Trapped in a trip

Dear Alice,

I have heard that people can become trapped in their own world of hallucinations permanently from taking 'shrooms, acid, or other hallucinogens and have to live in a mental health facility because they are so out of touch with reality. I'm wondering is this true? And if so what is this medical condition called? I've heard of Hppd, but what I have read about it, it doesn't sound exactly the same. I'm also curious what the likelihood of this happening would be and if it is dependent on the use of many drugs, dosage, or the user's mental state or other preexisting health conditions that could affect this. I'm really hoping you can answer this question because I haven't found any reliable sources about this topic.

Thanks so much!

Dear Reader,

There isn't currently anything in the research to indicate that some people who use these substances stay in their hallucinations permanently. However, hallucinogen persisting perception disorder (HPPD) may cause some people who have used hallucinogenic substances to experience hallucinations even after they have stopped using the drugs. HPPD is a rare post-hallucinogen intoxication disorder that typically occurs from long-term use of hallucinogenic drugs. While the research indicates that this may happen with hallucinogens as a whole, it particularly notes lysergic acid diethylamide (LSD, also sometimes called "acid"), with less information about the use of mushrooms or other hallucinogens. People with a diagnosis experience continuous (and typically visual) hallucinations that remind them of previous highs or “trips” they've had while on hallucinogenic drugs. While "flashbacks" (distorted visual perceptions) involve feeling the effects of past hallucinogenic trips every so often, an HPPD diagnosis requires that a person experience perceptive disturbances on a regular basis, and there are some factors that may increase the risk of HPPD (more on that in a bit). Unfortunately, there's currently no official mechanism or instrument to distinguish whether a person's experiencing flashbacks or HPPD. For more information about LSD, flashbacks, and HPPD, keep on reading!

LSD is a psychedelic drug whose effects typically kick in at least an hour after consumption and can last up to twelve hours. After ingestion, LSD targets receptors in the body that are responsible for regulating the production of serotonin, a “feel good” hormone that promotes feelings of happiness and well-being and may induce harmless flashbacks that many describe as relaxing and temporary. However, some people who take LSD experience unpredictable or bad trips, as well as various harmful short-and long-term health consequences (e.g., increased heart rate, blood pressure, and anxiety). How long can users expect to have flashbacks? Typically, those who've used hallucinogens experience mild, infrequent flashbacks up to a year after initial hallucinogen ingestion due to residual amounts of drugs in the system from previous use. These flashbacks may mirror experiences from LSD trips and include halo effects and bright spots of light across the visual field, falsely perceived motion in peripheral vision, and flickering patterns. Flashbacks triggered by HPPD — as compared to flashbacks without the presence of an HPPD diagnosis — are more likely to be chronic, uncontrollable, and potentially distressing.

Researchers have yet to determine whether the quantity or variety of hallucinogens ingested have an impact on the probability of experiencing flashbacks or their level of severity. They've also only determined one solid cause of flashbacks: long-term use of LSD can lead to organic brain damage that may cause flashbacks, as well as confusion, short attention span, and impaired ability to understand abstract concepts. Current research also suggests that those with family histories of anxiety, visual issues, and concentration and attention problems may be more at risk for HPPD. For more information about psilocybin mushrooms (also called 'shrooms), you can read Psilocybin ('magic') mushrooms for details about how it affects the body and some of the long-term effects.

Given that reputable information on this topic is limited and oftentimes challenging to find, you may be left with more questions than answers. If you have more questions about hallucinogenic drugs, flashbacks, or symptoms of HPPD, consider seeking out guidance from professional resources, such as a mental health professional or health care provider, and if you're a student, you may check to see if you can access these folks on-campus. Also be sure to check out the Go Ask Alice! Alcohol & Other Drugs archives for more information on reactions to drugs and to hallucinogens, more specifically.

Last updated Sep 21, 2018
Originally published Sep 21, 2012

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