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Uses. When LSD was invented in Switzerland during 1938 no one realized that this chemical was a hallucinogen even though it was known to be related to ergot. Its inventor Albert Hofmann wanted to make a stimulant to help people push past weariness. Five years passed before he accidentally discovered the drug's ability to alter physical and mental perceptions. One element of his discovery was the drug's potency. A later estimate calculated that one ounce is enough for 300,000 doses. Authorities list the substance as 3,000 to 4,000 times stronger than mescaline. One authority lists LSD as 30 times stronger than DOM.

LSD strikes down barriers. Barriers between physical senses can disappear, allowing colors to be smelled and sounds to be seen. Psychological barriers can disappear, allowing insights that help people to cope with long-standing problems. Barriers between shared realities and personal fantasies can disappear, with people perceiving sights and sounds that no one around them is experiencing. Those perceptions can be so compelling that some people believe the drug strikes down barriers separating us from realities that are otherwise inaccessible. Some users report a mystical experience; some simply gain pleasure. Other possibilities include terrifying hallucinations and psychoses impelling persons to do things that may harm themselves or other individuals (a 1968 report from a government official about LSD users staring at the sun until they were blinded turned out to be a hoax, but similar reports have appeared since then). An LSD user's personality, expectations, and surroundings all influence outcome of a dose. The drug's effects are not invariable. Investigators have found that LSD is more rewarding for people who are spontaneous and inspired by impulses from within themselves than for people who are conforming and controlling.

Some results perceived by users turn out to be illusory. Artists who took the drug felt more creative for months afterward, but scientists who gave tests to detect elements of creativity found no change from predrug performance. On a test of sketching the human form the artists did worse than before, indicating that technical proficiency declined. An experiment involving word and image tests found LSD did not enhance creativity of normal persons.

Despite LSD's power, volunteers have typically been able to push through their intoxication and produce almost normal results in psychological tests given during the drug experience. One investigator noted that the experimental setting of such tests seemed to weaken the drug's effects. Ability to perform "almost" normally in a laboratory does not necessarily transfer to tasks of everyday life, however. For example, a person intoxicated by LSD should not attempt to engage in dangerous activity such as driving a car. During 1943 in one of the first recorded LSD experiences the drug's inventor was barely able to ride a bicycle, let alone drive a car, while under the influence. He had the illusion of being almost motionless, although he was actually traveling at normal speed, an indication that so many events were happening to him at once that his perception of time contracted—and an indication that he was in no condition to judge the speed of vehicles on the road. His feeling of time contraction in turn expanded his perception of space, a linkage that drug researchers can demonstrate, which probably made him feel he had a vaster distance to travel and was making little progress.

Before American government authorities certified LSD as having no medical value in 1970, the substance was used for a variety of therapeutic purposes. LSD has stimulant effects allowing it to be used as an antidote for barbiturate poisoning. With varying degrees of success LSD has been used to treat neuroses, sexual disorders, heroin addiction, alcoholism, and psychopathology. The drug has also been given to reduce cancer pain, to supplement drugs used for pain relief in surgery, and to treat phantom limb pain (a sensation that an amputated limb is still present and hurting). After legal LSD research was phased out in the 1970s, relatively little new information has emerged about the drug. In subsequent years even reports in scientific literature occasionally had a casualness not often associated with science. For example, in 1997 a medical journal published a report about "presumed LSD intoxications," but medical personnel did not confirm that their patients had taken the drug.

Drawbacks. Although LSD fatalities have been reported in animal experimentation, by the 1990s no human overdose deaths had been documented despite LSD's tremendous potency. An overdose nonetheless can produce a physical collapse requiring hospitalization. In a population of psychiatric patients who took the drug, only 2 in 1,000 had a resultant psychosis lasting more than 48 hours; such a result was even less frequent for psychologically normal persons. In the 1990s, however, one review of LSD research noted that lengthy psychoses can be instituted by the substance. Research found that the suicide rate for psychiatric patients who used the drug under medical supervision was the same as for other psychiatric patients, indicating LSD might present no peril in that regard—although this aspect might be different in uncontrolled circumstances.

The drug's physical effects can include headache, nausea, vomiting, hot or cold feelings, sweating, elevated body temperature, trembling, dizziness, blood pressure changes (up or down), increased heart rate, numb hands, sensitive hearing, and extra urine production. In dog experiments the substance reduced appetite.

Rat experimentation shows that administering LSD for a month can alter brain structure and chemistry. LSD has been reported to impair abstract thinking, but one commentary on those reports noted that alcohol abuse among the studied persons might also explain their thinking problems. Brief visual afterimages (such as happens when someone looks at a bright object and then sees an image of it in opposite colors for a few seconds after looking away) are normal for everyone, but a formal experiment and a few case reports note lengthy visual afterimages in proper colors among LSD users. These are not flashbacks, incidentally.

Flashbacks are one of the most publicized effects of LSD. Flashback is a reappearance of LSD actions without taking a dose. This phenomenon is normal in other contexts; something may remind a person of an event that had high emotional content, and the memory may flood one's consciousness and temporarily sweep aside awareness of one's surroundings. People are usually able to push out of an LSD flashback if they wish and are not taken over by it; a survey of 247 persons who experienced LSD flashbacks found only 1 who claimed to be unable to stop the experience at will. A case report indicates behavior therapy can stop LSD flashbacks, implying that their cause may have more to do with psychology than chemistry. Another case report notes additional evidence that personality affects likelihood of flashback. Still another case report says that some types of antidepressants appear to promote flashbacks among LSD users, and a research study concluded that phenothiazine tranquilizers worsen flashbacks after they start. Investigations have revealed that many persons who claim to have LSD flashbacks do not really have them, that people often use the term casually and incorrectly to describe other types of experiences. Psychiatrists call the LSD type of flashback "hallucinogen persisting perception disorder." Some persons, however, regard LSD flashbacks not as a disorder but as a sign they have learned to achieve altered states of consciousness without using a drug anymore.

Abuse factors. Tolerance has developed in rats and humans. Humans have shown LSD cross-tolerance with mescaline and psilocybin and slight cross-tolerance with DMT—meaning that the drugs can be substituted for one another, for some purposes at least.

Drug interactions. Two case reports indicate that LSD alone or in combination with alcohol may cause muscles to stiffen, accompanied by fever and insensibility. Some antidepressants can increase LSD's psychedelic effects; some others reduce them. Rat experiments show that various opioids in various doses can either increase or decrease LSD actions and that the schizophrenia medicine clozapine can reduce LSD effects. Case reports say that chlorpromazine (Thorazine) can cause an LSD psychosis among persons who have used LSD in the past. Ambroxol, a substance used to help people clear congested respiratory tracts, can give a false-positive urine test for LSD.

Cancer. LSD stopped breast cancer growth in a rat experiment. Researchers believe this result came not because of hallucinogenic activity but probably because LSD reduced amounts of a hormone called prolactin. Animal and plant experiments show that LSD can be a mutagen, meaning it might have a potential for causing cancer. A mutagen effect has not been observed in humans who took LSD under controlled conditions.

Pregnancy. Researchers have demonstrated that LSD passes from a pregnant mouse into the fetus. In other experiments pregnant mice that received LSD produced offspring with eye defects. The same happened with rats, but in that experiment investigators noted no significant statistical difference between LSD and non-LSD rats in malformations of any type, so the LSD may not have been responsible for the eye problems. Researchers who gave LSD to dozens of rats, mice, and hamsters found no proof that the drug caused malformations in their fetuses (which numbered in the hundreds). In the 1970s claims arose that LSD causes human chromosome damage and birth defects even if the drug use stops before pregnancy begins, but subsequent research failed to verify those claims. Some of the original laboratory tests involved conditions that do not occur in the human body, and early investigators typically did not know what drug a woman had actually taken, nor what the dose was, nor did they consider whether a woman's health problems promoted congenital malformations. The birth defect rate among children of LSD users is no higher than the general population's. A case report notes a woman who took an LSD dose during early pregnancy with no apparent ill effect on her infant. A study of pregnant women who attempted to commit suicide with drugs found no infant malformation attributable to LSD, but the investigators said data were too scanty to allow a conclusion about LSD's potential for causing developmental abnormalities. The rate of birth defects was not elevated in 121 pregnancies of women who took LSD under medical supervision. Another study of 27 pregnancies reached no conclusion on whether LSD causes miscarriage.

Additional scientific information may be found in:

Abraham, H.D., and A.M. Aldridge. "Adverse Consequences of Lysergic Acid Diethylamide." Addiction 88 (1993): 1327-34. Cohen, S. "LSD: The Varieties of Psychotic Experience." Journal of Psychoactive Drugs 17 (1985): 291-96.

Hofmann, A. LSD, My Problem Child. Trans. J. Ott. New York: McGraw-Hill, 1980. Li, J-H., and L-F. Lin. "Genetic Toxicology of Abused Drugs: A Brief Review." Muta-

genesis 13 (1998): 557-65. Mangini, M. "Treatment of Alcoholism Using Psychedelic Drugs: A Review of the

Program of Research." Journal of Psychoactive Drugs 30 (1998): 381-418. Masters, R.E.L., and J. Houston. The Varieties of Psychedelic Experience. A Delta Book.

New York: Dell, 1966. McGlothlin, W.H., and D.O. Arnold. "LSD Revisited." Archives of General Psychiatry 24 (1971): 35-49.

Novak, S.J. "LSD before Leary. Sidney Cohen's Critique of 1950s Psychedelic Drug Research." Isis 88 (March 1997): 87-110.

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