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“
Hallucinogen Dependence
Refer, in addition, to the text and criteria for Substance dependence (see p. 192). One
of the generic Dependence criteria (i.e., withdrawal) does not apply to hallucinogens,
and others require further explanation. Tolerance has been reported to develop
rapidly to the euphoric and psychedelic effects of hallucinogens but not to the
autonomic effects such as pupillary dilation, hyperreflexia, increased blood pressure,
increased body temperature, piloerection and tachycardia. Cross-tolerance exists
between LSD and other hallucinogens (e.g., psilocybin and mescaline) but does not
extend to most other categories of drugs such as PCP and cannabis. Hallucinogen use,
even among individuals with presentations that meet full criteria for dependence, is
often limited to only a few times a week. Although withdrawal has been shown only
in animals, clear reports of craving after stopping hallucinogens arc known. Because
of the long half-life and extended duration of action of most hallucinogens,
individuals with Hallucinogen dependence often spend hours to days using and
recovering from their effects. In contrast some hallucinogenic drugs (e.g., DMT) are
quite short acting. Hallucinogens may continue to be used despite the knowledge of
adverse effects (c,g., memory impairment while intoxicated; bad tripping which are
usually panic reactions; or flashbacks). Some individuals who use MDMA (an
amphetamine-like drug with hallucinogenic effects) describe a hangover the day
after use that is characterized by insomnia, fatigue, drowsiness, sore jaw muscles
from teeth clenching, loss of balance, and headaches, Because adulterants or
substitutes are often sold as acid or other hallucinogens, some of the reported
adverse effects may be due to substances such as strychnine, PCP, or amphetamine.
Some individuals can manifest dangerous behavioral reactions (e.g., jumping out of a
window under the belief that one can fly) due to lack of insight and judgment while
intoxicated. These adverse effects appear to be more common among those who have
preexisting mental disorders.
Associated Features and Disorders
When intoxicated with a hallucinogen, individuals may be voluble and discursive and
show rapid alternation of moods. Fearfulness and anxiety may become intense, with
dread of insanity or death. Many hallucinogenic substances have stimulant effects
(e.g., tachycardia, mild hypertension, hyperthermia, and pupillary dilation) and may
cause some of the features of Amphetamine Intoxication. The perceptual
disturbances and impaired judgement associated with Hallucinogen Intoxication may
result in injuries or fatalities from automobile accidents, physical fights, or attempts
to fly from high places. Environmental factors and the personality and expectations
of the individual using the hallucinogen may contribute to the nature and severity of
Hallucinogen Intoxication. Intoxication may also be associated with physiological
changes, including increases in blood glucose, cortical, ACTH, and prolactin.
Hallucinogen Persisting Perception Disorder may produce considerable anxiety and
concern and may be more common in suggestible persons. It remains controversial
whether the chronic hallucinogen use produces a Psychotic Disorder de novo,
triggers psychotic symptoms only in vulnerable persons, or is simply an early and
continuing sign of an evolving psychotic process. Hallucinogen Abuse and
Dependence also frequently occur in persons with preexisting adolescent Conduct
Disorder or adult Antisocial Personality Disorder. LSD intoxication may be confirmed
by urine toxicology.
— DSM-IV, American Psychiatric Association [7]
”
HPPD som även benämns som flashbacks förkommer, se den separata artiklar i Magiska Molekylers
wiki om detta.
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