d-Lysergic acid diethylamide (LSD) is the most potent hallucinogenic
substance known to man. Doses of LSD are measured in micrograms, or
millionths of a gram. LSD has remained popular among certain segments of
society. The Drug Abuse Warning Network reports that LSD related emergency
department (ED) episodes have continued to show a "saw-tooth"
pattern (a yearly up and down pattern of mentions) since 1993 to the
present. There were 4,106 ED mentions of LSD in 2000.
Licit Uses
LSD was first synthesized in 1938. In the 1940s there was great
interest in the drug as a research tool in studies of mental illness,
especially as to its structural relationship to chemicals that would
produce psychosis in man. In the 1960s it became popular as part of
psychiatric therapy sessions to reduce the patients inhibition and to
enable them to "turn inward". LSD consumption is considered
"mind expanding". There is no current legitimate medical use in
treatment and there is a lack of accepted safety for its use under medical
supervision.
Chemistry/Pharmacology
Early on, the subjective effects produced by the drug seemed similar to
some schizophrenic symptoms. LSD was found to be structurally similar to
serotonin in that both contained an indole nucleus. Later it was found
that LSD could block the excitatory effects of serotonin on smooth muscle
of the intestine. Physiologically, LSD has sympathomimetic effects which
result in tachycardia, high blood pressure, dilated pupils, increased body
temperature, sweating, chills, increased glucose levels, and sometimes
headache, nausea, and vomiting. However, it is LSD’s psychological
effects that the abuser seeks. LSD induces a heightened awareness of
sensory input, often accompanied by an enhanced sense of clarity, but a
diminished control over what is experienced. The attention of the LSD-user
is turned inward; often there is a feeling that one part of the self is a
passive observer. Vivid hallucinations occur; the user of LSD may report
to "hear colors" or to "see sounds". LSD also disrupts
time perception and induces pleasure and euphoria. LSD is noted for its
induction of "bad trips," which centers around a fear of
fragmentation or disintegration of the self; thoughts and memories can
vividly emerge unexpectedly, to the user’s distress. Mood may be labile,
shifting from depression to gaiety, from elation to severe anxiety and
panic. What differentiates the LSD-trip from an acute schizophrenic
episode is that LSD rarely induces auditory hallucinations, the hallmark
of the schizophrenic’s milieu.
Acute tolerance to LSD’s effects occurs in both man and animals after
a few doses, with cross-tolerance extending to chemically-related drugs
such as psilocybin and unrelated drugs such as mescaline. 5 mg/kg
mescaline is equivalent to a dose of 1.5 microgram/kg of LSD.
Drops of LSD are usually sold absorbed in colorful designer blotter
papers or imbedded in sugar cubes. The design on the blotter paper is as
varied as its clandestine manufacturing. Recently LSD has become available
in gel wraps which look like small ‘bubble-wrap’ packing material,
blue in color, and sold in Rave clubs. LSD has also been found in small
"breath freshener" bottles and imbedded in "Smartie"
candies.
Illicit Uses
LSD is used for its hallucinogenic properties. Between the dose ranges
of 1 to 16 micrograms, the intensity of the psychophysiological effects of
LSD is proportional to the dose. Higher doses can induce a "bad
trip" characterized by intense anxiety or panic, confusion, and
combative behaviors. The entire syndrome begins to clear after about 12
hours, although the half-life of the drug in man is approximately 3 hours.
LSD has been used in combination with 3,4 methylenedioxymethamphetamine (MDMA,
Ecstasy) in a pattern referred to by "ravers" as
"candy-flipping".
User Population
Traditionally, it has been popular with high school and college
students. It has been integrated into the lifestyle of many individuals
who follow certain rock bands, but it has episodically emerged as a drug
of abuse in medical professionals related to work in psychotherapy.
Illicit Distribution
LSD most often is found in the form of small paper squares or, on
occasion, in tablets, powder, crystal, liquid, gelatin square, and
capsules. LSD has also been used to lace sugar cubes and other substances.
LSD is sold under more than 80 street names including acid, blotter, cid,
doses, and trips. It is also given a name that reflects the design on the
sheets of paper or blotter that the LSD is placed. There have been more
than 200 types of LSD tablets and more than 350 different paper designs.
Prices can range from $2 to $5 per unit or "hit".
The source of LSD to the street is through clandestine synthesis. Some
street samples of LSD have been found to contain phencyclidine (PCP).
Control Status
Lysergic acid diethylamide (LSD) is in Schedule I of the CSA; its two
precursors lysergic acid and lysergic acid amide are both in Schedule III
of the CSA. The LSD precursors, ergotamine and ergonovine are List I
chemicals.
Comments and additional information are welcomed by
the Drug and Chemical Evaluation Section, FAX 202-307-8570 or telephone
202-307-7183.
August, 2001
