Hallucinogens

Question 1

What is another term used to describe hallucinogens?

Answer 1

Psychedelics

Question 2

Define hallucinogens

Answer 2

Change the way people see, hear, taste, smell or feel, and affect mood and thought

Question 3

What are the two main categories of hallucinogens?

Answer 3

Psychedelics and dissociatives

Question 4

What are reported effects of hallucinogens?

Answer 4

Auditory, visual and sensory hallucinations
Distorted perceptions
Difficulty distinguishing between reality and illusion
Paranoia
Psychosis

Question 5

What are traditional hallucinogens?

Answer 5

Plant compounds that have been used for hundreds-thousands of years in spiritual ceremonies

Question 6

How do traditional hallucinogens act?

Answer 6

Via 5-HT (serotonin) receptors

Question 7

What is mescaline?

Answer 7

Found in several cactus species (e.g., peyote cactus), native to southwestern US and Mexico
Used for thousands of years in religious ceremonies

Question 8

What receptors does mescaline have affinity for?

Answer 8

High - 5-HT2A
Some - 5-HT2B

Question 9

Describe the structure of mescaline.

Answer 9

Substituted phenethylamine

Question 10

What does the amanita muscaria mushroom contain?

Answer 10

ibotenic acid and muscimol

Question 11

Describe the interactions that are thought to cause the psychoactive effects of amanita muscaria

Answer 11

Muscimol is a potent GABA A agonist
Ibotenic acid is an NMDA glutamate receptor agonist

Question 12

What are magic mushrooms?

Answer 12

Mushrooms that contain alkaloids with hallucinogenic properties

Question 13

What is the pharmacologically significant ingredient in magic mushrooms?

Answer 13

Psilocybin

Question 14

What is psilocybin?

Answer 14

A pro-drug that is dephosphorylated by alkaline phosphatase to psilocin

Question 15

Describe how psilocybin works in the body.

Answer 15

Partial agonist for 5-HT2B and 5-HT2C
Slightly lower affinity for 5-HT2A
Some effects on dopamine but no direct action

Question 16

Describe the case of R v Chan

Answer 16

Took magic mushrooms
Attacked and killed father with knife
Defence of automatism and underlying brain injury

Question 17

How was LSD discovered?

Answer 17

By Albert Hoffmann, research chemist experimenting with alkaloids of ergot (rye fungus)

Question 18

Compare LSD and mescaline

Answer 18

Similar early descriptions
LSD 5,000 - 10,000 times stronger

Question 19

How is LSD absorbed?

Answer 19

Easily absorbed via oral admin

Question 20

Describe how LSD works in the body.

Answer 20

Acts on 5-HT2A receptors in the brain
Has some effects on the dopamine D2 receptor

Question 21

What is the potency of LSD?

Answer 21

1 dose is 20-80 ug.

Question 22

Describe LSD blotters

Answer 22

LSD dissolved in water, single-dose drops applied to a sheet of paper (blotter) and dried
Paper divided into tabs
Each sheet typically contains 100 doses

Question 23

What are potential effects of LSD?

Answer 23

Vivid visual hallucinations
Slowing of the subjective sense of time
Feelings of depersonalization
Strong emotional reactions
Disruption of logical thought
Synesthesia

Question 24

What is synesthesia?

Answer 24

Crossing-over of sensations in which, for example, colours are heard and sounds are felt

Question 25

Differentiate between good and bad LSD trips

Answer 25

Good - mystical, spiritually enlightening Bad - disturbing, frightening

Question 26

What does a good or bad trip depend on?

Answer 26

Dose Individual Environment

Question 27

What are substituted phenylethylamines?

Answer 27

Chemical class of organic compounds based upon the phenethylamine structure. Many are psychoactivr

Question 28

Describe the structure of phenethylamine hallucinogens.

Answer 28

Catecholamine-like

Question 29

Describe the structure of mescaline

Answer 29

Similar to NE and amphetamine

Question 30

What receptors do phenylethylamines bind to?

Answer 30

Some 5-HT receptors

Question 31

What are flashbacks?

Answer 31

Re-experiencing one or more perceptual effects after the drug has worn off - months or years later

Question 32

What is HPPD?

Answer 32

Hallucinogenic persisting perception disorder Is listed in DSM-V

Question 33

What is the most severe adverse effect of hallucinogens?

Answer 33

Psychotic reaction

Question 34

Who is generally affected by prolonged psychotic episodes?

Answer 34

Those who have already been diagnosed with a psychotic disorder or who had a preexisting risk for developing psychosis

Question 35

Describe the case of the Oak Ridge facility.

Answer 35

Experimental forms of therapy Gave high doses of hallucinogens and mind-altering drugs, including LSD Some groups of naked men locked in rooms for up to 11 days

Question 36

What are some potential therapeutic treatments using hallucinogens?

Answer 36

OCD PTSD Alcoholism Depression Anxiety

Question 37

What are dissociative anesthetics?

Answer 37

Subcategory of hallucinogenic drugs Don't have the same mechanism of action as many classic hallucinogens

Question 38

Give examples of dissociative anesthetics

Answer 38

Ketamine Phencyclidine (PCP) Dextromethorphan

Question 39

Describe the first usage of dissociative anesthetics

Answer 39

First developed as a safer alternative to typical general anesthesia Not associated with respiratory depression PCP had unacceptable side effects so did not enter routine clinical use Ketamine developed - still had some side effects but less severe

Question 40

What can dissociative anesthetics often produce?

Answer 40

Visual and auditory distortions and a sense of floating and dissociation

Question 41

Describe effects of dissociative anesthetics in low/moderate doses.

Answer 41

Numbness Disorientation Changes in sensory perceptions Hallucinations Feelings of detachment from self Dizziness

Question 42

Describe effects of dissociative anesthetics at high doses.

Answer 42

Hallucinations Memory loss Extreme panic, fear, anxiety Paranoia Aggression

Question 43

How do dissociative anesthetics work?

Answer 43

NMDA receptor agonists NMDA receptor is an important inotropic receptor for glutamate Ionotropic receptors directly open ion channels that enable specific ions to stream in and out of the cell, leading to firing of the neuron Non-competitive atagonists

Question 44

What is a non-competitive antagonist?

Answer 44

Bind to different part of receptor but still stops the binding of neurotransmitters

Question 45

What are possible routes of administration for PCP?

Answer 45

Oral Intranasal IV Smoked (sometimes in regular cigs)

Question 46

What is the half-life of PCP?

Answer 46

7 - 46 hours

Question 47

What is important to keep in mind about drug-related media reports?

Answer 47

Drug use is often based on anecdotal evidence It is unusual for an accused individual to have drug testing done shortly after the crime Analysis of drugs found at scene is not always one Are illicit drugs reliable?

Question 48

Why/how is ketamine important?

Answer 48

Used in hospitals during surgery and during emergency treatment On the WHO list of essential medicine Low toxicity

Question 49

What are some therapeutic uses of ketamine?

Answer 49

Anesthesia in children Asthmatics or people with chronic obstructive airway disease Surgery in field conditions/war zones Widely used in animal surgery

Question 50

How is ketamine classified?

Answer 50

Club drug

Question 51

What is another name for ketamine?

Answer 51

K-hole

Question 52

What are possible administration routes for ketamine?

Answer 52

Oral Intranasal IM

Question 53

What is the half-life of ketamine?

Answer 53

2 hours

Question 54

What are some subjective experiences reported by ketamine users?

Answer 54

Light sensations coming through the body Bizarre distortions of body shape and time Sensations of floating or hovering weightlessly in space Feeling of leaving one's body Complete loss of time sense

Question 55

What is dextromethorphan?

Answer 55

OTC cough medication

Question 56

What do therapeutic doses of dextromethorphan act as?

Answer 56

Antitussive agent

Question 57

What happens to dextromethorphan at higher doses?

Answer 57

Metabolized to dextrophan

Question 58

What kind of agonist is dextromethorphan?

Answer 58

NMDA receptor agonist

Question 59

What is the half-life of dextromethorphan?

Answer 59

3 hours but up to 40 in slow metabolizers

Question 60

Why is dextromethorphan abused so widely?

Answer 60

Wide availability

Question 61

What is the standard dose of dextromethorphan for cough suppression?

Answer 61

20 mg

Question 62

What are recreational doses of dextromethorphan?

Answer 62

Can be 1000 mg (up to 2 bottles)

Question 63

Describe the case of R. v. Doodnaught.

Answer 63

Anesthesiologist Found guilty of SAing 21 women under surgery from 2006-2010 One of first complainants was told by head anesthesiologist that it couldn't have happened and she hallucinated the whole experience