integ: abpsych (substance-related and addictive disorders)

Substance

chemical compounds that are ingested to alter mood or behavior

SUBSTANCE USE DISORDERS

1.Taking the substance in larger amounts or for longer periods than intended.

2.Persistent desire or unsuccessful efforts to cut down or control substance use.

3.Spending a great deal of time obtaining, using, or recovering from the effects of

the substance.

4.Craving or strong desire to use the substance.

5.Recurrent use of the substance resulting in failure to fulfill major role obligations

at work, school, or home.

6.Continued use of the substance despite persistent or recurrent social or

interpersonal problems caused or exacerbated by its effects.

7.Important social, occupational, or recreational activities are given up or reduced

because of substance use.

8.Recurrent use of the substance in situations in which it is physically hazardous.

9.Continued use of the substance despite knowledge of having a persistent or

recurrent physical or psychological problem that is likely to have been caused or

exacerbated by the substance.

ADDICTION

• when you have a strong physical or psychological need or urge to do something or use something

• inability to stop using a substance or engaging in a behavior even though it may cause psychological or physical harm.

• neurological

Environmental norms

A person may experience pressure to adhere to what is “normal” among their peer group. For example, if everyone smokes, a person may feel left out when all of their friends take a smoke break. As a result, they may join in, even if their friends never encourage them to smoke or even actively discourage it.

Direct pressure

comes in the form of peers urging a person to do something, such as by threatening them, telling them how fun something will be, or suggesting a person do something they might not otherwise consider.

MENTAL HEALTH ISSUES

• Studies found that people with a mental disorder, such as anxiety, depression, or post-traumatic stress disorder (PTSD), may use drugs or alcohol as a form of self-medication.

• However, although some drugs may temporarily help with some symptoms of mental disorders, they may make the symptoms worse over time.

• Additionally, brain changes in people with mental disorders may enhance the rewarding effects of substances, making it more likely they will continue to use the substance.

Indirect pressure

happens when peers indirectly influence a person’s behavior. For example, several studies have shown that teens are more likely to be friends with people who share their habits, such as smoking.

DEPENDENCE AND ADDICTION

It’s possible to be dependent on a drug without being addicted (think caffeine withdrawal)

you can also be addicted to a drug without being physically dependent on it.

Psychoactive Substances

chemicals that alter brain function, leading to changes in mood, perception, consciousness, cognition, or behavior.

dependence

physical

Substance Use

ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning

Substance Intoxication

• physiological reaction to ingested substances

• recent use of a psychoactive substance, leading to behavioral, cognitive, or physiological changes.

• It’s essentially the acute “high” or immediate effects of a substance.

• reversible syndrome characterized by significant maladaptive behavioral or psychological changes that occur as a result of the ingestion of a substance.

Substance Use Disorders

• chronic, relapsing conditions in which the use of a psychoactive substance leads to clinically significant impairment or distress.

• category of mental health disorders characterized by problematic patterns of use of substances like alcohol, tobacco, or other drugs, leading to clinically significant impairment or distress.

Tolerance

• use of increasingly greater amounts of the drug to experience the same effect

• need for higher doses over time to achieve the same effect

substance withdrawal

• negative physical response when the substance is no longer ingested

• a syndrome that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance.

• development of a specific set of symptoms that occur upon abrupt cessation of or reduction in the use of a substance to which an individual has become physically dependent.

• typically distressing and can vary widely depending on the substance involved, the severity of dependence, and individual factors such as genetic predisposition and overall health.

sociopathic personality disturbance

In early editions of the DSM, alcoholism and drug abuse were categorized as

Depressants

• Result in behavioral sedation and can induce relaxation

• Decrease central nervous system activity

• Include alcohol and the sedative and hypnotic drugs in the families of barbiturates and benzodiazepines

Stimulants

• Cause us to be more active and alert and can elevate mood

• Include amphetamines, cocaine, nicotine, and caffeine

Opiates

• Produce analgesia temporarily (reduce pain) and euphoria

• Heroin, opium, codeine, and morphine

Hallucinogens

• Alter sensory perception and can produce delusions, paranoia, and hallucinations

• Cannabis and LSD

Gambling Disorder

Inability to resist the urge to gamble which, in turn, results in negative personal consequences

Alcohol

produced when certain yeasts react with sugar and water and fermentation takes place

mild substance use disorder

presence of two to three symptoms

moderate

four to five symptoms,

severe

six or more symptoms.

alcohol-related disorders

• Motor coordination is impaired (staggering, slurred speech)

• Reaction time is slowed

• Confusion

• Ability to make judgments is reduced

• Vision and hearing can be negatively affected

GABA

• A type of inhibitory neurotransmitter

• Sensitive to alcohol

• Alcohol’s anti-anxiety properties may result from its interaction with the what system

• When this attaches to its receptor, chloride ions enter the cell and make it less sensitive to the effects of other neurotransmitters

Glutamate System

• A type of excitatory neurotransmitter

• Suspected to involve learning and memory, and it may be the avenue through which alcohol affects cognitive abilities

• Causes blackouts

Serotonin System

believed to be responsible for alcohol cravings, and affects mood, sleep, and eating behavior

Dementia

general loss of intellectual abilities

Wernicke-Korsakoff Syndrome

results in confusion, loss of muscle coordination, and unintelligible speech

Fetal Alcohol Syndrome (FAS)

• fetal growth retardation, cognitive deficits, behavior problems, and learning difficulties

• prenatal exposure to alcohol, leading to permanent physical, cognitive, and behavioral abnormalities

Alcohol Dehydrogenase (ADH)

type of enzyme that metabolizes alcohol

Pre-Alcoholic Stage

Drinking occasionally with few serious consequence

Prodromal Stage

Drinking heavily but with few outward signs of a problem

Crucial Stage

Loss of control with occasional binges

Chronic Stage

Primary daily activities involve getting and drinking alcohol

withdrawal delirium

• Condition that can produce frightening hallucinations and body tremors

• Also called delirium tremens

Alcohol Intoxication

• Usually occurs as an episode developing over minutes to hours and typically lasting several hours

• Frequency and intensity usually decrease with further advancing age

Substance/Medication-Induced Mental Disorders

potentially severe, usually temporary, but sometimes persisting central nervous system (CNS) syndromes that develop in the context of the effects of substances of abuse, medications, or several toxins.

Substance/Medication-Induced Mental Disorders

A. The disorder represents a clinically significant symptomatic presentation of a relevant mental disorder.

B. There is evidence from the history, physical examination, or laboratory findings of both of the follov^ing:

1. The disorder developed during or within 1 month of a substance intoxication or

withdrawal or taking a medication; and

2. The involved substance/medication is capable of producing the mental disorder.

C. The disorder is not better explained by an independent mental disorder (i.e., one that is not substance- or medication-induced). Such evidence of an independent mental disorder could include the following:

1. The disorder preceded the onset of severe intoxication or withdrawal or exposure to the medication; or

2. The full mental disorder persisted for a substantial period of time (e.g., at least 1 month) after the cessation of acute withdrawal or severe intoxication or taking the medication. This criterion does not apply to substance-induced neurocognitive disorders or hallucinogen persisting perception disorder, which persist beyond the cessation of acute intoxication or withdrawal.

D. The disorder does not occur exclusively during the course of a delirium.

E. The disorder causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Alcohol Use Disorder

A. A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1. Alcohol is often taken in larger amounts or over a longer period than was intended.

2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.

3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recovôr from its effects.

4. Craving, or a strong desire or urge to use alcohol.

5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.

6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.

alcohol use disorder — early remission

After full criteria for alcohol use disorder were previously met, none of the criteria for alcohol use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use alcohol,” may be met).

alcohol use disorder — sustained remission

After full criteria for alcohol use disorder were previously met, none of the criteria for alcohol use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use alcohol,” may be met).

alcohol use disorder — controlled environment

This additional specifier is used if the individual is in an environment where access to alcohol is restricted.

alcohol use disorder — Mild

Presence of 2-3 symptoms

alcohol use disorder — moderate

Presence of 4-5 symptoms

alcohol use disorder — severe

Presence of 6 or more symptoms

Alcohol Intoxication

A. Recent ingestion of alcohol.

B. Clinically significant problematic beliavioral or psychological changes (e.g., inappropriate sexual or aggressive behavior, mood lability, impaired judgment) that developed during, or shortly after, alcohol ingestion.

C. One (or more) of the following signs or symptoms developing during, or shortly after, alcohol use:

1. Slurred speech.

2. Incoordination.

3. Unsteady gait.

4. Nystagmus.

5. Impairment in attention or memory.

6. Stupor or coma.

D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance.

Alcohol Withdrawal

A. Cessation of (or reduction in) alcohol use that has been heavy and prolonged.

B. Two (or more) of the following, developing within several hours to a few days after the cessation of (or reduction in) alcohol use described in Criterion A:

1. Autonomic hyperactivity (e.g., sweating or pulse rate greater than 100 bpm).

2. Increased hand tremor.

3. Insomnia.

4. Nausea or vomiting.

5. Transient visual, tactile, or auditory hallucinations or illusions.

6. Psychomotor agitation.

7. Anxiety.

8. Generalized tonic-clonic seizures.

C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

alcohol withdrawal With perceptual disturbances

This specifier applies in the rare instance when hallucinations (usually visual or tactile) occur with intact reality testing, or auditory, visual, or tactile illusions occur in the absence of a delirium.

Sedatives

• Has a calming effect on the body and mind

• Often used to treat anxiety, insomnia, and other conditions that involved hyperactivity or excessive arousal

Hypnotics

• Induce sleep

• Often used to treat insomnia and other sleep disorders

Anxiolytics

• Reduce anxiety

• Often used to treat anxiety, panic disorders, and other conditions that involve excessive fear or worry

Barbiturates

• a family of sedative drugs

• Include Amytal, Seconal, and Nembutal

• They were prescribed to help people sleep and replaced such drugs as alcohol and opium

Benzodiazepines

• medications that slow down the nervous system and treat anxiety, insomnia, seizures and other conditions

• Include Valium, Xanax, and Ativan

• Used since the 1960s, primarily to reduce anxiety

• Originally touted as a miracle cure for the anxieties

• Not appropriate for reducing the tension and anxiety resulting from everyday stresses and strains

• Considered much safer than barbiturates, with less risk of abuse and dependence

Rohypnol

• Otherwise known as “forget-me-pill,” “roofenol,” “roofies,” “ruffies”

• Has the same effect as alcohol without the telltale odor

Amphetamines

• induce feelings of elation and vigor and can reduce fatigue

• First synthesized in 1887 and later used as a treatment for asthma and as a nasal decongestant

• Can also reduce appetite

• Prescribed for people with narcolepsy

• Given to children with ADHD

Cocaine

• derived from the leaves of the coca plant

• Use and misuse of drugs wax and wane according to societal fashion, moods, and sanctions

• In small amounts, this increases alertness, produces euphoria, increases blood pressure and pulse, and causes insomnia and loss of appetite

Tobacco-Related Disorders

psychoactive substance that produces patterns of dependence, tolerance, and withdrawal

Nicotine

• Withdrawal symptoms include depressed mood, insomnia, irritability, anxiety, difficulty concentrating, restlessness, and increased appetite and weight gain

• In small doses, stimulates the central nervous system

• It can also relieve stress and improve mood

• Can also cause high blood pressure and increase the risk of heart disease and cancer

Caffeine

• most common of the psychoactive substances

• Called the “gentle stimulant”

• Thought to be the least harmful of all addictive drugs

Caffeine

• Found in tea, coffee, many soda drinks, and cocoa products

• Can make you feel jittery and can cause insomnia

• Takes a relatively long time to leave our bodies (6 hours)

Caffeine Intoxication

A. Recent consumption of caffeine (typically a high dose well in excess of 250 mg).

B. Five (or more) of the following signs or symptoms developing during, or shortly after, caffeine use:

1. Restlessness.

2. Nervousness.

3. Excitement.

4. Insomnia.

5. Flushed face.

6. Diuresis.

7. Gastrointestinal disturbance.

8. Muscle twitching.

9. Rambling flow of thought and speech.

10. Tachycardia or cardiac arrhythmia.

11. Periods of inexhaustibility.

12. Psychomotor agitation.

C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance.

Caffeine Withdrawal

A. Prolonged daily use of caffeine.

B. Abrupt cessation of or reduction in caffeine use, followed within 24 hours by three (or more) of the following signs or symptoms:

1. Headache.

2. Marked fatigue or drowsiness.

3. Dysphoric mood, depressed mood, or irritability.

4. Difficulty concentrating.

5. Flu-like symptoms (nausea, vomiting, or muscle pain/stiffness).

C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The signs or symptoms are not associated with the physiological effects of another medical condition (e.g., migraine, viral illness) and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

Opiate

natural chemicals in the opium poppy that have a narcotic effect

Opioids

the family of substances that includes natural opiates, synthetic variation, and the comparable substances that occur naturally in the brain

Opioid Intoxication

• recent use of opioids, leading to central nervous system depression and characteristic physical and behavioral symptoms.

• Pupillary constriction (or dilation in overdose)

Opioid Intoxication

• At least 1

  • Drowsiness or coma

  • Slurred speech

  • Impaired attention or memory

Opioid Withdrawal

• Develops after abrupt stop or reduction in prolonged/heavy opioid use

• Dysphoric mood

Opioid Use Disorder

Ongoing use of opioids causing distress or impairment

Cannabis

most routinely used illegal substance

Marijuana

name given to the dried parts of the cannabis or hemp plant

Cannabis Use Disorder

A. A problematic pattern of cannabis use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1. Cannabis is often taken in larger amounts or over a longer period than was intended.

2. There is a persistent desire or unsuccessful efforts to cut down or control cannabis use.

3. A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its effects.

4. Craving, or a strong desire or urge to use cannabis.

5. Recurrent cannabis use resulting in a failure to fulfill major role obligations at work, school, or home.

6. Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.

Cannabis Use Disorder — In early remission

After full criteria for cannabis use disorder were previously met, none of the criteria for cannabis use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use cannabis,” may be met).

Cannabis Use Disorder — In sustained remission

After full criteria for cannabis use disorder were previously met, none of the criteria for cannabis use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use cannabis,” may be present).

Cannabis Use Disorder — In a controlled environment

This additional specifier is used if the individual is in an environment where access to cannabis is restricted.

Cannabis Use Disorder — mild

Presence of 2-3 symptoms

Cannabis Use Disorder — Moderate

Presence of 4-5 symptoms.

Cannabis Use Disorder — severe

Presence of 6 or more symptoms.

Cannabis

is the generic and perhaps the most appropriate scientific term for the psychoactive substance(s) derived from the plant, and as such it is used in this manual to refer to all forms of cannabis-like substances, including synthetic cannabinoid compounds.

Cannabis

most commonly smoked via a variety of methods: pipes, water pipes (bongs or hookahs), cigarettes (joints or reefers), or, most recently, in the paper from hol- lowed out cigars (blunts).

Vaporization

heating the plant material to release psychoactive cannabinoids for inhalation.

Cannabis Intoxication

A. Recent use of cannabis.

B. Clinically significant problematic behavioral or psychological changes (e.g., impaired motor coordination, euphoria, anxiety, sensation of slowed time, impaired judgment, social withdrawal) that developed during, or shortly after, cannabis use.

C. Two (or more) of the following signs or symptoms developing within 2 hours of cannabis use:

1. Conjunctival injection.

2. Increased appetite.

3. Dry mouth.

4. Tachycardia.

D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance.

Cannabis Intoxication With perceptual disturbances

Hallucinations with intact reality testing or auditory, visual, or tactile illusions occur in the absence of a delirium.

Cannabis Intoxication

typically begins with a ''high" feeling followed by symptoms that include euphoria with inappropriate laughter and grandiosity, sedation, lethargy, impairment in short-term memory, difficulty carrying out complex mental processes, impaired judgment, distorted sensory perceptions, impaired motor performance, and the sensation that time is passing slowly.

Cannabis Withdrawal

A. Cessation of cannabis use tliat lias been heavy and prolonged (i.e., usually daily or almost daily use over a period of at least a few months).

B. Three (or more) of the following signs and symptoms develop within approximately 1 week after Criterion A:

1. Irritability, anger, or aggression.

2. Nervousness or anxiety.

3. Sleep difficulty (e.g., insomnia, disturbing dreams).

4. Decreased appetite or weight loss.

5. Restlessness.

6. Depressed mood.

7. At least one of the following physical symptoms causing significant discomfort: abdominal pain, shakiness/tremors, sweating, fever, chills, or headache.

C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

Phencyclidine

• can be an additive to other substances

• impaired control, social impairment, and pharmacological symptoms

Phencyclidine Use Disorder

A. A pattern of phencyclidine (or a pharmacologically similar substance) use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1. Phencyclidine is often taken in larger amounts or over a longer period than was intended.

2. There is a persistent desire or unsuccessful efforts to cut down or control phencyclidine use.

3. A great deal of time is spent in activities necessary to obtain phencyclidine, use the phencyclidine, or recover from its effects.

4. Craving, or a strong desire or urge to use phencyclidine.

5. Recurrent phencyclidine use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences from work or poor work performance related to phencyclidine use; phencyclidine-related absences, suspensions, or expulsions from school; neglect of children or household).

Phencyclidine Use Disorder

6. Continued phencyclidine use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the phencyclidine (e.g., arguments with a spouse about consequences of intoxication; physical fights).

7. Important social, occupational, or recreational activities are given up or reduced because of phencyclidine use.

8. Recurrent phencyclidine use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by a phencyclidine).

9. Phencyclidine use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the phencyclidine.

10. Tolerance, as defined by either of the following:

a. A need for markedly increased amounts of the phencyclidine to achieve intoxication or desired effect.

b. A markedly diminished effect with continued use of the same amount of the phencyclidine.

Phencyclidine Use Disorder — In early remission

After full criteria for phencyclidine use disorder were previously met, none of the criteria for phencyclidine use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the phencyclidine,” may be met).

Phencyclidine Use Disorder — In sustained remission

After full criteria for phencyclidine use disorder were previously met, none of the criteria for phencyclidine use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the phencyclidine,” may be met).

phencyclidines

They produce feelings of separation from mind and body (hence "dissociative") in low doses, and at high doses, stupor and coma can result.

Other Hallucinogen Use Disorder

A. A problematic pattern of hallucinogen (other than phencyclidine) use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1. The hallucinogen is often taken in larger amounts or over a longer period than was intended.

2. There is a persistent desire or unsuccessful efforts to cut down or control hallucinogen use.

3. A great deal of time is spent in activities necessary to obtain the hallucinogen, use the hallucinogen, or recover from its effects.

4. Craving, or a strong desire or urge to use the hallucinogen.

5. Recurrent hallucinogen use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences from work or poor work performance related to hallucinogen use; hallucinogen-related absences, suspensions, or expulsions from school; neglect of children or household).

Other Hallucinogen Use Disorder

6. Continued hallucinogen use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the hallucinogen (e.g., arguments with a spouse about consequences of intoxication; physical fights).

7. Important social, occupational, or recreational activities are given up or reduced because of hallucinogen use.

8. Recurrent hallucinogen use in situations in which it is physically hazardous (e.g. driving an automobile or operating a machine when impaired by the hallucinogen).

9. Hallucinogen use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the hallucinogen.

10. Tolerance, as defined by either of the following:

a. A need for markedly increased amounts of the hallucinogen to achieve intoxi-

cation or desired effect.

b. A markedly diminished effect with continued use of the same amount of the hallucinogen.

Phencyclidine Intoxication

A. Recent use of phencyclidine (or a pharmacologically similar substance).

B. Clinically significant problematic behavioral changes (e.g., belligerence, assaultiveness, impulsiveness, unpredictability, psychomotor agitation, impaired judgment) that developed during, or shortly after, phencyclidine use.

C. Within 1 hour, two (or more) of the following signs or symptoms:

Note: When the drug is smoked, “snorted,” or used intravenously, the onset may be particularly rapid.

1. Vertical or horizontal nystagmus.

2. Hypertension or tachycardia.

3. Numbness or diminished responsiveness to pain.

4. Ataxia.

5. Dysarthria.

6. Muscle rigidity.

7. Seizures or coma.

8. Hyperacusis.

D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including Intoxication with another substance.

8 days

Laboratory testing may be useful, as phencyclidine is detectable in urine for up to how many days following use, although the levels are only weakly associated with an individual's clinical presentation and may therefore not be useful for case management.

Other Hallucinogen Intoxication

A. Recent use of a hallucinogen (other than phencyclidine).

B. Clinically significant problematic behavioral or psychological changes (e.g., marked anxiety or depression, ideas of reference, fear of “losing one’s mind,” paranoid ideation, impaired judgment) 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:

1. Pupillary dilation.

2. Tachycardia.

3. Sweating.

4. Palpitations.

5. Blurring of vision.

6. Tremors.

7. Incoordination.

E. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance.

LSD (d-lysergic acid diethylamide)

• Sometimes referred to as acid / “truth serum”

• Most common hallucinogenic drug

• Produced synthetically in laboratories

• Naturally occurring derivatives of a fungus (ergot)

Hallucinogen Persisting Perception Disorder

reexperiencing, when the individual is sober, of the perceptual disturbances that were experienced while the individual was intoxicated with the hallucinogen