur, but are unlikely for stable individual. Still there is the potential
for permanent damage. Significant: YES; Typical: NO.
- 1967: Chromosome breaks.
Tetragenesis (leads to birth defects). Thalidomide scare.
- Heavy Press coverage,
distortions: "Acid Burned a Hole in My Genes"
- Problem of controls
in the studies: Street vs Pure drug; Frequency and dosage levels, Other drugs,
Animal studies vs. Humans
- And, chromosome breakage
does not mean birth defects: "normal" rate is about 4%. Question
is, is the rate significantly higher for mothers who take LSD. And, when did
she? First trimester is most critical
- Major studies suggest
that impurities in street acid seem to explain problems.
- Mutagenesis is related
to massive doses, Pure LSD does not appear to be significantly related to
- Politics and Ideology
- In 2000, LSD accounted
for .01% of DAWN ER cases
change, as well as media hype.
- Yet, early media attention
was instrumental force in passing Drug Abuse Control Act of 1966 (which leveled
controls on LSD). By 1970: Controlled Substances Act.
Use Patterns Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.
- Media and some researchers
view peak in late 1960's: ?? "Leary Phenomenon" ??
- Media coverage certainly
peaks in an eleven month span, March 1966- February 1967, BUT:
- Use College Students (really just speculation)--some estimates for LSD:
maybe 20-25% (18-25 year olds)
- Peak year of use by High School Seniors: 1979, 17.7% (lifetime report)
- Now stabilized. Drops
through 1980's. Levels of use, (Latest
NSDUH 2003-2012, 12 years
of age and older
- The slight increases
in persons reporting lifetime use of LSD from the late 1990s has stabilized,
figures on all hallucinogen use have remained fairly stable.
Little frequent, chronic use. User loyalty
- LOW "sensuous
appeal"-- animals will avoid.
- Why no dependence
or chronic use?... Tolerance develops rapidly, use requires a lot of effort--
it's physically exhausting (Like study of professional's use of XTC: can't
do other things); Effects are inconsistent.
- Massive revival: Unlikely
Stimulants: Xanthines, Amphetamine, Nicotine, and Cocaine
Owner: Robert O. Keel firstname.lastname@example.org
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