Are Hallucinogens Addictive?

The American Society of Addiction Medicine defines addiction in the following way: “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”[8]

Some hallucinogenic drugs don’t fit neatly into this definition, as they don’t seem to trigger compulsive use. However, other hallucinogenic drugs do seem capable of altering brain circuits and causing harmful drug use patterns.

Hallucinogens & Their Addictive Potential

Doctors use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose substance use disorders in their patients. The DSM-5 outlines what a disorder might look like in people who use hallucinogens.[9] The inclusion within the DSM-5 seems to suggest that experts think hallucinogens can and do cause substance use disorders.

Per the DSM-5 diagnostic criteria, people with SUDs have at least two of the following types of issues:[10]

• Impaired control: They consume more than they intended. They want to quit and can’t. They spend a lot of time getting, using, or recovering from drugs. They experience drug cravings.
• Social impairment: They can’t meet routine obligations due to drugs. They keep using despite social consequences. They stop spending time on activities that don’t involve drugs.
• Risky use: People use drugs in physically unsafe spaces. They keep using despite the knowledge that it causes physical or psychological problems.
• Pharmacologic: They need higher doses to get the same effect. They experience withdrawal when they try to quit.

Researchers say hallucinogens don’t always cause cravings, and some people don’t experience withdrawal when they quit.[9] However, they say the absence of these traits doesn’t mean people can’t get addicted. Instead, they say it makes diagnosing SUDs involving hallucinogens a little more difficult, and some people may have an SUD without showing all of the signs listed above.[9]

Can Hallucinogens Cause Physical Dependence?

Whether hallucinogens can cause physical dependence, meaning a person might experience withdrawal if they stop taking them, is another area that has seen only limited research.

Ketamine, a hallucinogen that can cause episodes of dissociation, has been suggested in a few studies to potentially cause drug cravings and other symptoms of withdrawal. However, the degree to which people experience withdrawal from hallucinogens in general isn’t known. 

There is, however, some evidence that people can quickly develop a tolerance to hallucinogens. This means a person must take more of the drug to achieve a similar effect that less of the drug once produced.[1]

Comparing Hallucinogens to Other Substances

Are hallucinogens addictive? The best way to answer this question might be to look at how addictive the drugs are when compared to other commonly abused substances. This chart could help to make the comparison easier:[11-13]

Hallucinogens & Mental Health

There are a few ways in which hallucinogen use can relate to mental health that bear highlighting:

Bad Trips & Schizophrenia

Hallucinogens have the potential to cause frightening, anxiety-inducing hallucinations, with these episodes often called bad trips. Another concern is that the general use of these drugs can cause episodes of psychosis, called drug-induced psychosis. One study showed that as many as 21% of people who experience substance-induced psychosis later receive a schizophrenia diagnosis.[4] 

The link between schizophrenia and the use of psychedelics isn’t fully understood, but it is generally believed that psychedelics can trigger schizophrenia in people who are already at risk of it, rather than hallucinogens having the potential to cause it in individuals who could not otherwise have developed the condition.[4] Even this claim is controversial and disputed, however. Some say that there may be a correlation between certain types of drug use and schizophrenia, but that there is no causation.[5] 

Other Mental Health Conditions

Despite its possible connection to schizophrenia, hallucinogen use doesn’t appear to have any general link to causing long-term mental health problems. A population study of LSD, psilocybin, and mescaline users noted that the drugs didn’t seem to cause brain damage and weren’t addictive.[6] Even lifetime use of these drugs wasn’t connected to an increased rate of any mental health outcome. In several cases, psychedelic use was associated with a lower rate of mental health issues.[6]

This would seem to at least somewhat contradict some findings regarding the use of hallucinogens potentially triggering schizophrenia. This isn’t discussed much in the population study, but it does help highlight the early stages of this research. Even well-conducted studies can sometimes come to conclusions that are contradictory in places. It will take time for enough research to be conducted so that these contradictions can be examined and more concrete answers found.

Hallucinogens as a Tool

There has been a re-emerging interest in examining hallucinogens and similar drugs for possibility utility in therapy.[7] Some experts believe these drugs may help to treat depression, anxiety, PTSD, and possibly even addiction. While many of these drugs have been classified such that they’re deemed to have “no medical value,” many researchers have questioned these kinds of severe classifications as politically based rather than science-based.[7]

In the early studies from this re-emergence period, it seems it is possible to safely conduct research into the use of psychedelics and dissociative drugs for therapy. Several studies have shown successful results from these experimental therapies with few serious adverse effects.[7] 

This type of research is important because it should be medical experts, not patients, deciding whether hallucinogens may improve an individual’s mental health. However, there currently isn’t enough evidence to properly make those decisions. More research is needed.