LSD: The Ultimate Guide

Brief Introduction About LSD

LSD (lysergic acid diethylamide) is a long-acting and very powerful psychedelic drug that gives heightened emotions, sensory illusions, free thought associations and increased alertness. The drug’s effects were discovered in 1943, and LSD was used as a drug in psychiatry from 1947 to 1966, when it was banned in the United States due to its prevalence as a drug among hippies and other countercultures.

LSD is not addictive and probably not toxic with normal use, but the intoxication can be very mentally demanding. LSD should be treated with great respect, as it can give life-changing experiences, and inexperienced users should not take high doses. Circumstances and surroundings (“set” and “setting”) have a great impact on how the drug experience turns out. It is recommended to use a rapid test (test kit) to avoid dangerous imitation substances that are sometimes sold as LSD.

Risk Information

ACUTE LETHALITY

LSD is one of the least lethal drugs available when the lethal dose is measured in the number of drug doses. Recent literature estimates that up to 100 milligrams may have to be ingested for death to occur in humans, i.e. a thousand times a normal drug dose of 100 micrograms [1]. In one case, an American woman is said to have consumed approximately 55 mg with no other consequences than a temporary loss of consciousness and strong intoxication for several days [2].

Two other cases have also been documented in which five and eight people respectively ended up in the emergency room after snorting “strips” of LSD in powder form, which they had mistaken for cocaine. Some of these had to be treated for overheating, rhabdomyolysis, failing respiration and bleeding tendencies, and could probably have died without medical supervision, but all of them survived and were discharged after a short time without lasting harm.

TOXICITY OVER TIME

LSD can be very little harmful to the body compared to most drugs [1]. It is nevertheless possible that frequent LSD use can lead to fibrosis in the heart valves, as other substances with similar receptor activity have this side effect. However, these substances have been used several times a week when this effect has been demonstrated, so there is little reason to worry about this if you only “trip” a few times a year [5]. Microdosing several times a week , on the other hand, can be thought to be harmful.

DEPENDENCE

It is not addictive or habit-forming, and with daily use, immunity to the addictive effect is quickly developed which lasts for several days after one has stopped taking the drug [6, 13]. LSD can also reduce the desire for other drugs, and it has previously been used in the treatment of alcohol addiction with good effect 

COGNITIVE PROBLEMS

Research finds no tendency towards poorer mental health among psychedelic users in general, quite the opposite (8-10). However, one study finds that LSD use is not associated with the same positive mental health outcomes as psilocybin and mescaline use, although it is not associated with poor outcomes (10).

Some people may experience anxiety or delusions when intoxicated with LSD, especially at high doses and in unfavorable surroundings. LSD can also trigger psychosis, but this is unusual; in two studies of 5,000 and 4,300 people, respectively, who had received LSD approximately 75,000 times in psychotherapy, the average risk for such outcomes was 1.25 parts per thousand [13]. People with psychotic disorders in close family or known vulnerability to drug-induced psychosis should still be careful with LSD.

Some may experience visual disturbances for a longer period of time after psychedelic use, reminiscent of the visual effects during intoxication. This is called hallucinogenic persistent perception disorder , often abbreviated to HPPD. It is unclear to what extent this is due to psychedelic use, as it is also seen with the use of other drugs and in people with anxiety disorders. HPPD usually goes away on its own if you abstain from drugs, but the drug lamotrigine is said to have had a good treatment effect for some

INTERACTIONS

LSD should not be used by people taking medications that lower the seizure threshold, such as lithium or tramadol , as this can trigger seizures [12]. LSD should also not be used with protease inhibitors such as ritonavir or indinavir , as these have potentially dangerous interactions with the substance ergotamine, from which LSD is chemically derived. 

It should preferably not be combined with cannabis , especially by people who are inexperienced with at least one of the substances, as this can significantly enhance the psychedelic effect and lead to confusion and anxiety [15]. Combination with large amounts of alcohol is also not recommended, as this can make you more disoriented and lead to accidents. SSRI-based antidepressants will normally block most of the effects of LSD.

Dosage and method of administration

DOSAGE

LSD is active in very small doses. Effects can already be felt at 5-10 micrograms (µg), i.e. millionths of a gram. Such amounts are called microdoses, and are used by some to promote good mood, creativity and concentration rather than to achieve intoxication. Slightly higher doses, 20-70 µg, give a more stimulating intoxication and a “psychedelic” flow of thought. A full-fledged “trip” with powerful effects is achieved from approx. 80-100 µg and upwards, and a typical dose is around 100-150 µg.

FORMAT

LSD is usually available pre-dried on a piece of paper, called a “blotter”. Those with access to the substance in liquid form will also be able to sell sugar cubes or candy laced with LSD. Exceptionally, LSD can be obtained in tablets; you should be careful with these, as they may contain many other substances. One should always use a quick test when acquiring a new charge of LSD.

Effect and intoxication experience

MECHANISM OF ACTION

Like other classic psychedelics, LSD imitates the signal substance serotonin in the brain and binds to the serotonin receptors. The main intoxicating effect is due to activity at serotonin receptor subtype 2A, but activity at other receptor subtypes (including 2B and 2C) may also play a role. In contrast to other classic psychedelics, LSD also imitates the signaling substance dopamine, and works at dopamine receptor subtype D4. Images of the brain under the influence of LSD show reduced activity in the thalamus and the resting network and a freer flow of information between the different parts of the brain than usual. This brain activity pattern has similarities to what is seen during deep meditation and dreaming.

DURATION

LSD has a very long duration of action and normally lasts 10-14 hours depending on the person and dosage. How long it takes for the drug to work depends on the dose, whether you have eaten recently and how sensitive you are. Normally, some effect will be felt after 30-40 minutes, and full intoxicating effect after up to 2 hours. LSD: The Ultimate Guide

The intoxication is most intense in the first 3-4 hours. Many users find that it is necessary to take it easy in a safe environment during this time, as it is common to experience temporary anxiety or confusion. Since it is normally impossible to fall asleep while the drug is working, you should not take LSD if you want to sleep within 12 hours, and it may be advantageous to start early in the day. Avoid taking LSD with a significant sleep deficit, as this increases the risk of an unpleasant experience.

INTOXICATION

LSD is known for its hallucinogenic effect. It is nevertheless unusual to see things with open eyes that have no root in reality. To the extent that this occurs, it will be at high doses or under special lighting conditions. As a rule, you will also be able to distinguish between hallucinations and real events, but delusions can occur at high doses. The most common is to see variations on the shapes in real objects, or colorful “light shows” and dream sequences with closed eyes. Many people also experience special depth perception and perspective effects, and light is often perceived as brighter or stronger than usual. LSD: The Ultimate Guide

The sense of hearing is also affected by psychedelics. Many people experience that their hearing is sharpened, and LSD has a strong synesthetic effect, i.e. that impressions on different senses can flow into each other. Sounds can thus affect what you see, especially with closed eyes, and it can be experienced as if sound “moves” the body physically. This makes LSD popular for use when listening to music and dancing, and research has shown that LSD enhances the listener’s emotional response to music.

Continuation..

LSD also affects the ability to feel touch, and it can become difficult to feel exactly where the body ends and the surroundings begin. You become less sensitive to temperature, and it is therefore important to make sure that you are not wearing too much or too little clothing in relation to your surroundings or activity level. One should be especially observant. on this if you are outside in cold weather, as LSD can almost remove the feeling of freezing for some.

LSD affects the user’s thoughts on a fundamental level. The intoxication greatly distorts the perception of time, and especially at the beginning of the intoxication, a few minutes can feel like hours. Intoxication also weakens the user’s self -perspective, and high doses can cause so-called “ego death” – an experience that can have a deeply spiritual character, but can also be very frightening. In moderate doses, LSD provides free thought associations that can promote creativity, humor and meditative states. It can sometimes be difficult to find the right words and expressions, and many find that they express themselves with synonyms or metaphors under the influence of LSD.

LSD: The Ultimate Guide

UNPLEASANT EXPERIENCES (“BAD TRIPS”)

The free thought associations mean that unwanted thoughts can easily stick and steer the experience in the wrong direction. The user must therefore learn to either control this, or to accept the thoughts as they come. Circumstances and surroundings (mood, place, music and who you are with) have a lot to say about the extent to which you manage to ensure a pleasant experience. The easiest way to avoid an unpleasant experience is to take a proper dose. In addition, certain personality types are probably more exposed; if you struggle with anxiety and intrusive thoughts, you should either avoid psychedelics or try cautiously with low doses. Some women find that the menstrual cycle can affect the risk of an unpleasant experience.

If you have an unpleasant experience, it will usually help to change the environment, change the music or allow yourself to be distracted in some other way. If this doesn’t help, it’s still better to “let go” and let the thoughts resolve themselves, than to try to resist. In such cases, it can be good to have a quiet place to lie down and rest until you feel better, and to have someone nearby to look after you. This person should remind you that it will pass, that everything is fine and that you are safe, but not to nag too much, as communication can be stressful. LSD: The Ultimate Guide

POWERFUL OR DEEPLY MEANINGFUL EXPERIENCES

LSD is one of the most powerful psychedelic substances known, and can give impressions that require processing afterwards. The intoxication challenges the user’s perception of reality, and can often provoke pondering over big, existential questions. You can also be confronted with unpleasant aspects of yourself and your life, as a lot of subconscious psychological material comes to the surface during the intoxication. This can be rewarding in the long run, but is not necessarily unproblematic. It is not entirely unusual for people to change their behavior or take major steps in their lives after a powerful psychedelic experience, and research shows that a single use of psychedelics can produce a lasting change in the personality domain of openness , i.e. receptivity to new ideas and points of view. LSD: The Ultimate Guide

This effect is particularly noticeable for some time immediately after the first experience, and one should be careful about making decisions of great importance during this period. Most users experience powerful psychedelic experiences as positive afterwards, even those that are very demanding or unpleasant while they are in progress. It is still recommended that you approach psychedelics prepared and with great respect, and have someone you can talk to about your experiences.

Sources/ LSD: The Ultimate Guide

1. Nichols & Grob, Is LSD toxic? Forensic Science International, 2018.

2. Haden & Woods, LSD Overdoses: Three Case Reports. Journal of Studies on Alcohol and Drugs, 2020.

3. Roberts et al., A cluster of lysergic acid diethylamide (LSD) poisonings following insufflation of a white powder sold as cocaine. Clinical Toxicology, 2021.

4.Klock et al., Coma, Hyperthermia and Bleeding Associated with Massive LSD Overdose . The Western Journal of Medicine, 1974.

5. Hutcheson et al,. Serotonin receptors and heart valve disease—It was meant 2B. Pharmacology & Therapeutics, 2011.

6. Nichols D., Dark Classics in Chemical Neuroscience: Lysergic Acid Diethylamide (LSD). ACS Chemical Neuroscience, 2018.

7. Krebs & Johansen, Lysergic Acid Diethylamide (LSD) for Alcoholism: Meta-Analysis of Randomized Controlled Trials. Journal of Psychopharmacology, 2012.

8. Krebs & Johansen, Psychedelics and Mental Health: A Population Study . PLOS One, 2013.

9. Hendricks et al., Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population. Journal of Psychopharmacology, 2015.

10. Jones & Nock, MDMA/ecstasy use and psilocybin use are associated with lowered odds of psychological distress and suicidal thoughts in a sample of US adults. Journal of Psychopharmacology, 2022.

11. Orsolini et al,. The “Endless Trip” among the NPS Users: Psychopathology and Psychopharmacology in the Hallucinogen-Persisting Perception Disorder. A Systematic Review . Front. Psychiatry, 2017.

12. Nayak et al., Classic Psychedelic Coadministration with Lithium, but Not Lamotrigine, is Associated with Seizures: An Analysis of Online Psychedelic Experience Reports . Pharmacopsychiatry, 2021

13. Passie et al., The Pharmacology of Lysergic Acid Diethylamide: A Review. CNS Neuroscience & Therapeutics, 2008.

14. Dolder et al,. Pharmacokinetics and Pharmacodynamics of Lysergic Acid Diethylamide in Healthy Subjects . Clinical Pharmacokinetics, 2017.

15. Kuc et al., Psychedelic experience dose‑dependently modulated by cannabis: results of a prospective online survey. Psychopharmacology, 2021.

LSD: The Ultimate Guide