METHORPHAN

METHORPHAN

Dextromethorpha_n is the main constituent of many over thecountercough remedies. At appropriate doses (a teaspoon or two), this drug decreases coughing and doesn't do much else. However, it is a cousin of the hallucinogenic anesthetics PCP and ketamine, and some resourceful drug users—usually teenagers—have discovered that if they take exces‑ sive doses (equivalent to drinking an entire bottle of cough syrup—about 300 milligrams—or taking anywhere from ten to sixty DXM-containing pills), they can experience a dissociative state that is dose-related. While the lower end of the abused range (10 pills) leads to a mild state, very high numbers of pills (60 pills) can lead to an intense dissociated, hallucinatory state, and there are case reports of psychotic behavior in people taking extremely high doses. Recent research shows that it indeed acts much like ketamine. Dextromethorphan also shows up in the guise of fake Ecstasy pills—it is a common substitute for MDMA. Toxic doses cause confusion, disorientation, elevated body temperature, high blood pres­sure, and vomiting or nausea. Some users develop patterns of repeated chronic use, although there is not much in the scientific literature about dextromethorphan tolerance, dependence, or addiction. Although it can cause toxicities, the lethal dose is still considerably above (roughly double or more) the highest doses the recreational users typically employ How­ever, the other constituents in cough syrups can add to the toxicities. Cough syrups with decongestants in them can raise blood pressure mark­edly, and the combination of DXM and the antihistamine (chlorpheni­ramble ma leate) in some preparations can cause a serotonin syndrome-like toxicity in rare cases. Ingestion of high doses (thirty to sixty pills) of for­mulations with acetaminophen can deliver enough of this analgesic drug to damage the liver. While DXM is not illegal, most states have laws that prevent sales to anyone under the age of18.

Ayahuasca

Ayahuasca

Ayahuasca (caapi, yage, vegetal) is a plant-based hallucinogen that users ingest as a drink containing a combination of plant products. Although formulations vary, the two essential components are the bark of the vine Banisteriopsis caapi and the leaves of Psychotria viridis. The active ingre­dients provided by this combination are the beta carbolines harmine and harmaline, and DMT (see previous section). This combination produces a period of intense nausea and vomiting, a period of anxiety or fear, fol­lowed by an intense hallucinatory and dissociative experience. The hallu­cinations are predominantly visual, although users report increased sensitivity to sensory stimuli also. Users frequently experience the disso­ciation common to other hallucinogens and a profound sense of insight. The experience lasts a number of hours.

Ethnobotanists including Richard Schultes documented use of this drug by indigenous peoples of the Amazon that probably goes back centuries. The Beat writer William Burroughs recorded his experiences with this drug in The Yage Letters, and the sixties generation learned about it from The Teachings of Don Juan by Carlos Castaneda. Use of aya huasca has migrated to the United States from South American religious groups like the Uniao do Vegetal (UDV) and Santo Daime that have revitalized the once common use of this drug by native shamans for magico-religious purposes, such as healing and divination. Unlike many hallucinogens, ayahuasca is almost never used recreationally, but more typically as a pharmacologic aid to per­sonal insight and enlightenment.

SALVIA DIVINORUM

Indians of Mexico use a plant called Salvia divinoruin (a rare member of the mint family) for religious purposes, and it has generated some curios­ity in the United States mainly because it is not yet illegal. Indians chew the leaves, but in the United States, people more typically smoke the leaves. Salvia causes an intense and sometimes unpleasant hallucinatory experience that lasts about an hour. Users report a unique experience that resembles neither LSD nor other hallucinogens. This drug is more likely than other hallucinogens to produce an unpleasant experience due to its novel mechanism of action, and so repeated use is somewhat unusual. The active agent is probably a compound called Salvinorin A, the second most potent hallucinogen known after LSD. A smoked dose of as little as 200 to 500 micrograms produces hallucinations.

HALLUCINOGEN HISTORY

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This class of psychoactive drugs boasts a longer history; a greater mys­tique; and more botanical, chemical, cultural, and historical diversity than almost any other. The use of hallucinogens is evident in plant remains from cultures on every continent. Each student of hallucinogens has his favorite "oldest story." One of ours explains how Siberian hunters discovered the fly agaric mushroom (Amanita muscaria). Apparently the hunters noticed the abnormal behavior of reindeer grazing on these mushrooms, and decided to experiment with them. They found that not only did the mushrooms have a profound hallucinatory effect, but they were so potent that the urine of those who had ingested the drug still con­tained active drug, so the drug could be recycled among tribe members. It has been suggested that the same mushroom provides the drug Soma described in the Rig-Veda, the book of religious writings from India that has been dated to at least 3,500 years ago. Hallucinogens were used in 

early Greece, and the plant riches of the New World provided a wealth of hallucinogenic agents that were known to the earliest migrants into South America from Eurasia. Archeological evidence suggests that the use of the peyote cactus goes back thousands of years.

Who uses hallucinogens today and why do they use them? Even the most commonly used drug, LSD, is only used by a small percentage of the population. Use has fallen from about 5 percent of high school seniors in 1999 to about 2.2 percent in 2013. There are probably several reasons for these low numbers. First and foremost, the use of this drug produces a powerful experience that is not typically "fun." Second, increased law enforcement pressure has decreased the availability of LSD. The typical LSD user is a white teenage male. We don't really have accurate statistics about the use of other hallucinogens, but the primary age group is the same for most. Finally, Native Americans and others also use hallucino­gens for religious purposes.