LSD

Introduction

Few substances in the history of chemistry are as notorious as lysergic acid diethylamide (LSD).

Known for its ability to profoundly alter one’s perception of reality, it has been called everything from a miracle drug to Richard Nixon’s declaration that LSD guru, Timothy Leary, was “the most dangerous man in America.” Some of the most renowned artists and thinkers of the past century have ascribed their inspiration to it. In the early days of its discovery, therapists embraced it as a near-miracle for mental health problems. Through it all, detractors have warned that it could destroy society as we know it. Suffice it to say, it has quite a reputation.⁽¹⁾

Though it’s been largely characterized by its association with the counterculture movement of the 1960s, before its prohibition, LSD enjoyed over two decades of avid research among psychiatrists who considered it a game changer. However, much of that research was lost when the work was halted following the prohibitory measures associated with the War on Drugs, which began in June of 1971. It has only recently begun to reemerge as a potential tool in the mental health space, as proponents have successfully captured the attention of the public with impressive evidence of its therapeutic potential.⁽²⁾

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The History of LSD

While researching lysergic acid derivatives, the Swiss chemist Albert Hofmann first synthesized lysergic acid diethylamide (LSD) on November 16, 1938. His main intention for the synthesis was to discover a respiratory and circulatory stimulant, otherwise known as an analeptic. He set aside LSD for five years until April 16, 1943, when he decided to take a second look at it. While re-synthesizing LSD, he accidentally absorbed some of the compound and discovered its powerful psychedelic effects.

On April 19, 1943, Hofmann purposely ingested 0.25 milligrams (250 micrograms) of LSD, which resulted in intense perceptual changes. He journeyed home by bicycle and would recount this initial experience with LSD many times, describing it as both beatific and hellish. In honor of the significance of his discovery, this day has been commemorated by LSD enthusiasts as “Bicycle Day.” 

LSD saw several decades of interest and a flurry of research within the psychiatric community before the compound became embroiled in the political machinations of the Nixon administration’s War on Drugs. 

Most research on LSD halted in 1965 when Sandoz Laboratories stopped producing the drug owing to increased concern about its use in the general public. LSD use was associated with anti-war activism during the Vietnam War, which many believe helped to drive efforts to criminalize the substance. Much of the “moral panic” surrounding LSD was also largely due to sensationalized media reporting and resulting stigma. 

The federal government officially banned LSD in 1967. It would be another 40 years until the next scientific study on LSD-assisted psychotherapy would appear.

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What is LSD, and Why is it Remarkable?

LSD is a powerful classical psychedelic compound that acts primarily on the brain’s serotonin system. Given its potency, LSD is always dosed in micrograms and offers a fairly long-lasting experience (around 12-18 hours). As mentioned, historically, it has been associated with the “flower power” movement of the 1960s. However, researchers in the 1950s through the early 1960s explored the compound as a tool to help treat mental health conditions such as depressive disorders, neurosis, and obsessive disorders. Over 1,000 scientific papers on LSD and other psychedelics were published in the 1950s and 1960s, and LSD was prescribed as a treatment to over 40,000 patients during that time.^{(3, 4)}

Researchers such as Dr. Humphry Osmond (who notably provided mescaline to Aldous Huxley) gave LSD to alcoholics in Alcoholics Anonymous (AA) who had failed to quit drinking. Osmond and his colleague Dr. Abram Hoffer reported that 40% to 45% of the alcoholics treated with LSD had not returned to drinking after a year. Osmond believed that psychedelics produced a terrifying artificial delirium that might frighten an alcoholic into change, though subsequent researchers have rejected this theory.⁽⁵⁾

Throughout the 1950s and 1960s, research was conducted to investigate LSD’s potential to treat mental health conditions. In 1961, a study conducted by Stanley Yolles found that 69% of participants reported improvement in their depression symptoms after taking LSD. Similarly, research conducted by the Czech psychiatrist Stanislav Grof in the 1960s demonstrated that LSD could reduce the frequency and intensity of symptoms experienced by schizophrenic patients. However, modern conventions do not recommend that individuals with schizophrenia or other schizoid disorders use LSD.⁽⁶⁾

Psychedelic-peak therapy involved higher doses, as this was believed to help patients by providing a mystical experience (also known as a “peak” or “transcendent” experience), which may produce a sense of unity with the environment. The aim was to catalyze rapid and fundamental changes in the value system and self-image of the subject.^{(7, 8)}

Stanislav Grof believed that LSD helped his patients resolve difficult early fetal and neonatal experiences. He built on Otto Rank’s theory of birth trauma, which is the idea that the trauma experienced at birth is key to understanding anxiety and neuroses later in life.^{(9, 10)}

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The LSD Experience

LSD induces a classical psychedelic experience. This means that after taking LSD, you may experience open or closed-eyed visual effects, such as color enhancement, objects morphing and “breathing,” the appearance of geometric patterns, and auditory or time distortions. Positive feelings like euphoria and an enhanced sense of connection are also common.^{(11, 12, 13)}

The LSD experience differs from that of other classical psychedelics, such as psilocybin, in some important ways. One key factor is that it is known to be more physically energizing and stimulating. Meaning, you’ll likely have a stronger desire to move around. The visuals may also be different and appear more “electric,” bright, sharp, and angular.

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What We Know About LSD-Assisted Psychotherapy

Historically, LSD has been used for alcoholism, end-of-life anxiety, and anxiety disorders featuring depressive symptoms.^{(14, 15, 16)}

Researchers have proposed different theories about the LSD experience and how it can help alleviate emotional distress. There has often been a focus on psychedelics’ influence on our relationship to our emotions. Researchers in the ‘50s and ‘60s believed that LSD might benefit various conditions by altering the sense of self, shifting people away from limiting and negative beliefs about themselves, and towards more positive ones.^{(17, 18)}

As is theorized with other psychedelics, LSD may also benefit patients with various mental health problems by promoting neuroplasticity (broadly speaking, the brain’s ability to change and grow), which has been observed in animal models.^{(19, 20)}

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The Risks and Side Effects of LSD

As mentioned, LSD, perhaps more than any other psychedelic, is often associated with much of the propaganda propagated by the War on Drugs, which perpetuated fears that if you take it, you risk “losing your mind” and never returning. Anti-drug campaigns that focused on telling people that LSD ruined people’s mental health can be traced to the 1960s and 1970s.

The history of LSD is complex. In some cases, recreational users took high doses of the drug (250 micrograms and above) without preparation and in less-than-ideal settings, resulting in isolated instances of psychiatric hospitalization. Marketing campaigns and news stories that included overblown scare tactics contributed to this negative impression of LSD.⁽²⁸⁾

The Nixon administration quickly capitalized on this hysteria in order to marginalize individuals associated with the counterculture and anti-Vietnam War movements. The few unfortunate cases of people suffering LSD-induced psychosis would be used to frighten regular Americans and U.S. legislators into supporting the establishment of the Controlled Substances Act of 1970.

The actual risks of LSD are similar to other classical psychedelics. Distressing experiences are more likely to occur if you take too high a dose, without psychological support, and when you fail to respect “set and setting” (your current mindset and the environment in which you take the drug — more on that below). The use of LSD may worsen certain pre-existing mental health conditions, such as schizophrenia. As with any psychedelic (or other drugs), you should proceed with caution.^{(29, 30, 31)}

LSD does carry risks like most substances, so it is important to consult a health professional before use. Clinical trials utilizing LSD ensure that these sorts of risks are minimized. Participants are screened for conditions that don’t mix well with the substance. They also receive plenty of support before, during, and after the experience. In a controlled and supervised setting, a positive and valuable experience is more than possible.

The day after your LSD journey, you may experience a positive side effect of psychedelics: the “afterglow.” This is a period, sometimes lasting weeks, when you feel more joyous, energized, optimistic, and confident. 

There have been some extremely rare cases of LSD triggering a condition called Hallucinogen Persisting Perception Disorder (HPPD). HPPD can cause some people to continue experiencing visual and auditory perceptual changes for months or years after a psychedelic event. However, it is not common.

While many opponents of psychedelics cite the much-touted “bad trip” as a reason to avoid the experience, the fact is that many who undergo a challenging journey later report that it resulted in an improvement in their sense of well-being, and even cite it as one of the most important experiences of their lives.⁽⁴⁰⁾

Even if you have a more difficult journey, it may not really be so “bad.” Mattha Busby’s article The Good Part of A Bad Trip explores how these events can be opportunities to learn about ourselves and our relationship with psychedelics.  

Challenging trips tend to arise for a variety of reasons. They may be the result of improper set and setting, or because an individual is confronting a painful topic. The latter is often, in fact, precisely the opportunity for growth and positive change that one is seeking in the first place. 

That said, when a challenging trip looms, you can do a few things to alleviate, or even make the best of, the situation:

The list can be endlessly tailored to your personality and intentions. Whatever the case, this is your time to play with, and integrate, the lessons and epiphanies LSD has imparted.