Using data from the world’s largest survey on substance use, researchers examined adverse experiences leading to emergency medical presentations following the use of LSD including factors contributing to the risk of such events and the nature of the events themselves. Drawing trends and patterns from 10,293 anonymous participant responses, researchers published findings noting an overall rarity of incidents in which participants sought emergency medical treatment (EMT) over the approximate one year period preceding the survey (with 1% of survey respondents seeking EMT due to adverse LSD-related outcomes). Authors of the study suggested that incidents resulting in EMT may be prevented with establishment of public policy measures geared toward harm reduction rather than criminalization of recreational LSD users.
The research, summarized:
- Adverse reactions from LSD were typically short-lived, self-limiting, and psychological, with the most common symptoms including anxiety, panic, and confusion.
- Participants of younger age sought EMT with higher frequency than older participants, though this was not due to younger participants having less experience with using LSD.
- Survey respondents indicated that adverse events typically arose from surrounding factors bearing influence on the LSD experience though unrelated to dosage or composition of the drug itself such as poor setting, individual mental health history, and personal mindset during the time of LSD use
- Following thorough analysis of survey answers, authors suggested that LSD is a relatively safe drug when used in recreational settings. Patient screening, preparation, and supervision should follow LSD given to patients in clinical settings to reduce and mitigate the occurrence of unsettling adverse events that may arise shortly after administration.
The therapeutic potential of LSD has been interrogated within clinical settings for conditions including anxiety, depression, and addiction. As more clinical attention is drawn towards eliciting the merits of LSD, prospects for its medicinal utility have burgeoned amongst researchers, healthcare professionals, and the general public alike. Drawing to the growing popularity of the chemical zeitgeist, researchers sought to explore the incidence of negative experiences following LSD use in work recently featured in the Journal of Psychopharmacology (British Association for Psychopharmacology, Oxford, England).
The 2017 Global Drug Survey was used to investigate the 12-month incidence and nature of adverse experiences related to LSD use. Most EMT seekers reported feeling back to normal within 24 hours following an adverse event, with 11 participants of 10,293 (0.1%) reporting a persistence of symptoms for over four weeks following the inciting event.
A significantly lower median age was noted amongst EMT seekers (21) compared to non-seekers. EMT seeking was also significantly more prevalent amongst those with a lifetime diagnosis of mental health conditions than those without. No significant differences were noted in EMT seeking between men and women or those who had used LSD for the first time in the year preceding the survey compared to those who had previous experience. Interestingly, although there was no difference in the number of daily LSD doses used by both EMT seekers and non-seekers, EMT seekers reported a significantly higher frequency of use than non-seekers.
The most common explanations offered by respondents who pursued EMT cited poor setting, poor mindset, taking too large of a dose, and taking LSD in conjunction with other drugs as causes for psychological symptoms such as anxiety, panic, and confusion driving the need for medical attention. LSD doses taken by EMT-seeking survey participants were noted to typically be higher than their normal (relative) dose of consumption. Additionally, survey respondents had also consumed cannabis in half of such incidences, with the co-consumption of alcohol and LSD accounting for a quarter. The two most reported reasons, poor setting and mindset, commonly occurred together. Slightly over half of EMT seekers reported being admitted to a hospital.
When taken at standard dosages often seen given to patients during the course of experimental clinical trials (50-200µg), LSD is non-toxic and physiologically safe from a physiological standpoint.
Authors of the study identified only two cases in which LSD overdose was directly linked to user death. As the lethal dose of LSD is estimated as approximately 100 times that or more than the typical recreational dose (ranging between 50 and 400µg), such circumstances are suggested to arise only after massive ingestion. Other reported cases of death following LSD consumption have resulted from external influences such as excessive police restraint or the use of other substances in conjunction with LSD. Some reports have implicated LSD as directly responsible for cause of death in instances of suicide (for one case in which LSD and cannabis were consumed prior to death and another where post-mortem chemical examination found LSD in the body of an individual who had either jumped or fell from a window).
Though modern experimental studies exploring the clinical applications of LSD report largely positive outcomes and relatively few adverse reactions, creating a profile of possible contextual influencers, personal characteristics, and mindsets that may influence the occurrence of an adverse event is vital for both determining the nature of a psychedelic experience and for mitigating any potential drawbacks of that experience in both clinical and recreational settings. As reports have indicated a growing number of people who have self-medicated with psychedelics without doctor supervision in non-clinical contexts, the presented findings of this study are important for deriving structured and targeted methods for harm reduction, particularly in those who are most vulnerable.
