There has been a great deal of debate around the idea of using psychedelics for the treatment of certain mental health conditions. While initial studies have been encouraging, much remains unknown about the effects of exposing the human brain to such powerful substances. As new frontiers open in the care of mental health, questions like whether acid, DMT, or other psychedelics can cause brain damage will have to be answered first.
Psychedelic drugs aren’t known to cause severe overdose or addiction problems. But are they dangerous in other ways? Does LSD kill brain cells? What are the effects of DMT on the brain? Learn more about how psychedelics affect your brain.
What are Psychedelics?
Psychedelics are a broad group of drugs that can cause mind-altering effects like hallucinations. They are also known as hallucinogens because of their ability to change your perception and alter your consciousness. Psychedelics are divided into two major categories called classic hallucinogens and dissociative drugs. Classic hallucinogens typically cause you to see and hear things that aren’t there, change your visual perceptions, or alter your consciousness. Dissociative drugs cause depersonalization or derealization, which is often described as an out-of-body experience. However, many drugs can cause both hallucinations and dissociative episodes.
They are both naturally occurring and synthetic psychedelic drugs. Natural psychedelics can come from certain mushrooms, plants, and even animals. Synthetic psychedelics are made in labs for research purposes. Historically, there have been few accepted medical uses of psychedelic drugs in modern medicine. However, they have been used in ritual ceremonies in various cultures for centuries. Today, they are most common among recreational users or people curious about their mind-altering effects.
However, in recent years psychedelics have been researched for their potential use in therapy for mental health issues, especially treatment-resistant depression. In 2018, the Food and Drug Administration approved research into psilocybin for the treatment of depression.
Examples of classical hallucinogens include:
- LSD. LSD is short for D-lysergic acid diethylamide. It’s one of the most commonly known psychedelic chemicals and among the most potent. It’s made from a substance called lysergic acid that’s found in a particular kind of fungus. LSD is also sold illegally under the street name acid.
- Psilocybin. Psilocybin is a psychedelic drug that’s found in a mushroom of the same name. They’re also called magic mushrooms. They grow in subtropical regions in the Americas. However, they may be visually indistinguishable from more dangerous toxic mushrooms in the wild.
- Peyote. Peyote is also called mescaline is a drug that comes from the peyote cactus that grows in Mexico and Southwest Texas. Mescaline is popular in recreational uses and ritual ceremonies.
- DMT. DMT is short for N,N-dimethyltryptamine, which is a chemical found in plants that grow in the Amazon. This plant is often mixed into a tea with other ingredients called ayahuasca. The drug is often taken by people that are seeking a transcendent experience.
- 251-NBOMe. This is a synthetic drug that has similarities to LSD. However, it also shares some characteristics with MDMA. It was first made to be used for research purposes, but it’s sometimes sold as an illegal drug.
Some popular dissociative drugs include:
- PCP. PCP is short for Phencyclidine, which was used as an anesthetic in surgeries starting in the 1950s. However, it’s no longer used because of its high likelihood of negative side effects. PCP is still sold and used illegally for recreational purposes.
- Ketamine. Ketamine is used as an anesthetic in both humans and animals. However, it’s also used illegally as a recreational drug. Like other hypnotic drugs, it’s sometimes used as a date rape drug. Recently, it has been used to treat depression, and research into its use for mental health treatment is ongoing.
- Dextromethorphan. Shortened to DXM, dextromethorphan is used as an ingredient in cough suppressant medications. It can even be bought over the counter. It’s sometimes misused by taking high doses of cough medications for its dissociative effects.
- Salvia. Salvia is a plant called Salvia divinorum that produces a psychoactive chemical called salvinorin A, which is native to Central and South America. Its leaves can be chewed, and dried leaves can be smoked for dissociative effects. Salvia is legal to buy and sell in the United States.
Many other psychedelics exist – some entirely found in the natural world, some the result of laboratory design, and some a combination of both – and all have different degrees of toxicity and effect. The way they work, however, is roughly the same. Psychedelics stimulate or suppress the activity of neurotransmitters (chemical messengers) whose chemical similarities they share. The result is a temporary chemical imbalance in the brain (too much or too little of a particular neurotransmitter), which causes euphoria, hallucinations, and changes to sensory perception.
With psychedelics, one of the main neurotransmitters affected is serotonin, which is usually produced by the brain to regulate feelings of well-being and happiness. The brains of people who have depression or other mood disorders usually cannot produce enough serotonin. Because of the effect of psychedelics on the serotonin neurotransmitter, it has been widely theorized that the careful administration of psychedelics can help to boost serotonin production in the brain without the negative side effects of more commonly prescribed antidepressants.
Set and Setting
Unlike other drugs, a large degree of the effect of psychedelic drugs comes from the so-called “set and setting” of the individual user, or their expectations and unique psychological composition. Set and setting entails a person’s previous experiences with the psychedelic (if any); their social and cultural conditions; and their thoughts, feelings, and mood at the time of consumption. For this reason, a single person can have positive and negative sets and settings with the same psychedelic.
Psychedelics tend to have a very slow onset. Some of this depends on the drug itself while other factors relate to the user’s own physical and psychological condition when taking the drug. DMT, for example, takes effect almost instantly, but the effects last less than an hour (sometimes fading as quickly as 30 minutes after consumption). LSD, on the other hand, has an onset of an hour, but the effects will be present anywhere between four hours and 12 hours.
Hallucinogenic drugs are metabolized fairly quickly, but their psychological effects can last. Depending on the user’s mental health state and setting, psychedelics can induce or exacerbate mental health issues (including, but not limited to, psychosis, anxiety, and depression). People who have a family history of these conditions, or who have a risk of developing the conditions on their own, would do well not to risk taking psychedelics.
How Psychedelics Change the Brain
Psychedelics have long been thought of as a new line of approach to treat many mental health illnesses. Writing in the Daily Beast, David E. Olson, an assistant professor in the Department of Chemistry Department of Biochemistry & Molecular Medicine at the Center for Neuroscience, University of California, Davis, explains that psychedelics “change the structures of neurons themselves.”
Psychedelics such as LSD, psilocybin, DMT, and MDMA – “among the most powerful drugs known to affect brain function” – cause neurons to grow, restructuring the wiring of the brain and changing how users behave, feel, and think.
Past research has indicated that psychedelics can produce lasting positive effects on brain function, which has led scientists to wonder if psychedelics can ultimately be used to fix the neural circuits that atrophy as a result of anxiety and mood disorders.
Vice magazine interviewed Olson about his research and the myths about psychedelics, asking if LSD staying with the serotonin neurotransmitter receptors for days at a time means that people will be “permafried,” a colloquial term to mean “appearing to be permanently under the influence of a drug.”
Olson clarified that being permafried by way of LSD or other psychedelic intake is “pretty much a myth,” but he warned that people who have a predisposition toward schizophrenia would eventually develop schizophrenia faster and to a much more severe degree if they used LSD than if they didn’t.
Psychedelics can trigger the onset of severe neurological disorders and distortions to normal brain functioning in people who are “primed” for those conditions. For people who are not primed – that is, they have good mental health and have no predispositions toward adverse mental states – a big dose of LSD will stay with them for a relatively short period, but they will then return to normal functioning.
HPPD and Psychedelic Risks
There is a rare condition known as hallucinogen persisting perception disorder (HPPD), where people experience continued visual hallucinations long after they have taken a psychedelic (usually LSD). The disorientation frequently causes anxiety in users.
Olson noted that HPPD occurs fairly rarely and possibly in people whose visual systems are more sensitive than usual. HPPD could be a manifestation of seizure activity in the visual cortex of the brain, but it is not a form of brain damage. He also clarified that there are systems in the brain to prevent the LSD-activated neurons from being too stimulated. LSD gets trapped in the serotonin receptors, “but it doesn’t stay there forever.” Six or seven hours later, it is broken down, and users should no longer be experiencing any of the hallucinations or sensory changes.
To that point, the PLos One journal published the results of a population study in 2013 that found that “classical psychedelics” that work on the serotonin neurotransmitter – specifically mentioning LSD, mescaline, and psilocybin – were nonaddictive and did not demonstrate any likelihood of causing brain damage. The conclusion came from an analysis of 21,967 people who were lifetime users of psychedelics.
Not only were there no notable associations between the long-term use of any of the psychedelics and negative mental health outcomes, but there were also several instances of psychedelic use being associated with a reduced rate of mental health problems.
When Terence McKenna, the ethnobotanist and author who wrote on, and experimented with, psychedelic plants, was diagnosed with an aggressive form of brain cancer in 1999, he feared that the tumor might have been the result of his many years of psychedelic drug consumption or having smoked marijuana every day for 35 years. McKenna’s doctors assured him that there was no causal connection between his psychedelic drug use and the tumor on his brain. He died the following year.
Do Psychedelics Cause Brain Damage?
Other potential, if uncommon, health problems occur when DMT (which produces “brief but intense” visual and auditory hallucinations) induces serotonin syndrome. DMT has a chemically similar structure to the serotonin neurotransmitter, and when the body accumulates too much serotonin, the patient usually experiences symptoms such as agitation, confusion, loss of muscle coordination, and high blood pressure.
Serotonin syndrome tends to occur in patients who are taking antidepressants and may already have elevated levels of serotonin as a result. If untreated, serotonin syndrome can get quite severe and lead to seizures, an irregular heartbeat, a loss of consciousness, and death.
As with other psychedelics, DMT can exacerbate pre-existing mental health conditions, but it is unlikely to be the impetus behind the development of psychological problems in people who were not “primed” for them. The little research conducted on DMT suggests that it is not a habit-forming substance, but as with any drug, there are risks that frequent use might lead users down the road of psychological dependence on it.
Unlike other psychedelics, DMT use does not induce tolerance (that is, a fixed amount will always result in the same level of hallucinogenic experiences).
A health blog on CNN answered the user-submitted question of whether acid causes permanent brain damage by saying that if people who have used psychedelics do not have occasional flashbacks, and do not develop hallucinogen persisting perception disorder, then there is little chance that the DMT use has harmed the brain.
LSD has been known to cause severe depression or psychosis, but this is primarily in users who have taken an extreme amount of the drug, have been using other drugs at the time of use, or have the genetic risk for developing those conditions; additionally, the conditions would happen at the time of use and not years later.
One of many myths about psychedelics is that the drugs “stay in your system forever,” but the doctor writing for CNN’s health blog dismisses that. The chemicals are usually out of the body by the following day.
Myths and the Harm of Psychedelics
Continuing that train of thought, Business Insider publishes that psychedelics “putting holes in your brain” is one of the many myths surrounding the effects of this class of drugs. In the 1990s and 2000s, anti-drug programs warned that using MDMA would burn a hole through the brains of unwitting users.
The truth, of course, is that while psychedelics change the wiring of the brain (as described above), only aggressively extreme use, combination use with other drugs, and a “priming” for certain mental health disorders will cause the kind of damage that the anti-drug campaigns warned about.
With all of this, it is worth asking if psychedelics are harmful at all. While much remains unknown about their full range of effects, hallucinogens have won cautious support from the scientific community.
The 2016 Global Drug Survey found that psychedelic mushrooms were among the safest recreational drugs to take, and researchers in the Lancet Psychiatry Journal noted that consuming psychedelics is about as dangerous as riding a bike or playing soccer; that is, with adequate protection, “not particularly dangerous.”
The scientists acknowledged that people taking hallucinogens would likely experience a brief state of confusion and emotional upheaval, but in the proper set and setting, these experiences will be safely controlled, and any hospitalizations and serious injuries that occur from psychedelic consumption are “extremely rare.”
Similarly, the researchers behind the Global Drug Survey pointed out that people who take magic mushrooms with alcohol, or who use mushrooms in unfamiliar or dangerous settings, expose themselves to a level of risk that would not occur if they consumed their drugs in a safer setting. In certain cases, users might experience panic attacks and flashbacks – again, if they have a negative set and setting or if they have a history or a predisposition toward anxiety attacks – so the researchers advise users to “plan your trip carefully, with trusted company, and in a safe place,” and also to know the exact nature of the substances that will be consumed.
The Fear of Psychedelics
The Cut summarizes that much of the fear of psychedelics – that they cause brain damage, burn holes in the brain, or “permafry” users – is the result of sensationalist media coverage and misunderstandings of cause and effect. Writing in Nature magazine (“No Link Found Between Psychedelics And Psychosis”), a scientist notes that the intense nature of the psychedelic experience has led many to assume the worst about hallucinogens. The Cut points out that since much remains a mystery about both psychedelics and mental illnesses, the two being conflated is unsurprising.
Ultimately, says The Cut, while there are legitimate concerns about the effects and safety of psychedelics, the most drastic predictions of brain damage or “acid casualties” are the result of “decades of […] unnecessary fear mongering.” A study author and associate professor in Behavioral Pharmacology Research Unit at Johns Hopkins University in Baltimore, Maryland, acknowledges that while the public health data suggests the dangers of psychedelics have been overstated, people have nonetheless been harmed as the result of their psychedelic consumption even if these cases are rare outliers.
The surest way to avoid any unwanted effects from psychedelic consumption is not to take psychedelics at all. For people who have a high risk of developing certain mental health disorders, psychedelic drug use will almost certainly exacerbate their conditions. For users who are going to take hallucinogens, it should be done only in the company of trusted friends, in a safe environment, and with full knowledge of the nature and dosage of the psychedelics they are taking.