Hallucinogens
Mark J Werner MD1
1 Assistant Professor of Pediatrics, Division of Adolescent Medicine, Vanderbilt University, Nashville, TN.
Substances that produce hallucinations have been used for thousands of years. It is said that the Oracle of Delphi inhaled carbon dioxide emanating from a rock fissure to alter consciousness. Cannabis and certain mushrooms were used at the time of the Vedas. Hallucinogenic drugs first captured the American public's attention and concern in the early to mid-1960s during the age of psychedelic experience and "flower children." Over the past 20 years the aura surrounding hallucinogens has changed so greatly that today they are sometimes considered to be just another class of drugs used inappropriately by adolescents. However, the use of hallucinogens by adolescents is much more widespread than many pediatricians may realize. Approximately 14% of adolescents have used hallucinogens. Annual surveys of high school seniors indicate that approximately 10% have used hallucinogens, with 2% to 3% having used them in the past month. Specifically, 1.8% have used lysergic acid diethylamide (LSD) and 1.4% have used phencyclidine (PCP) within the past 30 days. Studies suggest that PCP is the only drug for which use by adolescents has been increasing in recent years.
The purpose of this article is to review the major physiologic and behavioral consequences of hallucinogen abuse, the presentation and management of acute intoxication and withdrawal, and the association between maternal use of hallucinogens and fetal abnormalities or neonatal withdrawal syndromes.
