Lysergic acid diethylamide (LSD)is addictive and prone to abuse. It does not have the level of physical dependence and withdrawal symptoms common in other substances of abuse.1 However, the experience is one that may lead to psychological and behavioral addiction if not careful.1
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Is LSD Addictive?
LSD has the potential to be addictive. It is not met with as strong of a physical dependence and withdrawal factor as some other drugs of abuse (e.g., cocaine, heroin, alcohol, nicotine, & methamphetamines), but it is still possible to become addictive. First, one must consider the difference between addiction and dependence, which may occur simultaneously but not always. Simply defined, dependence refers to a physical dependence on something that results in withdrawal when the substance is cut back or eliminated, while addiction indicates a marked behavioral change consequent to neurochemical changes in the brain resulting from continued use.2 One can be physically dependent but not addicted, and vice versa.
Though physical dependence on LSD is highly unlikely, it can lead to psychological addiction and behavioral change in some individuals. Addiction potential varies from person to person. Continued use of LSD can yield cravings for its mind-altering effects, leading to a psychological addiction. Cravings may become even stronger if use is a means of maladaptive coping. Though tolerance (need of a higher dosage to experience the same desired effects) can occur with LSD, it’s temporary and tends to diminish after a few days of abstinence.1 Accordingly, one would nearly have to consume LSD daily to maintain increased tolerance levels. To this extent, further research should be conducted on the contemporary use of LSD insofar as microdosing in controlled clinical settings. The question is now being posed as to whether tolerance may continue building or if it is even safe to chronically microdose regardless of whether the use is recreational or for medicinal purposes.3
Understanding LSD
LSD is classified as a serotonergic psychedelic drug synthesized from a substance found in ergot, which is a fungus that grows on rye.4 Originally synthesized by chemist Albert Hoffman in the late 1930s, it wasn’t until 1943 that he tried it for the first time and bore witness to its effects. The history of LSD is marked by a sketched past in which it was originally designed for medical and military purposes but then became a cornerstone of the 1960s drug culture. It has since expanded to recreational use and is still used to this day, whether alone or in combination with other drugs, such as 3,4-methylenedioxymethamphetamine (MDMA), commonly referred to as “candy flipping.” Regardless, it has recently regained interest in research and medical purposes.
Common street names for LSD include acid, blotter acid, and window pane5, as well as doses, trips, mellow yellow, and yellow sunshine. It’s often consumed orally and typically comes in the form of small squares of paper (blotter tabs) that are soaked with the LSD solution. The chemical structure of LSD closely resembles serotonin, a neurotransmitter involved in regulating mood, perception, and cognition. This similarity allows LSD to bind to and activate serotonin receptors in the brain, particularly in the prefrontal cortex and visual processing areas.6 The activation of these receptors leads to profound alterations in perception, thoughts, and sensory experiences, resulting in the psychedelic effects associated with LSD use.
LSD Effects & Abuse
The effects of LSD vary widely by individual physiology, dosage, and potency. The drug induces an altered state of consciousness commonly known as a “trip.” During a “trip,” individuals may experience sensory distortions, hallucinations, intense changes in perception of time and space, and profound shifts in thoughts and emotions.1 Colors may appear more vibrant, patterns may seem to morph and breathe, and users may have a heightened sense of interconnectedness or transcendent experiences.
While many individuals use LSD for its hallucinogenic properties, the intense effects of the drug can also lead to its abuse. Some individuals may chase the intense euphoria and altered states of consciousness provided by LSD, leading to repeated and excessive use. However, it is crucial to recognize that not all experiences with LSD are positive. Negative effects, known as “bad trips,” can occur, causing extreme anxiety, paranoia, confusion, and even a loss of touch with reality from which some people never fully recover.1 These negative experiences can be distressing and potentially contribute to the abuse of the drug or the integration of other substances to counterbalance the effect.
Those who take LSD may experience both negative and positive effects, including:
Mental Effects1
- Delusions
- Visual hallucinations
- A distorted sense of time and identity
- An impaired depth and time perception
- Artificial euphoria and certainty
- A distorted perception of objects, movements, colors, sounds, touch, and the user’s body image
- Severe, terrifying thoughts and feelings
- Fear of losing control
- Fear of death
- Panic attacks
Visual Effects1
- Fixation on the intensity of specific colors
- “Hearing colors”
- “Seeing sounds”
Behavioral & Emotional Effects1
- Feelings of happiness
- Trust of and closeness to others
- Enhances explicit and implicit emotional empathy
- Impaired recognition of sad and fearful faces
Physical Effects1
- Dilated pupils
- Higher or lower body temperature
- Sweating or chills
- Loss of appetite
- Sleeplessness
- Dry mouth
- Tremors
Note that in more severe cases, “LSD use can lead to hypothermia, piloerection, tachycardia with palpitation, elevated blood pressure, and hyperglycemia.”1
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How Long Does LSD Stay in Your System?
The duration that LSD stays in a person’s system varies widely. Factors contributing to LSD’s length of stay in one’s system include method of ingestion, individual metabolism, dosage, and frequency of use. Duration is typically considered by the drug’s half-life, which refers to the time it takes for the concentration of the drug in one’s bloodstream to decrease by half. The half-life of LSD studies in a lab setting is roughly 3.6 hours.8
It’s important to note that LSD can still have lingering effects long after it has been metabolized and eliminated from the body. The psychological effects of the drug, such as changes in perception and mood, can last for 8 to 12 hours or longer. Though standard drug screens seldom test for LSD, specialized tests may be able to detect its presence. Here, “LSD can be detected in a urine test 2-4 days after last use, in a blood test 6-12 hours after use, and in a hair test for up to 90 days.”9
Note: some users have described the experience of flashbacks, which are defined as the “phenomenon of reoccurring drug-like experiences after the acute substance effects have worn off.”10 Though these typically occur briefly for a duration of seconds or minutes within a week after use, some users have reported such occurrences months after. Further, many reports have indicated a “reported phenomena [that was] predominantly mild and perceived as neutral to pleasant.”10
Causes of LSD Addiction & Abuse
While LSD, itself, does not lead to typically physical dependence, psychological addiction can develop due to several factors that closely align with those of other substances of abuse.1 One potential cause is the frequent and escalating use of LSD, where individuals may seek out the intense and mind-altering effects of the drug, leading to a desire for continued use. This impact may be further complicated when used as an escape or coping mechanism. Social and environmental factors are also prominent. Peer influence, availability of the drug, and/or a subculture that normalizes and supports drug use can all contribute to the maintenance of addictive patterns over time.
Whether used alone or with a group of people, repeated use that is close in duration may lead toward tolerance development. Though relatively rare, this can occur if uncareful. As individuals continue using LSD, the effects may diminish over time, leading to a need for higher doses to achieve the desired effects. In some cases, individuals may begin combining other drugs to heighten the effect. In any case, these factors—whether alone or in combination—can perpetuate the cycle of abuse.
Risks of LSD Abuse
The effects of LSD can vary widely between individuals and even across different trips for the same person. Abusing LSD carries various risks and potential adverse effects. One significant risk is the occurrence of “bad trips,” which are intense and distressing experiences characterized by extreme anxiety, paranoia, confusion, and a loss of touch with reality. These negative experiences can be highly unpredictable and may lead to psychological distress and long-lasting psychological effects.
LSD abuse may also incur physical risks. Users may experience increased heart rate, elevated blood pressure, dilated pupils, and impaired coordination, which can raise the likelihood of accidents or injuries. As is the case with other substances of abuse, such as alcohol, individuals may engage in dangerous behaviors or take risks they wouldn’t otherwise consider.
Some of the risks of abusing LSD include:
- Mood changes: Chronic LSD use may disrupt the brain’s serotonin system, potentially leading to long-term mood changes, such as depression or anxiety.
- LSD flashbacks: LSD flashbacks are unpredictable and spontaneous reoccurrences of the drug’s effects, even after the immediate effects have worn off, which can create intense and distressing hallucinatory experiences.
- Hallucination-induced persistent perception disorder (HPPD): HPPD is a condition where individuals continue to experience visual disturbances and hallucinatory effects long after ceasing LSD use, impacting their daily lives and perception of reality.
- Psychosis: In some cases, LSD abuse can trigger a temporary psychotic state characterized by delusions, paranoia, and disorganized thinking.
- Impaired judgment: LSD can impair decision-making abilities and lead individuals to engage in risky behaviors or actions they wouldn’t otherwise consider.
- Emotional instability: The intense and unpredictable emotional effects of LSD can result in emotional instability, mood swings, and difficulty regulating emotions.
- Substance-induced anxiety disorder: Prolonged LSD use may contribute to the development of anxiety disorders, manifesting as persistent worry, panic attacks, and a sense of impending doom.
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Symptoms of LSD Addiction
It’s possible for someone who is abusing LSD to become addicted without realizing they have crossed the line into addiction. In fact, this is a common experience for many who become addicted to various substances of abuse. However, as previously discussed, LSD addiction oftentimes does not follow the conventional pattern of physical dependence and withdrawal symptoms. Accordingly, identifying addiction to LSD can be challenging, as it may be difficult for individuals to recognize or admit that they have a problem. Fortunately, there are notable signs to help determine if an addiction to LSD is present. These signs follow the general symptomatology of addiction outlined in the Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.), which—in part—includes persistent cravings, an inability to control or discontinue use, neglecting responsibilities, and experiencing difficulties in daily life due to excessive drug use.12
“Drug-seeking behaviors” refer to the actions individuals take to obtain and use a substance compulsively. This can involve spending a significant amount of time and effort seeking out LSD, engaging in risky or illegal activities to obtain the drug, or prioritizing drug use over personal relationships and other life responsibilities. While the signs of addiction to LSD share similarities with other drug addictions, there may be some differences due to the unique effects of the substance itself.
Symptoms of an LSD addiction include:12
- Taking larger doses of LSD than intended or using it more frequently than planned.
- Using LSD in risky or dangerous situations, such as while driving or operating machinery.
- Continuing to use LSD despite experiencing negative consequences, such as relationship problems, work or school difficulties, or legal issues.
- Spending excessive time, effort, and resources obtaining LSD or recovering from its effects.
- Neglecting personal responsibilities and obligations in favor of using LSD.
- Experiencing cravings or strong urges to use LSD.
- Withdrawal symptoms, such as irritability, restlessness, or anxiety, when attempting to stop or reduce LSD use.
- Failing to control or cut back on LSD use despite a desire to do so.
- Giving up important social, occupational, or recreational activities in favor of using LSD.
Can You Overdose on Acid?
While it is possible to overdose on acid, it’s important to understand that the risks associated with an LSD overdose are different from those of other drugs. Misusing LSD can affect an individual’s tolerance, which is dangerous because larger amounts consumed to compensate increase the potential for adverse reactions and potential harm. Unlike some substances, LSD does not have a lethal dose, meaning it is unlikely to directly cause death. However, consuming excessive amounts of acid can lead to severe psychological distress and potentially dangerous behaviors.
If someone has taken a large dose of acid and is experiencing distressing symptoms, they should seek medical attention immediately. While the physical risks of an LSD overdose are minimal, the psychological and subsequent behavioral effects can be significant and potentially harmful or deadly.
Signs of an acid overdose include:
- Intense anxiety or panic attacks
- Severe hallucinations or delusions
- Extreme confusion or disorientation
- Paranoia or fearfulness
- Agitation or aggression
- Suicidal thoughts or self-destructive behavior
- Rapid mood swings
- Inability to communicate or connect with reality
- Loss of sense of time or identity
- Profound changes in perception, such as synesthesia (cross-sensory experiences)
- Overwhelming sensory overload
- Uncontrollable and excessive laughter or crying
- Elevated heart rate and blood pressure
Treating LSD Abuse
The treatment process for LSD abuse typically involves a combination of counseling, therapy, and support to address the underlying issues contributing to the misuse of the drug. Unlike many other substances, LSD does not produce physical dependence or withdrawal symptoms, which decreases the need for medical detox or medication (specific to LSD abuse). Regardless, there are likely preexisting or subsequent psychological and emotional factors driving use, which warrant remediation. Hence, the benefits of therapy are multifold. Getting started with therapy for LSD abuse typically involves reaching out to a mental health professional who specializes in addiction. They can conduct an initial assessment and tailor a treatment plan to the individual’s needs. Online therapy options can also be beneficial for treating LSD abuse, as they offer convenience, accessibility, and privacy and are oftentimes more cost-effective. These platforms provide a range of therapeutic interventions, including individual counseling and support groups, allowing individuals to receive help from the comfort of their own homes.
Therapy modalities that can be used to treat LSD abuse include:
- Cognitive-Behavioral Therapy (CBT): CBT helps individuals identify and modify negative thought, emotional, and behavioral patterns associated with LSD abuse while developing healthier coping mechanisms to prevent relapse.
- Motivational Interviewing (MI): MI focuses on enhancing an individual’s intrinsic motivation to change their LSD abuse by exploring and resolving ambivalence, increasing self-efficacy, and setting achievable goals. MI is often used in combination with other modalities such as CBT, DBT, person-centered therapy (PCT), and others when and where appropriate.
- Dialectical Behavior Therapy (DBT): DBT addresses emotional dysregulation and helps individuals develop distress tolerance skills, interpersonal effectiveness, and mindfulness techniques to manage triggers and cravings related to LSD abuse.
- Group Therapy: Group therapy provides a supportive environment where individuals can share their experiences, gain insights from others, and develop interpersonal skills while receiving guidance and feedback from a therapist. Further, group therapy offers an additional layer of accountability as members hold themselves and others responsible for their recovery.
- Family Therapy: Family therapy involves the participation of family members and/or designated loved ones to address dysfunctional dynamics, improve communication, and provide support for the individual in their recovery journey. When loved ones are involved with treatment, everyone may ultimately arrive at a better understanding of the condition while having their personal needs satisfied.
In My Experience
Given that LSD is not met with the same extent of physical dependence, tolerance, and withdrawal patterns as other substances of abuse; I do believe that the prognosis for motivated individuals is quite positive. In practice, it is few and far between that I meet anyone who is addicted to LSD itself. Rather, it is more often the result of a polysubstance use condition or abuse in combination with other drugs such as ecstasy (candy-flipping). When used in combination with more addictive substances, the prognosis becomes increasingly complicated. My advice to a client who came into therapy abusing LSD would be to commit themselves to therapy while seeking healthier creative outlets. If one insists on continued use, I recommend an adapted harm reduction strategy where one limits use and only partakes in psychedelic use under supervision. For example, Colorado may allow for use of natural psychedelics (e.g., psilocybin, ibogaine, mescaline, ayahuasca) by individuals aged 21 and older in accordance with the Natural Medicine Health Act.
Additional Resources
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For Further Reading
- Ketamine Addiction: Signs, Symptoms, & Treatments
- Best Addiction Recovery Blogs
- Best Addiction Podcasts
- Best Sobriety Apps
- SAMHASA’s National Helpline
- Narcotics Anonymous (NA)
- Johns Hopkins Medicine: Psychiatry and Behavioral Sciences
- National Library of Medicine: “Psychedelic Medicine: A Re-emerging Therapeutic Paradigm”
Best Online Therapy Services
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9 Types of Therapy for Trauma
Experiencing trauma can result in distressing and debilitating symptoms, but remind yourself that there is hope for healing. If you or a loved one is suffering from the aftereffects of trauma, consider seeking therapy. Trauma therapy can help you reclaim your life and a positive sense of self.