Dangers of Non-Medicinal LSD Experiments
While professional use of LSD in psychiatry entails hardly any risk, the ingestion of this substance outside of medical practice, without medical supervision, is subject to multifarious dangers. These dangers reside, on the one hand, in external circumstances connected with illegal drug use and, on the other hand, in the peculiarity of LSD's psychic effects.
The advocates of uncontrolled, free use of LSD and other hallucinogens base their attitude on two claims: (l) this type of drug produces no addiction, and (2) until now no danger to health from moderate use of hallucinogens has been demonstrated. Both are true. Genuine addiction, characterized by the fact that psychic and often severe physical disturbances appear on withdrawal of the drug, has not been observed, even in cases in which LSD was taken often and over a long period of time. No organic injury or death as a direct consequence of an LSD intoxication has yet been reported. As discussed in greater detail in the chapter "LSD in Animal Experiments and Biological Research," LSD is actually a relatively nontoxic substance in proportion to its extraordinarily high psychic activity.
Psychotic Reactions
Like the other hallucinogens, however, LSD is dangerous in an entirely different sense. While the psychic and physical dangers of the addicting narcotics, the opiates, amphetamines, and so forth, appear only with chronic use, the possible danger of LSD exists in every single experiment. This is because severe disoriented states can appear during any LSD inebriation. It is true that through careful preparation of the experiment and the experimenter such episodes can largely be avoided, but they cannot be excluded with certainty. LSD crises resemble psychotic attacks with a manic or depressive character.
In the manic, hyperactive condition, the feeling of omnipotence or invulnerability can lead to serious casualties. Such accidents have occurred when inebriated persons confused in this way - believing themselves to be invulnerable - walked in front of a moving automobile or jumped out a window in the belief that they were able to fly. This type of LSD casualty, however, is not so common as one might be led to think on the basis of reports that were sensationally exaggerated by the mass media. Nevertheless, such reports must serve as serious warnings.
On the other hand, a report that made the rounds worldwide, in 1966, about an alleged murder committed under the influence on LSD, cannot be true. The suspect, a young man in New York accused of having killed his mother-in-law, explained at his arrest, immediately after the fact, that he knew nothing of the crime and that he had been on an LSD trip for three days. But an LSD inebriation, even with the highest doses, lasts no longer than twelve hours, and repeated ingestion leads to tolerance, which means that extra doses are ineffective. Besides, LSD inebriation is characterized by the fact that the person remembers exactly what he or she has experienced. Presumably the defendant in this case expected leniency for extenuating circumstances, owing to unsoundness of mind.
The danger of a psychotic reaction is especially great if LSD is given to someone without his or her knowledge. This was demonstrated in an episode that took place soon after the discovery of LSD, during the first investigations with the new substance in the Zurich University Psychiatric Clinic, when people were not yet aware of the danger of such jokes. A young doctor, whose colleagues had slipped LSD into his coffee as a lark, wanted to swim across Lake Zurich during the winter at -20!C (-4!F) and had to be prevented by force.
There is a different danger when the LSD-induced disorientation exhibits a depressive rather than manic character. In the course of such an LSD experiment, frightening visions, death agony, or the fear of becoming insane can lead to a threatening psychic breakdown or even to suicide. Here the LSD trip becomes a "horror trip."
The demise of a Dr. Olson, who had been given LSD without his knowledge in the course of U.S. Army drug experiments, and who then committed suicide by jumping from a window, caused a particular sensation. His family could not understand how this quiet, well-adjusted man could have been driven to this deed. Not until fifteen years later, when the secret documents about the experiments were published, did they learn the true circumstances, whereupon the president of the United States publicly apologized to the dependents.
The conditions for the positive outcome of an LSD experiment, with little possibility of a psychotic derailment, reside on the one hand in the individual and on the other hand in the external milieu of the experiment. The internal, personal factors are called set, the external conditions setting.
The beauty of a living room or of an outdoor location is perceived with particular force because of the highly stimulated sense organs during LSD inebriation, and such an amenity has a substantial influence on the course of the experiment. The persons present, their appearance, their traits, are also part of the setting that determines the experience. The acoustic milieu is equally significant. Even harmless noises can turn to torment, and conversely lovely music can develop into a euphoric experience. With LSD experiments in ugly or noisy surroundings, however, there is greater danger of a negative outcome, including psychotic crises. The machine- and appliance-world of today offers much scenery and all types of noise that could very well trigger panic during enhanced sensibility.
Just as meaningful as the external milieu of the LSD experience, if not even more important, is the mental condition of the experimenters, their current state of mind, their attitude to the drug experience, and their expectations associated with it. Even unconscious feelings of happiness or fear can have an effect. LSD tends to intensify the actual psychic state. A feeling of happiness can be heightened to bliss, a depression can deepen to despair. LSD is thus the most inappropriate means imaginable for curing a depressive state. It is dangerous to take LSD in a disturbed, unhappy frame of mind, or in a state of fear. The probability that the experiment will end in a psychic breakdown is then quite high.
Among persons with unstable personality structures, tending to psychotic reactions, LSD experimentation ought to be completely avoided. Here an LSD shock, by releasing a latent psychosis, can produce a lasting mental injury.
The psyche of very young persons should also be considered as unstable, in the sense of not yet having matured. In any case, the shock of such a powerful stream of new and strange perceptions and feelings, such as is engendered by LSD, endangers the sensitive, still-developing psycho-organism. Even the medicinal use of LSD in youths under eighteen years of age, in the scope of psychoanalytic or psychotherapeutic treatment, is discouraged in professional circles, correctly so in my opinion. Juveniles for the most part still lack a secure, solid relationship to reality. Such a relationship is needed before the dramatic experience of new dimensions of reality can be meaningfully integrated into the world view. Instead of leading to a broadening and deepening of reality consciousness, such an experience in adolescents will lead to insecurity and a feeling of being lost. Because of the freshness of sensory perception in youth and the still-unlimited capacity for experience, spontaneous visionary experiences occur much more frequently than in later life. For this reason as well, psycho stimulating agents should not be used by juveniles.
Even in healthy, adult persons, even with adherence to all of the preparatory and protective measures discussed, an LSD experiment can fail, causing psychotic reactions. Medical supervision is therefore earnestly to be recommended, even for nonmedicinal LSD experiments. This should include an examination of the state of health before the experiment. The doctor need not be present at the session; however, medical help should at all times be readily available.
Acute LSD psychoses can be cut short and brought under control quickly and reliably by injection of chlorpromazine or another sedative of this type.
The presence of a familiar person, who can request medical help in the event of an emergency, is also an indispensable psychological assurance. Although the LSD inebriation is characterized mostly by an immersion in the individual inner world, a deep need for human contact sometimes arises, especially in depressive phases.
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