how can i change my mind

Erectile dysfunction

2011-11-15T07:12:00.001-08:00

The first thing your doctor will do is to make sure you're getting the right treatment for any health problems that could be causing or worsening your erectile dysfunction. A variety of options exist for treating erectile dysfunction. The cause and severity of your condition, and underlying health problems, are important factors in your doctor's recommending the best treatment or treatments for you. Your doctor can explain the risks and benefits of each treatment, and will consider your preferences. Your partner's preferences also may play a role in treatment choices. Oral medications Oral medications are a successful erectile dysfunction treatment for many men. They include: Sildenafil (Viagra)Tadalafil (Cialis)Vardenafil (Levitra) All three medications work in much the same way. These drugs enhance the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation. These medications vary in dosage, how long they work and their side effects. Your doctor will take into account your particular situation to determine which medication may work best. Don't expect these medications to fix your erectile dysfunction immediately. You may need to work with your doctor to find the right medication and dose for you. Before taking any prescription erectile dysfunction medication (including over-the-counter supplements or herbal remedies), get your doctor's OK. Although these medications can help many people, not all men should take them to treat erectile dysfunction. These medications may not work or may be dangerous for you if you: Take nitrate drugs for angina, such as nitroglycerin (Nitro-Bid, others), isosorbide mononitrate (Imdur) and isosorbide dinitrate (Isordil)Take a blood-thinning (anticoagulant) medication, alpha blockers for enlarged prostate (benign prostatic hyperplasia) or high blood pressure medicationsHave heart disease or heart failureHave had a strokeHave very low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)Have uncontrolled diabetesOther medications Other medications for erectile dysfunction include: Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Alprostadil, Caverject Impulse, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include papaverine, alprostadil and phentolamine. Each injection generally produces an erection in five to 20 minutes that lasts about an hour. Because the needle used is very fine, pain from the injection site is usually minor. Side effects can include bleeding from the injection, prolonged erection and formation of fibrous tissue at the injection site.Alprostadil penis suppository. Alprostadil intraurethral (MUSE) therapy involves placing a tiny alprostadil suppository inside your penis. You use a special applicator to insert the suppository about two inches down into your penis. Side effects can include pain, minor bleeding in the urethra, dizziness and formation of fibrous tissue inside your penis.Testosterone replacement. Some men have erectile dysfunction caused by low levels of the hormone testosterone, and may need testosterone replacement therapy.Penis pumps, surgery and implants Medications may not work or may not be a good choice for you. If this is the case, your doctor may recommend a different treatment. Other treatments include: Penis pumps. A penis pump (vacuum constriction device) is a hollow tube with a hand-powered or battery-powered pump. The tube is placed over your penis, and then the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into your penis. Once you get an erection, you slip a tension ring around the base of your penis to hold in the blood and keep it firm. You then remove the vacuum device. The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse.Penile implants. This treatment involves surgically placing devices into the two sides of the penis. These implants consist of either inflatable or semirigid rods made from silicone or polyurethane. The inflatable devices allow you to control when and how long you have an erection. The semirigid rods keep the penis firm but bendable. This treatment can be expensive and is usually not recommended until other methods have been tried first. As with any surgery, there is a risk of complications such as infection.Blood vessel surgery. In rare cases, a leaking blood vessel can cause erectile dysfunction and surgery is necessary to repair it.Psychological counseling If your erectile dysfunction is caused by stress, anxiety or depression, your doctor may suggest that you, or you and your partner, visit a psychologist or counselor. Even if it is caused by something physical, erectile dysfunction can create stress and relationship tension.Tests and diagnosisFor many men, a physical exam and answering questions (medical history) are all that's needed before a doctor is ready to recommend a treatment. If your doctor suspects that underlying problems may be involved, or you have chronic health problems, you may need further tests or you may need to see a specialist. Tests for underlying problems may include: Physical exam. This may include careful examination of your penis and testicles and checking your nerves for feeling.Blood tests. A sample of your blood may be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health problems.Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.Ultrasound. This test can check blood flow to your penis. It involves using a wand-like device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems. This test is sometimes done in combination with an injection of medications into the penis to determine if blood flow increases normally.Overnight erection test. Most men have erections during sleep without remembering them. This simple test involves wrapping special tape around your penis before you go to bed. If the tape is separated in the morning, your penis was erect at some time during the night. This indicates the cause is of your erectile dysfunction is most likely psychological and not physical.

2011-11-13T09:30:00.000-08:00

Media release from PfizerThe little blue pill called Viagra® (sildenafil citrate) which revolutionised the treatment of erectile dysfunction (ED) and made a positive impact on men's sexual health has now become more affordable.With the New Zealand patent period on Viagra expiring in June, the market will soon be open to generic medicines. Pfizer, the makers of Viagra, will now also sell this medicine in New Zealand under a second brand called Avigra®.Avigra will provide the thousands of Kiwi men currently using Viagra with a more affordable option, plus the confidence they'll be receiving the same quality of medicine from the makers of Viagra, the most prescribed treatment for ED in New Zealand since its launch in 1998 ."Because Viagra still remains patented throughout most of the world, by launching a second brand in a generic market it allows us to provide the same quality of medicine as Viagra at a more competitive price," says Frances Benge, Head of Primary Care, Pfizer New Zealand Limited.Until now the cost of treatment for ED has prevented some men from receiving it. The recommended retail cost of Avigra is around $8 per tablet (available in boxes of four or 12), almost half the price of Viagra, making it more affordable and allowing more men to access treatment for a healthier sex life.Viagra will still be available in New Zealand at a competitive price for those men who prefer to remain on it. The active ingredient in Avigra has helped more than 37 million men in 120 countries reclaim their sex lives by improving the hardness of their erection. Along with optimal erection, many men using this treatment report an increase in sexual confidence, self-esteem and sexual relations satisfaction.Product information:Prices may vary from pharmacy to pharmacy. Doctor fees and a pharmacy charge may apply. Avigra is a private purchase medicine. Avigra is available in boxes of 4 (sildenafil citrate 25mg, 50mg, 100mg) or 12 (100mg only). It is a prescription medicine for the treatment of erection problems. Avigra must not be used by men taking any form of nitrate medicine. Avigra must not be taken by men with heart conditions that may be affected by the strain of sexual activity. Side effects include headache, dizziness, flushing, indigestion, temporary changes in vision, stuffy nose, diarrhoea, urinary tract infection or rash. Use strictly as directed. If symptoms continue or you have side effects see your doctor.

2009-03-30T13:41:00.000-07:00

false MicrosoftInternetExplorer4

Состав: веществом препарата By Viagra является силденафила цитрат, содержится в таблетках в дозах, эквивалентных 50 мг или 100 мг силденафила.

Вспомогательные вещества: микрокристаллическая целлюлоза, кальция гидрофосфат (безводный), натрия кроскармеллоза, магния стеарат. гипромеллоза, титана двуокись (Е171), лактоза, триацетин, индиго кармин алюминиевый лак (Е132).
viagra

2009-03-28T17:30:00.003-07:00

How is erectile dysfunction treated?

How erectile dysfunction is treated depends on what is causing it. After your doctor checks you for medical problems and medicines that might cause erectile dysfunction, he or she may have you try a medicine to help with erectile dysfunction. Some of these medicines are injected into your penis. Other medicines are taken by mouth. Not everyone can use these medicines. Your doctor will help you decide if you can try them.

2009-03-28T17:30:00.001-07:00

How is erectile dysfunction treated?

2009-03-28T17:26:00.000-07:00

What causes erectile dysfunction?

See the box to the right for some physical causes of erectile dysfunction. The following medical problems can also cause erectile dysfunction:

Diabetes (high blood sugar)
Hypertension (high blood pressure)
Atherosclerosis (hardening of the arteries)

If you can't keep your blood sugar or your blood pressure under control, you can get erectile dysfunction. It's important that you take your medicines for these problems just the way your doctor tells you.

Sometimes your hormones get out of balance and this causes erectile dysfunction. Your doctor will decide if you need blood tests to check your hormones.

Some medicines can cause erectile dysfunction. If this is true for you, your doctor may take you off that medicine or give you a different one.

Drinking too much alcohol, smoking too much and abusing drugs can also cause erectile dysfunction.

Problems in your relationship with your sexual partner can also cause erectile dysfunction. Improving your relationship may help your sex life. If you decide to seek therapy, it will probably be most effective if your sex partner is included. Couples can learn new ways to please one another and to show affection. This can reduce anxiety about having erections.

Cocaine and Crack

2009-03-16T23:36:00.000-07:00

Cocaine and Crack

What are Cocaine and Crack?
Cocaine is a central nervous system
stimulant, the most powerful found in
nature. Most often seen in the form of a
white, crystalline powder, it is extracted
from the leaves of the coca plant.

What is Crack?
Crack is a smokeable, rapidly reacting form
of cocaine base, which is processed from
cocaine hydrochloride. It usually appears
as off-white chips, rocks, or chunks.
How Are These Drugs Taken?
The primary route of administration for cocaine powder is through inhalation, commonly
referred to as "snorting." This is often done in a ritualistic way; e.g., poured onto a mirror,
chopped, separated into "lines," and then "snorted" off a small "coke" spoon, or through
a straw or rolled-up currency. Some users dissolve the powder in water and inject it into
veins, though this is less common than "snorting."
Crack is smoked. This is easier than "snorting" and carries much less social stigma than
injection. Chips or chunks are usually placed in a pipe, often made of glass, or a similar
vessel and heated with a match or cigarette lighter. The user inhales the fumes.
How Do They Affect You?
Cocaine in all its forms stimulates the central nervous system. It causes the heart to beat
more rapidly and blood vessels to constrict. This results in the demand for a greater
supply of blood. But the narrowed blood vessels are unable to deliver the volume of
blood demanded, which significantly increases the risk of cardiovascular incidents or
strokes. Initially, use of these drugs reduces appetite and makes the user feel more
alert, energetic, and self-confident—even more powerful.
With high doses, users can become delusional, paranoid, and even suffer acute toxic
psychosis. Blood pressure increases, which can cause strokes or heart attacks. In some
cases these effects have proven fatal. As the drug’s effects wear off, a depression (often
called a "crash") can set in, leaving the user feeling fatigued, jumpy, fearful, and anxious. Crack causes the same effects as powder cocaine. Because it is smoked, however,
onset is more rapid and intensity greater. Thus, the effects may be significantly
exacerbated. The depression following use is described as considerably deeper and
more profound. The likelihood of cocaine psychosis after binging on crack may be
greater and notably more intense. Crack use is associated with incidents of hyperactive
violence by users and is capable of doing significant harm to fetuses of pregnant users.
Paying the Price of Cocaine and Crack Use
A broad range of consequences include:
• Dependence and addiction
• Cardiovascular problems, including irregular heartbeat, heart
attack, and heart failure
• Neurological incidents, including strokes, seizures, fungal brain
infections, and hemorrhaging in tissue surrounding the brain
• Pulmonary effects, such as fluid in the lungs, aggravation of
asthma and other lung disorders, and respiratory failure
• Psychiatric complications, including psychosis, paranoia,
depression, anxiety disorders, and delusions
• Increased risk of traumatic injury from accidents and aggressive,
violent, or criminal behavior
• Other effects include: sleeplessness, sexual dysfunction,
diminished sense of smell, perforated nasal septum, nausea, and
headaches.
• Crack users often singe eyebrows or eyelashes with the flame of
matches or lighters. They also burn fingertips and other body parts
from contact with superheated vessels (e.g., glass pipes).
• Fetal cocaine effects include premature separation of the
placenta, spontaneous abortion, premature labor, low birthweight
and head circumference at birth, greater chance of visual
impairment, mental retardation, genitourinary malformations, and
greater chance of developmental problems.
• For intravenous (IV) cocaine users, there is increased risk of
hepatitis, HIV infection, and endocarditis.
• For addicts, whether they smoke, inject, or snort, promiscuous sexual
activity can increase the risk of HIV infection.

PCP & LSD

2009-03-16T23:24:00.000-07:00

BASIC FACTS ABOUT DRUGS: PCP and LSD

Distorting the senses and clouding
the mind, hallucinogens pose grave
dangers; LSD may trigger anxiety,
panic, depression, paranoia, and
psychotic episodes. PCP prompts
violence, can induce psychosis, and
cause death by respiratory arrest.

The term hallucinogen is used to describe naturally occurring or synthetic drugs
taken primarily for the distorting effects they have on the user’s perceptions.
Hallucinogens effects range from mild sensory distortion to hallucinations,
paranoia, and delirium.
What is PCP?
Originally developed as a synthetic drug 1959, Phencyclidine (PCP, or angel dust) is a
dissociative anesthetic. In its pure form, PCP is a white, crystalline powder. A street drug
since the 1960’s, it is now produced in clandestine labs and sometimes passed off as
mescaline or as another hallucinogen with less extreme effects. In large quantities it smells
like strong ammonia. While use of PCP died down after the 70's PCP is making a resurgence
in parts of the Northeast parts of the country despite its now know dangers. It is marketed
under so many different names (wet, bobbies, dippies, dank, amp, hydro, purple haze, haze,
and lillie just to name a few) that users aren't always aware that they are using it.
What does it look like and how is it taken?
Usually smoked, PCP can also be taken orally, snorted, or injected. It is sold in capsules,
tablets, powder, and liquid. Most often the crystalline powder is sprinkled on a leafy
substance—tobacco, parsley, mint, oregano, or marijuana—and then smoked in rolled
cigarettes.
What are PCP's effects?
The effects of PCP can be unpredictable and are often severe. Moderate doses (5 milligrams or
less), generally produce initial feelings of relaxation and mild euphoria, but depression,
anxiety, or disorientation can also result. Within the normal dosage range, users feel powerful,
"spaced out," or detached and may experience LSD-like visual distortions. Physical effects
LSD Blotter Paper LSD Pills PCP
include: rising heart rate, blood pressure, and body temperature; flushing and sweating;
shallow breathing; numbness; and some loss of coordination.
At higher doses, respiration drops and users may experience nausea, vomiting, loss of
balance, and dizziness. They often display dramatic mood swings and are prone to anxiety,
paranoia, and aggressiveness. Violence is not uncommon.
Paranoid delusions and aggressive behavior are sometimes followed by PCP-induced psychosis
that may mimic symptoms of schizophrenia. Psychotic episodes can last several days, and it
may take as long as two weeks for patients to return to normal. At toxic levels, or when
interacting with alcohol or other depressant drugs, PCP can prove fatal, causing convulsions,
coma, and respiratory arrest. PCP can also exacerbate pre-existing mental disorders
What is LSD?
LSD, commonly called “acid”, is the best known of the hallucinogens. Discovered in 1938, LSD
was popular in the late 40’s through the 60’s. During these years many young people took
“acid trips.” Advocates thought LSD was a mind-expanding aid that helped users achieve
mystical states of perception.
How is LSD Taken?
LSD is generally taken orally and in very small doses. Most often, LSD is found in small
squares of impregnated paper, called "blotter acid." The squares may come in perforated
sheets, like postage stamps, sometimes with an eye-catching image on each square. The drug
may also come in tiny tablets, called "microdots," or in small, thin, gelatin squares, known as
"windowpane." LSD is sometimes available in a clear liquid solution. This is dispensed with an
eyedropper, onto sugar cubes or directly onto the tongue. Another variety, "blue dot acid,"
consists of paper slips smeared with a blue-colored solution of the drug.

How does LSD Affect You?

Physical effects of LSD may include: dialated pupils, high temperature, rapid heartbeat,
increased blood pressure, sleeplessness, appetite loss, and tremors.

Psychological effects can last for 12 hours. During the first 30 to 90 minutes, changes in
visual perception and mood are likely. As the drug achieves its one-to two-hour “peak,” the
user may experience distorted impressions of time, space, and distance. “Tracking” may
occur-the observation of streams of colored light following the path of a moving object and
“psychedelic” patterns may appear. Judgment and the ability to recognize immediate danger
can be impaired increasing the risk of injury.

Acute anxiety, depression, panic, paranoia, or psychotic behavior may accompany a bad trip or
may occur after most other effects of the drug have worn off. An overdose can result in a
longer, more intense and more frightening trip, and the spontaneous, recurring hallucinations
known as flashbacks can occur days, weeks, or more than a year after LSD use.BASIC FACTS ABOUT DRUGS: PCP and LSD

Distorting the senses and clouding
the mind, hallucinogens pose grave
dangers; LSD may trigger anxiety,
panic, depression, paranoia, and
psychotic episodes. PCP prompts
violence, can induce psychosis, and
cause death by respiratory arrest.

The term hallucinogen is used to describe naturally occurring or synthetic drugs
taken primarily for the distorting effects they have on the user’s perceptions.
Hallucinogens effects range from mild sensory distortion to hallucinations,
paranoia, and delirium.
What is PCP?
Originally developed as a synthetic drug 1959, Phencyclidine (PCP, or angel dust) is a
dissociative anesthetic. In its pure form, PCP is a white, crystalline powder. A street drug
since the 1960’s, it is now produced in clandestine labs and sometimes passed off as
mescaline or as another hallucinogen with less extreme effects. In large quantities it smells
like strong ammonia. While use of PCP died down after the 70's PCP is making a resurgence
in parts of the Northeast parts of the country despite its now know dangers. It is marketed
under so many different names (wet, bobbies, dippies, dank, amp, hydro, purple haze, haze,
and lillie just to name a few) that users aren't always aware that they are using it.
What does it look like and how is it taken?
Usually smoked, PCP can also be taken orally, snorted, or injected. It is sold in capsules,
tablets, powder, and liquid. Most often the crystalline powder is sprinkled on a leafy
substance—tobacco, parsley, mint, oregano, or marijuana—and then smoked in rolled
cigarettes.
What are PCP's effects?
The effects of PCP can be unpredictable and are often severe. Moderate doses (5 milligrams or
less), generally produce initial feelings of relaxation and mild euphoria, but depression,
anxiety, or disorientation can also result. Within the normal dosage range, users feel powerful,
"spaced out," or detached and may experience LSD-like visual distortions. Physical effects
LSD Blotter Paper LSD Pills PCP
include: rising heart rate, blood pressure, and body temperature; flushing and sweating;
shallow breathing; numbness; and some loss of coordination.
At higher doses, respiration drops and users may experience nausea, vomiting, loss of
balance, and dizziness. They often display dramatic mood swings and are prone to anxiety,
paranoia, and aggressiveness. Violence is not uncommon.
Paranoid delusions and aggressive behavior are sometimes followed by PCP-induced psychosis
that may mimic symptoms of schizophrenia. Psychotic episodes can last several days, and it
may take as long as two weeks for patients to return to normal. At toxic levels, or when
interacting with alcohol or other depressant drugs, PCP can prove fatal, causing convulsions,
coma, and respiratory arrest. PCP can also exacerbate pre-existing mental disorders
What is LSD?
LSD, commonly called “acid”, is the best known of the hallucinogens. Discovered in 1938, LSD
was popular in the late 40’s through the 60’s. During these years many young people took
“acid trips.” Advocates thought LSD was a mind-expanding aid that helped users achieve
mystical states of perception.
How is LSD Taken?
LSD is generally taken orally and in very small doses. Most often, LSD is found in small
squares of impregnated paper, called "blotter acid." The squares may come in perforated
sheets, like postage stamps, sometimes with an eye-catching image on each square. The drug
may also come in tiny tablets, called "microdots," or in small, thin, gelatin squares, known as
"windowpane." LSD is sometimes available in a clear liquid solution. This is dispensed with an
eyedropper, onto sugar cubes or directly onto the tongue. Another variety, "blue dot acid,"
consists of paper slips smeared with a blue-colored solution of the drug.

How does LSD Affect You?

Physical effects of LSD may include: dialated pupils, high temperature, rapid heartbeat,
increased blood pressure, sleeplessness, appetite loss, and tremors.

Psychological effects can last for 12 hours. During the first 30 to 90 minutes, changes in
visual perception and mood are likely. As the drug achieves its one-to two-hour “peak,” the
user may experience distorted impressions of time, space, and distance. “Tracking” may
occur-the observation of streams of colored light following the path of a moving object and
“psychedelic” patterns may appear. Judgment and the ability to recognize immediate danger
can be impaired increasing the risk of injury.

Acute anxiety, depression, panic, paranoia, or psychotic behavior may accompany a bad trip or
may occur after most other effects of the drug have worn off. An overdose can result in a
longer, more intense and more frightening trip, and the spontaneous, recurring hallucinations
known as flashbacks can occur days, weeks, or more than a year after LSD use.

about LSD

2009-03-15T13:12:00.001-07:00

The Call for Participation for Wikimania 2009 has been released. Submit your presentations before April 15.

[Hide]
[Help us with translations!]

Lysergic acid diethylamide

From Wikipedia, the free encyclopedia

Jump to: navigation, search

"LSD" redirects here. For other uses, see LSD (disambiguation).


Lysergic acid diethylamide
Systematic (IUPAC) name
(6aR,9R)- N,N- diethyl- 7-methyl- 4,6,6a,7,8,9- hexahydroindolo- [4,3-fg] quinoline- 9-carboxamide
Identifiers
CAS number	50-37-3
ATC code	?
PubChem	5761
ChemSpider	5558
Chemical data
Formula	C₂₀H₂₅N₃O
Mol. mass	323.43 g/mol
SMILES	eMolecules & PubChem
Synonyms	LSD, LSD-25, lysergide, D-lysergic acid diethyl amide, N,N- diethyl- D- lysergamide
Physical data
Melt. point	80 °C (176 °F)
Pharmacokinetic data
Bioavailability	?
Metabolism	hepatic
Half life	3 hours
Excretion	renal
Therapeutic considerations
Pregnancy cat.	X(AU) X(US)
Legal status	Prohibited (S9)(AU) Schedule III(CA) Class A(UK) Schedule I(US)
Routes	Oral, Intravenous

Lysergic acid diethylamide, LSD, LSD-25, or acid, is a semisynthetic psychedelic drug of the ergoline family. Its unusual psychological effects, which include visuals of colored patterns behind the eyes in the mind, a sense of time distorting, and crawling geometric patterns, have made it one of the most widely known psychedelic drugs. It has been used mainly as a recreational drug, an entheogen, and as a tool to supplement various practices for transcendence, including in meditation, psychonautics, art projects, and illicit (formerly legal) psychedelic therapy. Formally, LSD is classified as a hallucinogen of the psychedelic type.^[1]

It is synthesized from lysergic acid derived from ergot, a grain fungus that typically grows on rye, and was first synthesized by Swiss chemist Albert Hofmann. The short form LSD comes from its early code name LSD-25, which is an abbreviation for the German "Lysergsäure-diethylamid" followed by a sequential number.^[2]^[3]

LSD is sensitive to oxygen, ultraviolet light, and chlorine, especially in solution, though its potency may last for years if it is stored away from light and moisture at low temperature. In pure form it is colorless, odorless, and mildly bitter.^[3]

LSD is typically delivered orally, usually on a substrate such as absorbent blotter paper, a sugar cube, or gelatin. In its liquid form, it can be administered by intramuscular or intravenous injection. The threshold dosage level needed to cause a psychoactive effect on humans is between 20 and 30 µg (micrograms).^[4]

Introduced by Sandoz Laboratories as a drug with various psychiatric uses, LSD quickly became a therapeutic agent that appeared to show great promise. However, the extra-medicinal use of the drug in Western society during the mid-twentieth century led to a political firestorm that resulted in the banning of the substance.^[5] A number of organizations—including the Beckley Foundation, MAPS, Heffter Research Institute and the Albert Hofmann Foundation—exist to fund, encourage and coordinate research into its medicinal uses.^[6]

The European Monitoring Centre for Drugs and Drug Addiction reports that LSD retail prices range between €5 and €11 per unit in most European countries.^[7]

History

Main article: History of LSD

The discoverer of LSD, Albert Hofmann

LSD was first synthesized on November 16, 1938, by Swiss chemist Albert Hofmann at the Sandoz Laboratories in Basel, Switzerland, as part of a large research program searching for medically useful ergot alkaloid derivatives.^[8] Ergot is a fungus that, by infecting cereal grains used for making rye breads, causes ergotism. After Dr. Hofmann succeeded in synthesizing ergobasine (which became the preeminent uterotonic), he began working on other amide derivatives of lysergic acid. Lysergic acid diethylamide, the 25th lysergic acid derivative Hofmann synthesised (hence the name LSD-25), was developed initially as a probable analeptic, a circulatory and respiratory stimulant, based on its structural similarity to another known analeptic, nikethamide (nicotinic acid diethylamide). However, no extraordinary benefits of the compound were identified during animal tests (though laboratory notes briefly mention that the animals became "restless" under its effects), and its study was discontinued.^[9] Its psychedelic properties were unknown until five years later, when Hofmann, acting on what he has called a "peculiar presentiment," returned to work on the chemical.^[9]

While re-synthesizing LSD-25 for further study on April 16, 1943, Hofmann became dizzy and was forced to stop work. In his journal, Hofmann wrote that after becoming dizzy he proceeded home and was affected by a "remarkable restlessness, combined with a slight dizziness". Hofmann stated that as he lay in his bed he sank into a not-unpleasant "intoxicated like condition" which was characterized by an extremely stimulated imagination. He stated that he was in a dreamlike state, and with his eyes closed he could see uninterrupted streams of "fantastic pictures, extraordinary shapes with intense, kaleidoscopic play of colors." The condition lasted about two hours after which it faded away.^[10] Hofmann had attributed the psychoactive effects he experienced to accidentally absorbing a tiny amount of LSD-25 into his skin. Three days later he would take a much larger dose in order to test its effects further; this day would later be referred to as the "Bicycle Day".^[2]

Bicycle day

On April 19, 1943, Dr. Albert Hofmann intentionally ingested 250 µg of LSD, which he hypothesized would be at most a threshold level dose, based on his research on other ergot alkaloids. Surprisingly, the substance showed a potency orders of magnitude above almost any other substance known at the time, amounting to a much heavier dose than typically given in modern therapeutic use. After ingesting the substance Hofmann found himself struggling to speak intelligibly and asked his laboratory assistant, who knew of the self-experiment, to escort him home on his bicycle, since wartime restrictions made automobiles unavailable. On the bicycle ride home, Hofmann's condition became more severe and in his journal he stated that everything in his field of vision wavered and was distorted, as if seen in a curved mirror. Hofmann also stated that while riding on the bicycle, he had the sensation of being stationary, unable to move from where he was, despite the fact that he was moving very rapidly. Once Hofmann arrived home, he summoned a doctor and asked his neighbor for milk, believing it might help relieve the symptoms. Hofmann wrote that despite his delirious and bewildered condition, he was able to choose milk as a nonspecific antidote for poisoning.^[11]

Upon arriving the attending doctor could find no abnormal physical symptoms other than extremely dilated pupils. After spending several hours terrified that his body had been possessed by a demon, that his next door neighbor was a witch, and that his furniture was threatening him, Dr. Hofmann feared he had become completely insane. In his journal Hofmann said that the doctor saw no reason to prescribe medication and instead sent him to his bed. At this time Hofmann said that the feelings of fear had started to give way to feelings of good fortune and gratitude, and that he was now enjoying the colors and plays of shapes that persisted behind his closed eyes. Hofmann mentions seeing "fantastic images" surging past him, alternating and opening and closing themselves into circles and spirals and finally exploding into colored fountains and then rearranging themselves in a constant flux. Hofmann mentions that during the condition every acoustic perception, such as the sound of a passing automobile, was transformed into optical perceptions. Eventually Hofmann slept and upon awakening the next morning felt refreshed and clearheaded, though somewhat physically tired. He also stated that he had a sensation of well being and renewed life and that his breakfast tasted unusually delicious. Upon walking in his garden he remarked that all of his senses were "vibrating in a condition of highest sensitivity, which then persisted for the entire day".^[11]

Early research

Early researchers on LSD saw its potency and noticed that even in extremely small quantities it could significantly alter the mental functioning of healthy volunteers. Since LSD could produce changes in perceptions and emotions, early researchers hypothesized that the cause of some mental illnesses, particularly schizophrenia, were caused by endogenous compounds with a similar activity to LSD.^[12] Much of the research during the late 1940s dealt with this hypothesis and many LSD sessions conducted for scientific study were often termed "experimental psychoses", and this is where the terms "psychoactive" , "psychotomimetic" and "hallucinogenic" were coined to refer to such drugs.^{[citation needed]} Generally these studies revolved around the attempt to block the effects of LSD with premedication in order to find medical treatments for schizophrenia. The studies showed that there was no such connection (the effects of LSD and those of schizophrenia are drastically different and have different causes and functions). Some early researchers also started to suggest that LSD could have positive effects and could be used as a treatment for patients with psychiatric illnesses. Some reports suggested that even small doses of LSD could have dramatic effects on the personalities, attitudes, and even lifestyles of test subjects. Early LSD research also found evidence of the drug's ability to facilitate relief of various emotional episodes related to traumatic memories from childhood of patients.^[12]

Government research

A solution of LSD

During the Cold War, intelligence agencies were keenly interested in the possibilities of using LSD for interrogation and mind control, as well as for large-scale social engineering. The CIA research on LSD, most of which was done under Project MKULTRA, the code name for a CIA mind-control research program, began in the 1950s and continued until the late 1960s.^[13] Tests were also conducted by the U.S. Army Biomedical Laboratory (now known as the United States Army Medical Research Institute of Chemical Defense) located in the Edgewood Arsenal at Aberdeen Proving Grounds. The government would administer LSD to subjects (without consent) and then perform a battery of tests to investigate the effects of the drug on soldiers. Further CIA-funded testing was carried out at the Allan Memorial (Psychiatric) Institute in Montreal, a division of the Royal Victoria Hospital, which is a teaching hospital of McGill University. Most of the results of these experiments remain classified. Based on remaining publicly available records, the projects were said to be inconclusive.^[14]

Both the CIA and the Army experiments caused controversy when they became public knowledge in the 1970s, as the test subjects were not normally informed of the nature of the experiments, or even that they were subjects in experiments at all.^[13] In 1961, Paul Robeson attempted suicide in a Moscow hotel room. His son claimed this was precipitated by a CIA agent who placed some synthetic hallucinogen in his drink.^[15] At least one person, an Army scientist named Frank Olson is thought by some to have committed suicide by leaping from a tall building as a result of his being unknowingly given LSD.^[13] Frank Olson's son, Eric Olson, believes that his father was murdered by government officials and a 1994 exhumation and examination by forensic pathologists at George Washington University of the body suggested that Olson had suffered blunt trauma to the back of his head prior to falling from the building.^[16] Most of the MKULTRA records were deliberately destroyed in 1973. The controversy contributed to President Ford's creation of the Rockefeller Commission and new regulations on informed consent.^[13]

The British government also engaged in LSD testing. In 1953 and 1954, scientists working for MI6 dosed servicemen in an effort to find a "truth drug" that could be used in interrogations. The test subjects were not informed that they were being given LSD, and had in fact been told that they were participating in a medical project to find a cure for the common cold. One subject, aged 19 at the time, reported seeing "walls melting, cracks appearing in people's faces … eyes would run down cheeks, Salvador Dalí-type faces … a flower would turn into a slug". After keeping the trials secret for many years, MI6 agreed in 2006 to pay the former test subjects financial compensation. ^[17]

Current research

Today, most research with LSD involves animals or cells. However, a few groups are exploring LSD effects in humans. The Multidisciplinary Association for Psychedelic Studies has an eight-person study in Switzerland to see if a large dose of LSD (200 µg) is more helpful as part of psychotherapy for cancer patients than a lower dose (20 µg). The Beckley Foundation is studying the effects of LSD on mental activity and consciousness in LSD-experienced volunteers, in order to gain insight into its reported effects on creativity and insight.^[18] It is hypothesised that LSD could be used in the treatment of obsessive-compulsive disorder due to the substance's stimulation of the 5-HT2A receptors.^[19] There has been additional interest in studying the effects of LSD on cluster headaches, although the current status of this research is uncertain. While some of these studies could be criticized for being too small to lead to strong conclusions, they may represent the beginnings of renewed scientific interest into LSD.

Dosage

White on White blotters (WoW)

Gradient blotters of LSD containing 100ug

Dosages of LSD are measured in micrograms (µg), or millionths of a gram. By comparison, dosages of most drugs, both recreational and medicinal, are measured in milligrams (mg), or thousandths of a gram. Hofmann determined that an active dose of mescaline, roughly 0.2 to 0.5g, has effects comparable to 100 µg or less of LSD; put another way, LSD is between two to five thousand times more active than mescaline.^[2] While a single dose of LSD may be between 100 and 500 micrograms — an amount roughly equal to one-tenth the mass of a grain of sand — threshold effects can be felt with as little as 25 micrograms.^[4]

Generally, the dosage that will produce a threshold psychotropic effect in humans is considered to be 20 to 30 µg.^[20]^[4] According to Glass and Henderson's review, black-market LSD is largely iterated though sometimes contaminated by manufacturing by-products. Typical doses in the 1960s ranged from 200 to 1000 µg while street samples of the 1970s contained 30 to 300 µg. By the 1980s, the amount had reduced to between 100 to 125 µg, lowering more in the 1990s to the 20–80 µg range. (Lower doses, Glass and Henderson found, generally produce fewer bad trips.)^[21] Estimates for the lethal dosage (LD₅₀) of LSD range from between 200 µg/kg to more than 1 mg/kg of human body mass, though most sources report that there are no known human cases of such an overdose. Other sources note one report of a suspected fatal overdose of LSD occurring in November 1975 in Kentucky in which there were indications that ~1/3 of a gram (320 mg or 320,000 µg) had been injected intravenously. (This is a very extraordinary amount, particularly when compared to the average LSD dosage of ~100 µg)^[22]^[23] Experiments with LSD were also done on animals; in 1962, an elephant named Tusko died shortly after being injected with 297 mg, but whether the LSD was the cause of his death is controversial.^[24]

Comparison of the perceived harm for various psychoactive drugs from a poll among medical psychiatrists specialized in addiction treatment^[25]

LSD is not considered addictive, in that its users do not exhibit the medical community's commonly accepted definitions of addiction and physical dependence.^[26] Rapid tolerance build-up prevents regular use, and there is cross-tolerance shown between LSD, mescaline^[27] and psilocybin.^[28] This tolerance diminishes after a few days without use and is probably caused by downregulation of 5-HT_2A receptors in the brain.

Adverse effects of psychotropics are often treated with fast-acting benzodiazepines like diazepam or triazolam that have calming and antianxiety effects but do not directly affect the specific actions of psychotropics. Many rumors about home remedies to counteract psychedelic effects are circulated, including orange juice, vanilla essence, vitamin C, and anti-histamines. These may have a placebo effect, working by making the taker think they have done something to make it better.^[29] Theoretically, specific 5-HT_2A receptor antagonists, such as Seroquel, would be direct antidotes, although some anecdotal reports claim otherwise.^[30] Also, some people have reported that taking an SSRI such as Prozac or drugs that are 5-HT₂ receptor antagonists such as Trazodone will counteract the effects of LSD.^[31]

Effects

Pharmacokinetics

3D representation of an LSD molecule

LSD's effects normally last from 6-12 hours depending on dosage, tolerance, body weight and age^[3] - Sandoz's prospectus for "Delysid" warned: "intermittent disturbances of affect may occasionally persist for several days."^[2] Contrary to early reports and common belief, LSD effects do not last longer than the amount of time significant levels of the drug are present in the blood. Aghajanian and Bing found LSD had an elimination half-life of 175 minutes,^[32] while, more recently, Papac and Foltz reported that 1 µg/kg oral LSD given to a single male volunteer had an apparent plasma half-life of 5.1 hours, with a peak plasma concentration of 5 ng/mL at 3 hours post-dose.^[33]

Pharmacodynamics

LSD affects a large number of the G protein coupled receptors, including all dopamine receptor subtypes, all adrenoreceptor subtypes as well as many others. LSD binds to most serotonin receptor subtypes except for 5-HT₃ and 5-HT₄. However, most of these receptors are affected at too low affinity to be activated by the brain concentration of approximate 10–20 nM.^[34] Recreational doses of LSD can affect 5-HT_1A, 5-HT_2A, 5-HT_2C, 5-HT_5A, 5-HT_5B, and 5-HT₆ receptors. The psychotropic effects of LSD are attributed to its strong partial agonist effects at 5-HT_2A receptors as specific 5-HT_2A agonist drugs are psychotropics and largely 5-HT_2A specific antagonists block the psychotropic activity of LSD.^[34] Exactly how this produces the drug's effects is unknown, but it is thought that it works by increasing glutamate release and hence excitation in the cerebral cortex, specifically in layers IV and V.^[35] In the later stages, LSD might act through DARPP-32-related pathways that are likely the same for multiple drugs including cocaine, methamphetamine, nicotine, caffeine, PCP, ethanol and morphine.^[36]

One experiment studying the actions of LSD was performed by Barry Jacobs recording from electrodes implanted into Raphe nuclei.^[37] Behaviorally relevant doses of LSD result in a complete blockade of action potential activity in the dorsal raphe, effectively shutting off the principal endogenous source of serotonin to the telencephalon.

Affinity of LSD for various receptors, averaged from data from the K_i Database

Some reports indicate that although administration of chlorpromazine (Thorazine) or similar typical antipsychotic tranquilizers will not end an LSD trip, it will either lessen the intensity or immobilize and numb the patient, a side effect of the medication.^[38] While it also may not end an LSD trip, the best chemical treatment for a "bad trip" is an anxiolytic agent such as diazepam (Valium) or another benzodiazepine. As the effect of the drug is psychological as well as physical, any treatment should focus on calming the patient. Limiting stimuli such as bright light and loud sounds can help in the event of an abreaction.

Physical

Possible physical effects of LSD

Physical reactions to LSD are highly variable and nonspecific. The following symptoms have been reported: uterine contractions, hypothermia, fever, elevated levels of blood sugar, goose bumps, decrease in heart rate, jaw clenching, perspiration, pupil-dilation, saliva production, mucus production, sleeplessness, hyperreflexia, and tremors. Some users report a strong metallic taste for the duration of the effects. LSD users have reported numbness, weakness and nausea.^[39]

LSD was studied in the 1960s by Eric Kast as an analgesic for serious and chronic pain caused by cancer or other major trauma.^[40] Even at low (sub-psychedelic) dosages, it was found to be at least as effective as traditional opiates, while being much longer lasting (pain reduction lasting as long as a week after peak effects had subsided). Kast attributed this effect to a decrease in anxiety. This reported effect is being tested (though not using LSD) in an ongoing (as of 2006) study of the effects of the psychedelic tryptamine psilocybin on anxiety in terminal cancer patients.

Furthermore, LSD has been used as a treatment for cluster headaches, an uncommon but extremely painful disorder. Researcher Peter Goadsby describes the headaches as "worse than natural childbirth or even amputation without anesthetic."^[41] Although the phenomenon has not been formally investigated, case reports indicate that LSD and psilocybin can reduce cluster pain and also interrupt the cluster-headache cycle, preventing future headaches from occurring. Currently existing treatments include various ergolines, among other chemicals, so LSD's efficacy may not be surprising. A dose-response study testing the effectiveness of both LSD and psilocybin was planned at McLean Hospital, although the current status of this project is unclear. A 2006 study by McLean researchers interviewed 53 cluster-headache sufferers who treated themselves with either LSD or psilocybin, finding that a majority of the users of either drug reported beneficial effects.^[42] Unlike attempts to use LSD or MDMA in psychotherapy, this research involves non-psychological effects and often sub-psychedelic dosages; therefore, it is plausible that a respected medical use of LSD will arise.^[43]

Psychological

LSD's psychological effects (colloquially called a "trip") vary greatly from person to person, depending on factors such as previous experiences, state of mind and environment, as well as dose strength. They also vary from one trip to another, and even as time passes during a single trip. An LSD trip can have long-term psychoemotional effects; some users cite the LSD experience as causing significant changes in their personality and life perspective. Widely different effects emerge based on what has been called set and setting; the "set" being the general mindset of the user, and the "setting" being the physical and social environment in which the drug's effects are experienced.

Timothy Leary and Richard Alpert considered the chemical to be of potentially beneficial application in psychotherapy. If the user is in a hostile or otherwise unsettling environment, or is not mentally prepared for the powerful distortions in perception and thought that the drug causes, effects are more likely to be unpleasant than if he or she is in a comfortable environment and has a relaxed, balanced and open mindset.^[44]

Some psychological effects may include an experience of radiant colors, objects and surfaces appearing to ripple or "breathe," colored patterns behind the eyes, a sense of time distorting (time seems to be stretching, repeating itself, changing speed or stopping), crawling geometric patterns overlaying walls and other objects, morphing objects, a sense that one's thoughts are spiraling into themselves, loss of a sense of identity or the ego (known as "ego death"), and powerful, and sometimes brutal, psycho-physical reactions interpreted by some users as reliving their own birth.^[12]^[45] Many users experience a dissolution between themselves and the "outside world".^[46] This unitive quality may play a role in the spiritual and religious aspects of LSD. The drug sometimes leads to disintegration or restructuring of the user's historical personality and creates a mental state that some users report allows them to have more choice regarding the nature of their own personality.

Some experts hypothesize that drugs such as LSD may be useful in psychotherapy, especially when the patient is unable to "unblock" repressed subconscious material through other psychotherapeutic methods,^[47] and also for treating alcoholism. One study concluded, "The root of the therapeutic value of the LSD experience is its potential for producing self-acceptance and self-surrender,"^[48] presumably by forcing the user to face issues and problems in that individual's psyche. Many believe that, in contrast to other drugs (such as alcohol, heroin, and cocaine) which are used to escape from reality, LSD produces a more introspective experience.

Some studies in the 1950s that used LSD to treat alcoholism professed a 50% success rate,^[49] five times higher than estimates near 10% for Alcoholics Anonymous.^[50] These studies were criticized for methodological flaws, and different groups had inconsistent results. Mangini's 1998 paper reviewed this history. She concluded that the efficacy of LSD in treating alcoholism remains an open question.^[51]

Many notable individuals have commented publicly on their experiences with LSD.^[52] Some of these comments date from the era when it was legally available in the US and Europe for non-medical uses, and others pertain to psychiatric treatment in the 1950s and 60s. Still others describe experiences with illegal LSD, obtained for philosophic, artistic, therapeutic, spiritual, or recreational purposes.

Sensory / perception

LSD causes expansion and an altered experience of senses, emotions, memories, time, and awareness for 6 to 14 hours, depending on dosage and tolerance. Generally beginning within thirty to ninety minutes after ingestion, the user may experience anything from subtle changes in perception to overwhelming cognitive shifts. Changes in auditory and visual perception are typical.^[46]^[53] Visual effects include the illusion of movement of static surfaces ("walls breathing"), after image-like trails of moving objects ("tracers"), the appearance of moving colored geometric patterns (especially with closed eyes), an intensification of colors and brightness ("sparkling"), new textures on objects, blurred vision, and shape suggestibility. Users commonly report that the inanimate world appears to animate in an unexplained way; for instance, objects that are static in three dimensions can seem to be moving relative to one or more additional spatial dimensions.^[54] Many of the basic visual effects resemble the phosphenes seen after applying pressure to the eye and have also been studied under the name "form constants". The auditory effects of LSD may include echo-like distortions of sounds, changes in ability to discern concurrent auditory stimuli, and a general intensification of the experience of music. Higher doses often cause intense and fundamental distortions of sensory perception such as synaesthesia, the experience of additional spatial or temporal dimensions, and temporary dissociation.

Spiritual

LSD is considered an entheogen because it can catalyze intense spiritual experiences, during which users may feel they have come into contact with a greater spiritual or cosmic order. Some users report insights into the way the mind works, and some experience long-lasting changes in their life perspective. Some users consider LSD a religious sacrament, or a powerful tool for access to the divine. Dr. Stanislav Grof has written that religious and mystical experiences observed during LSD sessions appear to be phenomenologically indistinguishable from similar descriptions in the sacred scriptures of the great religions of the world and the secret mystical texts of ancient civilizations.^[55]

Potential risks of LSD use

LSD is generally considered nontoxic, although it may temporarily impair the ability to make sensible judgments and understand common dangers, thus making the user more susceptible to accidents and personal injury. There is also some indication that LSD may trigger a dissociative fugue state in individuals who are taking certain classes of antidepressants such as lithium salts and tricyclics. In such a state, the user has an impulse to wander, and may not be aware of his or her actions, which can lead to physical injury.^[56] SSRIs are believed to interact more benignly, with a tendency to noticeably reduce LSD's subjective effects.^[57] Similar and perhaps greater effects have also been reported with MAOIs.^[56]

As Albert Hofmann reports in LSD – My Problem Child, the early pharmacological testing Sandoz performed on the compound (before he ever discovered its psychoactive properties) indicated that LSD has a pronounced effect upon the mammalian uterus. Sandoz's testing showed that LSD can stimulate uterine contractions with efficacy comparable to ergobasine, the active uterotonic component of the ergot fungus (Hofmann's work on ergot derivatives also produced a modified form of ergobasine which became a widely accepted medication used in obstetrics, under the trade name Methergine). Therefore, LSD use by pregnant women could be dangerous and is contraindicated.^[2]

Initial studies in the 1960s and 1970s raised concerns that LSD might produce genetic damage^[58] or developmental abnormalities in fetuses. However, these initial reports were based on in vitro studies or were poorly controlled and have not been substantiated. In studies of chromosomal changes in human users and in monkeys, the balance of evidence suggests no increase in chromosomal damage. For example, studies were conducted with people who had been given LSD in a clinical setting.^[58] White blood cells from these people were examined for visible chromosomal abnormalities. Overall, there appeared to be no lasting changes. Several studies have been conducted using illicit LSD users and provide a less clear picture. Interpretation of this data is generally complicated by factors such as the unknown chemical composition of street LSD, concurrent use of other psychoactive drugs, and diseases such as hepatitis in the sampled populations. It seems possible that the small number of genetic abnormalities reported in users of street LSD is either coincidental or related to factors other than a toxic effect of pure LSD.^[58]

Flashbacks versus HPPD

"Flashbacks" are a reported psychological phenomenon in which an individual experiences an episode of some of LSD's subjective effects long after the drug has worn off — usually in the days after typical doses. In some rarer cases, flashbacks have lasted longer, but are generally short-lived and mild compared to the actual LSD "trip." Flashbacks can incorporate both positive and negative aspects of LSD trips. Flashbacks have proven difficult to study and are no longer officially recognized as a psychiatric syndrome. However, colloquial usage of the term persists and usually refers to any drug-free experience reminiscent of psychedelic drug effects, with the typical connotation that the episodes are of short duration.

No definitive explanation is currently available for these experiences. Any attempt at explanation must reflect several observations: first, over 70 percent of LSD users claim never to have "flashed back"; second, the phenomenon does appear linked with LSD use, though a causal connection has not been established; and third, a higher proportion of psychiatric patients report flashbacks than other users.^[59] Several studies have tried to determine how likely a user of LSD, not suffering from known psychiatric conditions, is to experience flashbacks. The larger studies include Blumenfeld's in 1971^[60] and Naditch and Fenwick's in 1977,^[61] which arrived at figures of 20% and 28%, respectively.

Although flashbacks themselves are not recognized as a medical syndrome, there is a recognized syndrome called Hallucinogen Persisting Perception Disorder (HPPD) in which LSD-like visual changes are not temporary and brief, as they are in flash-backs, but instead are persistent, and cause clinically significant impairment or distress. This syndrome can occur in people who have never taken hallucinogenic drugs. The syndrome is a DSM-IV diagnosis. Several scientific journal articles have described the disorder.^[62]

HPPD differs from flashbacks in that it is persistent and apparently entirely visual (although mood and anxiety disorders are sometimes diagnosed in the same individuals). A recent review suggests that HPPD (as defined in the DSM-IV) is rare and affects only a distinctly vulnerable subpopulation of users.^[63] However, it is possible that the prevalence of HPPD is underestimated because most of the diagnoses are applied to people who are willing to admit to their health care practitioner that they have previously used psychotropics, and presumably many people are reluctant to admit this.^[64]

There is no consensus regarding the nature and causes of HPPD (or flashbacks). Given that some symptoms have environmental triggers, it may represent a failure to adjust visual processing to changing environmental conditions. There are no explanations for why only some individuals develop HPPD. Explanations in terms of LSD physically remaining in the body for months or years after consumption have been discounted by experimental evidence.^[59] Some say HPPD is a manifestation of post-traumatic stress disorder, not related to the direct action of LSD on brain chemistry, and varies according to the susceptibility of the individual to the disorder. Many emotionally intense experiences can lead to flashbacks when a person is reminded acutely of the original experience. However, not all published case reports of HPPD appear to describe an anxious hyper-vigilant state reminiscent of post-traumatic stress disorder. Instead, some cases appear to involve only visual symptoms.^[59]

Psychosis

There are some cases of LSD inducing a psychosis in people who appeared to be healthy prior to taking LSD. This issue was reviewed extensively in a 1984 publication by Rick Strassman.^[65] In most cases, the psychosis-like reaction is of short duration, but in other cases it may be chronic. It is difficult to determine whether LSD itself induces these reactions or if it triggers latent conditions that would have manifested themselves otherwise. The similarities of time course and outcomes between putatively LSD-precipitated and other psychoses suggests that the two types of syndromes are not different and that LSD may have been a nonspecific trigger. Several studies have tried to estimate the prevalence of LSD-induced prolonged psychosis arriving at numbers of around 4 in 1,000 individuals (0.8 in 1,000 volunteers and 1.8 in 1,000 psychotherapy patients in Cohen 1960;^[66] 9 per 1,000 psychotherapy patients in Melleson 1971).^[67]

Chemistry

The four possible isomers of LSD. Only LSD is psychoactive.

LSD is an ergoline derivative. It is commonly produced from reacting diethylamine with an activated form of lysergic acid. Activating reagents include phosphoryl chloride^[68] and peptide coupling reagents.^[69] Lysergic acid is made by alkaline hydrolysis of lysergamides like ergotamine, a substance derived from the ergot fungus on rye, or from ergine (lysergic acid amide, LSA), a compound that is found in morning glory (Ipomoea tricolor) and hawaiian baby woodrose (Argyreia nervosa) seeds. LSD is a chiral compound with two stereocenters at the carbon atoms C-5 and C-8, so that theoretically four different optical isomers of LSD could exist. LSD, also called (+)-D-LSD, has the absolute configuration (5R,8R). The C-5 isomers of lysergamides do not exist in nature and are not formed during the synthesis from D-lysergic acid. However, LSD and iso-LSD, the two C-8 isomers, rapidly interconvert in the presence of base. Non-psychoactive iso-LSD which has formed during the synthesis can be removed by chromatography and can be isomerized to LSD. A totally pure salt of LSD will emit small flashes of white light when shaken in the dark.^[70] LSD is strongly fluorescent and will glow bluish-white under UV light.

Stability

"LSD," writes the chemist Alexander Shulgin, "is an unusually fragile molecule."^[3] It is stable for indefinite amounts of time if stored, as a solid salt or dissolved in water, at low temperature and protected from air and light exposure. Two portions of its molecular structure are particularly sensitive: the carboxamide attachment at the 8-position and the double bond between the 8-position and the aromatic ring. The former is affected by high pH, and if perturbed will produce isolysergic acid diethylamide (iso-LSD), which is biologically inactive. If water or alcohol adds to the double bond (especially in the presence of light), LSD converts to "lumi-LSD", which is totally inactive in human beings, to the best of current knowledge. Furthermore, chlorine destroys LSD molecules on contact; even though chlorinated tap water typically contains only a slight amount of chlorine, because a typical LSD solution only contains a small amount of LSD, dissolving LSD in tap water is likely to completely eliminate the substance.^[3]

A controlled study was undertaken to determine the stability of LSD in pooled urine samples.^[71] The concentrations of LSD in urine samples were followed over time at various temperatures, in different types of storage containers, at various exposures to different wavelengths of light, and at varying pH values. These studies demonstrated no significant loss in LSD concentration at 25 °C for up to four weeks. After four weeks of incubation, a 30% loss in LSD concentration at 37 °C and up to a 40% at 45 °C were observed. Urine fortified with LSD and stored in amber glass or nontransparent polyethylene containers showed no change in concentration under any light conditions. Stability of LSD in transparent containers under light was dependent on the distance between the light source and the samples, the wavelength of light, exposure time, and the intensity of light. After prolonged exposure to heat in alkaline pH conditions, 10 to 15% of the parent LSD epimerized to iso-LSD. Under acidic conditions, less than 5% of the LSD was converted to iso-LSD. It was also demonstrated that trace amounts of metal ions in buffer or urine could catalyze the decomposition of LSD and that this process can be avoided by the addition of EDTA.

Production

Glassware seized by the DEA

Because an active dose of LSD is very minute, a large number of doses can be synthesized from a comparatively small amount of raw material. Beginning with ergotamine tartrate, for example, one can manufacture roughly one kilogram of pure, crystalline LSD from five kilograms of the ergotamine salt. Five kilograms of LSD — 25 kilograms of ergotamine tartrate — could provide 100 million doses, according to the DEA, more than enough to meet what is believed to be the entire annual U.S. demand. Since the masses involved are so small, concealing and transporting illicit LSD is much easier than smuggling other illegal drugs like cocaine or cannabis.^[72]

Manufacturing LSD requires laboratory equipment and experience in the field of organic chemistry. It takes two to three days to produce 30 to 100 grams of pure compound. It is believed that LSD is not usually produced in large quantities, but rather in a series of small batches. This technique minimizes the loss of precursor chemicals in case a step does not work as expected.^[72]

Forms of LSD

A typical full sheet of LSD blotting paper with the Ruby Slippers pattern, around 900 ¼ inch squares, which are cut up for distribution. The name of this pattern is a reference to the sometimes hallucinatory aspects of The Wizard of Oz.

LSD is produced in crystalline form and then mixed with excipients or redissolved for production in ingestible forms. Liquid solution is either distributed in small vials or, more commonly, sprayed onto or soaked into a distribution medium. Historically, LSD solutions were first sold on sugar cubes, but practical considerations forced a change to tablet form. Appearing in 1968 as an orange tablet measuring about 6 mm across "Sunshine" acid was the first largely available form of LSD after its possession was made illegal. Tim Scully, a prominent chemist, made some of it, but said that most "Sunshine" came by way of Ronald Stark, who brought approximately thirty-five million doses over from Europe.^[73]

Over a period of time, tablet dimensions, weight, shape and concentration of LSD evolved from large (4.5-8.1 mm diameter), heavyweight (≥150 mg), round, high concentration (90-350 µg/tab) dosage units to small (2.0-3.5 mm diameter) lightweight (as low as 4.7 mg/tab), variously shaped, lower concentration (12-85 µg/tab, average range 30-40 µg/tab) dosage units. LSD tablet shapes have included cylinders, cones, stars, spacecraft and heart shapes. The smallest tablets became known as "Microdots".^[74]

After tablets came "computer acid" or "blotter paper LSD," typically made by dipping a preprinted sheet of blotting paper into an LSD/water/alcohol solution.^[73]^[74] More than 200 types of LSD tablets have been encountered since 1969 and more than 350 blotter paper designs have been observed since 1975.^[74] About the same time as blotter paper LSD came "Windopane" (aka "Clearlight"), which contained LSD inside a thin gelatin square a quarter of an inch across.^[73] LSD has been sold under a wide variety of often short-lived and regionally restricted street names including Acid, Trips, Blotter, Lucy, and doses, as well as names that reflect the designs on the sheets of blotter paper.^[75]^[76] Authorities have encountered the drug in other forms — including powder or crystal, and capsule.^[77]

Legal status

The United Nations Convention on Psychotropic Substances (adopted in 1971) requires its parties to prohibit LSD. Hence, it is illegal in all parties to the convention, which includes the United States, Australia, and most of Europe. However, enforcement of extant laws varies from country to country.

Canada

In Canada, LSD is a controlled substance under Schedule III of the Controlled Drugs and Substances Act.^[78] Every person who seeks to obtain the substance, without disclosing authorization to obtain such substances 30 days prior to obtaining another prescription from a practitioner, is guilty of an indictable offense and liable to imprisonment for a term not exceeding 3 years. Possession for purpose of trafficking is an indictable offense punishable by imprisonment for 10 years.

Hong Kong

In Hong Kong, Lysergide and derivatives are regulated under Schedule 1 of Hong Kong's Chapter 134 Dangerous Drugs Ordinance, and can be used legally only by health professionals and for university research purposes. The substance can be given by pharmacists under a prescription. Anyone who supplies the substance without prescription can be fined HK$10,000. The maximum penalty for trafficking or illegally manufacturing the substance is a HK$5,000,000 fine and life imprisonment. Possession of the substance for consumption without license from the Department of Health is illegal with a HK$1,000,000 fine and/or seven years' imprisonment.

United Kingdom

In the United Kingdom, LSD is a class A drug. This means that possession of the drug without a license is punishable with 7 years imprisonment and/or an unlimited fine, and trafficking is punishable with life imprisonment and an unlimited fine (see main article on drug punishments Misuse of Drugs Act 1971).

United States

LSD is Schedule I in the United States.^[79] This means it is illegal to manufacture, buy, possess, process or distribute LSD without a DEA license. There can also be substantial discrepancies between the amount of chemical LSD that one possesses and the amount of possession with which one can be charged in the U.S. This is because LSD is almost always present in a medium (e.g. blotter or neutral liquid), and the amount that can be considered with respect to sentencing is the total mass of the drug and its medium. This discrepancy was the subject of 1995 United States Supreme Court case, Neal v. U.S.^[80]

United States: Prior to 1967

Further information: Project MKULTRA

Beginning in the 1950s the Central Intelligence Agency began a research program code named Project MKULTRA. Experiments included administering LSD to CIA employees, military personnel, doctors, other government agents, prostitutes, mentally ill patients, and members of the general public in order to study their reactions, usually without the subject's knowledge. The project was revealed in the US congressional Rockefeller Commission report.

Prior to October 6, 1966, LSD was available legally in the United States as an experimental psychiatric drug. (LSD "apostle" Al Hubbard actively promoted the drug between the 1950s and the 1970s and introduced thousands of people to it.) The US Federal Government classified it as a Schedule I drug according to the Controlled Substances Act of 1970. As such, the Drug Enforcement Administration holds that LSD meets the following three criteria: it is deemed to have a high potential for abuse; it has no legitimate medical use in treatment; and there is a lack of accepted safety for its use under medical supervision. (LSD prohibition does not make an exception for religious use.) Lysergic acid and lysergic acid amide, LSD precursors, are both classified in Schedule III of the Controlled Substances Act. Ergotamine tartrate, a precursor to lysergic acid, is regulated under the Chemical Diversion and Trafficking Act.

LSD has been manufactured illegally since the 1960s. Historically, LSD was distributed not for profit, but because those who made and distributed it truly believed that the psychedelic experience could do good for humanity, that it expanded the mind and could bring understanding and love. A limited number of chemists, probably fewer than a dozen, are believed to have manufactured nearly all of the illicit LSD available in the United States. The best known of these is undoubtedly Augustus Owsley Stanley III, usually known simply as Owsley. The former chemistry student set up a private LSD lab in the mid-Sixties in San Francisco and supplied the LSD consumed at the famous Merry Pranksters parties held by Ken Kesey and his Merry Pranksters, and other major events such as the Gathering of the tribes in San Francisco in January 1967. He also had close social connections to leading San Francisco bands the Grateful Dead, Jefferson Airplane and Big Brother and The Holding Company, regularly supplied them with his LSD and also worked as their live sound engineer and made many tapes of these groups in concert. Owsley's LSD activities — immortalized by Steely Dan in their song "Kid Charlemagne" — ended with his arrest at the end of 1967, but some other manufacturers probably operated continuously for 30 years or more. Announcing Owsley's first bust in 1966, The San Francisco Chronicle's headline "LSD Millionaire Arrested" inspired the rare Grateful Dead song "Alice D. Millionaire."^[81]

United States: 1970–present

This section needs additional citations for verification. Please help improve this article by adding reliable references (ideally, using inline citations). Unsourced material may be challenged and removed. (March 2008)

Pickard and Apperson ran an LSD lab in this former missile silo in Kansas

American LSD usage declined in the 1970s and 1980s, then experienced a mild resurgence in popularity in the 1990s. Although there were many distribution channels during this decade, the U.S. DEA identified continued tours by the psychedelic rock band The Grateful Dead and the then-burgeoning rave scene as primary venues for LSD trafficking and consumption. American LSD usage fell sharply circa 2000, following a single major DEA operation.

Pickard and Apperson

The decline in prevalence of LSD is correlated with the arrest of two chemists, William Leonard Pickard, a Harvard-educated organic chemist, and Clyde Apperson. According to DEA reports, black market LSD availability dropped by 95% after the two were arrested in 2000. These arrests were a result of one of the largest LSD manufacturing raids in DEA history.^[82] Pickard was an alleged member of the Brotherhood of Eternal Love group that produced and sold LSD in California during the late 1960s and early 1970s. It is believed he had links to other "cooks" associated with this group — an original source of the drug back in the 1960s — and his arrest may have forced other operations to cease production, leading to the large decline in street availability. The DEA claims that these two individuals were responsible for supplying a third of the LSD in the United States and maybe the world;^[83] however, the government-quoted seizure amounts in connection with this case have been seriously questioned.^[84]

In November 2003, Pickard was sentenced to life imprisonment without parole, and Apperson was sentenced to 30 years imprisonment without parole, after being convicted in Federal Court of running a large scale LSD manufacturing operation out of several clandestine laboratories, including a former missile silo near Wamego, Kansas.^[82]

Modern distribution

LSD manufacturers and traffickers can be categorized into two groups: A few large-scale producers, such as the aforementioned Pickard and Apperson, and an equally limited number of small, clandestine chemists, consisting of independent producers who, operating on a comparatively limited scale, can be found throughout the country. As a group, independent producers are of less concern to the Drug Enforcement Administration than the larger groups, as their product reaches only local markets. Since LSD is difficult to synthesize, occasionally what is sold as "LSD" on the streets is actually drugs such as DOI or other similar dosing chemicals.^{[citation needed]}

References

^ "InfoFacts - LSD". Nida.nih.gov. 2008-07-23. http://www.nida.nih.gov/infofacts/LSD.html. Retrieved on 2009-02-05.
^ ^a ^b ^c ^d ^e Hofmann, Albert. LSD—My Problem Child (McGraw-Hill, 1980). ISBN 0-07-029325-2.
^ ^a ^b ^c ^d ^e Alexander and Ann Shulgin. "LSD", in TiHKAL (Berkeley: Transform Press, 1997). ISBN 0-963-00969-9.
^ ^a ^b ^c Greiner T, Burch NR, Edelberg R (1958). "Psychopathology and psychophysiology of minimal LSD-25 dosage; a preliminary dosage-response spectrum". AMA Arch Neurol Psychiatry 79 (2): 208–10. PMID 13497365.
^ "LSD: cultural revolution and medical advances". Royal Society of Chemistr. http://www.rsc.org/chemistryworld/Issues/2006/January/LSD.asp. Retrieved on 2007-09-27.
^ "The Albert Hofmann Foundation". Hofmann Foundation. http://www.hofmann.org/. Retrieved on 2007-09-27.
^ European Monitoring Centre for Drugs and Drug Addiction (2008) (PDF). Annual report: the state of the drugs problem in Europe. Luxembourg: Office for Official Publications of the European Communities. p. 49. ISBN 978-92-9168-324-6. http://www.emcdda.europa.eu/attachements.cfm/att_64227_EN_EMCDDA_AR08_en.pdf.
^ Dr. Albert Hofmann; "InfoFacts - LSD". Nida.nih.gov. 2008-07-23. http://www.nida.nih.gov/infofacts/LSD.html. Retrieved on 2009-02-05. translated from the original German (LSD Ganz Persönlich) by J. Ott. MAPS-Volume 6 Number 3 Summer 1996
^ ^a ^b Nichols, David (2003-05-24). "Hypothesis on Albert Hofmann's Famous 1943 "Bicycle Day"". Hofmann Foundation. http://www.erowid.org/general/conferences/conference_mindstates4_nichols.shtml. Retrieved on 2007-09-27.
^ Hofmann, Albert (2003-05-24). "LSD: My Problem Child: Reflections on Sacred Drugs, Mysticism, and Science.". Council on Spiritual Practices. http://www.csp.org/chrestomathy/lsd_my1.html. Retrieved on 2007-09-27.
^ ^a ^b Hofmann, Albert. "History Of LSD". http://www.a1b2c3.com/drugs/lsd01.htm. Retrieved on 2007-09-27.
^ ^a ^b ^c Grof, Stanislav. LSD Psychotherapy. Sarasota, FL: Multidisciplinary Association for Psychedelic Studies. ISBN 978-0966001945.
^ ^a ^b ^c ^d "Chapter 3: Supreme Court Dissents Invoke the Nuremberg Code: CIA and DOD Human Subjects Research Scandals". Human Radiation Experiments (United States Department of Energy). http://hss.energy.gov/healthsafety/ohre/roadmap/achre/chap3_4.html. Retrieved on 2007-10-04.
^ D. Moreno, Jonathan (September 1999). "Lessons Learned A Half-Century of Experimenting on Humans - U.S. Army experiments". Humanist. http://findarticles.com/p/articles/mi_m1374/is_5_59/ai_55722247. Retrieved on 2007-10-04.
^ "Did the U.S. Government Drug Paul Robeson?". http://www.democracynow.org/1999/7/6/did_the_u_s_government_drug.
^ Shane, Scott (2004-09-12). "Son probes strange death of WMD worker He believes agents murdered employee of Army to protect government secrets". Baltimore Sun. http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2004/09/12/MNG468MM8N1.DTL. Retrieved on 2007-10-04.
^ Rob Evans, "MI6 pays out over secret LSD mind control tests". The Guardian February 24, 2006.
^ "Reviving research into psychedelic drugs". Lancet 367 (9518): 1214. April 2006. doi:10.1016/S0140-6736(06)68515-2. PMID 16631858. http://www.beckleyfoundation.org/bib/doc/bf/2008_Kelly_211367_1.pdf.
^ "Hallucinogens and Obsessive-Compulsive Disorder -- PERRINE 156 (7): 1123 -- Am J Psychiatry". http://www.ajp.psychiatryonline.org/cgi/content/full/156/7/1123. Retrieved on 2007-06-28.
^ Stoll, W.A. (1947). Ein neues, in sehr kleinen Mengen wirsames Phantastikum. Schweiz. Arch. Neur. 60,483.
^ Henderson, Leigh A.; Glass, William J. (1994). LSD: Still with us after all these years. San Francisco: Jossey-Bass. ISBN 978-0787943790.
^ "LSD Vault: Dosage". 2006-07-06. http://www.erowid.org/chemicals/lsd/lsd_dose.shtml. Retrieved on 2007-01-31.
^ "LSD Toxicity: A Suspected Cause of Death". Journal of the Kentucky Medical Association. http://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&ID=1389&DocPartID=1151. Retrieved on 2007-11-26.
^ Erowid & R. Stuart (2002). "LSD Related Death of an Elephant - Controversy surrounding the 1962 death of an elephant after an injection of LSD". Erowid. http://www.erowid.org/chemicals/lsd/lsd_history4.shtml. Retrieved on 2008-07-28.
^ Nutt D, King LA, Saulsbury W, Blakemore C (2007). "Development of a rational scale to assess the harm of drugs of potential misuse". Lancet 369 (9566): 1047–53. doi:10.1016/S0140-6736(07)60464-4. PMID 17382831. http://www.antiproibizionisti.it/public/docs/thelancet_20070323.pdf.
^ Lüscher, Christian; Mark A. Ungless (2006). "The Mechanistic Classification of Addictive Drugs". Plos Medicine (Public Library of Science). doi:10.1371/journal.pmed.0030437.
^ Wolbach AB Jr, Isbell H, Miner EJ (1962). "Cross tolerance between mescaline and LSD-25, with a comparison of the mescaline and LSD reactions". Psychopharmacologia 3: 1–14. doi:10.1007/BF00413101. PMID 14007904. http://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&C=ref&ID=2032&DocPartID=1893.
^ Isbell H, Wolbach AB, Wikler A, Miner EJ (1961). "Cross Tolerance between LSD and Psilocybin". Psychopharmacologia 2: E353. doi:10.1007/BF00407974. PMID 13717955. http://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&C=ref&ID=1979&DocPartID=1843.
^ RaveSafe (1999). "RaveSafe Q&A - Can you actually end an acid trip?". http://www.ravesafe.org/qna/qna-2.htm. Retrieved on 2008-07-28.
^ Huxley, Aldous The Doors of Perception and Heaven & Hell, Harper & Row, 1954.
^ Bonson, Kit (1994). "The Interactions between Hallucinogens and Antidepressants - Summary of Results from Online Survey and Online Interviews". Erowid. http://www.erowid.org/chemicals/maois/maois_info4.shtml. Retrieved on 2008-07-28.
^ Aghajanian, George K. and Bing, Oscar H. L. (1964). "Persistence of lysergic acid diethylamide in the plasma of human subjects" (PDF). Clin. Pharmacol. Ther. 5: 611–4. PMID 14209776. http://www.maps.org/w3pb/new/1964/1964_aghajanian_2224_1.pdf.
^ Papac DI, Foltz RL (1990). "Measurement of lysergic acid diethylamide (LSD) in human plasma by gas chromatography/negative ion chemical ionization mass spectrometry". J Anal Toxicol 14 (3): 189–90. PMID 2374410.
^ ^a ^b Nichols, David E. (2004). "Psychotropics". Pharmacology & Therapeutics 101 (2): 131–81. doi:10.1016/j.pharmthera.2003.11.002. PMID 14761703. http://www.erowid.org/references/refs_view.php?A=ShowDoc1&ID=6318.
^ BilZ0r. "The Neuropharmacology of Hallucinogens: a technical overview". Erowid, v3.1 (August 2005).
^ Svenningsson P. , Nairn A. C., Greengard P. (2005). "DARPP-32 Mediates the Actions of Multiple Drugs of Abuse.". AAPS Journal 07 (02): E353–E360. doi:10.1208/aapsj070235. http://www.aapsj.org/view.asp?art=aapsj070235.
^ Jacobs B. L., Heym J., Rasmussen K. (1983). "Raphe neurons: firing rate correlates with size of drug response". European Journal of Pharmacology 90 (2-3): 275–8. doi:10.1016/0014-2999(83)90249-2. PMID 6873185.
^ Gilberti, F. and Gregoretti, L. L. (1955). "Prime esperienze di antaonismo psicofarmacologico" (PDF). Sistema Nervoso 4: 301–309. http://www.maps.org/w3pb/new/1955/1955_giberti_3993_1.pdf.
^ Schiff PL (2006). "Ergot and its alkaloids". American journal of pharmaceutical education 70 (5): 98. PMID 17149427.
^ Kast, Eric (1967). "Attenuation of anticipation: a therapeutic use of lysergic acid diethylamide" (PDF). Psychiat. Quart. 41 (4): 646–57. doi:10.1007/BF01575629. PMID 4169685. http://www.maps.org/w3pb/new/1967/1967_kast_3881_1.pdf.
^ Dr. Goadsby is quoted in "Research into psilocybin and LSD as cluster headache treatment", and he makes an equivalent statement in an Health Report interview on Australian Radio National (August 9, 1999). Pages accessed 2007-01-31.
^ Sewell, R. A.; Halpern, J. H.; Pope, H. G. Jr. (2006-06-27). "Response of cluster headache to psilocybin and LSD". Neurology 66 (12): 1920–2. doi:10.1212/01.wnl.0000219761.05466.43. PMID 16801660.
^ Summarized from "Research into psilocybin and LSD as cluster headache treatment" and the Clusterbusters website. Pages accessed 2007-01-31.
^ "LSD dangers". The Good Drugs Guide. http://www.thegooddrugsguide.com/lsd/dangers.htm. Retrieved on 2008-10-20.
^ The Good Drugs Guide. "LSD psychedelic effects". http://www.thegooddrugsguide.com/lsd/psychedelic.htm. Retrieved on 2008-03-03.
^ ^a ^b Linton, Harriet B. and Langs, Robert J. "Subjective Reactions to Lysergic Acid Diethylamide (LSD-25)". Arch. Gen. Psychiat. Vol. 6 (1962): 352–68.
^ Cohen, S. (1959). The therapeutic potential of LSD-25. A Pharmacologic Approach to the Study of the Mind, p251–258.
^ Chwelos N, Blewett D.B., Smith C.M., Hoffer A. (1959). "Use of d-lysergic acid diethylamide in the treatment of alcoholism". Quart. J. Stud. Alcohol 20: 577–90. PMID 13810249.
^ Maclean, J.R.; Macdonald, D.C.; Ogden, F.; Wilby, E., "LSD-25 and mescaline as therapeutic adjuvants." In: Abramson, H., Ed., The Use of LSD in Psychotherapy and Alcoholism, Bobbs-Merrill: New York, 1967, pp. 407–426; Ditman, K.S.; Bailey, J.J., "Evaluating LSD as a psychotherapeutic agent," pp.74–80; Hoffer, A., "A program for the treatment of alcoholism: LSD, malvaria, and nicotinic acid," pp. 353–402.
^ Minogue, S. J. "Alcoholics Anonymous." The Medical Journal of Australia May 8 (1948):586–587.
^ Mangini M (1998). "Treatment of alcoholism using psychedelic drugs: a review of the program of research". J Psychoactive Drugs 30 (4): 381–418. PMID 9924844.
^ "Famous LSD users". The Good Drugs Guide. http://www.thegooddrugsguide.com/articles/famous_users/lsd.htm. Retrieved on 2008-10-20.
^ Katz MM, Waskow IE, Olsson J (1968). "Characterizing the psychological state produced by LSD". J Abnorm Psychol 73 (1): 1–14. doi:10.1037/h0020114. PMID 5639999.
^ See, e.g., Gerald Oster's article "Moiré patterns and visual hallucinations". Psychedelic Rev. No. 7 (1966): 33–40.
^ Grof, Stanislav; Joan Halifax Grof (1979). Realms of the Human Unconscious (Observations from LSD Research). London: Souvenir Press (E & A) Ltd. pp. 13–14. ISBN 0 285 64882 9. http://www.csp.org/chrestomathy/realms_of3.html.
^ ^a ^b "LSD and Antidepressants" (2003) via Erowid.
^ Kit Bonson, "The Interactions between Hallucinogens and Antidepressants" (2006).
^ ^a ^b ^c Dishotsky NI, Loughman WD, Mogar RE, Lipscomb WR (1971). "LSD and genetic damage" (PDF). Science 172 (982): 431–40. doi:10.1126/science.172.3982.431. http://www.maps.org/w3pb/new/1971/1971_dishotsky_5148_1.pdf.
^ ^a ^b ^c David Abrahart (1998). "A Critical Review of Theories and Research Concerning Lysergic Acid Diethylamide (LSD) and Mental Health". http://www.maps.org/research/abrahart.html. Retrieved on 2007-02-02.
^ Blumenfield M (1971). "Flashback phenomena in basic trainees who enter the US Air Force". Military Medicine 136 (1): 39–41. PMID 5005369.
^ Naditch MP, Fenwick S (1977). "LSD flashbacks and ego functioning". Journal of Abnormal Psychology 86 (4): 352–9. doi:10.1037/0021-843X.86.4.352. PMID 757972.
^ See, for example, Abraham HD, Aldridge AM (1993). "Adverse consequences of lysergic acid diethylamide". Addiction 88 (10): 1327–34. doi:10.1111/j.1360-0443.1993.tb02018.x. PMID 8251869.
^ Halpern JH, Pope HG Jr (2003). "Hallucinogen persisting perception disorder: what do we know after 50 years?". Drug Alcohol Depend 69 (2): 109–19. doi:10.1016/S0376-8716(02)00306-X. PMID 12609692. ; Halpern JH (2003). "Hallucinogens: an update". Curr Psychiatry Rep 5 (5): 347–54. doi:10.1007/s11920-003-0067-4. PMID 13678554. [1]
^ Baggott et al. (2006) Prevalence of chronic flashbacks in hallucinogen users: a web-based questionnaire
^ Strassman RJ (1984). "Adverse reactions to psychedelic drugs. A review of the literature". J Nerv Ment Dis 172 (10): 577–95. PMID 6384428.
^ Cohen, Sidney (January 1960). "Lysergic Acid Diethylamide: Side Effects and Complications" (PDF). Journal of Nervous and Mental Disease 130 (1): 30–40. PMID 13811003. http://www.maps.org/w3pb/new/1960/1960_cohen_1848_1.pdf.
^ Malleson, Nicholas (1971). "Acute Adverse Reactions to LSD in Clinical and Experimental Use in the United Kingdom" (PDF). Brit. J. Psychiat. 118 (543): 229–30. doi:10.1192/bjp.118.543.229. PMID 4995932. http://www.maps.org/w3pb/new/1971/1971_malleson_5136_1.pdf.
^ Aaron P. Monte, Danuta Marona-Lewicka, Arthi Kanthasamy, Elaine Sanders-Bush, and David E. Nichols. (1995). "Stereoselective LSD-like Activity in a Series of D-Lysergic Acid Amides of (R)- and (S)-2-Aminoalkanes (requires subscription)". J. Med. Chem. 38 (6): 958–966. doi:10.1021/jm00006a015.
^ Nichols, D. E.; Frescas, S.; Marona-Lewicka, D.; Kurrasch-Orbaugh, D. M. (2002). "Lysergamides of Isomeric 2,4-Dimethylazetidines Map the Binding Orientation of the Diethylamide Moiety in the Potent Hallucinogenic Agent N,N-Diethyllysergamide (LSD) (requires subscription)". J. Med. Chem. 45 (19): 4344–4349. doi:10.1021/jm020153s.
^ "Erowid Online Books : "TIHKAL" - #26 LSD-25". http://www.erowid.org/library/books_online/tihkal/tihkal26.shtml. Retrieved on 2007-11-12.
^ Li Z., McNally A. J., Wang H., Salamone S. J. (October 1998). "Stability study of LSD under various storage conditions.". J. Anal. Toxicol. 22 (6): 520–5. PMID 9788528. http://www.jatox.com/abstracts/1998/october/226mcn.htm.
^ ^a ^b DEA (2007). "LSD Manufacture - Illegal LSD Production". LSD in the United States. U.S. Department of Justice Drug Enforcement Administration. Archived from the original on 2007-08-29. http://web.archive.org/web/20070829023659/http://www.fas.org/irp/agency/doj/dea/product/lsd/lsd-5.htm.
^ ^a ^b ^c Stafford, Peter (1992). "Chapter 1 - The LSD Family". Psychedelics Encyclopaedia (Third Expanded Edition ed.). Ronin Publishing Inc. p. 62. ISBN 0-914171-51-8.
^ ^a ^b ^c Laing, Richard R.; Barry L. Beyerstein, Jay A. Siegel (2003). "Chapter 2.2 - Forms of the Drug". Hallucinogens: A Forensic Drug Handbook. Academic Press. pp. 39-41. ISBN 0124339514.
^ Honig, David. Frequently Asked Questions via Erowid
^ "Street Terms: Drugs and the Drug Trade". Office of National Drug Control Policy. 2005-04-05. http://www.whitehousedrugpolicy.gov/streetterms/ByType.asp?intTypeID=6. Retrieved on 2007-01-31.
^ DEA (2008). "Photo Library (page 2)". US Drug Enforcement Administration. http://www.usdoj.gov/dea/photo_library2.html#lsd. Retrieved on 2008-06-27.
^ Canadian government (1996). "Controlled Drugs and Substances Act". Justice Laws. Canadian Department of Justice. http://laws.justice.gc.ca/en/showdoc/cs/C-38.8//20070705/en?command=HOME&caller=SI&fragment=lsd&search_type=all&day=5&month=7&year=2007&search_domain=cs&showall=L&statuteyear=all&lengthannual=50&length=50. Retrieved on 2007-07-05.
^ From [2]: LSD is a Schedule I substance under the Controlled Substances Act.
^ Neal v. United States, U.S. 284 ., originating from U.S. v. Neal, 46 F.3d 1405 (7th Cir. 1995)
^ Selvin, Joel (2007-07-12). "For the unrepentant patriarch of LSD, long, strange trip winds back to Bay Area". San Francisco Chronicle. p. A-1. http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2007/07/12/MNGK0QV7HS1.DTL. Retrieved on 2008-02-01.
^ ^a ^b Seper, Jerry. (2003-11-27). "Man sentenced to life in prison as dealer of LSD". The Washington Times. Archived from the original on 2007-01-30. http://web.archive.org/web/20070130103015/http://washingtontimes.com/national/20031126-110958-8471r.htm. Retrieved on 2008-02-01.
^ Rosenfeld, Seth (2000-12-07). "2 Bay Area Men Busted in Big LSD Lab Raid". San Francisco Chronicle. p. A-1. http://www.sfgate.com/cgi-bin/article.cgi?f=/chronicle/archive/2000/12/07/MN154990.DTL. Retrieved on 2008-02-01.
^ Grim, Ryan (2005-03-14). "The 91-Pound Acid Trip - The numbers touted by the government in its big LSD bust just don't add up". Slate (Washington Post / Newsweek Interactive Co). http://www.slate.com/id/2114793/. Retrieved on 2008-02-01.

External links

Wikimedia Commons has media related to: LSD

Wikinews has related news: Drug website surveys LSD users and culture

Erowid Vaults: LSD-25
The Lycaeum Archive: LSD
TIHKAL entry for LSD-25
Current LSD Research – MAPS
Talk to FrankUK government anti-drug site on LSD
Scholarly bibliography on the histories of LSD use
My LSD Trip: a non-cop, non-hippie report of the unvarnished facts, by Robert Gannon, Popular Science Magazine, Dec. 1967.

[show] v • d • e Psychedelic lysergamides

AL-LAD • ALD-52 • BU-LAD • CYP-LAD • Diallyllysergamide • DAM-57 • Ergonovine • ETH-LAD • LAE-32 • LSD • LPD-824 • LSM-775 • D-Lysergic acid N-(α-hydroxyethyl)amide • Lysergic acid methyl ester • Lysergic acid 2-butyl amide • Lysergic acid 2,4-dimethylazetidide • Methylergonovine • Methylisopropyllysergamide • MLD-41 • PARGY-LAD • PRO-LAD

[show]

Drugs from TiHKAL

[show]

Serotonin agonists

[show]

Serotonin antagonists

International Chemical Identifier
InChI=	1/C20H25N3O/c1-4-23(5-2)20(24)14-9-16-15-7-6-8-17-19(15)13(11-21-17)10-18(16)22(3)12-14/h6-9,11,14,18,21H,4-5,10,12H2,1-3H3/t14-,18-/m1/s1
InChIKey=	VAYOSLLFUXYJDT-RDTXWAMCBY
CASRN=	50-37-3
PIN=	Lysergic acid diethylamide

Retrieved from "http://en.wikipedia.org/wiki/Lysergic_acid_diethylamide"

Hidden categories: All articles with unsourced statements | Articles with unsourced statements since March 2009 | Articles needing additional references from March 2008 | Articles with unsourced statements since September 2008

Views

Personal tools

Search

Toolbox

2009-03-14T16:04:00.000-07:00

This article is about the drug classification. For the scuba diving reference, see Nitrogen narcosis. For the book reference, see Narcotic Drugs. For the song, see Liquido.

19th century Heroin bottle

The term narcotic (ναρκωτικός) is believed to have been coined by the Greek physician Galen to refer to agents that benumb or deaden, causing loss of feeling or paralysis. It is based on the Greek word ναρκωσις (narcosis), the term used by Hippocrates for the process of benumbing or the benumbed state. Galen listed mandrake root, altercus (eclata)^[1] seeds, and poppy juice (opium) as the chief examples.^[2]^[3]

Use of the word "narcotic" to refer to any illegal or unlawfully possessed drug including marijuana and cocaine is common worldwide, although these substances are not considered narcotics in a medical context. The central drug policy making body with in the United Nations, for instance, is the Commission on Narcotic Drugs, although the United Nations officially defines a narcotic drug to be "any of the substances, natural or synthetic, in Schedules I and II of the Single Convention on Narcotic Drugs, 1961, and that Convention as amended by the 1972 Protocol Amending the Single Convention on Narcotic Drugs, 1961"^[4]

In U.S. legal context, the term "narcotic" specifically refers to opium, opium derivatives, and their semi-synthetic or fully synthetic substitutes as well as cocaine and coca leaves.

Because the term is often used so broadly or pejoratively outside of medical contexts, most medical professionals advocate the use of more precise terms such as "opioid" and "opioid analgesic" to refer to the natural, semi-synthetic, and synthetic substances that behave pharmacologically like morphine and are used primarily for their pain-relieving qualities.^[5] The use of the term "narcotic" in various nonclinical contexts is not of educational or of informative value. The decision to term all illegal drugs as narcotics is often used as a shorthand way to politicize and demonize any illegal drug.

Effects

Drug effects depend heavily on the dose, route of administration, previous exposure to the drug, and the expectation of the user. Aside from their clinical use in the treatment of pain, cough, and acute diarrhea, narcotics produce a general sense of well-being, euphoria, and can reduce tension, anxiety, and aggression. These effects are helpful in a therapeutic setting and contribute to their popularity as recreational drugs, as well as helping to produce dependency. It should be noted that these effects may not be experienced all at once, or at all by some users.

Narcotic use is associated with a variety of side effects including drowsiness, itching, sleeplessness, inability to concentrate, apathy, lessened physical activity, drastically reduced attention-span, constriction of the pupils, dilation of the subcutaneous blood vessels causing flushing of the face and neck, constipation, nausea, vomiting, difficulty with urination, and respiratory depression. Reported, subjective, mental and physical effects also include a sense of pleasure, ranging from mild relaxation and freedom from irritation and worry, to wild euphoria and imperviousness to physical pain. As the dose is increased, the subjective, analgesic, and toxic effects become more pronounced. Except in cases of acute intoxication, there is only minor loss of motor coordination or slurred speech, as occurs with many depressants such as alcohol or barbiturates.

Hazards

Among the hazards of careless or excessive drug use are the increasing risk of infection, disease and overdose. Medical complications common among recreational narcotic users arise primarily from the non-sterile practices of injecting. Skin, lung and brain abscesses, endocarditis, hepatitis and HIV/AIDS are commonly found among persons with narcotic dependencies who share syringes or inhale the drug. There has been much discussion about the dangers related to the adulterants/diluents found in street drugs, such as heroin, where rumours abound about what is used to "cut" street drugs, e.g., ground glass, talcum powder, rat poison, domestic cleaning powders, and other cutting agents. Recent evidence shows that this kind of "dangerous adulteration" is largely mythical and that far less cutting of drugs than is normally assumed actually takes place^{[citation needed]}. However, since there is no simple way to determine the purity of a drug that is sold on the street, the effects of using street narcotics are unpredictable. It remains the case that the greatest risk presented by most illicit drugs relates to the drugs themselves and how they are used, e.g., in conjunction with other drugs (alcohol is a particularly risky drug to use whilst also using other street drugs), in excess (most recreational and non-excessive drug use does not result in harm), and how a drug is administered (such as the sharing of needles)^{[citation needed]}. HIV and hepatitis infection rates drop among opioid injectors who do not share injectors. Some agencies have attempted to provide clean syringes in order to lessen injector sharing.

Tolerance and dependence

With repeated use of narcotics, tolerance and dependence develop. The development of tolerance is characterized by a shortened duration and a decreased intensity of analgesia, euphoria and sedation, which creates the need to administer progressively larger doses to attain the desired effect. Tolerance does not develop uniformly for all actions of these drugs, giving rise to a number of toxic effects. Although the lethal dose is increased significantly in tolerant users, there is always a dose at which death can occur from respiratory depression. It is clear, however, that tolerance and dependence, both part of the conventional idea of addiction, are insufficient to explain in totality what addiction is^{[citation needed]}. Addiction is a broader behavioural phenomenon that also encapsulates nonsubstance based activity (such as excessive and compulsive gambling, excessive and compulsive eating, and a range of other excessive and compulsive behaviours) that has many of the same characteristics that substance based dependency displays. Moreover, it is not always the case that those with a physical dependency to opiates find it too difficult to get over their "addiction," because so-called medical addicts (those that become physically dependent on opiates given for pain relief after treatment) only have to "give-up" the physical symptoms - they do not also have the all-important psychological and life-style attachment to the drug which goes to make up the all-encompassing "addiction."^{[verification needed]}

Physical dependence refers to an alteration of normal body functions that necessitates the continued presence of a drug in order to prevent the withdrawal or abstinence syndrome. The intensity and character of the physical symptoms experienced during withdrawal are directly related to the particular drug in use, the total daily dose, the interval between doses, the duration of use and the health and personality of the user. In general, narcotics with shorter durations of action tend to produce shorter, more intense withdrawal symptoms, while drugs that produce longer narcotic effects have prolonged symptoms that tend to be less severe.

The withdrawal symptoms experienced from opioid addiction are usually first felt shortly before the time of the next scheduled dose. Early symptoms include watery eyes, runny nose, yawning and sweating. Restlessness, irritability, loss of appetite, tremors and severe sneezing appear as the syndrome progresses. Severe depression and vomiting are not uncommon. The rate and blood pressure are elevated. Chills alternating with flushing and excessive sweating are also characteristic symptoms. Pains in the bones and muscles of the back and extremities occur as do muscle spasms and kicking movements, which may be the source of the expression "kicking the habit." At any point during this process, a suitable dose of any opioid can be administered that will dramatically reverse the withdrawal symptoms. Without intervention, the syndrome will run its course and most of the overt physical symptoms will disappear within 5 to 15 days, depending on the opioid used.

The psychological dependence that is associated with narcotic addiction is complex and protracted. Long after the physical need for the drug has passed, the addict may continue to think and talk about the use of drugs. There is a high probability that relapse will occur after narcotic withdrawal when neither the physical environment nor the behavioral motivators that contributed to the abuse have been altered.

There are two major patterns of narcotic dependence seen in the United States. One involves individuals whose drug use was initiated within the context of medical treatment who escalate their dose through "doctor shopping" or branch out to illicit drugs.

The other common pattern of non-medical use is initiated outside the therapeutic setting with experimental or recreational use of narcotics. The majority of individuals in this category may use narcotics sporadically for months or even years. These occasional users are called "chippers." Although they are neither tolerant of nor dependent on narcotics, the social, medical and legal consequences of their behavior can be very serious. Some experimental users will escalate their narcotic use and will eventually become dependent, both physically and psychologically. The earlier drug use begins, the more likely it is to progress to dependence. Heroin use among males in inner cities is generally initiated in adolescence, and dependence often develops in about 1 or 2 years.

Examples

Heroin - popular street names include smack, skag, and junk.

Opium/Morphine/Codeine - the precursor to oxycodone(Percocet, Roxicet, etc.), and hydrocodone(Vicodin)

Barbiturates - popular slang names include yellow jackets, reds, blues, Amy's, and rainbows.

Street Methadone

Benzodiazepines - a family of sedative drugs.

Buprenorphine - also called bupe or subbies.

Overdose

Main article: Opioid overdose

Signs and symptoms of narcotic/opioid overdose include the following: euphoria, arousable somnolence ("nodding"), nausea, pinpoint pupils (except with Pethidine/Meperidine [Demerol]), hypoxia, or in combination with other types of drugs, coma, and seizures.

What type of drugs may be adminstradted trandemally and why?

2009-03-14T16:02:00.000-07:00

Transdermals are used to deliver a relatively continuous dose of a medication without having to constantly take oral medication. They are especially useful when treating patients who may be forgetful or have trouble keeping track of their doses (for one reason or another), or when administering drugs that could be harsh on the GI tract.

Lots of drugs have transdermal options. A few examples: narcotics (and other analgesics), nicotine patches, and contraceptives.

how can i change my mind

Erectile dysfunction

How is erectile dysfunction treated?

How is erectile dysfunction treated?

What causes erectile dysfunction?

Cocaine and Crack

PCP & LSD

about LSD

Lysergic acid diethylamide

From Wikipedia, the free encyclopedia

Contents

History

Bicycle day

Early research

Government research

Current research

Dosage

Effects

Pharmacokinetics

Pharmacodynamics

Physical

Psychological

Sensory / perception

Spiritual

Potential risks of LSD use

Flashbacks versus HPPD

Psychosis

Chemistry

Stability

Production

Forms of LSD

Legal status

Canada

Hong Kong

United Kingdom

United States

United States: Prior to 1967

United States: 1970–present

Pickard and Apperson

Modern distribution

See also

References

Further reading

External links

Views

Personal tools

Navigation

Search

Interaction

Toolbox

Languages

Effects

Hazards

Tolerance and dependence

Examples

Overdose

What type of drugs may be adminstradted trandemally and why?