Hallucinogen Use Disorder

Key Takeaways

• Hallucinogen use disorder is a mental health condition characterized by psychological (and occasionally physical) addiction to hallucinogenic drugs. The disorder is linked to numerous psychiatric conditions and can cause severe dysfunction in day-to-day life.
• Symptoms include mental or physical cravings, loss of control over use, prioritizing hallucinogens over responsibilities, and continuing use despite harm. Warning signs of HUD commonly present as dilated pupils, mood swings, paranoia, flashbacks, and more.
• Treatments such as cognitive-behavioral therapy, twelve-step programs, and meditation have been shown to assist individuals with hallucinogen use disorder in managing cravings, developing healthy coping skills, and reducing the risk of relapse.

What are Hallucinogens?

Hallucinogens have been used since ancient times to induce spiritual experiences, and today, are still believed by many to act as a doorway to a mystical inner journey. However, this remains unproven, and while hallucinogens are widely believed to be harmless and non-addictive, abusing these substances can lead to the onset of hallucinogen use disorder (HUD). ^[1]

In reality, hallucinogens are defined by the US Alcohol and Drug Foundation as “a class of psychoactive substances that cause changes in perception, mood, and cognitive processes.” This means that the drugs have the ability to affect all five senses and additionally influence an individual’s thoughts, emotions, and even their perception of time. ^[1]

Hallucinogens trigger both delusions (false beliefs, such as being convinced one holds supernatural powers) and hallucinations (sensory experiences that are not real, such as seeing, hearing, or feeling sensations that are not real). However, while these experiences are the key attraction for hallucinogen users, unfortunately, they can also be deeply disturbing.

In other words, a person under the influence of hallucinogens could believe themselves to be flying through the clouds one moment, and find themselves trapped in a nightmare of persecutory delusions the next. These present as the belief that one is in danger of real, life-threatening harm, and are incredibly common while under the influence of hallucinogens.

What is the Difference Between Hallucinogens and Psychedelics?

The terms "hallucinogens" and "psychedelics" are often used interchangeably, and while the definitions are related, they are not identical in meaning. Instead, hallucinogens are a broad category of psychoactive substances that change perception, mood, and thinking, typically causing sensory and cognitive experiences without external stimuli.

Hallucinogenic drugs are categorized into subtypes depending on the different chemical makeup of each group that affects perception through different mechanisms. The primary hallucinogenic subtypes include psychedelics, dissociatives, and deliriants. In light of this, while all psychedelics are hallucinogens, not all hallucinogens are psychedelics.

Understanding Hallucinogen Use Disorder

Hallucinogen use disorder is defined as a form of substance use disorder that may involve both physical and psychological addiction to hallucinogens. Although the mental health condition is less widespread than other substance use disorders, such as alcoholism, HUD can result in equally destructive consequences and change a person’s life trajectory forever. ^[2]

The disorder can not only lead to severe impairments in health (both physical and psychiatric), but also dysfunction and severe consequences in one’s relationships, occupation, and personal life. Furthermore, hallucinogen use disorder is linked to a variety of psychiatric conditions like psychosis, anxiety, depression, and even suicidal thoughts and attempts. ^[2]

While not classified in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) as a standalone mental health condition, hallucinogen-related conditions are grouped under the broader category of substance use disorders, with the term “hallucinogen use disorder” often used informally to refer to an addiction caused by hallucinogenic drugs. ^[3]

However, the manual does indeed have a chapter titled “other hallucinogen-induced disorders,” which includes hallucinogen intoxication, hallucinogen withdrawal (for certain substances), and hallucinogen-induced psychotic disorder. That said, according to the DSM-5, an official HUD diagnosis must align with the general substance use disorder criteria. ^[3]

On the other hand, the International Classification of Diseases, Eleventh Revision (ICD-11) lists hallucinogen use disorder as a distinct condition under the category of “disorders due to psychoactive substance use”. Within this chapter, HUD is characterized by patterns similar to other substance use disorders, such as cravings and use despite harmful consequences. ^[4]

Are Hallucinogens Addictive?

Despite the persisting myth that hallucinogens are not addictive, hallucinogen use disorder is a form of substance use disorder that involves dependence on hallucinogens (whether physical, psychological, or both). In other words, hallucinogens can lead to cravings that affect the body, as well as a mental preoccupation or obsession with these seemingly harmless drugs. ^[2]

In fact, according to the ICD-11, hallucinogen use disorder can be diagnosed as either “harmful use” or “dependence” (also known as addiction). Although some hallucinogens, such as PCP and ketamine, are considered more addictive than others, in reality, any mind and mood-altering substance holds the potential to trigger dependence and chronically rewire the brain. ^[2]

This is due to the way in which drugs influence perception and emotions, often producing experiences that many feel compelled to repeat. In cases where an individual abuses hallucinogens frequently over a prolonged period, some may begin to use these substances as an escape or unhealthy coping mechanism, instead of directly confronting life’s challenges. ^[2]

With this in mind, it is important to note that hallucinogen use disorder is generally associated more with compulsive behaviors and psychological dependence than with physical addiction. However, it is possible to become physically addicted to certain hallucinogens, and anyone who regularly uses hallucinogens is at risk of developing a dependence. ^[2]

Are Hallucinogens Good for Mental Health?

According to the Newport Institute (an American network of psychiatric treatment centers), hallucinogen use doubled between 2013 and 2023 and recently reached its highest recorded level. This surge in popularity could be due to the hype surrounding emerging scientific research suggesting that certain hallucinogens may have a positive effect on mental health. ^[2]

More specifically, in recent years, interest in prescribing drugs such as LSD, psilocybin, and ketamine to treat addiction and other mental health conditions has grown, with research since the 1960s generally showing positive results in terms of reducing drug use in addicts while supporting abstinence. ^[5]

That being said, it is important to note that many of these studies involve only small, non-diverse populations and made use of inaccurate measuring systems. In reality, the current scientific literature shows that hallucinogens can intensify or bring on a range of mental health conditions (including psychosis), lead to co-occurring substance use disorders, and even trigger suicide. ^{[2] [5]}

While large-scale trials surrounding the psychiatric benefits of hallucinogens are now underway, traditional holistic treatments (including psychological, social, and practical support) remain the most reliable path to mental health recovery, and further research is needed to confirm the efficacy of hallucinogens in improving mental health conditions. ^[5]

Furthermore, although there is some promising evidence surrounding the benefits of hallucinogens on psychiatric health, it is important to note that taking hallucinogens without medical supervision or according to recommended dosages cannot cure or even improve mental health and comes with a whole host of risks, including fatality. ^[2]

Commonly Used Hallucinogens

Thousands of chemical compounds have hallucinogenic effects, and many naturally occur in plants. For example, mescaline is derived from the peyote cacti, and psilocybin (magic mushrooms) is sourced from fungi. ^[2]

On the other hand, some hallucinogens (such as acid, PCP, or ketamine) are created artificially in laboratories. This means that hallucinogens are divided into two primary categories, natural and synthetic (man-made). ^[2]

Natural Hallucinogens

There is a wide range of natural hallucinogens, all of which have been taken in various forms since ancient times as part of traditional spiritual rituals. However, no matter whether natural or synthetic, these substances can trigger hallucinogen use disorder and cause serious consequences in a person’s life. ^[1]

Psilocybin

Psilocybin, also known as magic mushrooms, causes a psychedelic experience (such as colors appearing more vivid and patterns seeming to move) and is one of the most widely used hallucinogens for both recreational and emerging therapeutic purposes.

Typically consumed orally (either fresh or dried), psilocybin can also be brewed into a tea or ground into capsules. The intoxicating effects of this substance tend to last four to six hours, depending on the specific mushroom species and dose.

Mescaline

Mescaline is derived from the small Peyote cactus, which has been used ceremoniously by indigenous people for thousands of years to catalyze spiritual experiences. The effects of mescaline last for up to twelve hours, and the drug is known for its intense visual effects.

This hallucinogen is less common than magic mushrooms and is not typically used in a therapeutic setting. Instead, the drug is generally consumed without professional supervision by chewing the cactus’s buttons or brewing them into a bitter tea.

Dimethyltryptamine (DMT)

Dimethyltryptamine, also known as DMT, is a natural chemical that produces potent, short-lived psychedelic experiences lasting between 5 and 30 minutes. Most frequently smoked through a pipe or vaporized to rapidly induce hallucinations, the substance can also be swallowed.

Like many natural hallucinogens, DMT has also been used ritualistically since ancient times. Although commonly referred to as the “God molecule” (due to its association with near-death and mystical experiences), its exact role in the body is not yet understood.

Ayahuasca

Originating from Amazonian spiritual ceremonies and gaining popularity globally as a “plant medicine”, ayahuasca is an ancient brew that combines DMT-containing plants with MAO inhibitors to induce powerful, prolonged visual hallucinations.

However, ayahuasca is dangerous to use even as part of a guided spiritual practice, with some individuals developing a reliance on the psychedelic experiences, and ultimately using the substance repeatedly to escape reality or as an unhealthy coping mechanism.

Salvia Divinorum

Salvia divinorum, also known as “salvia,” is a plant that produces short but intense dissociative and hallucinogenic experiences. Recreational use of the drug has spread worldwide, especially as a legal alternative psychedelic in some countries.

Primarily smoked or vaporized for five to fifteen minutes of intoxication, salvia can take the form of dried leaves, concentrated extracts, smoking blends, or liquid tinctures, with extracts being the most common today.

Ibogaine

Ibogaine is a naturally occurring psychedelic compound found in the bark of the African iboga plant, which has been used in traditional spiritual rites for centuries. Typically ingested orally, the drug’s effects tend to last longer than 24 hours and can lead to psychological dependence.

While ibogaine is increasingly being studied for addiction treatment and has recently been adopted worldwide in addiction therapy contexts for its ability to affect multiple brain regions (including glutamate, opioid, and serotonin networks), its efficacy is not yet proven.

Synthetic Hallucinogens

Synthetic (or man-made) hallucinogens were first developed in the early 20th century for scientific and medical purposes, with most of the psychoactive chemical compounds discovered between the 1930s and 1940s, when people began to use them recreationally.

At first, the dangers of these drugs were not well known, but within a few years, reports of unpredictable and unappealing psychological experiences began to emerge, although these were not scientifically understood at the time.

Today, synthetic hallucinogens are used despite strong evidence having revealed the link between hallucinogenic drugs and mental health complications, with some man-made hallucinogens more likely to cause physical dependence than others.

Lysergic Acid Diethylamide (LSD/Acid)

LSD, colloquially known as acid, was the first man-made hallucinogen to be developed, and is well renowned for its mind-altering effects, with musicians like The Beatles popularizing the concept of psychedelic culture and music in the 1960s.

Commonly distributed in liquid form or on small tabs (known as “blotters”) which are placed on the tongue, the effects of acid last between 8 and 12 hours and can lead to psychological addiction, along with distressing hallucinations, also known as “bad trips.”

Phencyclidine (PCP)

PCP, also known as “angel dust,” is a dissociative hallucinogen, which means that users feel detached from reality and disconnected from their body and their surroundings during intoxication.

Unlike many other hallucinogens, PCP can cause physical dependence, which comes with withdrawal symptoms such as depression, anxiety, and strong cravings. While all hallucinogens can trigger psychosis, PCP is notorious for its strong link to psychotic symptoms.

Ketamine

Ketamine is a dissociative hallucinogen typically snorted as a powder, but also taken orally or injected. The substance is widely used medically and recreationally, most famously by Elon Musk, who claims to use the drug for mental health purposes.

Although ketamine is primarily psychologically addictive, the drug can also lead to co-occurring substance use disorders and physical cravings. In light of the fact that using ketamine for psychiatric wellbeing is an emerging area of research, it is important to consider the risks.

Synthetic Dimethyltryptamine (DMT)

Although DMT occurs naturally in plants, animals, and humans, the drug can also be manufactured in laboratories for research and recreational use. Chemically-produced DMT is typically more potent than natural DMT and is reported to cause a more “mind-oriented” effect.

This means that the hallucinogen (which, like natural DMT, takes the form of a powder) could potentially be more psychologically overwhelming for some users, and more likely to trigger psychiatric symptoms such as psychosis or paranoia.

Signs and Symptoms of Hallucinogen Addiction

Hallucinogen use disorder is not classified as a standalone disorder in the DSM-5. Instead, hallucinogen-related conditions are grouped under the broader category of substance use disorders, with the term “hallucinogen use disorder” often used informally to refer to an addiction caused by hallucinogens. ^[3]

That said, the DSM-5 does have a chapter titled “other hallucinogen-induced disorders,” such as hallucinogen intoxication, hallucinogen withdrawal (for certain substances), and hallucinogen-induced psychotic disorder; however, the formal diagnosis follows the general substance use disorder criteria as applied to hallucinogens. ^[3]

Alternatively, the International Classification of Diseases, Eleventh Revision (ICD-11) lists hallucinogen use disorder under the category of “disorders due to psychoactive substance use” but does not include a section on withdrawal. While dependence on psychedelics is rare, within this chapter, hallucinogen use is characterized by different patterns and consequences. ^[4]

Harmful Pattern of Use of Hallucinogens

This category is defined as a repeated use of hallucinogens resulting in harm to oneself or others - whether in the form of physical, mental, or behavioral consequences. This pattern of harmful use must have been present for at least twelve months (if episodic) or more than one month (if an individual’s use is continuous, or daily). There is also a diagnosis for “unspecified pattern of harmful use” where the timeline is not clear. ^[4]

Hallucinogen Dependence

Although unusual, it is not impossible to become addicted to psychedelics. According to the ICD-11, hallucinogen dependence can be diagnosed when an individual struggles with intense cravings to use these substances repeatedly, along with a loss of control and continued use despite harmful consequences. ^[4]

The condition is generally only diagnosed after a year of episodic use, or more than three months of continuous use. Within this category are several sub-categories, including current use, early full remission, sustained partial remission, sustained full remission, and unspecified hallucinogen dependence. ^[4]

Diagnosing Hallucinogen Use Disorder

Hallucinogen use disorder, as defined in the ICD-11, is diagnosed when there is clear evidence of harmful use or dependence on hallucinogens. This can involve repeated use for at least 12 months (episodic) or continued use for 3 months (daily or almost daily), resulting in addiction and a variety of the following symptoms: ^[4]

• Strong craving or internal drive to use hallucinogens
• Impaired control over use (using more than intended or for longer periods of time, or unsuccessful attempts to cut down)
• Increasing priority of substance use over daily responsibilities
• Persistent use despite awareness of harm
• Patterns of use causing physical or mental health damage
• Risky behavior during intoxication

Overall, the ICD-11 hallucinogen use disorder diagnosis is similar to the DSM-5 substance use disorder diagnosis (with the exception of tolerance or withdrawal symptoms) and helps to support early intervention and treatments in order to address both the physical and psychological impacts of harmful hallucinogen use.

Noticeable Signs of Hallucinogen Addiction

In addition to the behavioral symptoms of hallucinogen use disorder listed in the DSM-5 and ICD-11, individuals with an addiction to hallucinogenic drugs typically show noticeable physical and emotional warning signs. These signs can develop gradually over time, or manifest suddenly, particularly with frequent or high-dose usage:

Physical Signs

• Dilated pupils
• Altered heart rate or blood pressure
• Sweating
• Nausea
• Vomiting
• Dizziness
• Tremors
• Muscle spasms
• Loss of coordination
• Blurred vision
• Respiratory distress
• Mydriasis
• Palpitations
• Muscle twitching
• Bloodshot eyes
• Abrupt changes in weight
• Deteriorating hygiene
• Slurred speech (during intoxication or withdrawal)
• Drowsiness
• Difficulty distinguishing reality from hallucinations

Emotional Signs

• Anxiety, panic attacks, paranoia, or fear
• Increased restlessness
• Sudden mood swings (including depression or irritability)
• Feeling disconnected from self or reality
• Difficulty coping with stress (leading to agitation)
• Persistent negative emotions, such as sadness or emotional numbness
• Physical cravings or preoccupation with hallucinogenic experiences
• Sleep disturbances, including insomnia, vivid dreams, or nightmares

Causes and Risk Factors

While the exact cause of hallucinogen use disorder is unknown, there are a number of risk factors linked to HUD that are influenced by a combination of genetic, psychological, behavioral, and environmental factors. These can increase individual vulnerability to hallucinogen addiction, with some more likely to initiate or continue hallucinogen use than others. ^{[6] [7]}

• Family history of addiction: Like other substance disorders, genetics increases the likelihood of developing an addiction, including hallucinogen use disorder.
• Mental health disorders: Conditions such as depression, anxiety, ADHD, and more, raise the risk of turning to hallucinogens to self-medicate or cope with symptoms. ^[6]
• Peer pressure and social environment: Influences from peers, especially during adolescence and young adulthood, significantly contribute to initial and continued use. ^[7]
• Starting substance use at a young age: Beginning hallucinogen or other substance use early in life can disrupt brain development and increase vulnerability to addiction. ^[7]
• Polysubstance use: Using multiple substances concurrently or successively increases the risk of developing HUD due to their combined effects on the brain. ^[6]
• Impulsivity and risk-taking: Personality traits such as impulsivity are linked to a higher likelihood of hallucinogen use and related problems. ^[6]
• Environmental factors: Poor parental monitoring, family conflict, childhood maltreatment, and traumatic experiences elevate the risk of hallucinogen addiction. ^[7]
• Personal history of other substance use disorders: Previous substance use disorders heighten the chance of cross-addiction to HUD. ^[7]

Risks and Complications

Hallucinogen use carries both short-term and long-term risks, affecting the mind and body in a variety of ways that can range from uncomfortable to dangerous. Short-term effects may include disturbing hallucinations, unpleasant physical effects, and unsafe behavior, while long-term use may result in persistent psychiatric and medical issues.

Short-Term Complications of Hallucinogen Use

While hallucinogen users aim to induce pleasant experiences during intoxication, taking hallucinogens is a gamble that can easily lead to terrifying hallucinations and delusions, which may last as long as 24 hours, depending on which type is taken. This is known as a “bad trip” and is one of the most common short-term complications of hallucinogen use, along with unwelcome physical effects.

Psychological Complications

Hallucinogen intoxication varies widely depending on a person’s mental state (known as set) and the environment (referred to as setting) in which the drugs are taken. In other words, poor mental health, stimulating or unfamiliar environments, and unknown people typically lead to a “bad trip.”

A “bad trip” is when hallucinogen intoxication becomes frightening, disturbing, or overwhelming. It can involve terrifying hallucinations, panic, and dangerous or unpredictable behavior, such as running into traffic or even jumping off a tall building. Additionally, high doses or particularly potent batches increase the risk of experiencing these negative effects.

Physical Complications

Hallucinogen intoxication can cause a wide range of undesirable effects beyond mind-altering experiences. While short-term psychological complications, such as a bad trip, are widely recognized, what is less well-known is that these substances also trigger uncomfortable physical reactions that may even be dangerous. ^[1]

• Hallucinations
• Confusion
• Difficulty concentrating
• Dizziness
• Blurred vision
• Clumsiness
• Rapid or irregular heartbeat
• Accelerated breathing
• Vomiting
• Sweating and chills
• Numbness

Long-Term Complications of Hallucinogen Use

Hallucinogen use can have a wide range of chronic psychological consequences, including numerous psychiatric disorders, flashbacks, co-occurring substance use, and even suicidal thoughts or behaviors. Physical complications such as weight loss and speech difficulties may also emerge.

Flashbacks

One of the most common long-term effects of psychedelics is for individuals to struggle with flashbacks, which involve reliving aspects of a past hallucinogenic experience. These can occur days or even years after the original experience and may be triggered by stress, fatigue, physical activity, or the use of other substances. ^[1]

These flashbacks typically last a minute or two and are often visual, ranging from pleasant and neutral experiences to highly anxiety-inducing episodes. It is important to keep in mind that due to the vivid and unpredictable nature of flashbacks, this lingering complication holds the potential to cause serious harm, such as a car accident or another injury. ^[1]

Psychiatric Disorders

Studies have shown that a wide range of mental health conditions are linked to hallucinogen use, with one study showing that around 50% of those who had previously or currently used hallucinogenic drugs to have received treatment for psychological or emotional issues. ^[2]

It was also found that these individuals were nearly twice as likely to be on prescription medication for mental health compared to peers who had never used hallucinogens. The following psychiatric disorders have been shown to be influenced by hallucinogen use. ^[2]

Psychotic Disorders

Among hallucinogen users, there are often stories of those who “never come back,” and of all debilitating mental health conditions linked to these substances, hallucinogen-induced psychotic disorder is the most severe observed. ^[4]

Though it remains relatively rare on a global scale, this psychiatric condition is incredibly distressing, and symptoms include hallucinations, delusions, paranoia, or disorganized thinking that are more intense and longer-lasting than the typical effects of intoxication. ^[4]

Additionally, hallucinogen-persisting perception disorder (which causes sudden flashbacks or hallucinations) can develop after even a single use. HPPD may appear days to over a year after taking hallucinogens. ^[8]

Depressive and Anxiety Disorders

A 2023 study found that approximately nine out of ten hallucinogen users experienced new or worsening anxiety after taking hallucinogens. According to the research paper, anxiety and depression are the most common long-term psychiatric complications caused by hallucinogen use. ^[9]

Co-Occurring Substance Use Disorders

A large study with over 56,000 people found that those who had used hallucinogens (in this case, LSD or psilocybin) were more likely to struggle with substance abuse compared to people who had never used psychedelics, particularly if the LSD use was more recent. ^[10]

In light of the fact that combining hallucinogens with other drugs can put the body under intense strain and have unpredictable psychiatric consequences, co-occurring substance use disorders can further complicate mental health. ^[1]

Suicidal Ideation

Research has shown that hallucinogen users are more likely to experience a sense of hopelessness and consider suicide, with 36% of adolescent users reporting suicidal thoughts compared to 15% in non-users. This population group was tragically also found to be nearly ten times more likely to attempt suicide that required medical attention. ^[2]

Other Long-Term Complications

In addition to the strong link between mental health disorders and hallucinogen abuse, frequent use of these substances can lead to certain chronic psychiatric and physical symptoms that persist without a formal diagnosis. Depending on the type of hallucinogen abused, these effects may include: ^[8]

• Paranoia
• Mood swings
• Disorganized thinking
• Chronic hallucinations
• Persistent visual disturbances
• Symptoms resembling neurological disorders
• Memory loss or amnesia
• Speech difficulties
• Weight loss

Can a Person Overdose on Hallucinogens?

It is entirely possible to overdose on hallucinogens, although fatal overdoses are uncommon with some of these substances. However, a number of hallucinogens have been associated with deaths and serious health complications, particularly at very high doses or when combined with other substances such as alcohol.

Most overdose incidents result in emergency care due to acute behavioral effects or accidents rather than direct toxicity. Large-scale data also indicates a higher risk of mortality within five years after hospital treatment for hallucinogen use (primarily from suicide or accidental poisoning), underscoring the dangers of these drugs. ^[11]

Treatment Options

While there is limited research on treatments specifically designed for hallucinogen use disorder, it has been shown that psychological addictions benefit from the same therapies employed for other substance use disorders, as addiction treatment typically targets both mental and physical components of dependence. ^[12]

In light of this, traditional approaches used to treat addiction to substances, such as cognitive-behavioral therapy, 12-step programs, and complementary methods such as meditation, can assist individuals in managing cravings and building healthier coping skills that can reduce the risk of relapse and support recovery maintenance. ^[12]

Contrary to popular belief, it is common for those with psychological addictions such as HUD to relapse, and some experts consider psychological addiction even harder to overcome than physical dependence. That said, some hallucinogens can cause physical addiction, yet it is important to treat the condition as one would another substance use disorder, regardless of the substance involved. ^[12]

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is based on the idea that thoughts shape emotions, which in turn affect behaviors. This therapeutic approach is designed to teach individuals how to identify and challenge harmful thought patterns, so as to replace them with healthier alternatives, which supports an awareness of cravings, thereby reducing the risk of relapse. ^[13]

Although CBT is among the most thoroughly studied behavioral treatments for substance use disorders (including hallucinogen use disorder), research indicates it generally provides only moderate benefits compared with little or no treatment. In fact, it has been found that its effects may be less pronounced or enduring than those of other therapies. ^[14]

12-Step Programs

While some clinicians view psychological and physical dependence as inseparable, others emphasize that psychological dependence can persist long after physical withdrawal ends, contributing to the risk of relapse. In light of this, it is beneficial to participate in a 12-step program such as Narcotics Anonymous (NA) in order to successfully maintain recovery. ^[12]

NA can aid addiction recovery by providing peer support, guidance from a mentor (sponsor), and inspiring drug-free role models. The program also combats denial and serves as a reminder that hallucinogen recovery requires ongoing management and vigilance. Depending on the severity of HUD, these groups may be used alone or in combination with other treatments. ^[14]

The core principles of Narcotics Anonymous include surrender, acceptance, and leading a principled life, which lead to a sense of purpose and serenity. Building on these principles, the 12-step approach has been adapted into a therapeutic framework that, alongside traditional group participation, has been found effective in supporting long-term recovery. ^[13]

Meditation

Numerous studies have shown the benefit of meditation for mental health, and the practice has been found to enhance recovery maintenance. Furthermore, the Narcotics Anonymous program encourages daily meditation as a means of becoming aware of underlying thoughts and emotions that can contribute to cravings.

12-Step Treatment Centers and Sober Living Communities

For individuals with more severe cases of hallucinogen use disorder, inpatient rehabilitation programs can provide essential support, particularly when paired with the Narcotics Anonymous program. These treatment facilities offer a controlled, substance-free environment that supports addiction recovery and introduces the 12-step program without access to hallucinogens.

Rehabilitation facilities are equipped to address medical needs such as hallucinogen-induced psychosis and typically provide a combination of cognitive-behavioral therapy, meditation, and peer support. Following treatment, joining a sober living environment (often colloquially termed a “halfway house”) can help individuals to reintegrate into everyday life.

Helping a Loved One With a Hallucinogen Use Disorder

Supporting a loved one with hallucinogen use disorder requires empathy, patience, and understanding. Individuals struggling with addiction often experience shame and isolation due to an underlying awareness that their actions have harmed themselves and others.

In the case of hallucinogen users, there is the added complication of HUD not being a widely recognized mental health challenge. For this reason, avoiding judgment is essential, and instead of criticizing or questioning the person, it is best to express a desire to help.

Providing reassurance is equally important, as many hallucinogen users feel alone and fear further abandonment. By letting a loved one know you are there for them (even if a relapse occurs), you can create a sense of safety and stability beneficial to recovery.

Focusing on remaining curious and caring instead of placing blame can enhance communication and understanding. This can be achieved by asking nonjudgmental questions about your loved one’s experiences and feelings, which encourages honest sharing.

It is also essential to acknowledge that full understanding may never be possible, but support can still be offered unconditionally. By emphasizing connection over judgment, loved ones can help the individual feel seen and supported, reducing isolation and shame.

While the process is often messy and emotionally challenging, consistent empathy, reassurance, and commitment provide a foundation for recovery and strengthen the relationship, turning a difficult situation into an opportunity for meaningful connection.

Can You Prevent Hallucinogen Use Disorders?

Like other substance use disorders, hallucinogen use disorder can cause individuals to become preoccupied with obtaining, using, and recovering from drug use. Although hallucinogens rarely cause physical cravings, the mental obsession with using these substances can result in serious consequences.

In light of the fact that frequency of use strengthens dependency, the most effective way to prevent hallucinogen use disorder is to avoid the habitual use of hallucinogens. As it is not possible to know before trying a hallucinogen for the first time whether an addiction will develop, the best way to prevent hallucinogen use disorder is to abstain from hallucinogenic drugs entirely.

Early recognition of unhealthy use is crucial, as abstinence during the early stages of hallucinogen use disorder can greatly reduce the risk of long-term dependence, co-occurring substance use disorders, and a wide range of psychiatric conditions. Ultimately, the widespread myth that hallucinogens are non-addictive is inaccurate, and the substance should be avoided.

Final Thoughts

While hallucinogens have been used since ancient times for their spiritual and recreational purposes, misusing these drugs can result in hallucinogen use disorder (HUD) and profound mental, social, and occupational consequences alongside a range of complications, including psychiatric disorders, flashbacks, co-occurring substance use, and suicidal ideation.

HUD is a frequently underestimated form of substance use disorder, characterized primarily by psychological dependence and, in some cases, physical addiction. Despite ongoing research into potential therapeutic applications of certain hallucinogens, self-medication remains highly risky, and large-scale evidence supporting the safety and efficacy of medically supervised use is limited.

Effective treatment relies on a combination of interventions, including cognitive-behavioral therapy, twelve-step groups, meditation, and, in severe cases, rehabilitation. With early recognition and support from loved ones, recovery becomes more likely, and it is possible for those with hallucinogen use disorder to recover and lead a fulfilling life.

FAQs

What is microdosing?

Microdosing involves consuming very small amounts of a drug (generally a psychedelic) with users aiming to take around 1/5 to 1/20 of a standard recreational dose. This quantity is too low to produce a typical "high" or noticeable hallucinations. The goal of microdosing is to achieve subtle cognitive, emotional, or creative benefits without experiencing full-blown intoxication.

Are psychedelics legal?

Psychedelics are mostly illegal in the U.S, where they are classified as Schedule I substances, which means they are viewed as having no accepted medical use and a high risk of abuse. Despite this, some states and cities have decriminalized or allowed certain psychedelics (such as psilocybin) for medical or therapeutic purposes.

Author

Jack Cincotta

Jack Cincotta holds a M.S. degree in Psychology. He is also a board-certified holistic health practitioner through AADP and an AFPA-certified holistic health coach and nutritionist.

Activity History - Last updated: March 19, 2026, Published date: March 19, 2026

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Reviewer

Jennifer Brown

Dr. Jennifer Brown is dual board-certified in family medicine and obesity medicine. She currently works for Amwell Medical Group, providing virtual primary care services, including mental health treatment.

Activity History - Medically reviewed on April 13, 2026 and last checked on March 19, 2026