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Hallucinogens. Hallucinogens. Where do they come from? Organic and synthesized origins History plants used in religious ceremonies and as part of indian rituals LSD discovered in 1938; Hoffman absorbed it became widely recognized and used in 1960s

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Where do they come from?

Organic and synthesized origins


plants used in religious ceremonies and as part of indian rituals

LSD discovered in 1938; Hoffman absorbed it

became widely recognized and used in 1960s

e.g., cultish subculture: T. Leary--turn on, tune in, drop out

reemergence of LSD in rave subculture in 1990s

uses of LSD in psychotherapy




1. Serotonergic hallucinogens

chem similar to serotonin

2. Methylated amphetamines

chem similar to norepinephrine...alterations in mood without much change in senses

3. Anticholinergic - (Ach)

found in plants: belladonna, mandrake, jimson weed

trance or dream-like states

4. Dissociative anesthetics

can remain conscious in surgery; causes euphoria, numbness, aggressive behavior, and tactile sense disturbances

Serotonergic hallucinogens

Lysergic acid diethylamide (LSD) Ergot fungus

Psilocybin (mushrooms) mushrooms

Dimethyltryptamine (DMT) Virola trees

Mescaline Peyote cactus

Harmaline, Harmine Ayahuasca vine

Ergine, Isoergine morning glory

Lysergic Acid Amide morning glory

Serotonergic Hallucinogens

Methylated amphetamines

MDMA (Ecstacy; X) synthetic

MDA (Love Drug) synthetic

Methylated Amphetamines

Acetylcholinergic hallucinogens

Atropine belladonna plant

Scopolamine roots of mandrake, herbane

Hyoscyamine roots of mandrake, herbane

Ibogaine Iboga plant

Acetylcholinergic Hallucinogens

Dissociative anesthetic hallucinogens

Phencyclidine (PCP, Angel Dust) synthetic

Ketamine PCP-like drug

Dissociative Anesthetic Hallucinogens


Effects Vary by Type



  • “MDMA” for short

  • It is popularly called:

  • Ecstasy

  • X

  • Adam

  • Lover’s Speed

  • XTC

  • E

  • Clarity

  • (among other names)

Pharmacology history
Pharmacology & History

  • MDMA is a synthetic norepinephrine-related hallucinogenic drug

  • Not to be confused with “Herbal ecstasy” containing ephedrine and other herbs

  • Reputed to be a safe “recreational” or “therapeutic” drug in a dose of 1 to 2 mg.

  • At least 68 deaths have been attributed to the use of MDMA (mostly from symptoms resembling heatstroke). Pediatrics vol 100 (1997)


MDMA Appeal

MDMA has the stimulant qualities of amphetamines and the hallucinogenic (psychedelic) qualities of mescaline

It’s effects last approximately 3-6 hours


  • First synthesized in Germany in 1914

  • First used in the 1970s in the U.S. as an adjunct to psychotherapy

    • to enhance empathy, introspection, communication

    • to induce positive mood states & feelings of intimacy and tranquility

  • At the same time animal studies showed it produced permanent brain damage

  • Popular with young people since the late 1980s

    • often used at dance parties called “raves” and on college campuses


  • In 1989 the Drug Enforcement Administration placed MDMA on the Schedule I drug list

  • Interestingly, the Multidisciplinary Association for Psychedelic Study continues to lobby to legalize MDMA for research

  • Has undeserved reputation as being safe

Methods of use
Methods of Use

  • Distributed in tablet form for oral ingestion

  • In New York, 100 mg. tablet costs approx. $20

  • Many “rave-goers” report experimenting with “stacking” --

    • taking 3 or more tablets at once and/or

    • mixing MDMA with herbal ecstasy, LSD, alcohol, marijuana, and other drugs of abuse

Signs and symptoms of mdma intoxication
Signs and Symptoms ofMDMA Intoxication:

Most Common Symptoms and Signs:

  • Muscle tension and aches

  • jaw clenching

  • sweating

  • fatigue

  • difficulty concentrating & retaining newly learned material

  • Confusion or delirium even weeks after drug use

    Occasional Symptoms:

  • Intense dysphoria (depression, anxiety)

Common serious adverse effects of mdma
Common Serious Adverse Effects of MDMA

Serious Illness and Death have occurred from:

  • Dehydration

  • Hyperthermia

  • Cardiac arrhythmia

  • Hypertensive crises

  • Disseminated intravascular coagulation (blood clot)

  • Acute renal failure

  • Hepatic toxicity (liver)

Your brain on ecstasy
Your Brain on Ecstasy

  • The brain scan on the right belongs to an individual who used Ecstasy many times, but had not used any drugs in the last 3 weeks before the scan.

  • The bright red spots on the left “normal” brain scan are serotonin receptor sites.

  • Whereas, the dark spots at the top of the right scan are serotonin receptor sites which are not active



Ecstasy Use by Students, 2000:Grade:8th 10th 12th

Ever Used 4.3% 7.3% 11.0%

Used in Past Year 3.1% 5.4% 8.2%

Used in Past Month 1.4% 2.6% 3.6%

Ecstasy tablets seized by the Drug Enforcement Administration increased from 13,342 in 1996

to 949,257 in 2000

What are raves
What are Raves?

  • Clandestine dance parties (location usually kept quiet until 1-2 days before event)

  • Held at abandoned warehouses…

  • Advertised by flyers or word of mouth

What are they like
What are they like?

  • Loud, repetitive, synthesized electronic music at 80-120 beats per minute mixed by disk jockeys

  • Only laser lights illuminate the darkened building

  • Vigorous, all night dancing


  • Rave attendees are usually high school and college students (some junior high students)

  • Because alcohol may not be served at some raves, water and power drinks are served to help to replenish fluid losses from vigorous dancing and MDMA use

  • Carnival-like atmosphere with sales of:

    • drug paraphernalia and drugs

    • brightly-colored nitrous oxide filled balloons

    • baby bottles and pacifiers (used to help mediate adverse effects of jaw-clenching)


  • PLUR Philosophy (Peace, love, unity, and respect)plus the focus on drugs (ecstasy, LSD, GHB, speed & pot) has earned ravers the name “techno-hippies”

  • According to rave-goers, PLUR is what Raves are all about.

    Quote from a rave attendee:“We have unconditionally-accepting ‘freaks are us’ love.”


  • “The rave scene is great as an accepting environment, but it becomes problematic when it’s intrinsically tied to drug use. It can set up a pattern of lifelong drug use. Drug use can lead to unsafe sex and HIV transmission.”

  • “Anything goes at a rave, and that’s both its strongest asset and its biggest flaw.”

    • Caitlin Ryan, clinical social worker and co-author of Lesbian and Gay Youth: Care and Counseling.

Screening emergency treatment of acute toxicity
Screening & Emergency Treatment of Acute Toxicity

  • MDMA can be detected by drug screening for amphetamines

    • but test sensitivity is reduced by about 50%

  • Treatment:

    • Rapid Cooling

    • Rehydration

    • Monitoring electrolytes

    • Monitoring organ function

Risk factors of mdma usage
Risk Factors of MDMA Usage

Adolescents who have aggregates of the following:

  • Have close friends who use drugs

  • Frequently attend raves

  • Early use of nicotine

  • Frequent use of marijuana

  • May have interpersonal issues with parents and authority figures

Diagnosis and treatment
Diagnosis and Treatment

  • The diagnosis is complicated by comorbidity

  • Least intrusive method is outpatient after-school drug treatment and education

  • Most drug treatment programs recommend:

    • abstinence from drugs and alcohol

    • severing ties with drug-using friends

    • Self-help groups

    • Unscheduled monitoring by urine toxicology tests