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On November 16, 1938, LSD (Lysergic acid diethylamide) is first synthesized by Swiss chemist Dr. Albert Hofmann at the Sandoz Laboratories in Basel, Switzerland. From the article:
"Lysergic acid diethylamide (LSD), also known as acid, is a hallucinogenic drug.[11] Effects typically include altered thoughts, feelings, and awareness of one's surroundings.[11] Many users see or hear things that do not exist.[12] Dilated pupils, increased blood pressure, and increased body temperature are typical.[13] Effects typically begin within half an hour and can last for up to 12 hours.[13] It is used mainly as a recreational drug and for spiritual reasons.[13][14]
While LSD does not appear to be addictive, tolerance with use of increasing doses may occur.[11][15] Adverse psychiatric reactions such as anxiety, paranoia, and delusions are possible.[7] Long-term flashbacks may occur despite no further use.[16] Death as a result of LSD is very rare, though occasionally occurs via accidents.[13] The effects of LSD are believed to occur as a result of alterations in the serotonin system.[13] As little as 20 micrograms can produce an effect.[13] In pure form LSD is clear or white in color, has no smell, and is crystalline.[11] It breaks down with exposure to ultraviolet light.[13]
In the United States, as of 2017, about 10% of people have used LSD at some point in their life, while 0.7% have used it in the last year.[12] It was most popular in the 1960s to 1980s.[13] LSD is typically either swallowed or held under the tongue.[11] It is most often sold on blotter paper and less commonly as tablets or in gelatin squares.[13] There are no known treatments for addiction, if it occurs.[16]
LSD was first made by Albert Hofmann in 1938 from lysergic acid, a chemical from the fungus ergot.[13][16] Hofmann discovered its hallucinogenic properties in 1943.[17] In the 1950s, the Central Intelligence Agency (CIA) believed the drug might be useful for mind control so tested it on people, some without their knowledge, in a program called MKUltra.[18] LSD was sold as a medication for research purposes under the trade-name Delysid in the 1950s and 1960s.[13][19] It was listed as a schedule 1 controlled substance by the United Nations in 1971.[13] It currently has no approved medical use.[13] In Europe, as of 2011, the typical cost of a dose was between 4.50 and 25 Euro.[13]
LSD is commonly used as a recreational drug.[20]
Spiritual
LSD is considered an entheogen because it can catalyze intense spiritual experiences, during which users may feel they have come into contact with a greater spiritual or cosmic order. Users sometimes report out of body experiences. In 1966, Timothy Leary established the League for Spiritual Discovery with LSD as its sacrament.[21][22] Stanislav Grof has written that religious and mystical experiences observed during LSD sessions appear to be phenomenologically indistinguishable from similar descriptions in the sacred scriptures of the great religions of the world and the texts of ancient civilizations.[23]
Medical
See also: Lysergic acid diethylamide § Research
LSD currently has no approved uses in medicine.[24][25] A meta analysis concluded that a single dose was effective at reducing alcohol consumption in alcoholism.[26] LSD has also been studied in depression, anxiety, and drug dependence, with positive preliminary results.[27]
Physical
LSD can cause pupil dilation, reduced appetite, and wakefulness. Other physical reactions to LSD are highly variable and nonspecific, some of which may be secondary to the psychological effects of LSD. Among the reported symptoms are numbness, weakness, nausea, hypothermia or hyperthermia, elevated blood sugar, goose bumps, heart rate increase, jaw clenching, perspiration, saliva production, mucus production, hyperreflexia, and tremors.[medical citation needed]
Psychological
The most common immediate psychological effects of LSD are visual hallucinations and illusions (colloquially known as "trips"), which can vary greatly depending on how much is used and how the brain responds. Trips usually start within 20–30 minutes of taking LSD by mouth (less if snorted or taken intravenously), peak three to four hours after ingestion, and last up to 12 hours. Negative experiences, referred to as "bad trips", produce intense negative emotions, such as irrational fears and anxiety, panic attacks, paranoia, rapid mood swings, intrusive thoughts of hopelessness, wanting to harm others, and suicidal ideation. It is impossible to predict when a bad trip will occur.[30][31] Good trips are stimulating and pleasurable, and typically involve feeling as if one is floating, disconnected from reality, feelings of joy or euphoria (sometimes called a "rush"), decreased inhibitions, and the belief that one has extreme mental clarity or superpowers.[30]
Sensory
Some sensory effects may include an experience of radiant colors, objects and surfaces appearing to ripple or "breathe", colored patterns behind the closed eyelids (eidetic imagery), an altered sense of time (time seems to be stretching, repeating itself, changing speed or stopping), crawling geometric patterns overlaying walls and other objects, and morphing objects.[32] Some users, including Albert Hofmann, report a strong metallic taste for the duration of the effects.[33]
LSD causes an animated sensory experience of senses, emotions, memories, time, and awareness for 6 to 14 hours, depending on dosage and tolerance. Generally beginning within 30 to 90 minutes after ingestion, the user may experience anything from subtle changes in perception to overwhelming cognitive shifts. Changes in auditory and visual perception are typical.[32][34] Visual effects include the illusion of movement of static surfaces ("walls breathing"), after image-like trails of moving objects ("tracers"), the appearance of moving colored geometric patterns (especially with closed eyes), an intensification of colors and brightness ("sparkling"), new textures on objects, blurred vision, and shape suggestibility. Some users report that the inanimate world appears to animate in an inexplicable way; for instance, objects that are static in three dimensions can seem to be moving relative to one or more additional spatial dimensions.[35] Many of the basic visual effects resemble the phosphenes seen after applying pressure to the eye and have also been studied under the name "form constants". The auditory effects of LSD may include echo-like distortions of sounds, changes in ability to discern concurrent auditory stimuli, and a general intensification of the experience of music. Higher doses often cause intense and fundamental distortions of sensory perception such as synaesthesia, the experience of additional spatial or temporal dimensions, and temporary dissociation.[medical citation needed]
Of the 20 drugs ranked according to individual and societal harm by David Nutt, LSD was third to last, approximately 1/10th as harmful as alcohol. The most significant adverse effect was impairment of mental functioning while intoxicated.[37]
Mental disorders
LSD may trigger panic attacks or feelings of extreme anxiety, known familiarly as a "bad trip." Review studies suggest that LSD likely plays a role in precipitating the onset of acute psychosis in previously healthy individuals with an increased likelihood in individuals who have a family history of schizophrenia.[7][38] There is evidence that people with severe mental illnesses like schizophrenia have a higher likelihood of experiencing adverse effects from taking LSD.[38]
Suggestibility
While publicly available documents indicate that the CIA and Department of Defense have discontinued research into the use of LSD as a means of mind control,[39] research from the 1960s suggests that both mentally ill and healthy people are more suggestible while under its influence.[40][41][non-primary source needed]
Flashbacks
See also: Flashback (psychology)
Some individuals may experience "flashbacks" and a syndrome of long-term and occasionally distressing perceptual changes.[42][43]
"Flashbacks" are a reported psychological phenomenon in which an individual experiences an episode of some of LSD's subjective effects after the drug has worn off, "persisting for months or years after hallucinogen use".[43] Several studies have tried to determine the likelihood that a user of LSD, not suffering from known psychiatric conditions, will experience flashbacks. The larger studies include Blumenfeld's in 1971[43][44][45][46][47] and Naditch and Fenwick's in 1977,[48][49][50][51][52] which arrived at figures of 20%[44] and 28%,[48] respectively.[42][53][54]
Hallucinogen persisting perception disorder (HPPD) describes a post-LSD exposure syndrome in which LSD-like visual changes are not temporary and brief, as they are in flashbacks, but instead are persistent, and cause clinically significant impairment or distress. The syndrome is a DSM-IV diagnosis. Several scientific journal articles have described the disorder.[55] HPPD differs from flashbacks in that it is persistent and apparently entirely visual (although mood and anxiety disorders are sometimes diagnosed in the same individuals). A recent review suggests that HPPD (as defined in the DSM-IV) is uncommon and affects a distinctly vulnerable subpopulation of users.[43][56]
Cancer and pregnancy
The mutagenic potential of LSD is unclear. Overall, the evidence seems to point to limited or no effect at commonly used doses.[57] Empirical studies showed no evidence of teratogenic or mutagenic effects from use of LSD in man.[7]
Tolerance
Tolerance to LSD builds up over consistent use[58] and cross-tolerance has been demonstrated between LSD, mescaline[59] and psilocybin.[60] This tolerance is probably caused by downregulation of 5-HT2A receptors in the brain and diminishes a few days after cessation of use.
LSD is not addictive.[2][15][61] Experimental evidence has demonstrated that LSD use does not yield positive reinforcement in either human or animal subjects.[2][62][63]
Overdose
As of 2008 there were no documented fatalities attributed directly to an LSD overdose.[7] Despite this several behavioral fatalities and suicides have occurred due to LSD.[64][65] Eight individuals who accidentally consumed very high amounts by mistaking LSD for cocaine developed comatose states, hyperthermia, vomiting, gastric bleeding, and respiratory problems–however, all survived with supportive care.[7]
Reassurance in a calm, safe environment is beneficial. Agitation can be safely addressed with benzodiazepines such as lorazepam or diazepam. Neuroleptics such as haloperidol are recommended against because they may have adverse effects. LSD is rapidly absorbed, so activated charcoal and emptying of the stomach will be of little benefit, unless done within 30–60 minutes of ingesting an overdose of LSD. Sedation or physical restraint is rarely required, and excessive restraint may cause complications such as hyperthermia (over-heating) or rhabdomyolysis.[66]
Research suggests that massive doses are not lethal, but do typically require supportive care, which may include endotracheal intubation or respiratory support.[66] It is recommended that high blood pressure, tachycardia (rapid heart-beat), and hyperthermia, if present, are treated symptomatically, and that low blood pressure is treated initially with fluids and then with pressors if necessary. Intravenous administration of anticoagulants, vasodilators, and sympatholytics may be useful with massive doses.[66]"
"Lysergic acid diethylamide (LSD), also known as acid, is a hallucinogenic drug.[11] Effects typically include altered thoughts, feelings, and awareness of one's surroundings.[11] Many users see or hear things that do not exist.[12] Dilated pupils, increased blood pressure, and increased body temperature are typical.[13] Effects typically begin within half an hour and can last for up to 12 hours.[13] It is used mainly as a recreational drug and for spiritual reasons.[13][14]
While LSD does not appear to be addictive, tolerance with use of increasing doses may occur.[11][15] Adverse psychiatric reactions such as anxiety, paranoia, and delusions are possible.[7] Long-term flashbacks may occur despite no further use.[16] Death as a result of LSD is very rare, though occasionally occurs via accidents.[13] The effects of LSD are believed to occur as a result of alterations in the serotonin system.[13] As little as 20 micrograms can produce an effect.[13] In pure form LSD is clear or white in color, has no smell, and is crystalline.[11] It breaks down with exposure to ultraviolet light.[13]
In the United States, as of 2017, about 10% of people have used LSD at some point in their life, while 0.7% have used it in the last year.[12] It was most popular in the 1960s to 1980s.[13] LSD is typically either swallowed or held under the tongue.[11] It is most often sold on blotter paper and less commonly as tablets or in gelatin squares.[13] There are no known treatments for addiction, if it occurs.[16]
LSD was first made by Albert Hofmann in 1938 from lysergic acid, a chemical from the fungus ergot.[13][16] Hofmann discovered its hallucinogenic properties in 1943.[17] In the 1950s, the Central Intelligence Agency (CIA) believed the drug might be useful for mind control so tested it on people, some without their knowledge, in a program called MKUltra.[18] LSD was sold as a medication for research purposes under the trade-name Delysid in the 1950s and 1960s.[13][19] It was listed as a schedule 1 controlled substance by the United Nations in 1971.[13] It currently has no approved medical use.[13] In Europe, as of 2011, the typical cost of a dose was between 4.50 and 25 Euro.[13]
LSD is commonly used as a recreational drug.[20]
Spiritual
LSD is considered an entheogen because it can catalyze intense spiritual experiences, during which users may feel they have come into contact with a greater spiritual or cosmic order. Users sometimes report out of body experiences. In 1966, Timothy Leary established the League for Spiritual Discovery with LSD as its sacrament.[21][22] Stanislav Grof has written that religious and mystical experiences observed during LSD sessions appear to be phenomenologically indistinguishable from similar descriptions in the sacred scriptures of the great religions of the world and the texts of ancient civilizations.[23]
Medical
See also: Lysergic acid diethylamide § Research
LSD currently has no approved uses in medicine.[24][25] A meta analysis concluded that a single dose was effective at reducing alcohol consumption in alcoholism.[26] LSD has also been studied in depression, anxiety, and drug dependence, with positive preliminary results.[27]
Physical
LSD can cause pupil dilation, reduced appetite, and wakefulness. Other physical reactions to LSD are highly variable and nonspecific, some of which may be secondary to the psychological effects of LSD. Among the reported symptoms are numbness, weakness, nausea, hypothermia or hyperthermia, elevated blood sugar, goose bumps, heart rate increase, jaw clenching, perspiration, saliva production, mucus production, hyperreflexia, and tremors.[medical citation needed]
Psychological
The most common immediate psychological effects of LSD are visual hallucinations and illusions (colloquially known as "trips"), which can vary greatly depending on how much is used and how the brain responds. Trips usually start within 20–30 minutes of taking LSD by mouth (less if snorted or taken intravenously), peak three to four hours after ingestion, and last up to 12 hours. Negative experiences, referred to as "bad trips", produce intense negative emotions, such as irrational fears and anxiety, panic attacks, paranoia, rapid mood swings, intrusive thoughts of hopelessness, wanting to harm others, and suicidal ideation. It is impossible to predict when a bad trip will occur.[30][31] Good trips are stimulating and pleasurable, and typically involve feeling as if one is floating, disconnected from reality, feelings of joy or euphoria (sometimes called a "rush"), decreased inhibitions, and the belief that one has extreme mental clarity or superpowers.[30]
Sensory
Some sensory effects may include an experience of radiant colors, objects and surfaces appearing to ripple or "breathe", colored patterns behind the closed eyelids (eidetic imagery), an altered sense of time (time seems to be stretching, repeating itself, changing speed or stopping), crawling geometric patterns overlaying walls and other objects, and morphing objects.[32] Some users, including Albert Hofmann, report a strong metallic taste for the duration of the effects.[33]
LSD causes an animated sensory experience of senses, emotions, memories, time, and awareness for 6 to 14 hours, depending on dosage and tolerance. Generally beginning within 30 to 90 minutes after ingestion, the user may experience anything from subtle changes in perception to overwhelming cognitive shifts. Changes in auditory and visual perception are typical.[32][34] Visual effects include the illusion of movement of static surfaces ("walls breathing"), after image-like trails of moving objects ("tracers"), the appearance of moving colored geometric patterns (especially with closed eyes), an intensification of colors and brightness ("sparkling"), new textures on objects, blurred vision, and shape suggestibility. Some users report that the inanimate world appears to animate in an inexplicable way; for instance, objects that are static in three dimensions can seem to be moving relative to one or more additional spatial dimensions.[35] Many of the basic visual effects resemble the phosphenes seen after applying pressure to the eye and have also been studied under the name "form constants". The auditory effects of LSD may include echo-like distortions of sounds, changes in ability to discern concurrent auditory stimuli, and a general intensification of the experience of music. Higher doses often cause intense and fundamental distortions of sensory perception such as synaesthesia, the experience of additional spatial or temporal dimensions, and temporary dissociation.[medical citation needed]
Of the 20 drugs ranked according to individual and societal harm by David Nutt, LSD was third to last, approximately 1/10th as harmful as alcohol. The most significant adverse effect was impairment of mental functioning while intoxicated.[37]
Mental disorders
LSD may trigger panic attacks or feelings of extreme anxiety, known familiarly as a "bad trip." Review studies suggest that LSD likely plays a role in precipitating the onset of acute psychosis in previously healthy individuals with an increased likelihood in individuals who have a family history of schizophrenia.[7][38] There is evidence that people with severe mental illnesses like schizophrenia have a higher likelihood of experiencing adverse effects from taking LSD.[38]
Suggestibility
While publicly available documents indicate that the CIA and Department of Defense have discontinued research into the use of LSD as a means of mind control,[39] research from the 1960s suggests that both mentally ill and healthy people are more suggestible while under its influence.[40][41][non-primary source needed]
Flashbacks
See also: Flashback (psychology)
Some individuals may experience "flashbacks" and a syndrome of long-term and occasionally distressing perceptual changes.[42][43]
"Flashbacks" are a reported psychological phenomenon in which an individual experiences an episode of some of LSD's subjective effects after the drug has worn off, "persisting for months or years after hallucinogen use".[43] Several studies have tried to determine the likelihood that a user of LSD, not suffering from known psychiatric conditions, will experience flashbacks. The larger studies include Blumenfeld's in 1971[43][44][45][46][47] and Naditch and Fenwick's in 1977,[48][49][50][51][52] which arrived at figures of 20%[44] and 28%,[48] respectively.[42][53][54]
Hallucinogen persisting perception disorder (HPPD) describes a post-LSD exposure syndrome in which LSD-like visual changes are not temporary and brief, as they are in flashbacks, but instead are persistent, and cause clinically significant impairment or distress. The syndrome is a DSM-IV diagnosis. Several scientific journal articles have described the disorder.[55] HPPD differs from flashbacks in that it is persistent and apparently entirely visual (although mood and anxiety disorders are sometimes diagnosed in the same individuals). A recent review suggests that HPPD (as defined in the DSM-IV) is uncommon and affects a distinctly vulnerable subpopulation of users.[43][56]
Cancer and pregnancy
The mutagenic potential of LSD is unclear. Overall, the evidence seems to point to limited or no effect at commonly used doses.[57] Empirical studies showed no evidence of teratogenic or mutagenic effects from use of LSD in man.[7]
Tolerance
Tolerance to LSD builds up over consistent use[58] and cross-tolerance has been demonstrated between LSD, mescaline[59] and psilocybin.[60] This tolerance is probably caused by downregulation of 5-HT2A receptors in the brain and diminishes a few days after cessation of use.
LSD is not addictive.[2][15][61] Experimental evidence has demonstrated that LSD use does not yield positive reinforcement in either human or animal subjects.[2][62][63]
Overdose
As of 2008 there were no documented fatalities attributed directly to an LSD overdose.[7] Despite this several behavioral fatalities and suicides have occurred due to LSD.[64][65] Eight individuals who accidentally consumed very high amounts by mistaking LSD for cocaine developed comatose states, hyperthermia, vomiting, gastric bleeding, and respiratory problems–however, all survived with supportive care.[7]
Reassurance in a calm, safe environment is beneficial. Agitation can be safely addressed with benzodiazepines such as lorazepam or diazepam. Neuroleptics such as haloperidol are recommended against because they may have adverse effects. LSD is rapidly absorbed, so activated charcoal and emptying of the stomach will be of little benefit, unless done within 30–60 minutes of ingesting an overdose of LSD. Sedation or physical restraint is rarely required, and excessive restraint may cause complications such as hyperthermia (over-heating) or rhabdomyolysis.[66]
Research suggests that massive doses are not lethal, but do typically require supportive care, which may include endotracheal intubation or respiratory support.[66] It is recommended that high blood pressure, tachycardia (rapid heart-beat), and hyperthermia, if present, are treated symptomatically, and that low blood pressure is treated initially with fluids and then with pressors if necessary. Intravenous administration of anticoagulants, vasodilators, and sympatholytics may be useful with massive doses.[66]"
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