LSD 25 , an indole derivative from ergot, was synthesized by Hoffman in 1938, but for a good many years little attention was paid to the drug. Then, within the past year or two, interest in this psychedelic or "mind manifesting" drug has soared among both professionals and the lay public. LSD has been widely publicized in nonmedical publications, a number of sociologic studies exist, and a journal has been founded to report experiences resulting from its use.
Three different approaches to LSD have been described and studied to date. The first is the experimental administration of the drug in controlled laboratory setting, a record being kept of subjective and/or objective effects. Initially the so-called "model psychoses" induced by LSD were compared with schizophrenia and with delirium. However, this method of comparative study has proved to be somewhat disappointing.
The second aspect of study has been the psychotherapeutic use of LSD to increase awareness, lift repressions and facilitate insight during psychotherapy LSD is also used for treatment of specific disorders such as alcoholism.
The third type of study, and the one which concerns us most, has to do with the psychiatric side effects that follow ingestion of LSD. Most of this study is concerned with self-administered doses of the drug. The side effects occur regardless of the sources of the drug and regardless of the setting in which it has been administered, but far more LSD is bought on the black market (it is either imported illegally from Mexico or produced locally by amateur chemists) than is given experimentally or psychotherapeutically. LSD obtained on the street often contains a number of impurities; sometimes other compounds (among them atropine) are sold allegedly as LSD. Black market doses, usually diluted as they are passed on, contain an unknown number of micrograms of LSD.
Psychiatrists throughout the country have been observing increasing numbers of severe side effects from the drug over the past seven or eight months. (An excellent early personal account of a "bad trip" from LSD was "They Split My Personality" by Harry Asher, Saturday Review, June 1, 1963.) At the UCLA Medical Center, approximately one psychiatric disorder associated with LSD ingestion had been turning up every other month. However, beginning in September of 1965, the figure jumped to between five and fifteen cases a month. Other local facilities in the Los Angeles area have reported a similar increase. The new Federal Drug Abuse Control Amendments of 1965, which went into effect on February 1, have had no apparent effect in decreasing the number of LSD cases seen in our psychiatric emergency room. About one-third of the LSD cases at UCLA have required admission to the psychiatric hospital; approximately half of these to the ward on which the authors work.
In addition, we have conducted group therapy sessions once a week for several months among all the hospitalized LSD patients whose doctors would permit them to attend. The purpose was to learn what reactions these patients had experienced and to become acquainted with the patients themselves. The LSD users who come to the hospital are primarily young, single, Caucasian, male; few are religious. They live throughout the Los Angeles area, but particularly in the Hollywood section and the beach cities. Most of them are unemployed, but some are students. Many of our patients had used other drugs besides LSD, particularly marijuana; some had taken LSD as often as sixty times. These people came to the emergency room suffering from confusion, anxiety, depression, suspiciousness and hallucinations.