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LSD
LSD is a long-acting and highly potent classical psychedelic.
Normal dose: 80–150 micrograms (µg)
Duration: 10–14 hours
Risks:
Acute lethality: ⦿⦾⦾⦾⦾ (Very low)
Long-term toxicity: ⦿⦾⦾⦾⦾ (Very low)
Dependence: ⦿⦾⦾⦾⦾ (Very low)
Cognitive problems: ⦿⦿⦾⦾⦾ (Low)
Undesirable events: ⦿⦿⦿⦾⦾ (Moderate)
Interactions: ⦿⦿⦾⦾⦾ (Low)
Scroll down for the full risk profile.
Acute lethality: ⦿⦾⦾⦾⦾ (Very low)
Long-term toxicity: ⦿⦾⦾⦾⦾ (Very low)
Dependence: ⦿⦾⦾⦾⦾ (Very low)
Cognitive problems: ⦿⦿⦾⦾⦾ (Low)
Undesirable events: ⦿⦿⦿⦾⦾ (Moderate)
Interactions: ⦿⦿⦾⦾⦾ (Low)
Scroll down for the full risk profile.
LSD (lysergic acid diethylamide) is a long-lasting and highly potent psychedelic substance that enhances feelings, alters perception, leads to free association of thoughts, and increases wakefulness. LSD's effects were discovered in 1943, and it was used as a medicine in psychiatry from 1947–1966, when it was banned in the United States due to its use as a recreational drug among hippies and the countercultural movement.
LSD is not addictive and likely non-toxic in normal use, but the experience can be psychologically demanding. LSD should be treated with great respect, as it can produce life-changing experiences, and inexperienced users should not take high doses. Mood, circumstances, and surroundings ("set and setting") have a significant impact on how the experience plays out. It is recommended to use a test kit to avoid dangerous substances that are sometimes falsely marketed as LSD.
LSD is not addictive and likely non-toxic in normal use, but the experience can be psychologically demanding. LSD should be treated with great respect, as it can produce life-changing experiences, and inexperienced users should not take high doses. Mood, circumstances, and surroundings ("set and setting") have a significant impact on how the experience plays out. It is recommended to use a test kit to avoid dangerous substances that are sometimes falsely marketed as LSD.
Please see our 10 general rules for sensible drug use. You should also be mindful of the following:
- If the substance has a strong taste, it is very likely not LSD, and may instead be a dangerous substance falsely sold as LSD. Always use a test kit or analysis service if possible.
- Avoid taking LSD if you or someone in your immediate family has a psychotic disorder. Also be cautious if you have a severe anxiety disorder.
- Avoid taking LSD if you are on medications that contain lithium or tramadol, as this can lead to seizures. Protease inhibitors may also have dangerous interactions with LSD. Note that SSRI-based antidepressants can give a greatly reduced drug effect.
- It is best to have a fast-acting benzodiazepine (like diazepam) on hand in case of an anxiety attack. Simply knowing that you have it can also provide a feeling of safety and thus reduce the risk of anxiety.
- Avoid high doses if you are inexperienced, and have an experienced and preferably sober friend present.
- Do not try LSD spontaneously at a party. Thoroughly research the substance and mentally prepare yourself beforehand.
- Be careful when combining LSD with other drugs. Cannabis in particular can increase the risk of anxiety and confusion during the trip.
- Assess your mood, life situation, immediate surroundings, and who you are with. Make sure you have the option of moving over to another safe spot if necessary. Put away your phone and make sure you have no appointments or tasks for the rest of the day.
- If you feel anxious during the trip: change your surroundings or music, breathe calmly, and try not to resist what is happening inside you. If you feel like you are losing control, ask a friend to sit with you and remind you that you are safe. Have an anxiolytic (e.g. diazepam) readily available in case the situation cannot be managed.
- Avoid taking LSD if you are already sleep-deprived, as you will not be able to sleep for at least 12 hours.
We employ a five-step risk scale with values ranging from "very low" to "very high" within six categories: Acute toxicity, Long-term toxicity, Dependence, Cognitive problems, Unpleasant events, and Interactions.
These values are based on qualitative reviews of available knowledge, and should only be viewed as guidelines. They are also relative, so a score of "very low risk" does not mean the substance is risk-free. The scale assumes users are normal, healthy individuals; beware that even drugs which are well-tolerated by most people may nevertheless be harmful to some users. It also assumes normal use patterns; that is, if a given drug is only harmful when used in a certain way, yet is almost never used in that way, then the drug will be considered less harmful compared to a similar drug which is commonly used in a harmful way.
ACUTE LETHALITY
⦿⦾⦾⦾⦾ (Very low risk)
LSD is one of the least lethal drugs when measuring lethality relative to the effective dose. Recent literature estimates that up to 100 milligrams (mg) may be needed for death to occur in humans, which is a thousand times more than a typical recreational dose of 100 micrograms (µg) [1]. In one case, a woman in the US reportedly ingested approximately 55 mg (i.e. 550 recreational doses), resulting only in intermittent loss of consciousness and strong intoxication lasting for several days [2]. Two additional cases have been documented where five and eight people, respectively, ended up in the emergency room after snorting "lines" of pure LSD powder that they had mistaken for cocaine, amounting to several hundred times a typical recreational dose. In both cases, some of the patients of them had to be treated for overheating, rhabdomyolysis, failing respiration, and bleeding tendencies, and could have died without medical intervention; however, all thirteen survived, and were discharged after a short time without any lasting harm [3,4].
LONG-TERM TOXICITY
⦿⦾⦾⦾⦾ (Very low risk)
LSD is remarkably non-toxic to the body compared to most recreational drugs [1]. There is reason to believe that highly frequent LSD use could lead to heart valve fibrosis, as other substances with similar receptor activity are known to have this side effect – albeit only when used several times a week, so there is little reason for concern for people who only use LSD a few times per year [5]. Microdosing LSD several times a week, on the other hand, may be harmful.
DEPENDENCE
⦿⦾⦾⦾⦾ (Very low risk)
LSD is neither addictive nor habit-forming, and daily use is practically impossible due to users rapid building a near-total tolerance, making them essentially immune to the drug's effects for several days after ceasing their use [6,13]. LSD can also reduce cravings for other drugs, an effect with has previously been used to successfully treat alcoholism [7].
COGNITIVE PROBLEMS
⦿⦿⦾⦾⦾ (Low risk)
Science has not found a strong link between poor mental health and psychedelics use; on the contrary, psychedelics use has been found to correlate with better mental health outcomes in general [8–10]. However, one study did find that while use of LSD is not associated with any negative mental health outcomes, it is not associated with the same positive mental health outcomes as use of psilocybin or mescaline [10].
Some people may develop anxiety or delusions under the influence of LSD, particularly with high doses and in unfavorable environments. LSD can also trigger psychosis, but this is uncommon; in two studies of 5,000 and 4,300 people who had collectively taken LSD around 75,000 times in psychotherapy, the average risk of such outcomes was 1.25 per thousand [13]. This being said, people with family histories of psychosis or known vulnerabilities to drug-induced psychosis should still be cautious with LSD.
Some people may experience visual disturbances for some time after using psychedelics, reminiscent of the visual effects of the drug. This is known as hallucinogen persisting perception disorder, often abbreviated as HPPD. It is unclear the what extent this is caused by psychedelic use, as it is also seen with other drugs and in people with anxiety disorders. HPPD usually resolves on its own upon abstinence, but the drug lamotrigine seems to have been effective in treating some cases [11].
UNDESIRABLE EVENTS
⦿⦿⦾⦾⦾ (Low risk)
Psilocybe mushrooms may cause confusion or fear in the user, increasing the risk of accidents in situations where irrational behavior can be dangerous. However, serious accidents following psilocybe mushroom use are rare [7]. The risk of this occurring is greatest when consuming large doses and tripping without supervision. When picking psilocybe semilanceata in nature, there is some risk of picking a lookalike mushroom, some of which are quite poisonous. Therefore, if you plan on picking mushrooms yourself, you should first familiarize yourself thoroughly with the defining characteristics of psilocybe semilanceata and its typical habitat.
INTERACTIONS
⦿⦿⦾⦾⦾ (Low risk)
LSD should not be used by anyone currently taking lithium or tramadol, as this combination can trigger seizures [12]. LSD should also not be used with protease inhibitors like ritonavir or indinavir, as these are known to interact dangerously with the substance ergotamine, a chemical precursor to LSD.
It is not recommended to combine LSD with cannabis unless one is thoroughly familiar and experienced with each drug, as this combination can both significantly enhance the psychedelic effect and lead to confusion and anxiety [15]. Combining LSD with large amounts of alcohol is also not recommended, as this can make one more disoriented and lead to accidents and injuries.
SSRI-based antidepressants tend to block most of the effects of LSD.
These values are based on qualitative reviews of available knowledge, and should only be viewed as guidelines. They are also relative, so a score of "very low risk" does not mean the substance is risk-free. The scale assumes users are normal, healthy individuals; beware that even drugs which are well-tolerated by most people may nevertheless be harmful to some users. It also assumes normal use patterns; that is, if a given drug is only harmful when used in a certain way, yet is almost never used in that way, then the drug will be considered less harmful compared to a similar drug which is commonly used in a harmful way.
ACUTE LETHALITY
⦿⦾⦾⦾⦾ (Very low risk)
LSD is one of the least lethal drugs when measuring lethality relative to the effective dose. Recent literature estimates that up to 100 milligrams (mg) may be needed for death to occur in humans, which is a thousand times more than a typical recreational dose of 100 micrograms (µg) [1]. In one case, a woman in the US reportedly ingested approximately 55 mg (i.e. 550 recreational doses), resulting only in intermittent loss of consciousness and strong intoxication lasting for several days [2]. Two additional cases have been documented where five and eight people, respectively, ended up in the emergency room after snorting "lines" of pure LSD powder that they had mistaken for cocaine, amounting to several hundred times a typical recreational dose. In both cases, some of the patients of them had to be treated for overheating, rhabdomyolysis, failing respiration, and bleeding tendencies, and could have died without medical intervention; however, all thirteen survived, and were discharged after a short time without any lasting harm [3,4].
LONG-TERM TOXICITY
⦿⦾⦾⦾⦾ (Very low risk)
LSD is remarkably non-toxic to the body compared to most recreational drugs [1]. There is reason to believe that highly frequent LSD use could lead to heart valve fibrosis, as other substances with similar receptor activity are known to have this side effect – albeit only when used several times a week, so there is little reason for concern for people who only use LSD a few times per year [5]. Microdosing LSD several times a week, on the other hand, may be harmful.
DEPENDENCE
⦿⦾⦾⦾⦾ (Very low risk)
LSD is neither addictive nor habit-forming, and daily use is practically impossible due to users rapid building a near-total tolerance, making them essentially immune to the drug's effects for several days after ceasing their use [6,13]. LSD can also reduce cravings for other drugs, an effect with has previously been used to successfully treat alcoholism [7].
COGNITIVE PROBLEMS
⦿⦿⦾⦾⦾ (Low risk)
Science has not found a strong link between poor mental health and psychedelics use; on the contrary, psychedelics use has been found to correlate with better mental health outcomes in general [8–10]. However, one study did find that while use of LSD is not associated with any negative mental health outcomes, it is not associated with the same positive mental health outcomes as use of psilocybin or mescaline [10].
Some people may develop anxiety or delusions under the influence of LSD, particularly with high doses and in unfavorable environments. LSD can also trigger psychosis, but this is uncommon; in two studies of 5,000 and 4,300 people who had collectively taken LSD around 75,000 times in psychotherapy, the average risk of such outcomes was 1.25 per thousand [13]. This being said, people with family histories of psychosis or known vulnerabilities to drug-induced psychosis should still be cautious with LSD.
Some people may experience visual disturbances for some time after using psychedelics, reminiscent of the visual effects of the drug. This is known as hallucinogen persisting perception disorder, often abbreviated as HPPD. It is unclear the what extent this is caused by psychedelic use, as it is also seen with other drugs and in people with anxiety disorders. HPPD usually resolves on its own upon abstinence, but the drug lamotrigine seems to have been effective in treating some cases [11].
UNDESIRABLE EVENTS
⦿⦿⦾⦾⦾ (Low risk)
Psilocybe mushrooms may cause confusion or fear in the user, increasing the risk of accidents in situations where irrational behavior can be dangerous. However, serious accidents following psilocybe mushroom use are rare [7]. The risk of this occurring is greatest when consuming large doses and tripping without supervision. When picking psilocybe semilanceata in nature, there is some risk of picking a lookalike mushroom, some of which are quite poisonous. Therefore, if you plan on picking mushrooms yourself, you should first familiarize yourself thoroughly with the defining characteristics of psilocybe semilanceata and its typical habitat.
INTERACTIONS
⦿⦿⦾⦾⦾ (Low risk)
LSD should not be used by anyone currently taking lithium or tramadol, as this combination can trigger seizures [12]. LSD should also not be used with protease inhibitors like ritonavir or indinavir, as these are known to interact dangerously with the substance ergotamine, a chemical precursor to LSD.
It is not recommended to combine LSD with cannabis unless one is thoroughly familiar and experienced with each drug, as this combination can both significantly enhance the psychedelic effect and lead to confusion and anxiety [15]. Combining LSD with large amounts of alcohol is also not recommended, as this can make one more disoriented and lead to accidents and injuries.
SSRI-based antidepressants tend to block most of the effects of LSD.
Before taking any drug, it is important to confirm that the substance you have really is the drug you think you are taking. Professional chemical analysis is the only option that gives a more or less definitive answer, and we offer one such service in Oslo, although we can only accept samples in person. See how to book an appointment here.
If you do not have the option to have your sample analyzed in Oslo, there is a paid service in Spain called Energy Control which accepts drug samples from abroad by post, 100% anonymously.
Rapid reagent kits (test kits) are less reliable, but still very useful, and should always be used whenever a professional analysis is not possible. Test kits should be stored in a refrigerator and used within the expiration date, as expired tests can give misleading color reactions.
LSD produces the following color reactions:
If you do not have the option to have your sample analyzed in Oslo, there is a paid service in Spain called Energy Control which accepts drug samples from abroad by post, 100% anonymously.
Rapid reagent kits (test kits) are less reliable, but still very useful, and should always be used whenever a professional analysis is not possible. Test kits should be stored in a refrigerator and used within the expiration date, as expired tests can give misleading color reactions.
LSD produces the following color reactions:
- Ehrlich reagent: intensely purple
- Marquis reagent: colorless
DOSAGE
LSD is active in very small doses, with noticeable effects being felt already at 5–10 micrograms (µg), or millionths of a gram. A dose in this range is typically called a microdose, and these are used by some to promote positive mood, creativity, and concentration, as they are generally too small to produce a full "trip".
Slightly higher doses of 20–70 µg give a more stimulating high and a characteristically "psychedelic" flow of thoughts.
A full trip with powerful psychedelic effects is achieved at about 80–100 µg and higher, with a typical recreational dose being around 100–150 µg.
FORMAT
LSD is typically only available in one of two main forms: as either liquid drops from an eyedropper bottle, where one drop* normally equals one dose; or liquid drops pre-dosed onto a piece of paper (called a blotter), sugar cube, or piece of candy.
Occasionally, LSD may be found in tablet or pill form; in such cases, one should be cautious, as each pill may contain many other substances in addition to LSD. It is always recommended to use a rapid reagent test (test kit) before trying a newly acquired batch of LSD.
* This unusual format is due to LSD being active at such extremely small doses that the only practical way to measure out a dose is volumetrically, i.e. dissolving a known quantity of pure LSD in a known volume of water, and then dividing the solution up into drops of a known volume.
ROUTE OF ADMINISTRATION
LSD drops, blotters, candies, etc. are taken by mouth, where the LSD needs to be absorbed through the mucus membranes.
Contrary to popular belief, LSD drops can not be absorbed transdermally (through the skin). This persistent myth likely stems from people touching their eyes, nose, or mouth after handling LSD, thus transferring the drug onto the mucus membranes in those areas.
LSD is active in very small doses, with noticeable effects being felt already at 5–10 micrograms (µg), or millionths of a gram. A dose in this range is typically called a microdose, and these are used by some to promote positive mood, creativity, and concentration, as they are generally too small to produce a full "trip".
Slightly higher doses of 20–70 µg give a more stimulating high and a characteristically "psychedelic" flow of thoughts.
A full trip with powerful psychedelic effects is achieved at about 80–100 µg and higher, with a typical recreational dose being around 100–150 µg.
FORMAT
LSD is typically only available in one of two main forms: as either liquid drops from an eyedropper bottle, where one drop* normally equals one dose; or liquid drops pre-dosed onto a piece of paper (called a blotter), sugar cube, or piece of candy.
Occasionally, LSD may be found in tablet or pill form; in such cases, one should be cautious, as each pill may contain many other substances in addition to LSD. It is always recommended to use a rapid reagent test (test kit) before trying a newly acquired batch of LSD.
* This unusual format is due to LSD being active at such extremely small doses that the only practical way to measure out a dose is volumetrically, i.e. dissolving a known quantity of pure LSD in a known volume of water, and then dividing the solution up into drops of a known volume.
ROUTE OF ADMINISTRATION
LSD drops, blotters, candies, etc. are taken by mouth, where the LSD needs to be absorbed through the mucus membranes.
Contrary to popular belief, LSD drops can not be absorbed transdermally (through the skin). This persistent myth likely stems from people touching their eyes, nose, or mouth after handling LSD, thus transferring the drug onto the mucus membranes in those areas.
SMECHANISM OF ACTION
Like other classic psychedelics, LSD mimics the neurotransmitter serotonin in the brain and binds to serotonin receptors. The main psychoactive effect is due to activity at serotonin receptor subtype 2A, but activity at other receptor subtypes (including 2B and 2C) may also play a role. In addition to other classic psychedelics, LSD also mimics the neurotransmitter dopamine and acts at dopamine receptor subtype D4. Brain images under the influence of LSD show decreased activity in the thalamus and the default network and increased information flow between the different brain areas than usual. This pattern of brain activity has similarities to what is seen during deep meditation and dreaming.
DURATION
LSD has a very long duration of action and usually lasts 10-14 hours depending on the person and dose. The time until onset of effects depends on the dose, how much time has passed since the user's last meal and how the user is to the drug. Normally, some effect can be felt after 30-40 minutes, and full effects may take up to 2 hours. The effects are most intense for the first 3-4 hours. Many users find it necessary to be in a safe environment during this time, as it is common to experience temporary anxiety or confusion. Since it is usually impossible to fall asleep while the drug is active, one should not take LSD if intending to sleep within 12 hours, and it may be beneficial to take the drug early in the day. Avoid taking LSD if you are significantly sleep deprived, as this increases the risk of an unpleasant experience.
SUBJECTIVE EFFECTS
LSD is known for its hallucinogenic effects. However, it is not common to see things with open eyes that have no basis in reality. To the extent that this may occur, it will usually be at very high doses or under special lighting conditions. The user is also normally able to distinguish between hallucinations and real events, but delusions may occur at high doses. The most common thing is to see variations on the shapes of real objects, or colorful "light shows" and dream sequences with closed eyes. One may also experience changes in depth perception, and light can be perceived more clearly or strongly than usual. The user's sense of hearing is also affected by psychedelics. Many fell that their sense of hearing is heightened, and LSD has a strong synesthetic effect, meaning that different sensory modalities may mix with each other. Sounds may therefore affect what the user sees, especially with closed eyes, or it can feel as if sounds "move" the user's body physically. This makes LSD popular for listening to music or dancing, and research has shown that LSD enhances the listener's emotional reaction to a piece of music. LSD also affects the user's sense of touch, making it difficult to know exactly where the body ends and where the surroundings begin. The user also becomes less sensitive to ambient temperatures, so it is important not to wear too much or too little clothing relative to the surrounding environment or physical activity level. Particular care should be taken if outdoors in cold weather, as LSD may almost remove the ability to feel cold in some individuals. LSD affects the user's thoughts on a fundamental level. The psychedelic effects distort one's sense of time profoundly, and especially during the beginning of the experience, a few minutes may feel like several hours. The user's first-person perspective may also be compromised, and high doses can result in so-called "ego death" – an experience that may feel deeply spiritually significant, but also very frightening. In moderate doses, LSD promotes free associations of thought that can be conducive to creativity, humor, and meditative states. It can be difficult to find the right words and idioms when speaking under the influence of LSD, and users can find themselves speaking almost in metaphors at times.
Unpleasant experiences ("bad trips")
The freely associating state of mind that LSD produces can lead to unwanted thoughts becoming intrusive and steering the trip in the wrong direction. The user needs to either learn how to control this or accept any thought and let it run its course. Set and setting (mood, place, music, and who one is with) are key in maximizing the likelihood a pleasant experience. The most important factor, however, is taking a sensible dose.
Additionally, certain personality types are likely be more prone to unpleasant experiences. Individuals struggling with anxiety and intrusive thoughts should either avoid psychedelics entirely or proceed with great caution using moderate doses. Some women find that their menstrual cycle can affect the risk of having an unpleasant experience on psychedelics.
If an LSD experience becomes unpleasant, it usually helps to change the setting by moving to another location or changing the music, or to allow oneself to be distracted in some way. If this does not help, it is better to "let go" and let the thoughts run their course than to try to resist. In such cases, it can be useful to have a quiet place to lie down and rest until it gets better, and to have someone nearby looking out. This person should remind you that it will pass, that it will be alright, and that you are safe, but not to nag too much, as communication can be stressful.
Profound or deeply meaningful experiences
Being of the strongest psychedelic substances, LSD can cause impressions that require some processing afterwards. The intoxication challenges the user's perception of reality, and can often provoke contemplation of large, existential questions. One can also be confronted with unpleasant aspects of oneself and one's life, as much subconscious psychological material comes to the surface during the intoxication. This can be rewarding in the long run, but is not necessarily problem-free. It is not entirely uncommon for people to change their behavior or make major changes in their lives after a strong psychedelic experience, and research shows that one-time use of psychedelics can lead to lasting changes in the domain of openness, i.e. receptivity to new ideas and perspectives. This effect is particularly noticeable in some period immediately after the first experience, and one should be cautious when making decisions of great importance in this period. Most users experience powerful psychedelic experiences as positive in hindsight, even those that are very demanding or unpleasant while they are occurring. It is nevertheless recommended that one approach psychedelics prepared and with great respect, and have someone to talk to about one's experiences.
Like other classic psychedelics, LSD mimics the neurotransmitter serotonin in the brain and binds to serotonin receptors. The main psychoactive effect is due to activity at serotonin receptor subtype 2A, but activity at other receptor subtypes (including 2B and 2C) may also play a role. In addition to other classic psychedelics, LSD also mimics the neurotransmitter dopamine and acts at dopamine receptor subtype D4. Brain images under the influence of LSD show decreased activity in the thalamus and the default network and increased information flow between the different brain areas than usual. This pattern of brain activity has similarities to what is seen during deep meditation and dreaming.
DURATION
LSD has a very long duration of action and usually lasts 10-14 hours depending on the person and dose. The time until onset of effects depends on the dose, how much time has passed since the user's last meal and how the user is to the drug. Normally, some effect can be felt after 30-40 minutes, and full effects may take up to 2 hours. The effects are most intense for the first 3-4 hours. Many users find it necessary to be in a safe environment during this time, as it is common to experience temporary anxiety or confusion. Since it is usually impossible to fall asleep while the drug is active, one should not take LSD if intending to sleep within 12 hours, and it may be beneficial to take the drug early in the day. Avoid taking LSD if you are significantly sleep deprived, as this increases the risk of an unpleasant experience.
SUBJECTIVE EFFECTS
LSD is known for its hallucinogenic effects. However, it is not common to see things with open eyes that have no basis in reality. To the extent that this may occur, it will usually be at very high doses or under special lighting conditions. The user is also normally able to distinguish between hallucinations and real events, but delusions may occur at high doses. The most common thing is to see variations on the shapes of real objects, or colorful "light shows" and dream sequences with closed eyes. One may also experience changes in depth perception, and light can be perceived more clearly or strongly than usual. The user's sense of hearing is also affected by psychedelics. Many fell that their sense of hearing is heightened, and LSD has a strong synesthetic effect, meaning that different sensory modalities may mix with each other. Sounds may therefore affect what the user sees, especially with closed eyes, or it can feel as if sounds "move" the user's body physically. This makes LSD popular for listening to music or dancing, and research has shown that LSD enhances the listener's emotional reaction to a piece of music. LSD also affects the user's sense of touch, making it difficult to know exactly where the body ends and where the surroundings begin. The user also becomes less sensitive to ambient temperatures, so it is important not to wear too much or too little clothing relative to the surrounding environment or physical activity level. Particular care should be taken if outdoors in cold weather, as LSD may almost remove the ability to feel cold in some individuals. LSD affects the user's thoughts on a fundamental level. The psychedelic effects distort one's sense of time profoundly, and especially during the beginning of the experience, a few minutes may feel like several hours. The user's first-person perspective may also be compromised, and high doses can result in so-called "ego death" – an experience that may feel deeply spiritually significant, but also very frightening. In moderate doses, LSD promotes free associations of thought that can be conducive to creativity, humor, and meditative states. It can be difficult to find the right words and idioms when speaking under the influence of LSD, and users can find themselves speaking almost in metaphors at times.
Unpleasant experiences ("bad trips")
The freely associating state of mind that LSD produces can lead to unwanted thoughts becoming intrusive and steering the trip in the wrong direction. The user needs to either learn how to control this or accept any thought and let it run its course. Set and setting (mood, place, music, and who one is with) are key in maximizing the likelihood a pleasant experience. The most important factor, however, is taking a sensible dose.
Additionally, certain personality types are likely be more prone to unpleasant experiences. Individuals struggling with anxiety and intrusive thoughts should either avoid psychedelics entirely or proceed with great caution using moderate doses. Some women find that their menstrual cycle can affect the risk of having an unpleasant experience on psychedelics.
If an LSD experience becomes unpleasant, it usually helps to change the setting by moving to another location or changing the music, or to allow oneself to be distracted in some way. If this does not help, it is better to "let go" and let the thoughts run their course than to try to resist. In such cases, it can be useful to have a quiet place to lie down and rest until it gets better, and to have someone nearby looking out. This person should remind you that it will pass, that it will be alright, and that you are safe, but not to nag too much, as communication can be stressful.
Profound or deeply meaningful experiences
Being of the strongest psychedelic substances, LSD can cause impressions that require some processing afterwards. The intoxication challenges the user's perception of reality, and can often provoke contemplation of large, existential questions. One can also be confronted with unpleasant aspects of oneself and one's life, as much subconscious psychological material comes to the surface during the intoxication. This can be rewarding in the long run, but is not necessarily problem-free. It is not entirely uncommon for people to change their behavior or make major changes in their lives after a strong psychedelic experience, and research shows that one-time use of psychedelics can lead to lasting changes in the domain of openness, i.e. receptivity to new ideas and perspectives. This effect is particularly noticeable in some period immediately after the first experience, and one should be cautious when making decisions of great importance in this period. Most users experience powerful psychedelic experiences as positive in hindsight, even those that are very demanding or unpleasant while they are occurring. It is nevertheless recommended that one approach psychedelics prepared and with great respect, and have someone to talk to about one's experiences.
LSD is listed as an illicit drug in Norway (narkotikalisten, narkotikaforskriften, legemiddelloven §22). This means it is punishable by law to use, possess, sell, manufacture, import, acquire, store, or ship LSD without a special license for medical or scientific research purposes (legemiddelloven §31, §24; straffeloven §231).
1. Nichols & Grob, Is LSD toxic? Forensic Science International, 2018.
2. Haden & Woods, LSD Overdoses: Three Case Reports. Journal of Studies on Alcohol and Drugs, 2020.
3. Roberts et al., A cluster of lysergic acid diethylamide (LSD) poisonings following insufflation of a white powder sold as cocaine. Clinical Toxicology, 2021.
4.Klock et al., Coma, Hyperthermia and Bleeding Associated with Massive LSD Overdose. The Western Journal of Medicine, 1974.
5. Hutcheson et al,. Serotonin receptors and heart valve disease—It was meant 2B. Pharmacology & Therapeutics, 2011.
6. Nichols D., Dark Classics in Chemical Neuroscience: Lysergic Acid Diethylamide (LSD). ACS Chemical Neuroscience, 2018.
7. Krebs & Johansen, Lysergic Acid Diethylamide (LSD) for Alcoholism: Meta-Analysis of Randomized Controlled Trials. Journal of Psychopharmacology, 2012.
8. Krebs & Johansen, Psychedelics and Mental Health: A Population Study. PLOS One, 2013.
9. Hendricks et al., Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population. Journal of Psychopharmacology, 2015.
10. Jones & Nock, MDMA/ecstasy use and psilocybin use are associated with lowered odds of psychological distress and suicidal thoughts in a sample of US adults. Journal of Psychopharmacology, 2022.
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12. Nayak et al., Classic Psychedelic Coadministration with Lithium, but Not Lamotrigine, is Associated with Seizures: An Analysis of Online Psychedelic Experience Reports. Pharmacopsychiatry, 2021
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