Are Psychedelics Addictive?

Psychedelics are hallucinogenic substances that lead to changes in perception, sensation, mood, and cognition. Evidence suggests that psychedelic drugs are generally not addictive. However, you can develop a tolerance for them, potentially leading to misuse.

In this article, we talk about the consequences of psychedelic drug tolerance and misuse, along with their potential side effects and health risks. If you currently use psychedelics and want to stop, we also provide resources that can help.

Are Psychedelics Addictive?

Psychedelics are not considered addictive. This means that they don't meet the definition of addiction in that people do not become physically dependent on them, nor do they engage in compulsive drug-seeking behavior.

People also do not typically experience withdrawal symptoms when they stop using psychedelics, another characteristic of addiction. Though, research on ketamine suggests that some people do develop a dependence on this psychedelic drug, leading to withdrawal symptoms such as depression and cravings when trying to discontinue its use.

Psychedelic Drug Tolerance

While they may not be addictive, some psychedelics can produce tolerance. Tolerance means that a person has to keep taking higher doses of the substance to experience the same effects. This can be dangerous because the effects of psychedelic drugs can be unpredictable.

Lysergic acid diethylamide (LSD) also creates a cross-tolerance to certain other psychedelics, including psilocybin and mescaline. This means that if a person takes LSD, they would experience decreased effects if they took one of these other drugs.

Impact of Psychedelics on the Brain

Psychedelic drugs impact the neural circuits in the brain that utilize the neurotransmitter serotonin, particularly those in the prefrontal cortex. Their action in this area leads to changes in mood, perception, and cognition.

Psychedelics act as agonists or partial agonists on serotonin 5-hydroxytryptamine 2A receptors. They also impact areas of the brain that play a role in regulating arousal and stress responses. 

Visual hallucinations are common with psychedelics. This category of drugs can also strengthen or intensify a person's emotions, such as by increasing their feelings of fear and anxiety.

Research on Psychedelics and Mental Health

The therapeutic use of psychedelics was an interest in the 1950s and 1960s, but research on their effects was halted with the passage of the Controlled Substances Act in 1970. These substances are still classified as Schedule I drugs, which indicates that they have a high potential for misuse.  

Interest in this topic has been renewed, with some research suggesting that psychedelics may be effective in the treatment of a variety of mental health conditions, including:

• Anxiety disorders: Studies have found that psychedelics may help relieve anxiety symptoms.
• Depression: Research has shown that psychedelic therapy may be beneficial in the treatment of depression and other mood-related disorders.
• Alcohol and substance use disorders: A 2019 meta-analysis indicates that psychedelics might be helpful for people recovering from substance use disorders, though it is unclear as to why.
• Post-traumatic stress disorder (PTSD): An evaluation of six trials indicates that MDMA, also known as ecstasy or molly, may be beneficial for people with treatment-resistant PTSD. While MDMA is not a classic psychedelic drug, it does have psychedelic effects.

It's important to note that this research is in the very early stages. This means that we do not yet have a complete picture of the benefits versus risks of using psychedelics in the treatment of mental health disorders.

Illicit vs. Therapeutic Psychedelics

It's also critical to understand that the psychedelics used in research studies are not the same as psychedelics one might purchase on the streets. For instance, illicit psychedelics are sometimes mixed with other substances that can be dangerous to take.

A dangerous substance sometimes mixed with psychedelics is fentanyl, a highly addictive drug and one of the most common substances involved in drug overdose deaths. Since you can't see, taste, or smell fentanyl, individuals using illicit psychedelics could be unknowingly at risk of ingesting this substance.

Potential Side Effects of Psychedelics

Psychedelics can produce both short and long-term effects. Shortly after taking a psychedelic substance, people begin to experience hallucinations. These effects begin within 90 minutes of ingesting the substance and can last as long as 12 hours.

Additional side effects can vary from person to person but may include:

• Abdominal pain
• Agitation
• Confusion
• Diarrhea
• Headache
• Heart rate changes
• High blood pressure
• Increased feelings of fear or anxiety
• Nausea or vomiting
• Trembling

Using illicit psychedelics can also result in long-time, serious side effects, even after using them only one time. Some research indicates that, after a single dose of psychedelics, some individuals have developed longer-lasting conditions such as persistent psychosis and hallucinogen persisting perception disorder (HPPD).

Other Risks of Taking Psychedelics

The effects of psychedelics can be highly variable and unpredictable. Factors such as the substance used, the quantity ingested, mood, expectations, personality, and setting can all play a part in how a psychedelic experience takes place.

In some instances, people using psychedelics may experience what is known as a "bad trip." This is characterized by intense feelings of panic and frightening thoughts.

Combining psychedelics with other substances can also have negative consequences. If mixed with drugs that affect serotonin levels—including prescription medications such as monoamine oxidase inhibitors (MAOIs)—psychedelics may increase a person's risk of developing a condition called serotonin syndrome.

Serotonin syndrome occurs when there is too much serotonin in the body, leading to symptoms such as muscle spasms, confusion, tremors, nausea, and rapid heartbeat. It can also cause high fever, muscle breakdown, seizures, and death.

Getting Help for Psychedelic Use

Psychedelics are not considered addictive, but this does not mean they are safe or without side effects. While these substances show promise in treating various mental health conditions, this does not mean you should use them on your own for such purposes.

If you are interested in psychedelic therapy, one option available at this time is to sign up for an ongoing research trial. Talk with your primary care provider first to discuss whether this is a good option for you.

If you use psychedelics for mental health reasons—such as if you have anxiety, depression, or PTSD—a mental health professional can recommend fully researched treatment options. Working with this type of professional can also be helpful for individuals using psychedelics to overcome addiction to alcohol or other drugs.