LSD is a hallucinogen drug capable of altering thoughts and perceptions in those who use it, including pseudo-hallucinations and synesthesias—a condition where they see and hear things that are not real, while others report being able to hear colors 1. People have experimented with hallucinogens for thousands of years, using plants or fungi found in nature, such as peyote or hallucinogenic mushrooms, but unlike these, LSD is synthesized in a lab from a chemical precursor isolated from a fungal source.
LSD—full name, D-lysergic acid diethylamide, and also known historically as acid, dots or microdot, windowpane, and Yellow Sunshine—is most frequently taken orally in liquid or pill form, or from a piece of LSD-impregnated gelatin or paper placed on the tongue 2,3.
Signs and Symptoms of LSD Overdose
When someone takes too much LSD, they may experience terrifying hallucinations, but technically a person cannot take so much LSD that it kills them. LSD is not like heroin, Xanax, or even alcohol in that there is no known lethal dose of LSD.
When someone experiences an LSD “overdose,” likely they have experienced what is more commonly known as a “bad trip.” This is not to say that LSD use is without its dose-dependent dangers, however. Severe injury and death has occurred as an indirect result of using LSD, in that accidents, self-mutilation, and suicide have occurred during these trips, when people are largely unaware of what they are doing 4.
Some commonly experienced side effects of LSD can include 4:
- Dilated pupils.
- Rapid heartbeat.
- Dry mouth.
- Blurred vision.
- Raised body temperature.
- A distorted sense of time.
- Visual hallucinations.
- Mixed senses (for example, “seeing” sounds).
- Intensified sense of smells and noises.
- A sense of a mystical experience.
In contrast to some of these relatively mild symptoms, when someone has a bad trip, the experience may be overwhelmingly unpleasant. LSD users may experience frightening alterations in their thoughts and moods, which places them at increased risk for associated injury and even fatal consequences.
Some of the potentially adverse outcomes include 4:
- Extreme anxiety.
- Feelings of lost identity, that they are ceasing to exist.
- Rapid mood swings.
- Aggression towards others, including homicide.
- Dying in an accident.
- Committing suicide.
- Features of psychosis that don’t immediately end when the LSD trip is over.
LSD is such an unpredictable drug insofar as it is hard to know when a person might experience a so-called overdose. People who have used LSD many times before without any problem may unexpectedly have a bad trip.
One real danger with LSD is the way in which users quickly develop tolerance for the drug. When someone first uses LSD, they are likely to experience the hallucinogenic effects quickly and intensely. However, as time goes on, the body builds a tolerance to LSD, and a person who abuses it must use more and more of it to achieve the same high as before.
Given how unpredictable LSD is, taking higher doses is dangerous. If someone abuses LSD, it can also increase their tolerance to other hallucinogenic drugs, such as PCP, which results in the person taking more of other unpredictable drugs while attempting to have a “good” trip 2. This issue is further complicated by the fact that it is so difficult to control the dose of any illicit drug, particularly one like LSD, which has effective doses in the microgram range. The weights of its various delivery forms—such as tablets and blotter papers—can be significantly higher than the dry weight of an “average” LSD dose, so there is an exceptionally large margin for error. What this means in practical terms is that one blotter paper could easily carry multiple times the dose that another paper does, so a user can never be sure how much of the drug they are actually consuming, dramatically escalating their odds of overdosing.
However, LSD is not physically addictive. Users of LSD do not normally crave the drug, and stopping the use of LSD does not lead to symptoms of physical withdrawal (a symptom characteristic of addiction). There is not a substantial body of research on LSD dependence, tolerance, and withdrawal, so much remains unknown here 2.
If you or a loved one uses LSD and experiences the symptoms of an overdose or bad trip, seek emergency medical treatment, which can help prevent harm through self-mutilation, suicide, or highly dangerous behavior, such as walking into traffic or jumping off buildings. It may also prevent someone from harming others in the setting of extreme paranoia and frightening hallucinations they may experience in one of these situations 5.
Preventing LSD Overdose
The best way to avoid an overdose with LSD is to never take the drug in the first place. It is unpredictable and dangerous—a person can use LSD many times without serious problems, and then suddenly experience aggression, self-harm, psychosis, or other adverse side effects.
When someone seeks help for an adverse experience with LSD, immediate medical intervention is important. However, treatment shouldn’t stop there with someone who regularly abuses LSD and experiences these types of serious side effects—they may benefit from more extended treatment programs. Additionally, very often those who abuse LSD abuse other substances as well, which not only complicates the predictability of overdose, but further signals the need for comprehensive substance abuse treatment.
Drug abuse treatment is the best way for a person to stop putting themselves at risk of the dangerous outcomes of LSD abuse. After someone experiences a bad trip, they may be more willing to seek treatment, since the extremely frightening experience can serve as a wake-up call.
A substance abuse professional assesses numerous factors in determining the best treatment program for a person’s addiction, such as if they have a co-occurring mental health disorder (such as bipolar disorder or depression), or if the person has underlying medical issues (such as a heart problem or diabetes). In more complex cases, inpatient treatment may be necessary to provide the safest environment that includes around-the-clock supervision. The intensity of a person’s addiction, as well as the length of time that they have abused LSD and other drugs, will further help determine if inpatient or outpatient treatment is the best approach.
Inpatient treatment programs come in many styles so that people can find one that best fits their needs. These programs are more intensive than outpatient programs and require patients to live at the facility as part of the treatment protocol. Most programs rely heavily on group therapy, but a few offer larger amounts of individual counseling; most programs also offer family therapy as part of the treatment program. Inpatient programs typically last between 30 and 90 days, but can continue for longer durations, if necessary.
Outpatient treatment programs are also a viable option for someone abusing LSD. Depending on the evaluating clinician’s assessment, a person may attend treatment anywhere from 2-4 hours a day, 2 days a week, to 4-8 hours per day, 5 or 6 days per week. Patients continue to live at home while attending outpatient treatment at some point during the day, allowing them to tend to responsibilities with children, work, or school at the same time.
Many programs use the cognitive behavioral therapy (CBT) model to teach clients how to recognize faulty thoughts and replace them with more positive and productive ones. Out of these new thoughts come healthier behaviors that help clients effectively deal with urges to use LSD and other drugs and to develop new ways to cope with common stressors that trigger drug use. The approach also emphasizes examining the pros and cons of behavioral choices.
Motivational interviewing is an approach that helps people find internal motivation for positive change. This modality tends to be more effective in getting people to engage in treatment and stay in it.
Contingency management is yet another approach in which the patients receive actual rewards for staying clean from drugs. For instance, they might receive vouchers for items ranging from diapers to movie tickets.
The purpose of addiction treatment is to help people with addictions to stop using drugs, enhance their coping skills, and help them avoid relapse, as well as work on the underlying issues which started the drug abuse in the first place.6
- National Institute on Drug Abuse. (2016). What are Hallucinogens?
- National Institute on Drug Abuse. (2014). Hallucinogens.
- Center for Substance Abuse Research. (2013). LSD.
- University of California, Santa Cruz. (2016). LSD.
- National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.