Is it possible to be permanently trapped in a trip?

Dear Reader,  

You’re wise for learning about the different effects of taking drugs. While it’s not possible to be sure without consulting a health care provider, several possible conditions might relate to what you described, including hallucinogen persisting perception disorder (HPPD) type 2, substance-induced psychosis (SIP), and schizophrenia that may develop from SIP. Read on for more about these conditions, their treatment options, and what you can do to reduce potential negative effects. 

What are the effects of hallucinogens? 

As you mentioned, one of the typical effects of hallucinogens, also known as psychedelics, is hallucinations, or seeing things that aren’t there in reality. Hallucinogens may also change how you feel or think and cause negative bodily effects, like decreased appetite, sleep disruptions, and tremors. Different types of hallucinogens work differently and have specific effects. Some examples of other possible effects include heightened awareness, decreased ability to make judgments, disturbing hallucinations, and mood symptoms like depression. 

Current research has shown there’s no dosage, no matter how small, that's safe from these effects. However, you’re on point with some factors that may make these effects more likely to develop. 

Can hallucinogens lead to permanent hallucinations? 

There are two conditions that could be related to these hallucinations: hallucinogen persisting perception disorder (HPPD) and substance-induced psychosis (SIP), which can turn into schizophrenia. 

HPPD involves visual disturbances, which can present as visual flashbacks, or seeing things you saw during a past trip. These experiences can also come with feelings of anxiety. Other common symptoms include seeing things that aren’t there, seeing movements and colors differently, and having distorted vision. People who experience HPPD type 1 generally have short, random, and mild episodes. They may also have some pleasant episodes. People who experience HPPD type 2  might experience more permanent and distressing symptoms, recurring for months or years. These episodes may vary in intensity and come without warning. HPPD type 2 can also cause persistent problems with vision, and in severe cases, have a significant impact on day-to-day activities. 

On the other hand, SIP often includes psychotic symptoms that are related to substance use, which can include delusions, hallucinations, or both. These symptoms typically end within days or weeks after stopping use of the substance that triggered them. However, SIP may develop into schizophrenia, a more long-term and serious condition where psychotic symptoms happen without substance use. Cannabis (or marijuana) is the most common drug associated with this conversion, but research has found that hallucinogens can trigger the development of schizophrenia as well. 

What makes HPPD more likely, and how is it treated? 

HPPD is quite rare—only around four percent of those who have taken hallucinogens may develop it. Some factors that can increase your risk of developing HPPD are family history or previous personal experience with anxiety, tinnitus (ringing in your ear), eye floaters (seeing drifting spots), and difficulty with concentration.  

Medication to alleviate symptoms of HPPD is often the main treatment. Lifestyle practices may also be helpful for mental symptoms, such as exercising regularly, having nutritious and balanced meals, drinking adequate water, maintaining good sleep hygiene, and doing relaxation practices. 

What makes SIP and schizophrenia more likely, and how are they treated? 

Research is still ongoing to determine the mechanisms of SIP and schizophrenia. However, existing studies have found  the development of schizophrenia from SIP and the use of hallucinogens is associated with: 

• Current substance use disorder 
• Pre-existing substance use disorder, personality disorder, or eating disorder 
• Pre-existing psychotic experiences that aren’t associated with drug use 
• High family risk for schizophrenia 

SIP can generally be managed by behavioral therapies that help stop substance use in combination with antipsychotic medication. For SIP, due to hallucinogens, waiting for the substance to leave the system might be sufficient. However, when it comes to schizophrenia, treatment can be longer and more complicated, including hospitalization if necessary. 

How can you reduce the harmful effects of hallucinogen use? 

There's always a chance of experiencing side effects when using substances. If you decide to use hallucinogens or other drugs, you might consider taking some measures to help minimize the effects. For example:  

• Avoid taking hallucinogens with alcohol or other drugs, especially stimulants. 
• If taking hallucinogens, do so in familiar environments and with the presence of trusted people who can help you counter negative emotional effects. 
• Sit down, breathe deeply and regularly if you begin experiencing anxiety. 
• Ensure that you have access to medical assistance, such as by having information handy or being near a medical facility. 

You may also find reviewing some additional harm reduction resources beforehand helpful. These include harm reduction websites created by the Substance Abuse and Mental Health Services Administration and the National Harm Reduction Coalition.  

Best of luck and stay safe,