Hallucinogen Intoxication (292.89)

DSM-IV-TR criteria

A. Recent use of a Hallucinogen.

B. Clinically Significant maladaptive behavioral or psychological changes (e.g., marked anxiety or depression, ideas of reference, fear of losing one’s mind, paranoid ideation, impaired judgment, or impaired social or occupational functioning) that developed during, or shortly after, hallucinogen use.

C. Perceptual changes occurring in a state of full wakefulness and alertness (e.g., subjective intensification of perceptions, depersonalization, derealization, illusions, hallucinations, synesthesias) that developed during, or shortly after, hallucinogen use.

D. Two (or more) of the following signs, developing during, or shortly after, hallucinogen use:

• pupillary dilation
• tachycardia
• sweating
• palpitations
• blurring of vision
• tremors
• incoordination

E. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.

Associated features

• Hallucinogen Intoxication usually begins with some stimulant effects such as restlessness and autonomic activation. Nausea may occur. A sequence of experiences then follows, with higher doses producing more intense symptoms. Feelings of euphoria may alternate rapidly with depression or anxiety. Initial visual illusions or enhanced sensory experience may give way to hallucinations. At low doses, perceptual changes frequently do not include hallucinations. Synesthesias (a blending of senses) may result, for example, in sounds being “seen.” The hallucinations are usually visual, often of geometric forms or figures, sometimes of persons and objects. More rarely, auditory or tactile hallucinations are experienced. In most cases, reality testing is preserved (i.e., the individual knows that the effects are substance induced).
• Symptoms include distortion of sight, sound, and touch, disorientation, paranoia, anxiety attacks, blissful calm or state of being mellow, increased empathy, long-term memory loss, and impaired concentration and motivation.
• Physical symptoms include increased blood pressure, increased heart rate, vomiting, blurred vision, enlarged pupils, sweating, diarrhea, restlessness, muscle cramping, dehydration, and increase in body temperature that may lead to seizures.

Child vs. adult presentation

Gender and cultural differences in presentation

Epidemiology

Etiology

Empirically supported treatments

While someone is suffering from Hallucinogen Intoxication it is best to have physical contact with the person, although sometimes adverse reactions do occur to physical touch sometimes it helps to keep the person intact with reality. Helping the intoxicated person to breath slowly and keep them away from large groups of people helps.

Links:

• ONF NFB: Hoffman’s Potion