Psychedelic Drugs

by Food and Drug Administration (FDA)

Scientists at the Orenda Institute in Baltimore are taking a novel approach to treating drug addiction: They plan to give patients LSD.

That's lysergic acid diethylamide, or "acid" for short, one of several psychedelic drugs that were placed under the U.S. Controlled Substances Act in 1970. They're Schedule I drugs, which means they're considered to have a high potential for abuse, present an unacceptable safety risk, and have no acceptable medical use.

However, in recent years, the Food and Drug Administration has sought ways to allow human studies to test LSD and other Schedule I psychedelic drugs to see if they have any medical usefulness. The National Institute on Drug Abuse funds some of these studies.

In the Baltimore study, scientists are examining LSD as a possible treatment for addiction to heroin, opium, alcohol, and sedative hypnotics. University of Miami researchers are studying the psychedelic drug ibogaine to treat cocaine addiction. Other scientists are focusing their psychedelic research on learning more about the human brain, discovering antidotes to drug overdoses, and relieving pain in cancer patients.

It's still too early to say whether the drugs have medicinal uses or not, according to government scientists. "These are all very small studies, mostly with fewer than 10 patients," said Curtis Wright, M.D., a medical officer with the addiction medicine staff in FDA's Center for Drug Evaluation and Research. "It's far too early to tell whether these drugs work or not or provide any therapeutic benefit."

Drugs of Abuse

The drugs are known more for their abuse potential. They include, in addition to LSD and ibogaine, mescaline, MDMA (3-4-methylenedioxymethamphetamine — commonly called "Ecstasy"), DMT (dimethyltryptamine — known on the street as "Businessman's Special"), PCP ("Angel Dust"), N,N-diethyltryptamine (DET), psilocybin, psilocin, and alpha-ethyltryptamine (alpha-ET — also known on the street as "Trip" and "ET").

Some of the drugs occur naturally, such as ibogaine, which comes from the root of a rain forest shrub. Others, such as MDMA, are synthesized, mostly illegally, in clandestine laboratories.

As a group, the drugs are often referred to as psychedelic (meaning mind-altering) or hallucinogenic because they cause people to have hallucinations; that is, to imagine they see and hear things.

Each drug has its own unique properties, though. "There are differences, big pharmacological and psychopharmacological differences," said Frank Vocci, Ph.D., deputy director for the medications development branch of the National Institute on Drug Abuse (NIDA). "The drugs are alike only in that they share a common ability to alter perceptions or result in some type of hallucinatory experience."

Street users call these experiences "trips," which can be extremely pleasant or highly unpleasant and frightening.

Hallucinogens' Hazards

The drugs can cause other adverse reactions, too. LSD, for example, can dilate pupils; increase body temperature, heart rate, blood pressure, and sweating; and cause loss of appetite, sleeplessness, dry mouth, and tremors. Also, many LSD users experience flashbacks, spontaneous recurrences of certain aspects of the person's "trip" (without the user having taken the drug again). Long-term LSD users may develop psychoses, such as schizophrenia and severe depression.

MDMA users also may suffer from psychological difficulties, including confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia — during and sometimes weeks after taking the drug. Physical symptoms of MDMA use include muscle tension, nausea, blurred vision, rapid eye movements, faintness, chills or sweating, and increased heart rate and blood pressure — a special risk for people with heart disease.

Overuse of some pyschedelic drugs is associated with death. The pyschedelic drug alpha-ET, which was sold legally under the trade name Monase in the early 1960s for depression, was taken off the market after only one year because three illnesses and four deaths in patients taking the drug were documented. The drug was associated with a significant decrease in certain body cells.

Ibogaine as well has been linked to at least three deaths overseas.

"We have to realize that there are problems with these drugs," said Michael Klein, Ph.D., a senior interdisciplinary scientist on FDA's pilot drug evaluation staff. "We don't want to make it sound as though these drugs offer exciting possibilities, when we really don't know for sure. Each drug has to be weighed on its own merits."

Hallucinogen History

Scientific interest in these drugs is not new. Information about the effects of ibogaine, which West Africans use as a stimulant and aphrodisiac and in religious rituals, began appearing in the medical literature in the early 1900s. Mescaline, from the peyote cactus and used in Native American religious rituals, was studied in the 1920s.

LSD, perhaps the most popular of the psychedelic drugs, was first synthesized in 1938. It is made from lysergic acid, which is found in ergot, a fungus that grows on rye and other grains and has been known throughout history as a source of various types of medications. Its psychedelic effects were discovered in 1943.

During the 20 years following World War II, LSD was used to study brain chemistry and to determine its effects in patients with schizophrenia and other mental disorders. It also was studied for use in conjunction with psychotherapy — with, for example, alcoholics and cancer patients.

Due to concern about possible unpredictable side effects and abuse, LSD research came to a virtual halt by the mid-1970s. Unsupervised use of these drugs by millions of young adults in the 1960s made use and abuse of psychedelic drugs a major public health concern.

According to FDA's Klein, the Controlled Substances Act was an attempt to control the use of these drugs so that they would be used only for scientific reasons. "The purpose of the act was not to hinder or stop research," he said, "but to ensure that as the research proceeded, proper controls were in place to prevent abuse and misuse of the drugs."

However, by the 1970s, psychedelic drugs were not only viewed as a public health problem but also carried a social implication. Psychedelic drugs were associated with "hippies," a counterculture of mostly young people who felt alienated from the mainstream American society and grew, in part, out of the anti-Vietnam war sentiment of the time.

"There seemed to be an increasing hysteria about hallucinogenic drugs in the 1960s that essentially shut down the research," NIDA's Vocci said. "It became socially unacceptable to do this kind of work."

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