Announcement: New office hours

Starting March 6, 2017 Nationwide Medical Review will observe new office hours:

Monday through Friday:  8am – 7pm EST

Saturday:  9am – 12pm EST

Drug Overview


Important information regarding HALLUCINOGENS drug use.

Marijuana, PCP, and the “designer drugs” are often categorized as “hallucinogens” and are all discussed in separate sections of this work. Marijuana and PCP are in the current testing system. The other commonly abused hallucinations are Mushrooms, LSD, and Peyote. Although PCP is probably much less often abused, it is the ONLY “true hallucinogen” in the federally mandated testing program… probably because it is easy and cheap to test for.

Peyote is a small, spineless cactus, Lophophora williamsii, whose principal active ingredient is the hallucinogen mescaline. From earliest recorded time, peyote has been used by natives in northern Mexico and the southwestern United States as a part of traditional religious rites.

The top of the cactus above ground–also referred to as the crown–consists of disc-shaped buttons that are cut from the roots and dried. These buttons are generally chewed or soaked in water to produce an intoxicating liquid. The hallucinogenic dose for mescaline is about 0.3 to 0.5 grams (equivalent to about 5 grams of dried peyote) and lasts about 12 hours. While peyote produced rich visual hallucinations which were important to the native peyote cults, the full spectrum of effects served as a chemically induced model of mental illness. Mescaline can be extracted from peyote or produced synthetically.

DIMETHYLTRYPTAMINE [DMT] Dimethyltryptamine (DMT) has a long history of use worldwide as it is found in a variety of plants and seeds, and can also be produced synthetically. It is ineffective when taken orally unless combined with another drug that inhibits its metabolism. Generally it is sniffed, smoked or injected. The effective hallucinogenic dose in humans is about 50 to 100 milligrams and lasts for about 45 to 60 minutes. Because the effects last only about an hour, the experience was called a “businessman’s trip.”

A number of other hallucinogens have very similar structures and properties to those of DMT, Diethyltryptamine (DET), for example, is an analogue of DMT and produces the same pharmacological effects but is somewhat less potent than DMT. Alpha-ethyltryptamine (AET) is another tryptamine hallucinogen recently added to the list of Schedule I substances in the CSA.

Lysergic acid diethylamide (LSD) is the most potent and highly studied hallucinogen known to man. It was originally synthesized in 1938 by Dr. Albert Hoffman, but its hallucinogenic effects were unknown until 1943 when Hoffman accidently consumed some LSD. It was later found that an oral dose of as little as 0.025 mg (or 25 micrograms, equal to a few grains of salt) was capable of producing rich and vivid hallucinations.

Because of its structural similarity to a chemical present in the brain and its similarity in effects to certain aspects of psychosis, LSD was used as a research tool to study mental illness. Although there was a decline in its illicit use from its initial popularity in the 1960s, LSD is making a comeback in the 1990s. The average effective oral dose is from 20 to 80 micrograms with the effects of higher doses lasting for 10 to 12 hours. LSD is usually sold in the form of impregnated paper (blotter acid), tablets (microdots), or thin squares of gelatin (window panes).

Physical reactions may include dilated pupils, lowered body temperature, nausea, “goose bumps,” profuse perspiration, increased blood sugar and rapid heart rate. During the first hour after ingestion, the user may experience visual changes with extreme changes in mood. In the hallucinatory state, the user may suffer impaired depth and time perception, accompanied by distorted perception of the size and shape of objects, movements, color, sound, touch and the user’s own body image. During this period, the user’s ability to perceive objects through the senses is distorted. He may describe “hearing colors” and “seeing sounds.” The ability to make sensible judgements and see common dangers is impaired, making the user susceptible to personal injury. He may also injure others by attempting to drive a car or by operating machinery.

Afte an LSD “trip,” the user may suffer acute anxiety or depression for a variable period of time. Flashbacks have been reported days or even months after taking the last dose.


Psilocybin and psilocyn are both chemicals obtained from certain mushrooms found in Mexico and Central America. Like peyote, the mushrooms have been used in native rites for centuries. Dried mushrooms contain about 0.2 to 0.4 percent psilocybin and only trace amounts of psilocyn. The hallucinogenic dose of both substances is about 4 to 8 milligrams or about 2 grams of mushrooms with effects lasting for about six hours. Both psilocybin and psilocyn can be produced synthetically.

[Abstracted from D.E.A. website q.v.]

LSD is shown above in it’s most common street forms: a blotter (l), sugar cubes, and pills”Use of this drug is growing rapidly and the purity is much higher today than in past decades. LSD does not produce compulsive drug seeking behavior like cocaine or alcohol. LSD produces tolerance (tachyphylaxis) so that users who take the drug repeatedly must take progressively higher doses to achieve a given state of intoxication. This is an extremely dangerous practice, given the unpredictability of the drug….. and can result in increased risk of convulsions, coma, heart failure and even death!

The drugs can produce unpredictable erratic and violent types of behavior in users. Drownings, burns, falls, and crashes have been reported. In 1991, over 800 hospital emergency room visits and approximately 110 deaths were associated with the use of hallucinogen.

Drug Effects

Methods of Abuse and Effects
The effects of hallucinogens are unpredictable. They depend on the amount taken, the user’s personality, mood and expectations and the surroundings in which the drug is used. Experienced users all report that dose is critical! Abusers report very pleasant effects (increased and pleasurably distorted perception) at low doses but very unpleasant effects at higher doses! Usually, the user feels the first effects of the drug 30-90 minutes after taking it. These effects include dilated pupils, higher body temperature, increased heart rate and blood pressure, sweating, loss of appetite, sleeplessness, dry mouth and tremors. The user may feel several emotions at once or swing rapidly from one emotion to another.

Depending on the dose, the drug can produce delusions and visual hallucinations which can be frightening and cause panic! Users refer to these acute adverse reactions as a “bad trip,” and the effects typically last for about twelve hours.

The most commonly used hallucinogen is LSD. The most common medium is that of “blotters.” Liquid LSD is absorbed into a large (usually decorated) blotter which allows buyers to purchase doses of the drug by purchasing small squares of the blotter. Other forms of impregnable paper is also used. Several doses of LSD can be easily concealed in a small piece of paper.

Incidence of Abuse
Expect to see Mushroom & LSD abuse in middle & high schools! Mushrooms (Psilocybin) Very commonly abused, and grown, by young abusers.
L.S.D.: Very commonly sold & abused. Testing rare because of expense and unreliability.
PEYOTE & MESCALINE: somewhat less frequent because not synthesized & difficult to procure.
Chemical Name
See Discussion above
Forms and Street Names
Psilocybin = “Mushrooms,” LSD = Lysergic Acid Diethylamide, Peyote, and mescaline. Mushrooms are referred to as “‘shrooms.” Almost all abuse is oral