There is no doubt that LSD has acquired a cultural mythology and scientific curiosity that most other drugs can’t match.
First developed by Albert Hofmann in 1938 from ergot, a fungus that grows on rye and other grains, LSD was one of the most popular hallucinogenic substances of the 20th century and remains ever-present in public discourse about possible medical and therapeutic uses of psychoactive drugs. It’s associated with the hippie movement of the 1960s, psychedelic music and art, and is often depicted in pop culture as a type of “gateway” to a mythical higher state of consciousness.
But is LSD an addictive drug with potential for harm? The answer is a complicated yes. This article will examine how LSD use can fit the definition of addiction, how it interacts with the brain, and the risks associated with use.
What Is LSD?
LSD, scientifically known as lysergic acid diethylamide, is a type of hallucinogenic drug that causes a person to experience significant changes in perception, thought, and feelings. It is one of the most powerful hallucinogenic drugs, with effects measurable even at microgram doses.[1]
LSD can come in multiple forms. It is most commonly found on small squares of paper called blotter paper, but can also be found as windowpane (thin gelatin squares), microdots (tiny pills), or sugar cubes.
The drug works by interacting with numerous neurotransmitter receptors in the brain. LSD primarily binds to the serotonin receptor 5-HT2A, producing the characteristic hallucinogenic effects that are associated with psychedelic episodes.[2] Unlike opioids or stimulants, LSD does not directly trigger a flood of dopamine in the brain’s reward system, which is one reason that it is not as physically addictive as other substances.[3]
LSD is classified as a Schedule I controlled substance by the United States Drug Enforcement Administration (DEA).[4] This means it has a high potential for abuse, no currently accepted medical use in the United States, and safety has not been established.
The Effects of LSD
To understand the potential dangers associated with using LSD, you must first understand what the drug does. Most people begin feeling the effects within 30 to 90 minutes after taking LSD, and the effects usually last between 8 and 12 hours. The exact experience can vary greatly based on the amount ingested, the mental state of the person using it, and their surroundings.
Short-term effects of LSD use include:
- Visual hallucinations and distortions of color, shape, and movement
- Altered sense of time, which may feel dramatically slowed or accelerated
- Intense emotional experiences ranging from euphoria to terror
- Dilated pupils
- Increased heart rate and elevated blood pressure
- Elevated body temperature
- Dry mouth, sweating, and loss of appetite
- Sensory crossover, where sounds may appear as colors or vice versa
A “bad trip” is when someone experiences overwhelming feelings of distress while under the influence. Bad trips can be psychologically traumatic, particularly at higher doses, and in people vulnerable to them, they can trigger lasting psychological effects.
Is LSD Physically Addictive?
Physical dependence occurs when the body becomes conditioned to the effects of a substance and produces certain withdrawal symptoms when the substance is stopped.
By this definition, LSD does not create physical dependence. There is a large body of research supporting that LSD does not create the same type of physical dependence associated with opioids, alcohol, and benzodiazepines, and there are no clinically significant physical withdrawal symptoms associated with stopping use.[5]
There is still, however, the possibility of becoming psychologically addicted.[6] Psychological dependence occurs when a person relies on a substance emotionally and mentally to cope with stress or other emotional issues in life. This is very common for those who use the drug frequently or have pre-existing mental health vulnerabilities.
LSD Tolerance: A Unique Mechanism
A unique quality of LSD is that people build tolerance to the drug’s effects extremely quickly. Tolerance is the need to continually take larger amounts of a substance to produce the same effect. With LSD, this tolerance builds almost immediately.[7]
After taking LSD just once, a person may find that they can take the same dose two days later without it having an effect. Full tolerance can develop anywhere from two days to four days after continuous use, which means that daily use of LSD becomes self-limiting since the hallucinogenic effects diminish rapidly and do not return unless the user abstains for a time.[8]
This rapidity with which tolerance builds is also observed with other hallucinogens, such as psilocybin, and cross-tolerance between these substances is well-documented. Researchers believe this happens through the rapid downregulation of serotonin receptors, specifically the ones on which LSD acts.[9] Because tolerance diminishes relatively quickly after stopping use, many users take the drug in cycles rather than every day. However, this cycle can still lead to psychological dependence and long-term complications.
Psychological Dependence and LSD Abuse
Many users of LSD develop patterns of use that meet the clinical definition of a substance use disorder (SUD). Users who present with SUD-related behaviors continue to use the substance even though they have experienced negative consequences, become preoccupied with obtaining or using the substance, and are unable to function without it.
Psychological effects that can develop with regular LSD use include cravings for the altered state of consciousness produced by the substance, emotional instability, and an inability to differentiate between the effects of LSD and reality.[10] Pre-existing mental illnesses may worsen with continued use. People who have been diagnosed with schizophrenia or have a family history of it have a very high potential of suffering from serious psychological side effects when using LSD.[11]
Long-Term Effects of LSD Use
Long-term effects of using LSD include serious mental health risks. Although there are several, two deserve special mention:
Hallucinogen Persisting Perception Disorder (HPPD)
Hallucinogen persisting perception disorder (HPPD) is a condition in which someone experiences visual images, flashbacks, or distorted perceptions long after they have stopped using the drug, sometimes weeks, months, or years later.
These episodes may include visual snow, trailing images, halos around objects, or elements of a previous trip occurring again. HPPD is likely to occur in only a small number of people, but it can cause significant distress and impairment in a person’s day-to-day functioning.[12] It is an uncommon but very real risk associated with hallucinogen abuse.
Psychosis and Mental Health Risks
LSD has been associated with triggering or worsening psychosis (hallucinations, delusions, and disordered thought or speech) in people who may be genetically vulnerable to conditions like schizophrenia.
According to the National Institute on Drug Abuse (NIDA), although LSD alone typically does not directly cause schizophrenia, for those without an existing risk, it can serve as a precipitating factor.[13]
“Bad trips” associated with LSD can also create long-lasting psychological issues, including post-trauma symptoms, anxiety, and feeling so shaken that the user struggles to feel normal again.
Who Is Most at Risk?
Not everyone who tries LSD will suffer from addiction or mental health problems. The following can increase the risk:
- Personal or family history of mental health disorders, particularly schizophrenia or psychosis
- History of trauma or adverse childhood experiences
- Frequent or high-dose LSD use
- LSD use with other substances, such as stimulants, cannabis, or opioids
- Adolescents and young adults are more vulnerable, because the still-developing brain is more sensitive to the prolonged psychological effects of hallucinogenic drugs
- Using LSD for emotional assistance or support for mental health issues
LSD Addiction Treatment
Because there is no physiological dependence on LSD like with many other drugs, treatment is primarily geared toward addressing the psychological components of LSD use. Medical detoxification is typically not needed unless the user is also dependent on other drugs.
Effective treatment for LSD abuse and hallucinogen-related substance use disorder typically includes:
- Cognitive behavioral therapy (CBT): This type of talk therapy helps identify and alter distorted thoughts and unproductive behaviors to help address the psychological patterns that accompany drug use.
- Dialectical behavior therapy (DBT): This is a form of talk therapy that helps people manage intense emotional and behavioral responses, particularly when their LSD use accompanies emotional dysregulation.
- Mental health treatment: Some common conditions that are triggered or worsened by LSD use include depression, anxiety, and psychosis.
- Peer support and group therapy: These types of therapy reduce feelings of social isolation and create shared experience as people work together within a community toward recovery.
At The Freedom Center in Maryland, our treatment programs are designed to address both the addiction and the underlying mental health factors that contribute to substance use. Whether you are concerned about your own LSD use or that of a loved one, our team is here to help.
Ready To Take the First Step?
LSD may not follow the same addiction pattern as other drugs, but that does not mean it is without risk. If your mental health, relationships, or daily functioning is being affected by LSD use, seeking assistance from a mental health or addiction professional is in your best interests.
The Freedom Center provides compassionate, evidence-based substance addiction treatment specifically designed to meet the needs of Maryland residents struggling with substance use.
