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Are Hallucinogens Addictive? | Looking at the Science

There isn’t evidence that hallucinogens pose a significant addiction risk, although some evidence suggests they can be weakly reinforcing. Less clear is whether they may cause physical dependence. Ketamine seems able to cause at least some level of physical dependence, but there haven’t been many studies into whether similar drugs can also cause such dependence.

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Hallucinogens & Their Addictive Potential

Generally speaking, hallucinogens aren’t considered addictive.[1] Although research into hallucinogens is ongoing, and many questions still need answering about the mechanics of how these drugs interact with the human body, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has only limited definitions for use disorders relating to hallucinogens. The available research suggests that hallucinogens don’t typically cause addiction, but some hallucinogens are more closely linked to addiction issues, such as PCP.[2]

There is evidence that some hallucinogens can be “weakly reinforcing.” This means their use may draw a person to use more, but not to such a degree that it is a major concern in the same way that other drugs (like opioids) pose an addiction risk.[3]  

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]

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 the 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. 

Updated December 21, 2023
Resources
  1. Psychedelic and dissociative drugs. National Institute on Drug Abuse. Published April 13, 2023. Accessed December 1, 2023.
  2. Associations between individual hallucinogens and hallucinogen misuse among U.S. Jones G, Herrmann F, Wang E. Adults who recently initiated hallucinogen use. Addictive Behaviors Reports. 2023;18:100513.
  3. The behavioral pharmacology of hallucinogens. Fantegrossi WE, Murnane KS, Reissig CJ. Biochemical Pharmacology. 2008;75(1):17-33.
  4. Diagnostic stability of ICD/DSM first episode psychosis diagnoses: Meta-analysis. Fusar-Poli P, Cappucciati M, Rutigliano G, et al. Schizophrenia Bulletin. 2016;42(6):1395-1406.
  5. Psychosis and psychedelics: Historical entanglements and contemporary contrasts. Friesen P. Transcultural Psychiatry. October 2022:136346152211291.
  6. Psychedelics and mental health: A population study. Krebs TS, Johansen PØ. Lu L, ed. PLOS ONE. 2013;8(8):e63972.
  7. Psychedelic medicine: a re-emerging therapeutic paradigm. Tupper KW, Wood E, Yensen R, Johnson MW. Canadian Medical Association Journal. 2015;187(14):1054-1059.
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