There are so many substances out there used as a "healing" agent to promote personal growth and self-understanding. In fact, the word “psychedelic,” derived from Greek, literally means “mind made visible.” Some of these include psilocybin (magic mushrooms), LSD (acid), MDMA (ecstasy), ketamine (special K or vitamin k), 251-NBOMe, DMT, ayahuasca (which contains DMT), salvia, ibogaine, peyote, PCP (angel dust), DXM (dextromethorphan), toad venom, 2c-b, and bath salts. Some of these are naturally occurring (found in nature), while others are not (man-made and produced in a lab). Many of these have a long history of being used in native ceremonies, rituals, and practices, and a lot of these substances are now being used to treat depression, trauma, addiction, and other mental health illnesses and symptoms. Sometimes, these drugs are marketed for people who have treatment-resistant illnesses. Other times, individuals take these drugs to improve performance and to have a life-changing experience filled with self-exploration.
Categories: Classic Hallucinogens and Dissociative Drugs
Hallucinogens are typically divided into two categories: classic hallucinogens (LSD, psilocybin, peyote, DMT, ayahuasca) and dissociative drugs (PCP, ketamine, DXM, salvia). Drugs such as MDMA, salvia, and ibogaine affect a variety of brain functions to cause psychedelic and/or dissociative effects. In addition, MDMA acts as both a stimulant and psychedelic and falls into a novel category of drugs called "entactogens". Of note, DXM is in a class of medications called antitussives and works as a cough suppressor; at high doses, DXM is classified as a dissociative general anesthetic and hallucinogen. Drugs like 2c-b, bath salts, ayahuasca, toad venom, and DMT work a little like LSD and MDMA, but they’re much stronger.
Overall, the term "hallucinogens" encompasses a wide range of drugs that alter a person's perception and sense of reality. Dissociative drugs do exactly that - make a person feel dissociated from reality. This may include the person feeling a loss of control of their body and feeling disconnected from their environment. Classic hallucinogens also alter a person's perception of reality, sometimes causing sensory, auditory, and visual hallucinations. They do not usually make people feel detached from their bodies like dissociative drugs do. Most hallucinogens take about 20 to 90 minutes after ingestion to take effect and can last as long as 12 hours.
The Dark Side of Hallucinogens
While a lot of these drugs may sound enticing and promising, there are serious risks that come with taking them. Some short-term risks may include a break from reality, causing people to do things they wouldn't do while sober. Other effects include paranoia, psychosis, insomnia, dizziness, tremors, rapid emotional shifts, nervousness, and panic. Hallucinogens can also increase blood pressure, heart rate, and body temperature. Sometimes people have "bad trips" that result in terrifying thoughts and nightmarish feelings of anxiety and despair that include fears of losing control, insanity, or death.
Some long-term risks include psychosis, hallucinations, flashbacks, memory loss, anxiety, visual disturbances, disorganized thinking, paranoia, and mood disturbances. While classic hallucinogens aren’t associated with life-threatening problems, some synthetic versions are. In addition, dissociative drugs can cause an overdose. The concern is that the effects of taking such drugs are often unpredictable, and it is hard to know how much to ingest and what the effect will be on each individual person as the effect will depend on the person's mood, surroundings, expectations, personality, genetic make-up, size, weight, health, and other drugs taken/tolerance.
Why Do People Take Hallucinogens?
There are a lot of trials and studies conducted on the use of hallucinogens for a variety of psychiatric disorders. For example, psilocybin is in trials for depression, anxiety, PTSD, and OCD. DMT has also been studied for depression and addiction. Ketamine is being studied for a wide range of disorders and symptoms, including depression, bipolar disorder, anxiety, suicidal ideation, and addiction. A study summarizes: more recently, emerging evidence has pointed out the potential therapeutic properties of psilocybin and LSD, as well as their ability to modulate functional brain connectivity. Moreover, MDMA, a compound belonging to the family of entactogens, has been demonstrated to be useful to treat post-traumatic stress disorders. Together, these data substantiate the potentials of these compounds in treating mental diseases.
Psychiatric disorders are a major public health concern affecting about 350 million people and imposing social and economic burdens worldwide. While there are many available pharmaceutical drugs, many of these have unfavorable side effects, and sometimes, finding the right medication takes a long time (for example, there are numerous anti-depressants on the market, and people often have to go through many types/brands to find one that works best). In addition, it is not clear how some of the marketed drugs work, as they impact various parts of the brain. Finding the right medication is not as much of an exact science as it may seem and can be a long and bumpy journey. People may want a short-term, quicker treatment than what psychotherapy and long-term medication adherence provide.
Because of this, many people turn to various alternative options, which may include hallucinogens. Some consider these "safer" to use because they are naturally occurring and have been used by Indigenous communities for thousands of years. Others who turn to hallucinogens have tried a variety of other methods to no avail (long-term therapy, traditional medication, etc.). It can become frustrating when you feel stagnant in your life, even when seeking widely available and clinically studied treatment methods. Other reasons people use psychedelics include self-discovery and exploration. Some individuals may feel intimidated starting therapy or traditional methods of mental health healing and so seek alternative, more private methods (*please see my note on this at the bottom of this post). The reason for the use of psychedelics varies greatly from person to person.
My Opinion on the Use of Hallucinogens
My thoughts on this topic have changed a lot over the years and throughout my career in the psychology field. I started off being very hopeful and optimistic about the use of alternative methods for healing, such as hallucinogens. Then, I became very skeptical of the widespread use of these drugs and how little control or monitoring there is of the use and distribution of such. After all, overuse or misuse of hallucinogens can have very serious negative effects that can do the opposite of promoting healing and instead cause more lasting and long-term negative consequences. Now, I have a more balanced and even approach regarding the use of hallucinogens for the treatment of mental health illnesses and symptoms.
Due to the new research documenting the positive effects of using hallucinogens to treat some disorders, I believe there is some justification for using them in mental health treatment, especially for difficult-to-treat disorders. My concern is that many people view these drugs as a quick fix, instead of examining their lives and doing the work around whatever uncomfortable situation they may be experiencing (such as by noticing their emotions and becoming curious about their experiences and triggers). Even if hallucinogens are used for treatment, individuals still have to put in the work daily to make a change in their maladaptive habits and patterns. A quick one-day drug "trip" is not going to magically change that. And my concern is that there is a misconception that with hallucinogens, everything will magically change.
In addition, I believe that people should not become reliant on such drugs to make progress but instead should learn to rely on themselves for lasting change by having the appropriate coping mechanisms and healing tools; to me, relying on an external source feels like taking away the power from the self. I've seen some people become addicted to hallucinogens due to regular use. Overall, I am not opposed to the use of various hallucinogens in treatment but would only recommend doing so if nothing else has worked and/or if change has plateaued for a while. When administered in the presence of licensed clinicians, the positive effects of hallucinogens can be maximized and the negative effects can be mitigated.
A Word on Ethics
In my research for this post, I came across an article that touched on the ethics of using psychedelics in Western science. There is increased media attention, and various clinical trials are being conducted. The psychedelic drug market was estimated to be $3.8 billion in 2020 and is projected to increase to $11.82 billion by 2029. But both Native and non-Native critics say the industry is ignoring the emotional, cultural, and ecological harms it is causing the Indigenous peoples who originated psychedelic medicine. In addition, there is little to no representation of Indigenous peoples in the field. A critic of the movement, Yuria Celidwen, described her observations: "I was seeing all these white people … pretending to know our ways." She was struck by how much Western facilitators were profiting compared with Indigenous medicine practitioners.
The article further notes: Celidwen and a group of Indigenous researchers, traditional medicine practitioners, and human rights activists published ethical guidelines for engaging with Indigenous peoples in psychedelic research and practice. Many Indigenous Nations are concerned they are being excluded from psychedelic spaces that extract their knowledge, threaten what they see as their intellectual property, and detach their medicines from their spiritual contexts. In addition, international demand is driving people to unsustainably harvest iboga, the plants used to make ayahuasca, and the hallucinogenic cactus peyote. Meanwhile, burgeoning retreat centers that offer psychedelic therapy often charge thousands of dollars for experiences that culturally appropriate Indigenous traditions yet share few benefits with these often impoverished communities.
Conclusion
If you are considering using hallucinogens in your healing journey, do very thorough research. Be mindful of what you are consuming and how/where you turn for such medicine and treatment.
*Note: if you are considering using hallucinogens, it is important that you do so under the supervision of licensed medical professionals, who can ensure that the drugs are administered in measured doses. Using these drugs recreationally or without a prescription to manage mental health issues is not only illegal, but it's also dangerous, as it can lead to the opposite effect — worsening symptoms instead of relieving them.
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