Evaluating Hallucinogenic or Psychedelic Drug Intoxication in an Emergency Setting

Hallucinogens and psychedelic agents can induce altered perception, thought, and mood. Many produce sympathomimetic effects like hyperactivity, dilated pupils, hypertension, rapid heartbeat, and high body temperature, though effects vary by drug. Common toxicologic drug screens do not detect many hallucinogens, such as LSD, making diagnosis reliant on patient history and physical examination rather than lab tests.

Study at a glance

Abstract

Under certain conditions or in an overdose setting, several classes of drugs can induce illusions, hallucinations, or delusions. However, one of the hallmark features of hallucinogens or psychedelic agents is their ability to induce states of altered or distorted perception, thought, and mood. Many hallucinogens produce classic sympathomimetic effects; that is, hyperactivity, mydriasis (dilated pupils), hypertension, tachycardia, and hyperthermia. However, the effects vary considerably, depending upon the hallucinogen ingested. Qualitative confirmation by the laboratory that the patient is suffering from hallucinogen intoxication such as marijuana use can be helpful to the clinician. However, the common toxicologic drug screens used by most clinical laboratories do not detect many hallucinogenic agents (such as LSD [lysergic acid diethylamide]). Thus, diagnosis of hallucinogen ingestion and treatment is often based on history of use and physical examination.