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Textbook of Addiction Treatment pp 259–279Cite as

Addiction of Hallucinogens, Dissociatives, Designer Drugs and “Legal Highs”: Update on Potential Therapeutic Use

Abstract

Hallucinogenic drugs have as their primary effect the production of disturbances of perception. Hallucinogens can be classified according to their chemical structure as indoleamines (similar to serotonin), phenethylamines (similar to catecholamines), dissociatives (phencyclidines) and others (including salvinorin, dextromethorphan, muscarinic antagonists and cannabinoids). The hallucinogenic effects appear to be related to the agonistic action on 5-HT2A receptors in the cortex. These actions seem to cause a functional imbalance at various levels (cortical areas, limbic system, which is a group of brain structures involved in emotional regulation), contributing to distort the integrative action. Hallucinogens produce substance use disorder, induce acute tolerance to its effects and do not present withdrawal syndrome. The novel psychoactive substances (NPS) can induce substance use disorder, intoxication and in some cases withdrawal syndrome (for those with psychostimulant properties). Depending on the substance and pharmacological effects, the DSM-5 diagnostic criteria for hallucinogens or stimulants can be applied. The therapeutic aim in these cases is to reduce consumption and achieve the abstinence. There are no specific drugs for treating the addiction caused by these substances. Some hallucinogens are under evaluation for its therapeutic use in different mental disorders.

Keywords

  • Hallucinogens
  • LSD
  • Psilocybin
  • Mescaline
  • MDMA
  • Esketamine
  • Therapeutic use
  • Substance use disorder
  • New psychoactive substances

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Acknowledgements

This work was supported by the following grants: Instituto de Salud Carlos III (PI17/01962, JR16/0020) and Red de Trastornos Adictivos-RTA RD16/0017/0003 and RD16/0017/0010, integrated in the National RCDCI and funded by the ISCIII and the European Regional Development Fund [FEDER], European Commission action grants (Directorate-General for Migration and Home Affairs, Grant Agreement number: 806996-JUSTSO-JUST-2017-AGDRUG), Suport Grups de Recerca AGAUR Gencat (2017SGR 316 and 2017SGR 530) and Instrumental Action for the Intensification of Health Professionals-Specialist practitioners (PERIS: SLT006/17/00014).

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Authors and Affiliations

  1. Universitat Autònoma de Barcelona, Barcelona, Spain

    Magi Farré, Esther Papaseit, Francina Fonseca & Marta Torrens

  2. Hospital Universitari Germans Trias i Pujol (IGTP), Badalona, Spain

    Magi Farré & Esther Papaseit

  3. Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain

    Francina Fonseca & Marta Torrens

  4. IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), Barcelona, Spain

    Francina Fonseca & Marta Torrens

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  1. Magi Farré
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  2. Esther Papaseit
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  3. Francina Fonseca
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  4. Marta Torrens
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Correspondence to Magi Farré .

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Editors and Affiliations

  1. Division of Addiction Department of Psychiatry, University of Calgary, Calgary, AB, Canada

    Nady el-Guebaly

  2. Mental Health Department, University of Milano-Bicocca, Monza, Monza e Brianza, Italy

    Prof. Giuseppe Carrà

  3. Division of Alcoholism and Drug Abuse Department of Psychiatry, NYU School of Medicine, New York, NY, USA

    Marc Galanter

  4. Population and Behavioural Science Division (Psychiatry and Addictions), University of St Andrews, St.Andrews, UK

    Prof. Dr. Alexander M. Baldacchino

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Farré, M., Papaseit, E., Fonseca, F., Torrens, M. (2021). Addiction of Hallucinogens, Dissociatives, Designer Drugs and “Legal Highs”: Update on Potential Therapeutic Use. In: el-Guebaly, N., Carrà, G., Galanter, M., Baldacchino, A.M. (eds) Textbook of Addiction Treatment. Springer, Cham. https://doi.org/10.1007/978-3-030-36391-8_19

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