Are psychedelics addictive?

What are psychedelics?

A 2021 study describes psychedelics as serotonergic hallucinogens, which are agonists of serotonergic 5-HT2A receptors. This means that they bind to these receptors, producing a certain response.

Some serotonergic hallucinogens are present in nature, including psilocybin, a compound in mushrooms of the genus Psilocybe, or N,N-dimethyltryptamine, a compound in the botanical beverage ayahuasca. They can also be synthetic, such as the recreational drug LSD.

The effects that psychedelics produce are dependent on various factors, such as dosage and the personality of an individual. However, they include the following:

• hallucinations, mainly visual
• blissful mood or euphoria
• changes in cognition, or thinking, such as:
  • mystical experiences
  • self-consciousness
  • altered time passage
  • introspection

What are their uses?

Psychedelics have both recreational and medical uses:

Recreational uses

In addition to producing visual hallucinations, euphoria, and mystical experiences, psychedelics have other effects that underlie their recreational use. According to one clinical trial, these include derealization, which is when a person feels detached from their surroundings, and depersonalization, which is when they feel detached from their body or mind.

According to the NIDA, people may misuse psychedelics with the hope of:

• detaching from reality
• coping with stress
• entering a spirit world or a more enlightened way of thinking

Medical uses

More research is necessary to provide proof, but a few studies suggest that psychedelics may have a few uses relating to mental health and substance use disorders.

Reduce depression and anxiety

Research from 2016 investigated the effects of psilocybin on 12 people with treatment-resistant depression. Following two doses — 10 milligrams (mg) and then 25 mg — of the drug, the symptoms diminished, and the improvements remained significant for 3 months.

Additionally, a 2016 clinical trial explored the effects of psilocybin on the symptoms of depression and anxiety in 51 individuals with a diagnosis of potentially life threatening cancer. The results suggested that psilocybin produced a substantial and long lasting reduction in depression and anxiety, as well as increases in optimism and quality of life.

An older 2014 study examined the use of LSD in 12 people who had anxiety associated with life threatening conditions. The findings indicated that two moderate doses of 200 micrograms decreased anxiety, with these effects persisting throughout a 12-month follow-up period.

Help with smoking and alcohol abstinence

Research from 2016 assessed the use of psilocybin in helping 15 individuals quit smoking. An analysis of the data indicated that the drug might hold promise in fostering long-term smoking abstinence.

A 2015 clinical trial evaluated the value of psilocybin in 10 participants with alcohol dependence. The results suggested that the drug reduced cravings for alcohol and increased abstinence. For the most part, the benefits lasted throughout a 36-week follow-up period.

Are they addictive?

Research from 2016 reports that psychedelics do not lead to dependence or addiction. Dependence refers to a physical reliance on a drug, whereas addiction refers to a behavioral change arising from a compulsion to continue taking a drug.

However, the NIDA warns that LSD produces tolerance. This means that a person has to take larger dosages to receive the same effect. LSD also can cause tolerance to other hallucinogens, such as psilocybin.

Side effects and risks of psychedelics

Psychedelics have various side effects and risks, including:

Side effects

The NIDA cautions that short-term side effects of psychedelics include:

• nausea
• increased heart rate
• changes in the sense of time, such as a feeling that time is passing slowly
• heightened feelings and sensory experiences, such as seeing brighter colors

Long-term side effects include persistent psychosis. The effects of psychosis may involve:

• paranoia
• visual disturbances
• disorganized thinking
• mood changes

Another long-term effect is a phenomenon called hallucinogen persisting perception disorder (HPPD). This involves flashbacks of a prior drug experience that can happen without warning and cause significant distress or impairment. The flashbacks may occur within a few days or more than 1 year after drug use. HPPD can cause alarm, as a person may mistake the symptoms for a brain tumor or stroke.

Risks

The following risks are associated with psychedelics:

Risks from a bad trip

Older research from 2008 reports that the most common risk is what people call a “bad trip.” It may involve:

• fear
• dysphoria
• panic
• frightening illusions
• troubling thoughts about one’s life or evil forces
• hyperawareness of physiological processes

Risks from dangerous behavior

Psychedelics can impair judgment, which may sometimes cause a person to believe that they have superhuman powers. This belief may induce them to do hazardous things, such as jump off a building.

Risks from high dosages

Experts note that high dosages can affect the blood vessels, potentially causing:

• thrombus formation
• accumulation of platelets
• coronary artery spasms

Risk of death

According to the Department of Justice, an overdose of LSD or psilocybin rarely causes death. When death does occur, it usually stems from:

• accidents
• suicide
• inadvertent ingestion of poisonous plant material

Risks from contaminants

Drugs of abuse pose the danger of having metal or bacterial contamination, which can cause toxicity or infections.

Should people with a history of substance use disorder use them?

People with a history of a substance use disorder should not use psychedelics. Repeated drug use can lead to brain changes that make self-control more challenging.

Some psychedelics, such as LSD, can cause tolerance, which can increase the risk of an overdose and potentially cause death.

The bottom line is that psychedelics are drugs that can be very dangerous if a person uses them without proper medical guidance. As those with a history of harmful drug use may find it more difficult to limit their dosage, it is safer for them to abstain.

Summary

Psychedelics are generally not addictive, but LSD may cause tolerance, which creates the need to take larger dosages.

As psychedelics can produce euphoria and a feeling of detachment from the surroundings, some people use them recreationally to reduce feelings of stress.

Research on the possible medical uses of psychedelics is still at a preliminary stage, but early studies suggest that psychedelics may decrease depression and anxiety. These drugs may also help a person quit smoking or abstain from alcohol.

There is certainly a lot of potential, but many more studies are necessary to confirm the safety and benefits of using psychedelics as a medical treatment.

Despite their general safety, psychedelics pose a number of risks and dangers, which increase with higher dosages.