Hallucinogen Withdrawal and Detox
Hallucinogen withdrawal symptoms result from brain chemical imbalances and vary based on the frequency and duration of use as well as the drug abused. Most hallucinogen drugs interfere with the neurotransmitters glutamate and serotonin, which play key roles in regulating several major bodily processes. Serotonin helps activate the sympathetic nervous system, responsible for the body’s “fight-or-flight” reaction. Long-term hallucinogen use can lead to widespread brain damage for years, even after a person stops using. Psychological withdrawal symptoms are typically worse than physical symptoms, although every hallucinogen has some unique characteristics. In general terms, people withdrawing from hallucinogens may experience any of the following withdrawal symptoms.1,2
Hallucinogen effects on brain chemical levels impact a person’s emotional and psychological states, both during and after the “high.” Psychological withdrawal symptoms vary in intensity based on the type of drug used. Symptoms may include:
- Panic episodes
- Psychotic-type breaks from reality
- Severe mood swings
- Speech problems
- Feelings of rage
- Low impulse control1
- Stiffening muscles
- Elevated heart rate
- Increase in blood pressure
- Increase in breathing rate
- Fluctuations in body temperature1
Although some users do not experience any withdrawal symptoms, LSD can intensely impact and alter perceptions, moods and thoughts. This may cause ongoing psychological distress and lead to impaired functioning for varying periods of time after drug cessation. Drug treatment programs or professional psychological support may be necessitated for long-term LSD users who want to stop. Withdrawal symptoms may include:
- Concentration problems
- Fear of going crazy
- Mood swings
- Suicidal thoughts
- Schizophrenic-type symptoms
- Random flashback episodes of drug-related hallucinations
- Hallucinogen Persisting Perception Disorder3
Hallucinogen Detox and Treatment
Several types of therapy are used to help a person overcome hallucinogen addiction. While most hallucinogens do not require detox in the same sense as other illicit drugs, if a person has co-occurring addictions or is suffering from PCP addiction, inpatient detox may be warranted. Professionally supervised detox clears the presence and influence of PCP gradually and safely, mitigating any unpleasant side effects of withdrawal. Outpatient programs include group and individual therapy. Because they do not rely on chemical detox, outpatient programs are more suitable for people with less severe drug problems. Therapies such as cognitive behavioral therapy, dialectical behavioral therapy and interpersonal therapy focus on the psychological issues of hallucinogen addiction. Support groups and 12-step programs also play an important role in overcoming hallucinogen abuse.
Detox for PCPs and Extreme Behavior
PCPs produce the most severe symptoms and may require pharmacological interventions, unlike most other hallucinogens. Frightening and disorienting effects of a bad trip can result in violent or hazardous behavior, leading to accidental fatalities, homicides, self-mutilation or suicide. If someone on hallucinogens is unable to regain their grip on reality and is in serious danger of harming themselves or others, this is a medical emergency and 911 should be called immediately. Getting raging addicts to seek treatment can require extreme measures such as forced, emergency hospitalization if they are exhibiting dangerous, violent behavior.4
Benzodiazepines are the cornerstone of treatment for anxious or highly agitated individuals because they reduce anxiety and the sympathomimetic effects of hallucinogens. Benzos are effective both intravenously and intramuscularly, have rapid onset and do not have the potential for cardiac conduction delays or decreased seizure threshold associated with antipsychotics (e.g. haloperidol or droperidol). Intramuscular diazepam (Valium) or midazolam (Versed) have rapid onset and should be used if safe intravenous access is not available. Phenothiazines may reduce the seizure threshold. However, their anticholinergic effects only worsen symptoms of hyperthermia and tachycardia, so they should be avoided.5,6
- What Do Hallucinogens Withdrawal Symptoms Feel Like? Hallucinogens website. http://hallucinogens.com/hallucinogens-effects/what-do-hallucinogens-withdrawal-symptoms-feel-like/ Accessed January 15, 2017.
- The Effects of Acid. Drug Abuse website. http://drugabuse.com/library/effects-acid-lsd/ Accessed January 15, 2017.
- LSD Withdrawal Symptoms: Are There Any? Mental Health Daily website. http://mentalhealthdaily.com/2014/04/30/lsd-withdrawal-symptoms-are-there-any/
- How to Help a PCP Addict. Drug Abuse website. http://drugabuse.com/library/how-to-help-a-pcp-addict/ Accessed January 15, 2017.
- Hallucinogen Use Treatment & Management: Medical Care. Medscape website. http://emedicine.medscape.com/article/293752-treatment Updated November 23, 2015. Accessed January 15, 2017.
- Hallucinogen Toxicity Treatment & Management: Prehospital Care. Medscape website. http://emedicine.medscape.com/article/814848-treatment Updated February 14, 2015. Accessed January 15, 2017.