What are psychedelics and what can they do?

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Psychedelics are also known as hallucinogens because taking them can result in hallucinations. Hallucinations are sensory experiences that cause a person to see, hear, smell, taste, or feel things that are not really there. Someone who takes psychedelics may experience changes in their awareness of their thoughts and surroundings.

Some psychedelics come from plants or mushrooms (often referred to as “magic mushrooms”), while others are synthetic and manufactured by humans.

According to the National Institute on Drug Abuse (NIDA), there are two main types of psychedelics: classic hallucinogens and dissociative drugs.

Classic hallucinogens

Classic hallucinogens include substances such as:

LSD (D-lysergic acid diethylamide)

LSD is a potent mind-altering chemical that is clear or white in color and has no smell. It is made from lysergic acid, which is found in a fungus that grows on grains.

Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine)

Psilocybin is the main active ingredient in “magic mushrooms,” which include a wide range of mushrooms found in tropical and subtropical regions of South America, Mexico, and the U.S.

Peyote (mescaline)

Peyote is a small cactus native to Mexico and southern regions of the U.S. It can also be synthetic.

It is used in some Native American religious ceremonies, but the Drug Enforcement Administration (DEA) restricts it as a Schedule I substance. It contains mescaline, which can cause hallucinations, altered body image, and euphoria.

DMT (N,N-dimethyltryptamine)

DMT is a powerful chemical present in certain plant groups, including Phalaris, Delosperma, Acacia, Mimosa, and in the leaves of citrus plants. People can make a tea called ayahuasca, which is also known as hoasca, aya, or yagé, from the natural plant version.

There is also a synthetic version of DMT, which is a white powder that people can smoke.

251-NBOMe

251-NBOMe is a synthetic substance originally developed by neuroscience researchers. It has similar qualities to LSD and MDMA. MDMA stands for 3,4-Methyl​enedioxy​methamphetamine, and is a recreational psychoactive drug. However, 251-NBOMe is more powerful than LSD and MDMA.

Dissociative drugs

Dissociative drugs include substances such as:

PCP (Phencyclidine)

Surgeons used PCP in the 1950s as a general anesthetic, but manufacturers stopped producing it due to its serious side effects, which included postoperative delirium and hallucinations. At high doses, PCP can cause seizures, severe muscle contractions, violent or aggressive behavior, and symptoms of psychosis.

At lower doses, PCP can cause feelings of detachment from a person’s surroundings and self, slurred speech, and loss of coordination. It is also a strong pain reliever.

The effects of PCP can develop within 2–5 minutes after smoking, and 30–60 minutes after swallowing. Some people experience these effects for 4–8 hours.

It is an illegal, schedule II controlled drug. Its street names include:

• angel dust
• hog
• ozone
• rocket fuel
• wack
• crystal
• embalming fluid

A person can consume PCP by smoking, snorting, or swallowing the drug. It comes in powder, crystal, tablet, capsules, and liquid forms, with powder and liquid PCP being the most commonly sold forms.

Ketamine

Doctors and veterinarians use ketamine as an anesthetic for humans and animals undergoing surgery.

According to the DEA, most of the illegally-distributed ketamine is stolen from veterinary surgeries. It is often sold at parties, nightclubs, and raves. It is manufactured commercially as a liquid or powder. Liquid ketamine can be mixed into drinks. Powder ketamine can be smoked and snorted.

A person who takes ketamine may experience distortions to sights and sounds, feelings of dissociation, and a sense of calm. It also relieves pain.

It is also used to facilitate sexual assault and is also known as a date rape drug.

Its effects can last for 30–60 minutes.

Its street names include:

• cat tranquilizer
• cat valium
• jet k
• kit kat
• purple
• special K
• special la coke
• super acid
• super K
• vitamin K

Dextromethorphan (DXM)

DXM is found in a wide range of over-the-counter cold and cough medicines, such as syrups, tablets, and gel capsules. It is a cough suppressor that does not tend to cause side effects.

It is not an illegal or controlled substance because it is used to treat health conditions. When taken as a treatment for a cough, a typical dose for adults is between 15–30 milligrams (mg), three to four times a day.

However, some people misuse DXM to achieve the feelings of euphoria it creates when taken in doses of 250–1,500 mg — much higher than the therapeutic range.

When a person takes DXM at these higher doses, it can have hallucinatory effects. It can also cause confusion, inappropriate laughter, agitation, paranoia, and a feeling of floating.

Salvia (Salvia divinorum)

Salvia is a plant native to Mexico.

Its common street names are Maria Pastora, sally-D, and salvia.

People can smoke, chew, or vaporize Salvia, and its effects can come on quickly.

Some effects can include seeing bright lights and colors, shapes, and visual distortions of bodies or objects. It can also cause feelings of panic, fear, and paranoia, as well as hallucinations and uncontrollable laughter.

According to the DEA, Salvia is not a controlled substance under the Controlled Substances Act, although some U.S. states do control it.

Researchers have found a range of possible medical benefits of psychedelics, including:

• chronic pain
• cluster headache
• post-traumatic stress disorder (PTSD)
• mood disorders
• substance use disorders
• psychological distress linked to life threatening illness

Anxiety and depression

An animal study published in Neuropsychopharmacologyin 2022 suggests that repeat doses of LSD over time can help to reduce stress-related anxiety and depression symptoms.

In terms of LSD’s effects on humans, a 2018 study in Psychopharmacology found that people taking LSD in conjunction with having psychotherapy sessions reported increased feelings of happiness, trust, and empathy, resulting in positive social effects and altruism.

Furthermore, in 2019, the U.S. Food & Drug Administration (FDA) approved a drug closely related to ketamine, called esketamine, for treating severe depression in people for whom other treatments don’t work.

Psilocybin may also be helpful in the treatment of depression and anxiety when these mental health conditions are specifically linked to life threatening diseases, according to a 2020 systematic review and meta-analyses of clinical trials in Biomedicines.

Obsessive-compulsive disorder (OCD)

Authors of a 2017 study into the therapeutic effects of psilocybin stated that more research is needed to confirm whether this particular psychedelic can benefit OCD after a small, 2009 study stated it decreased OCD symptoms in all of its study participants.

The 2017 study stated that participants experienced reductions in their symptoms regardless of the dose they took and questioned whether the results were influenced by a placebo effect.

Migraine and cluster headaches

In a 2017 qualitative study in Harm Reduction Journal, researchers explored how alternative treatments, including psychedelics, could help people with migraine and cluster headaches. People using these substances for this purpose reported that psilocybin, LSD, and related psychedelics worked to prevent and treat cluster headaches and migraine.

Substance use disorders

According to a 2018 review, between the 1950s and 1970s, researchers carried out early phase studies investigating the effectiveness of classic psychedelics, but then discontinued their work. However, the evidence available from that time suggests that classic hallucinogens can be effective therapies, especially in the case of treating alcoholism with LSD.

Additionally, the authors of a 2020 systematic review found evidence to further support this therapeutic use.

This research presents encouraging evidence for the use of psychedelics in the treatment of a range of health conditions. However, researchers need to carry out more, and larger, well-designed clinical trials to help medical regulatory agencies decide whether to authorize psychedelics as medical treatments.

People who use psychedelics may experience one or several of a range of side effects, which range from moderate to severe. Along with the altered perception of reality that comes with hallucinations, which may be frightening to experience, short-term side effects of psychedelics can include paranoia and psychosis.

Psychedelic-induced psychosis can also persist in some people. These individuals can experience ongoing mental health issues, such as paranoia, altered mood, and visual disturbances.

Other people may experience a type of flashback known as Hallucinogen Persisting Perception Disorder (HPPD). The flashbacks can happen between a few days to over a year after the person took the psychedelics. People have sometimes mistaken the associated symptoms for a stroke or brain tumor.

In the most serious of cases, the long-term effects of using dissociative drugs, in particular, may include suicidal thoughts.

Psychedelics come in two main categories: classic hallucinogens and dissociative drugs. Emerging research suggests a range of potential therapeutic uses for psychedelics, from treating anxiety and depression to reducing the symptoms of OCD.

However, scientists need to carry out more clinical studies to investigate how effective psychedelics are for health conditions and the safety and long-term effects of psychedelics.

Additionally, many psychedelics are illegal and can cause dependence.