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The Psychological Effects of LSD Introduction LSD has always been a center of controversy in American society, often times because people have been miseducated about its effects or exposed to media bias. Its physiological effects on the brain and body have become more and more apparent in the last few decades when research in neuroscience peaked. The psychological effects of LSD have been often difficult to describe and document very well -- they were first discovered on April 16, 1943 by research chemist Albert Hofmann when a small amount of the drug soaked through his fingers during a routine synthesis. He experienced an imaginative dream-like state for a duration of about 2-3 hours (Hofmann, 1983). Since then, a great deal of work has been done attempting to document the health effects of LSD. Acute Effects LSD is very potent: the effective dose is measured in micrograms (ug) -- however, the lethal dose is literally thousands of times that, making the drug essentially non- toxic. There have been only a few cases of possible overdose where people ingested extremely large amounts of the drug (Allen et al., 1978; Griggs et al., 1977). LSD can be administered a number of ways, the most common: orally through paper, sugar cubes, on a piece of gelatin, or by pill; intravenously; or intramuscularly. A standard dose with noticeable hallucinogenic effects is about 100-200 ug. The intensity of the trip is proportional to the size of the dose -- it is interesting to note, though, that the duration of the trip seems to stay the same at higher doses (Freedman, 1984). The initial effects begin 20-40 minutes with a sense of euphoria and dizziness. Hallucinations then begin to occur, with the trip peaking for 4-5 hours after about an hour since the drug is taken. LSD is best described as a drug that strikes down barriers. The person who uses LSD is likely to feel detached from his/her ego, and can cross between states of consciousness. The user's perceptions are altered, causing visual and auditory hallucinations. One may notice that the walls of room are "breathing" or that motionless curtains appear to be moving. Senses appear to mix: a user might see music, taste colors, or hear visual stimuli. The LSD experience is often difficult to describe by users -- words lose meaning and are often insufficient in describing the effects of the drug; thoughts may seem unclear. Effects taper off after about 6-8 hours and are usually completely gone after a nights sleep. The user's mood is likely to change depending on how he/she feels at various stages of the trip. The outcome of the trip is almost always dependent on two primary variables: the set and the setting. The set refers to a user's expectations of the drug's effects and the user's state-of-mind. The setting is the environment in which the drug is taken. If an inexperienced user takes LSD in stressed condition or in a bad mood, a bad experience may occur. By the same token, taking LSD in a chaotic environment like a noisy rock concert could turn into trouble for someone unsure of the drugs effects. When users on LSD become frightened or enter a state of panic, they can usually be relieved or "talked down" by a friend. With this in mind, probably the best way to use LSD would be in one's home with several trusting supportive friends. The following is a fairly long, but very informative account of one of the first documented LSD trips done by Albert Hofmann in 1943: "4/19/43 16:20: 0.5 cc of 1/2 promil aqueous solution of diethylamide tartrate orally=0.25 mg tartrate. Taken diluted with about 10 cc water. Tasteless. 17:00: Beginning dizziness, feeling of anxiety, visual distortions, symptoms of paralysis, desire to laugh. Supplement of 4/21: Home by bicycle. From 18:00- ca.20:00 most severe crisis. (See special report.) * * * * Here the notes in my laboratory journal cease. I was able to write the last words only with great effort. By now it was already clear to me that LSD had been the cause of the remarkable experience of the previous Friday, for the altered perceptions were of the same type as before, only much more intense. I had to struggle to speak intelligibly. I asked my laboratory assistant, who was informed of the self-experiment, to escort me home. We went by bicycle, no automobile available because of wartime restrictions on their use. On the way home, my condition began to assume threatening forms. Everything in my field of vision wavered and was distorted as if seen in a curved mirror. I also had the sensation of being unable to move from the spot. Nevertheless, my assistant later told me that we had traveled very rapidly. Finally, we arrived at home safe and sound, and I was just barely capable of asking my companion to summon our family doctor and request milk from the neighbors. [...] The dizziness and sensation of fainting became so strong at times that I could no longer hold myself erect, and had to lie down on a sofa. My surroundings had now transformed themselves in more terrifying ways. Everything in the room spun around, and the familiar objects and pieces of furniture assumed grotesque, threatening forms. They were in continuous motion, animated, as if driven by an inner restlessness. The lady next door, whom I scarcely recognized, brought me milk -- in the course of the evening I drank more than two liters. She was no longer Mrs. R., but rather a malevolent, insidious witch with a colored mask. Even worse than these demonic transformations of the outer world, were the alterations that I perceived in myself, in my inner being. Every exertion of my will, every attempt to put an end to the disintegration of the outer world and the dissolution of my ego, seemed to be a wasted effort. A demon had invaded me, had taken possession of my body, mind, and soul. I jumped up and screamed, trying to free myself from him, but then sank down again and lay helpless on the sofa. The substance, with which I wanted to experiment, had vanquished me. It was the demon that scornfully triumphed over my will. I was seized by the dreadful fear of going insane. I was taken to another world, another place, another time. My body seemed to be without sensation, lifeless, strange. Was I dying? Was this the transition? At times I believed myself to be outside my body, and then perceived clearly, as an outside observer, the complete tragedy of my situation. I had not even taken leave of my family (my wife, with our three children had traveled that day to visit her parents, in Lucerne). Would they ever understand that I had not experimented thoughtlessly, irresponsibly, but rather with the utmost caution, and that such a result was in no way foreseeable? My fear and despair intensified, not only because a young family should lose its father, but also because I dreaded leaving my chemical research work, which meant so much to me, unfinished in the midst of fruitful, promising development. Another reflection took shape, an idea full of bitter irony: if I was now forced to leave this world prematurely, it was because of this lysergic acid diethylamide that I myself had brought forth into the world. By the time the doctor arrived, the climax of my despondent condition had already passed. My laboratory assistant informed him about my self- experiment, as I myself was not yet able to formulate a coherent sentence. He shook his head in perplexity, after my attempts to describe the mortal danger that threatened my body. He could detect no abnormal symptoms other than extremely dilated pupils. Pulse, blood pressure, breathing were all normal. He saw no reason to prescribe any medication. Instead he conveyed me to my bed and stood watch over me. Slowly I came back from a weird, unfamiliar world to reassuring everyday reality. The horror softened and gave way to a feeling of good fortune and gratitude, the more normal perceptions and thoughts returned, and I became more confident that the danger of insanity was conclusively past. Now, little by little I could begin to enjoy the unprecedented colors and plays of shapes that persisted behind my closed eyes. Kaleidoscopic, fantastic images surged in on me, alternating, variegated, opening and then closing themselves in circles and spirals, exploding in colored fountains, rearranging and hybridizing themselves in constant flux. It was particularly remarkable how every acoustic perception, such as the sound of a door handle or a passing automobile, became transformed into optical perceptions. Every sound generated a vividly changing image, with its own consistent form and color. Late in the evening my wife returned from Lucerne. Someone had informed her by telephone that I was suffering a mysterious breakdown. She had returned home at once, leaving the children behind with her parents. By now, I had recovered myself sufficiently to tell her what had happened. Exhausted, I then slept, to awake next morning refreshed, with a clear head, though still somewhat tired physically. A sensation of well- being and renewed life flowed through me. Breakfast tasted delicious and gave me extraordinary pleasure. When I later walked into the garden, in which the sun shone now after a spring rain, everything glistened and sparkled in fresh light. The world was as if newly created. All my senses vibrated in a condition of highest sensitivity, which persisted for the entire day." (Hofmann, 1983). Chronic Effects The long-term effects of LSD use can be both good and bad. There are cases of people who claim to have had their entire lives turned around, for the better, due to LSD use. On the other hand, some people have been hospitalized by so- called "LSD psychosis." In the late 1960s, several studies indicated possible chromosome breakage due to LSD use. Some people report experiencing "LSD flashbacks" -- brief vivid repetitions of a previous LSD experience. The effects of LSD are very strong and profound. Many people have claimed to have discovered their inner selves under the influence of LSD. One interesting analogy was made by Professor Jeffrey M. Blum of the University of Buffalo School of Law: "The problems posed by LSD, for example, in some ways resemble those presented by scuba diving. Each is seen as a form of exploration that opens new vistas. Hence participants often find the activity enormously stimulating and inspiring. Each activity poses a small but significant risk of serious personal harm, these being death in one and aggravation of pre-existing states of mental instability for the other. Untrained, unsupervised use of unchecked substances or equipment are ill-advised in both cases." (Blum, 1990) LSD also has shown to have therapeutic usefulness. It has been successful in treating some forms of schizophrenia (Hoffer, 1970). Another study found notable success in treating terminally-ill cancer patients: two-thirds of the subjects showed positive change in anxiety, emotional tension, psychological isolation, fear of death, and the amount of pain medication needed (Pahnke et al., 1970). Studies that have shown LSD useful in treating alcoholism and other addictions are contradictory and may be inconclusive. Pahnke's group (1970) reported moderate success in treating alcoholism, but Ludwig (1970) found less-than-encouraging results. It's important to note, though, that both of these studies used vastly different treatment styles and dosages of the drug. Some users of LSD experience what is clinically referred to as LSD psychosis, schizophrenic-like disorders that seem to be triggered by using the drug. However, in careful analysis of LSD psychosis patients, it appears that those who have strong family histories of major psychosis or psychopathology are more vulnerable than those who do not (Tsuang et al., 1982). Vardy et al. (1983) reported similar findings, as well as that LSD psychotics have significantly higher rates of parental alcoholism than control groups. In a survey of five-thousand individuals who had used LSD a total of twenty-five-thousand times, Cohen (1960) found 1.8 psychotic episodes per thousand ingestions, 1.2 attempted suicides, and 0.4 completed suicides -- figures consistent with the those of the general population. Regarding dangers of psychosis in therapeutic uses of LSD, Pahnke et al. (1970) notes: "Since 1963 at the Spring Grove State Hospital, and now at the Maryland Psychiatric Research Center, over 300 patients have been treated with LSD without a single case of long-term psychological or physical harm directly attributable to the treatment, although there have been two post-LSD disturbances which have subsequently responded to conventional treatment." Bad reactions to LSD are almost certainly dependent on the user. It is becoming increasingly easier to diagnose schizophrenics clinically as patients suffering physical disorders -- these people should be very cautious, if not completely avoidant of truly powerful psychoactive drugs like LSD. There are another class of people who use LSD irresponsibly, ignoring important factors like set and setting -- bad reactions, more acute then chronic, are likely to occur here as well. Really the only serious physiological concern about LSD use has been that it may cause chromosome damage -- this was first reported by Cohen et al. in 1967. These findings were seldom replicated, and were contradicted by other studies (Loughman et al., 1967; Bender et al., 1968; Pahnke, 1970). In 1977, Maimon Cohen, one of the invesigators who first reported this a decade earlier, stated that no conclusions could be drawn based on existing evidence (Cohen et al., 1977). The phenomena of LSD flashbacks has been over-sensualized by the media for many years. Flashbacks are associated with highly emotional experiences and often happen to people who have never used psychedelic drugs. A frightening war memory, being raped, or even getting married, can all trigger flashbacks quite some time later. Thus, an emotional experience on LSD can also cause flashbacks. Flashbacks also occur due to post-traumatic stress disorder, associated with victims of disaster and extreme violence -- it is estimated that 1% of the general population suffers from this ("Journey for Better Life," 1992). Conclusion LSD is a very potent drug, but is physically quite safe and non-toxic. Its effects include mild euphoria and anxiety, altered perceptions, and the ability to pass between states of consciousness. Visual hallucinations are the most noticeable by users. The acute effects taper off as time progresses and are usually gone by the next morning. Chronic effects of the drug can be positive and negative. Positive effects include spiritual contact and self- exploration; the most severe negative effect is known as LSD psychosis. LSD has shown to have therapeutic usefulness, although research has been severely limited for the last several decades. LSD psychosis has been linked to forms of schizophrenia, and thus, to some physiological disorders -- it appears to be dependent on the user, and not on the drug. References Cited Allen, R.M. & Young, S.J. (1978): Phencyclidine-induced psychosis. Am. J. Psychiatry. 135:1081-1083. Bender, L. & Siva Sankar, D.V. (1968, 16 February): Chromosomal damage not found in leukocytes of children treated with LSD-25. Science. 159:749. Blum, J. (1990): Letter to Judge John L. Elfvin; United States District Court. Cohen, M.M., Hirschhorn, K. & Frosch, W.A. (1967, 16 November): In vivo and in vitro chromosomal damage induced by LSD-25. NEJM. 277:1043-1049. Cohen, M.M. & Shiloh, Y. (1977-1978): Genetic toxicology of lysergic acid diethylamide (LSD-25). Mutat. Res. 47:183-209. Cohen, S. (1960): Lysergic acid diethylamide: side effects and complications. Journal of Nervous and Mental Disease. 130:30-40. Freedman, D.X. (1984): LSD: The bridge from human to animal. In: Jacobs, B.L. (Ed.) Hallucinogens: Neurochemical, Behavioral, and Clinical Perspectives. New York: Raven Press. Griggs, E.A. & Ward, M. (1977): LSD toxcity: A suspected cause of death. J. Ky. Med. Assoc. 75:172-173. Hoffer, A. (1970): Treatment of psychosis with LSD. In Gamage, J.R. & Zerkin, E.L. Hallucinogenic Drug Research. Beloit, Wisconsin: Stash Press. Hofmann, A. (1983): LSD -- My Problem Child. (J. Ott, Trans.) Los Angeles: J.P. Tarcher. Journey for better life hell for some women. (1992, Feb 18): LA Times. pg. A3. Loughman, W.D., Sargent, T.W. & Israelstam, D.M. (1967, 27 October): Leukocytes of humans exposed to lysergic acid diethylamide: lack of chromosomal damage. Science. 158:508-510. Ludwig, A. (1970): LSD treatment in alcoholism. In Gamage, J.R. & Zerkin, E.L. Hallucinogenic Drug Research. Beloit, Wisconsin: Stash Press. Pahnke, W.N., Kurland, A.A., Unger, S., Savage, C. & Grof, S. (1970): The experimental use of psychedelic (LSD) psychotherapy. In Gamage, J.R. & Zerkin, E.L. Hallucinogenic Drug Research. Beloit, Wisconsin: Stash Press. Tsuang, M.T., Simpson, J.C., & Kronfol, Z. (1982): Subtypes of drug abuse with psychosis. Arch. Gen Psychiatry. 39:141-147. Vardy, N.M. & Kay, S.R. (1983): LSD psychosis or LSD- induced schizophrenia? A multi-method inquiry. Arch. Gen. Psychiatry. 40:877-83. Wesson, D.R. & Smith, D.E. (1976): An analysis of psychedelic flashbacks. Am. J. Drug Alcohol Abuse. 3:425-435.