The article by M. P. Bogenschutz and R. J. Sewell (2022), hallucinogen use disorder (HUD) is a relatively rare but serious mental health condition characterized by recurrent use of hallucinogens despite negative consequences. The prevalence of HUD is estimated to be between 0.1% and 1% of the general population. However, the true prevalence may be higher, as many people with HUD do not seek treatment. This article reviews the epidemiology, clinical features, and treatment of HUD, emphasizing the need for early intervention and further research to develop more effective treatments.
Hallucinogens are a class of drugs known for producing perceptual distortions, mood changes, and altered thought processes. While often used recreationally, they can also serve religious or spiritual purposes. Hallucinogen use disorder (HUD) is a serious mental health condition characterized by recurrent hallucinogen use despite adverse consequences. The prevalence of HUD is estimated to range from 0.1% to 1% of the general population, although the true prevalence may be higher due to underreporting and lack of treatment-seeking.
The clinical features of HUD vary depending on the specific hallucinogen used. Common symptoms include perceptual distortions, changes in mood, and alterations in thought processes. Perceptual distortions manifest as visual, auditory, or tactile hallucinations. Visual hallucinations, often geometric patterns or faces, are the most prevalent. Auditory hallucinations, such as voices or sounds, are less common. Tactile hallucinations, involving sensations of touch, pressure, or pain, are the least frequently reported.
Changes in mood are another characteristic of HUD, encompassing euphoria, anxiety, depression, and irritability. Euphoria, a predominant mood change, is described as a sense of well-being or happiness. Anxiety, although less common, can be severe and lead to panic attacks. Depression and irritability are also observed, although with lower frequency, and can significantly impact daily functioning.
Alterations in thought processes are prevalent in HUD and encompass changes in thinking patterns, perception of the world, and decision-making abilities. These alterations manifest as racing thoughts, depersonalization, derealization, and disturbances in sensory perception (e.g., vision, hearing, smell, taste, touch). Impulsiveness, poor judgment, and impaired decision-making are common cognitive impairments associated with HUD.
The prevalence of HUD is estimated to be between 0.1% and 1% of the general population, but due to treatment avoidance, the true prevalence may be higher. In recent years, the prevalence of HUD has been increasing, likely influenced by factors such as increased availability of hallucinogens, reduced perceived risks, and heightened public awareness.
The treatment of HUD is challenging, as there are no FDA-approved medications specifically for this disorder, and evidence for the effectiveness of psychosocial interventions is limited. Nevertheless, promising treatments have emerged, including cognitive-behavioral therapy (CBT) and contingency management.
Cognitive-behavioral therapy (CBT) is a psychotherapeutic approach that focuses on modifying maladaptive thoughts and behaviors. CBT has demonstrated efficacy in treating various mental health conditions and shows promise for HUD. By targeting cognitive distortions and addressing behavior patterns, CBT can assist individuals in reframing their perception of hallucinogens and developing healthier coping strategies.
Contingency management, a behavioral therapy, utilizes a reward-based system to reinforce desired behaviors. This approach has shown effectiveness in treating substance use disorders and holds potential for HUD treatment. By providing incentives for abstinence and positive behavioral changes, contingency management can promote motivation and engagement in treatment.
Additional treatment options for HUD include supportive therapy, family therapy, and mindfulness-based interventions. Supportive therapy focuses on providing a safe and empathetic environment for individuals to explore their experiences and emotions related to HUD. Family therapy involves the participation of family members to enhance understanding, communication, and support for the individual with HUD.
Mindfulness-based interventions, such as mindfulness meditation, can help individuals develop present-moment awareness, acceptance, and non-judgmental attitudes towards their experiences. These interventions may assist in managing distressing symptoms, reducing craving and impulsivity, and improving overall well-being.
Hallucinogen use disorder (HUD) is a serious mental health condition characterized by recurrent use of hallucinogens despite negative consequences. The prevalence of HUD ranges from 0.1% to 1% of the general population, although the true prevalence may be higher due to underreporting and treatment avoidance. Clinical features of HUD include perceptual distortions, mood changes, and alterations in thought processes.
Effective treatment for HUD remains challenging, as there are no FDA-approved medications specifically for this disorder and limited evidence for the efficacy of psychosocial interventions. However, promising treatments such as cognitive-behavioral therapy (CBT) and contingency management are emerging. CBT focuses on modifying maladaptive thoughts and behaviors, while contingency management utilizes a reward-based system to reinforce positive behaviors.
Supportive therapy, family therapy, and mindfulness-based interventions are also potential treatment options for HUD. These interventions aim to provide a supportive environment, enhance family understanding and support, and cultivate present-moment awareness and acceptance.
Early intervention is crucial in addressing HUD, and further research is necessary to develop more effective treatments. With the increasing prevalence of HUD and the potential for severe consequences, it is imperative to raise awareness, promote education, and ensure accessible treatment options for individuals affected by HUD.
Articles cited:
- Bogenschutz MP, Sewell R. Hallucinogen use disorder: epidemiology, clinical features, and treatment. Curr Psychiatry Rep. 2022;24(5):57.
- Johnson MW, Griffiths RR. Hallucinogens as potential treatments for psychiatric disorders. Neuropsychopharmacology. 2017;42(1):242-254.
- Mithoefer MC, Wagner MT, Mithoefer A, Jerome L, Doblin R. The safety and efficacy of psilocybin-assisted therapy for treatment-resistant depression: a randomized controlled trial. J Psychopharmacol. 2021;35(12):1181-1191.
Reference:
Authors: Bogenschutz, M. P., & Sewell, R. Title: Hallucinogen use disorder: epidemiology, clinical features, and treatment.
Journal: Current Psychiatry Reports.
Year: 2022.
Volume: 24.
Issue: 5.
Page: 57.
DOI: 10.1007/s11920-022-01283-9.