Key takeaways:
You can take hallucinogens for cultural reasons or to alter your perception of reality.
If you take them over time, they can cause a type of addiction known as hallucinogen use disorder.
Treatment is available and important, since repeated misuse of hallucinogens can cause mental health problems.
Hallucinogens are a group of substances that affect a person’s awareness of reality. People report using hallucinogens for pleasure or as a way to “expand one’s mind.” They are also used in some cultures for religious or healing purposes. In 2020, 7.1 million (almost 3% of) Americans had used hallucinogens in the previous year.
Hallucinogen use disorder is a type of substance use disorder that can develop after a person repeatedly uses hallucinogens. People with hallucinogen use disorder will continue to take hallucinogens even though they cause problems in many parts of their lives. These problems can negatively affect a person’s relationships, work, and physical and mental health.
There are no established treatment guidelines for hallucinogen use disorder. People with this condition may need to seek other types of substance use disorder treatment. It is important that anyone getting help also receives a mental health evaluation, since misusing hallucinogens can lead to mental health problems.
What are hallucinogens?
A hallucinogen is a type of substance that alters a person’s thoughts, feelings, and sensations. There are many different hallucinogens. Some are human made, and others are derived from plants. Hallucinogens have been used throughout history for healing and religious purposes. Some people also consume them for pleasure or stress relief.
People under the influence of hallucinogens may experience:
Changes in mood
Hallucinations (seeing, hearing, or feeling things that are not there)
Sense of detachment from self or the world
There are two types of hallucinogens: classic hallucinogens and dissociative drugs.
Classic hallucinogens include:
LSD
Psilocybin (mushrooms)
Peyote (mescaline)
DMT
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Dissociative drugs are more likely to make users feel detached from their surroundings. Common examples include:
PCP (phencyclidine)
Ketamine
Very high doses of DXM (dextromethorphan)
Salvia divinorum
Are hallucinogens legal?
Most hallucinogens are classified as Schedule I drugs by the U.S. Drug Enforcement Administration. They have a high likelihood of misuse. They are illegal, except for religious exceptions or when used in research.
DXM is not a controlled substance and is found in many cough medicines. It is legal but can be misused at high doses.
Ketamine is classified as Schedule III, which means it has a low to moderate likelihood of misuse. It is only legal when administered by a healthcare provider.
What conditions can hallucinogens help treat?
So far, hallucinogens aren’t FDA approved to treat any health conditions. Researchers are currently studying hallucinogens like ketamine and psilocybin as potential treatments for certain conditions, like:
Depression
Post-traumatic stress disorder (PTSD)
Substance use disorders
When hallucinogens are used in research settings, they are taken in controlled doses and with monitoring by a healthcare professional. Some providers also currently use ketamine to treat depression — but keep in mind this is an “off-label” use (meaning it’s not FDA approved).
What are the mental health risks of misusing hallucinogens?
Misusing hallucinogens can pose mental health risks. Hallucinogen misuse can lead to the following short- and long-term effects:
Mood swings
Anxiety
Panic
Paranoia
Persistent psychosis
Depression
Suicidal thoughts
Hallucinogen persisting perception disorder (HPPD) is a condition where a person continues to experience hallucinations and flashbacks for days, months, or years — to the point where it interferes with their daily life.
The effects of hallucinogens on a person’s mental health depends on the type of hallucinogen, how much is used, and how often. Some long-term effects may last for a year or more. More research is needed to fully understand these effects.
Can hallucinogens be addictive?
Some but not all hallucinogens can be addictive if repeatedly misused:
PCP: PCP is one hallucinogen that is known to be addictive. It can also cause withdrawal symptoms like headaches, sweating, and cravings.
Ketamine: There is also evidence to suggest that recreational ketamine use may lead to addiction.
LSD: LSD is not considered addictive, but people can develop a tolerance to it, where they may feel less effects over time.
Researchers are still looking into whether other hallucinogens are addictive. Researchers are also studying whether some hallucinogens can actually be helpful for treating addictions.
What causes hallucinogen use disorder?
Like other substance use disorders, there is no single cause of hallucinogen use disorder. Initially, a person might use hallucinogens recreationally. But doing this over time can put them at risk of developing an addiction.
It is possible to use hallucinogens and not develop a disorder. Some people use these substances on occasion without problems for social or cultural purposes. But the truth is: Some people do go on to develop hallucinogen use disorder. Certain risk factors may increase the likelihood that a person who uses hallucinogens will develop an addiction.
These risk factors include:
Biological factors: genetics, ethnicity, and mental health
Environmental factors: a person’s environment, including how accessible substances are in their community
Psychological factors: stress and trauma
Social factors: peer pressure and family relationships
The more risk factors a person has, the greater their likelihood of developing hallucinogen use disorder.
What are the symptoms of hallucinogen use disorder?
Hallucinogen use disorder is also referred to as a hallucinogen addiction. The symptoms of hallucinogen use disorder are the same as other substance use disorders. To be diagnosed with hallucinogen use disorder, you must experience at least two of the following:
Using hallucinogens repeatedly in situations that could be dangerous (like driving)
Failed attempts to quit or cut back, even if you want to stop using
Cravings
Taking larger amounts of hallucinogens or taking them for longer than intended
Spending lots of time obtaining, using, and recovering from hallucinogens
Continuing to use hallucinogens even if it causes relationship problems
Giving up your other usual activities because of hallucinogens
Neglecting your responsibilities at work, home, or school because of hallucinogens
Continuing to use hallucinogens even after they have caused or worsened mental or physical health problems
Tolerance
How is hallucinogen use disorder diagnosed?
Hallucinogen use disorder can be diagnosed by a physician, psychiatrist, or other mental health professional. To diagnose this condition, a provider will meet with you and gather information about your hallucinogen use. They may also have you complete self-report screening tools. They may ask questions about your:
Hallucinogen use, including what type and how long
Use of any other substances
Mental health history
Family history of addiction and mental health
To make a diagnosis, your provider needs to understand how hallucinogen use is affecting your life. They will then determine whether you are experiencing symptoms of hallucinogen use disorder.
Your provider will also assess you for mental health issues caused by hallucinogen use. If they find that you are dealing with mental health concerns, they will discuss a treatment plan that addresses both the addiction and mental health issues.
How do you treat hallucinogen use disorder?
There are currently no FDA-approved medications or evidence-based therapies available for treating hallucinogen use disorder. Research on treatment for hallucinogen use disorder is scarce compared to other substance use disorders. More research is emerging on the use of hallucinogens as a treatment for other mental health conditions and substance use disorders.
Finding a treatment program that specializes in hallucinogen use disorder is difficult. But addiction treatment programs that treat other substance use disorders may be helpful, especially for people who are misusing multiple substances.
Hallucinogen misuse also increases the risk of certain mental health conditions. People who are struggling with both substance use and mental health conditions should seek a co-occurring disorders treatment program.
How to help yourself or someone else with hallucinogen use disorder?
Finding help specifically for a hallucinogen use disorder is tricky, since programs and providers that specialize in this condition are rare. If you or someone you know is dealing with a hallucinogen addiction, you may benefit from seeking substance use disorder treatment. While there are no evidence-based therapies for treating hallucinogen use disorder, addiction therapies like cognitive behavioral therapy (CBT) and motivational interviewing may be helpful.
Getting a mental health evaluation is important before starting treatment. If you have a mental health condition related to your hallucinogen misuse, you should seek a co-occurring disorders treatment program.
What resources are available to help with hallucinogen use disorder?
For help finding substance use or mental health treatment, you can call SAMHSA’s National Helpline at 1-800-662-HELP (4357). The Helpline offers free and confidential assistance finding treatment or community resources. Representatives are available 24/7, and they provide help in English and Spanish.
You can also search SAMHSA’s online Behavioral Health Treatment Services Locator, which allows you to search for resources in your area.
References
American Psychiatric Association. (2020). What is a substance use disorder?.
Bogenschutz, M. P., & Johnson, M. W. (2016). Classic hallucinogens in the treatment of addictions. Progress in Neuro-Psychopharmacology and Biological Psychiatry.
Callahan, J. & Kirby, M. (2020). Legal status of psychedelic drugs and research involving possible medical uses. Office of Legislative Research.
Garcia-Romeu, A. et al. (2016). Clinical applications of hallucinogens: A review. Experimental and Clinical Psychopharmacology.
Khan, M. (2020). Substance use disorders. Merck Manual.
Martinotti, G. et al. (2018). Hallucinogen persisting perception disorder: Etiology, clinical features, and therapeutic perspectives. Brain Sciences.
Morgan, C. J. et al. (2012). Ketamine use: A review. Addiction.
National Institute on Drug Abuse. (2015). Hallucinogens and dissociative drugs research report.
National Institute on Drug Abuse. (2018). Comorbidity: Substance use disorders and other mental illnesses DrugFacts.
National Institute on Drug Abuse. (2018). Understanding drug use and addiction DrugFacts.
National Institute on Drug Abuse. (2021). Hallucinogens DrugFacts.
Substance Abuse and Mental Health Services Administration. (n.d.). Behavioral health treatment services locator.
Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health.
Substance Abuse and Mental Health Services Administration. (2022). SAMHSA’s National Helpline.
United States Drug Enforcement Administration. (n.d.). Drug scheduling.
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