Chlorpromazine was synthesized on December 1950, the first drug claimed to have specific effects on madness, and would serve as the prototype for the phenothiazine class of drugs, which later grew to comprise several other agents. The introduction of chlorpromazine into clinical use has been described as the single greatest advance in “psychiatric” care, said to dramatically improve the “prognosis” of inmates of insane asylums worldwide. Of more import the availability of such drugs sharply curtailed use of shock and lobotomy and was one of the driving forces behind the emptying of insane asylums.
Chlorpromazine is said to cause constipation, sedation, and cholination and help relieve nausea and anxiety. It can produce restlessness, where the patient walks almost constantly, despite the lack of anywhere much to walk to due to mandatory confinement, and takes small, shuffling steps. It is known to result in tardive dyskinesia which can be irreversible.
Deliriants or psychodelics have a long history of use within medicine and religion around the world. They are used in ritual healing, divination, and initiation. When used in religious rites, such drugs are referred to as “en-theo-gens”—i.e. god attractors. Also, in some states and on some reservations, certain deliriants like Peyote are used in religious ceremony, and so are considered legal. Starting in the mid-20th century, deliriants have been the object of extensive attention in the Western world. They have been and are being explored as potential agents in treating various kinds of madness.
Yet the most popular use of deliriants in Western culture has been associated with the search for religious experience, creativity, and mental expansion. The use of such drugs was a major part of the 1960s counterculture in which it became associated with various social movements and a general atmosphere of strife between generations.
The recreational, religious, and medical uses of psychedelics continue today, with advocacy groups pushing for their legalization. In addition to this activity by proponents, hallucinogens are also widely used in research to understand the brain. However, ever since hallucinogenic experimentation was discontinued back in the late Sixties, research into the therapeutic applications of such drugs have been almost nonexistent, that is until this last decade when research was allowed to resume.
Many psychedelics (e.g. LSD, psilocybin, mescaline) are non-toxic in dosages typically ingested, making it difficult or impossible to overdose on these compounds. Though the natural drugs have a long history of use and usually have an extensive study profile aside from the mortality rates of the drugs, in recent times there has been large production of hundreds of virtually unstudied that may be potentially harmful. This is especially the case with the designer drugs in the psychedelic-amphetamine class. Because of this factor, one should not make the generalization that all psychedelics cannot be potentially harmful at normal doses.
Some dissociatives can have neural depressant effects, thereby carrying similar risks as opiods, which can slow breathing or heart rate to levels resulting in death (when using very high doses). However, although DXM and PCP are close neuro-chemical cousins, DXM is an analog of morphine (while PCP is not), and it has been noted to depress respiration in some instances. Paradoxically, DXM in higher doses can increase heart rate and blood pressure and still depress respiration. Inversely, PCP can have more unpredictable effects and has often been classified as a stimulant and a depressant in some texts along with being as a dissociative. While many have reported that they “feel no pain” while under the effects of PCP, DXM and Ketamine, this does not fall under the usual classification of anesthetics in recreational doses (anesthetic doses of dxm can be highly dangerous). Rather, true to their name, they process pain as a kind of “far away” sensation; pain, although present, becomes a disembodied experience and there is much less emotion associated with it. As for probably the most common dissociative, N2O, the principal risk seems to be due to oxygen deprivation. Injury from falling is also a danger, as nitrous oxide may cause sudden loss of consciousness, an effect of oxygen deprivation.
Deliriants are sometimes called true hallucinogens, because they do cause hallucinations in the proper sense: a user may have conversations with people who aren’t there, or become angry at a ‘person’ mimicking their actions, not realizing it is their own reflection in a mirror. They are called deliriants because their effects are similar to the experiences of people with delirious fevers. While dissociatives can produce effects similar to lucid dreaming (during which one is consciously aware of dreaming), the deliriants have effects akin to sleepwalking (during which one does not remember the experience).
In addition to the dangers of being far more disconnected from reality than with other drugs and retaining a truly fragmented dissociation from regular consciousness without being immobilized, the anticholinergics are toxic, carry the risk of death by overdose, and also include a number of uncomfortable side effects, such as dehydration and dilation of the pupils.
Most modern-day users of deliriants report similar or identical hallucinations. For example, when taken in a high enough dosage, users report vivid, dark, and entity-like hallucinations, peripheral disturbances, feelings of being alone but simultaneously of being watched, and hallucinations of real things ceasing to exist. Deliriants also may cause confusion or even rage, and thus have been used by ancient peoples as a stimulant before going into battle..
Hallucinogenic substances are among the oldest drugs used by human kind, as hallucinogenic substances naturally occur in mushrooms, cacti, and a variety of other plants. Numerous cultures worldwide have endorsed the use of hallucinogens in medicine, religion, and recreation, to varying extents, while some cultures have regulated or outright prohibited their use. In most developed countries today, the possession of many hallucinogens, even those found commonly in nature, is considered a crime punishable by fines, imprisonment or even death.
Although natural hallucinogenic drugs have been known to mankind for millennia, it was not until the early 20th century that they received extensive attention. Earlier beginnings include studies of nitrous oxide in the late 18th century, and initial studies of the constituents of the peyote cactus in the late 19th century.
After World War II there was an explosion of interest in hallucinogenic drugs in medicine, owing mainly to the invention of LSD. Interest in the drugs tended to focus on either the possible beneficial effects of the drugs, or on the use of hallucinogens to produce madness in order to understand disorders such as what Bleuler and Jung called “schizophrenia.” By 1951, more than 100 articles on LSD had appeared in medical journals, and by 1961, the number had increased to more than 1000 articles.
The class of drugs described in this article has been described by a profusion of names, most of which are associated with a particular theory of their nature. Following the discovery of LSD came numerous attempts to improve on it, such as hallucinogen, phanerothyme, psychodelic, psychomimetic, psycholytic, schizophrenogenic, cataleptogenic, mysticomimetic, psychodysleptic, and entheogenic.
The word psychotomimetic reflects the guess of early researchers that the effects of psychedelic drugs are similar to naturally-occurring symptoms of Bleuler’s and Jung’s “schizophrenia.” It remained for a long time somewhat of a shibboleth to be used in the titles of papers as a signal that the researcher disapproved of the casual use of a drug, but has of late been displaced in the medical literature by hallucinogen.
The word psychedelic was coined by Humphrey Osmond and has the rather mysterious but at least somewhat value-neutral meaning of “mind manifesting”. The word entheogen, on the other hand, which is often used to describe the religious and ritual use of psychedelic drugs in anthropological studies, is associated with the idea that it could be relevant to religion. The words entactogen, empathogen, dissociative, and deliriant, at last, have all been coined to refer to classes of drugs similar to the psychedelics that seemed deserving of a name of their own.
The most popular words—hallucinogen, psychotomimetic, psychedelic—have often been used interchangeably. Hallucinogen is now, however, the most common designation, although it is an inaccurate descriptor of the actual effects of these drugs. In the lay press, the term psychedelic is still the most popular and has held sway for nearly four decades. Most recently, there has been a movement to recognize the ability of these substances to provoke mystical experiences and evoke feelings of spiritual significance. Thus, the term entheogen, derived from the Greek word entheos, which means “god within”, has seen increasing use. Although it seems unlikely that this name will ever be accepted in formal scientific circles, its use has dramatically increased in the popular media and on internet sites. Indeed, in much of the counterculture that uses these substances, entheogen has replaced psychedelic as the name of choice and we may expect to see this trend continue.