HOW HALLUCINOGENS MOVE THROUGH THE BODY

HOW HALLUCINOGENS MOVE THROUGH THE BODY

Ritual use of hallucinogens by indigenous peoples involves many routes of administration, ranging from herbal teas to application to the skin to hallu­cinogenic snuffs. However, the major hallucinogens used in the developed world are almost always taken by mouth. All of the drugs listed in the pre­vious section can be absorbed easily from the stomach or intestines. PCP is an exception because users also smoke or inject it. Only LSD is potent enough to be effective in tiny doses absorbed on paper. Users most often simply chew and swallow the plant-derived hallucinogens such as cactus buttons or dried mushrooms. Most hallucinogens, and frequently LSD or various drugs that are supposed to be LSD, are ingested in pill form.

The lag time between taking the drug and beginning the drug experi­ence, and the duration of the experience itself, depends upon the drug. A typical LSD experience begins between thirty and sixty minutes after a user takes the drug. LSD is absorbed efficiently from the stomach and intestines and enters the brain fairly quickly. LSD trips last the longest of typical hallucinogens: the drug effects typically last four to six—but occasionally up to twelve—hours for a single dose. The reason for this is simple: the liver degrades LSD slowly, so active drug remains in the body for hours.

Despite many rumors to the contrary, LSD is not stored in the spinal fluid for months, nor does it remain hidden in any organ. It is elimi­nated just like many other drugs, but more slowly. LSD flashbacks do not occur because hidden drug in the body suddenly reappears. We do not understand the neurobiology underlying flashbacks, but it would be reasonable to speculate that they represent a change in the brain that remains after the drug experience. As we will see later, in the "Brain Basics" chapter, the central nervous system has the capacity to recall all sorts of experiences, and flashbacks may be just that.

Peyote trips can last almost as long as LSD trips. In contrast, psilocybin experiences usually last two to four hours. Dimethyltryptamine (DMT) is the shortest-acting of the commonly used hallucinogens, producing notice­able effects within ten minutes, peaking at about thirty minutes, and end­ing within an hour. This drug is often described as a "businessman's special" for that reason. The differences from drug to drug are caused by differences in two properties. First, the more fat-soluble a drug is, the more quickly it enters the brain (this explains the rapid onset of DMT action). Second, the more slowly the drug gets degraded, the longer the trip. Again, this varies according to the particular chemical structure of the drug. Some drugs, like LSD and mescaline, produce particularly long-lived effects because they are not quickly metabolized by the liver.

PCP deserves some special notice because of the problems its chemical characteristics often cause. PCP is well absorbed when taken by mouth, and peak blood levels are reached even faster (within fifteen to thirty minutes) if it is smoked. However, it is broken down quite slowly, so the effects last a long time. The main drug experience lasts four to six hours, but significant amounts of the drug are present for twenty-four to forty-eight hours. The body's slow metabolism of PCP, along with some users' tendency to use it repeatedly over a day's time, leads to overdose and very persistent drug effects for days after ingestion.

Myths about how to stop a trip abound; drinking milk is the most unlikely we have heard. There is no simple way to speed up the removal of most hallucinogens from the body. Users must simply wait for the liver and kidneys to do their job. PCP is the only exception. In critical situations, emergency room personnel can use a drug that makes the urine more acidic, speeding up the removal of PCP by the kidneys. Some drug treat­ments (see the following) can help with the symptoms of acute panic, and a drug is being tested that could block the action of LSD. However, at the moment there is no quick fix like there is for opiate overdose.

So it's important to remember that, once begun, the trip on some of these drugs can last for hours. If the trip is unpleasant, there is not much to do except receive support from unimpaired companions. If someone is going to experiment with any of these drugs, it is crucial that he or she do so in a safe and supportive environment. Doing even the least dangerous of these drugs alone invites trouble.