The term “hallucinogen” encompasses a variety of different substances, each with different effects upon the body and mind. In general, hallucinogens are not believed to be physically addictive – that is, they do not lead to a physical dependence whereby the body needs more of the substance to function properly and physical ailments can result from a cessation of use; however, they can be psychologically addictive, and lead to an array of withdrawal symptoms – some highly unpleasant – when the user stops taking them.
Hallucinogen withdrawal occurs when a person has developed a psychological dependence on hallucinogens and their body and mind have come to accept the presence of hallucinogens in the system as “normal”. When a person who has become addicted in this way stops taking hallucinogens, a period of readjustment normally follows during which any of a number of symptoms can occur. This readjustment is known as withdrawal.
While every user experiences withdrawal from hallucinogens differently – and while some substances may provoke different symptoms from others – generally speaking hallucinogen withdrawal comprises some or all of the following:
Users may also experience a condition known as hallucinogen persisting perception disorder (HPPD), which can last for many years after even only one dose of hallucinogens (though it normally results from prolonged heavy use). HPPD is a consequence of brain damage sustained after taking hallucinogens and provokes symptoms including:
It is important to note that research into many hallucinogens and their effects is fairly limited, thanks in part to their illegal nature and partly also because until fairly recently some of these hallucinogens were comparatively rare. With this in mind, it’s quite possible that other withdrawal symptoms may well be associated with certain hallucinogenic substances but that this association has not yet emerged in a way or to an extent that would see it recognised by the medical community.
It’s very difficult to compose a timeline that could be used as a guide to hallucinogen withdrawal since the symptoms vary so considerably from one person to the next, and from substance to substance. The duration of the effects of hallucinogens itself can vary significantly – from a matter of minutes in the case of DMT to potentially several days for ayahuasca – and as such even saying when withdrawal is likely to begin is more or less an exercise in guesswork. However, most of the symptoms listed above, if they manifest at all, are likely to subside within a few days of the last does; on the other hand, some of the more profoundly and persistently unpleasant symptoms such as depression can begin to surface even before the immediate effects of some of these drugs have worn off and can last long after the drug itself has left the body (while, as noted, users run the risk of developing hallucinogen persisting perception disorder which can last for years, or even for the rest of the user’s life).
A person who has developed a psychological addiction to hallucinogens runs the risk of long-term mental health issues and should seek help immediately; fortunately, a range of treatment options are available, including residential rehab which, combined with ongoing therapy, is usually viewed as the most effective treatment for addiction.
While rehabilitation – “rehab” refers broadly to the process by which a person conquers an addiction, it is most commonly used to refer specifically to treatment facilities catering to people suffering from addictions. Rehabs are typically set in peaceful, attractive environments conducive to healing, and offer complete confidentiality; they provide a safe environment for an addict to go through medically assisted detoxification (always advisable) before moving into any of a variety of therapies aimed at addressing the fundamental causes of their addiction.
A person can attend rehab on either an inpatient or outpatient basis. The former provides 24/7 care, and an environment free of temptation: the addict will not be able to access hallucinogens (or any other substance of abuse) and will, therefore, be able to cleanse their body completely of drugs before focussing on the therapy which will, amongst other benefits, teach them the techniques they need to resist temptation once back in the outside world. On the other hand, some patients with work and/or family obligations which mean 24/7 residency is out of the question may opt for outpatient treatment, which is more flexible but which means that they will not be isolated from their drug-taking environment and will be able to make contact with dealers and other sources of hallucinogens should they so desire.
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There are currently no medications available to treat hallucinogen addiction directly – mostly because as it is a psychological addiction the necessary treatment is necessarily of a psychological nature (ie, therapy) – and similarly none exists which can tackle hallucinogen withdrawal as a whole. Some medication may be useful in treating specific withdrawal symptoms – for example, some sedatives might be used to address acute anxiety, agitation, restlessness or sleep disorders, while if a recovering addict is experiencing depression a range of antidepressants are available (though doctors are unlikely to prescribe these to tackle short-term episodes).
If the hallucinogen abuse has resulted in the emergence of psychosis, whether during or prior to the withdrawal phase, doctors may prescribe antipsychotics; however, this would probably occur after a period of observation and therefore again is unlikely to form treatment of short-term episodes – antipsychotics could well, however, be used to treat HPPD.
As some medication is itself habit-forming, and as certain substances can trigger significant complications in the presence of pre-existing conditions, addicts should never attempt to self-medicate and should always consult a GP before beginning any treatment independently.
Therapy is a cornerstone of addiction treatment and a variety of different models are used both within and outside rehab. Every addict responds differently to therapy and some forms may be much more effective on any given individual than others. The most common models within rehab are cognitive behavioural therapy (CBT) and motivational therapy (MT), both of which have demonstrated huge efficacy in treating addiction; however, they are by no means the only option available and an addict may be advised to speak with their GP or an addiction specialist to get some idea of what models might be most appropriate.
Along with traditional one-to-one therapy models, group therapy can also be extremely effective. Because of the diverse nature of hallucinogens as a group and the comparative rarity of hallucinogen addiction, it may be hard to find a group composed solely of hallucinogen addicts; however, that doesn’t mean that people addicted to other substances won’t have useful advice, support strategies and valuable companionship for any addict. Organisations such as Narcotics Anonymous, with meetings around the country, also provide much-needed support for people whose recover is ongoing.