What it is
Hallucinogens are substances that profoundly alter perception, thinking and mood, including LSD, psilocybin (“magic mushrooms”), and dissociative drugs such as ketamine and PCP. Unlike alcohol, opioids or stimulants, the classic hallucinogens are not strongly physically addictive and rarely produce the compulsive, dependent pattern seen with those substances. The DSM-5-TR still recognises hallucinogen use disorder where use becomes problematic, along with intoxication and a specific lingering condition described below.
This entry sits within a fast-moving scientific story: some of these substances are being studied as potential treatments for certain mental health conditions under strict clinical conditions. That research is genuinely promising but is not the same as recreational use, which carries real risks and no medical supervision.
The real risks
The dangers are mainly psychological and situational. A “bad trip” can bring intense fear, paranoia and distress, and intoxication impairs judgement in ways that lead to accidents and injury. In vulnerable people, hallucinogens can trigger or worsen psychosis. A specific condition, hallucinogen persisting perception disorder, involves distressing perceptual disturbances (such as visual trails or flashes) continuing after the drug has worn off. Dissociatives like ketamine carry their own dependence and bladder-damage risks with heavy use.
What helps
There is no specific medicine for hallucinogen use disorder; support is psychological. Acute distress (a “bad trip”) is managed with calm reassurance in a safe, low-stimulation environment and medical help if needed. Where use has become problematic, or is being used to escape underlying distress, counselling and treatment of any co-occurring anxiety, depression or psychosis are the path forward. Honest assessment, without judgement, helps people get the right help.
Hallucinogen use in the African context
Hallucinogen use is far less common here than substances like alcohol, khat, or cannabis, but it does occur, and where it does it is poorly understood. The main dangers are not physical dependence, which is not typical, but the risk of a frightening experience, a bad trip, with intense fear or panic, the danger of accidents or harm while perceptions are distorted, and, in some people, the triggering or worsening of lasting mental health problems, including in those already vulnerable to psychosis. A rare effect is ongoing visual disturbances after use. The useful messages are calm, practical safety, honest disclosure to clinicians, and seeking help for any persistent fear, low mood, or unusual experiences afterward.
Staying safe and getting help
A calm, practical, honest approach matters most.
- During a frightening experience, calm reassurance in a safe, quiet place helps, and serious distress needs medical care.
- Be honest with clinicians about what was taken, since it directly guides safe care.
- Seek help for any lasting fear, low mood, anxiety, or unusual perceptions after use.
- Take particular care where there is any personal or family history of psychosis, which hallucinogens can worsen. See our psychosis guide.
- Avoid driving or risky situations while perceptions are affected. Our find a therapist page can help.
When to seek help
Seek help if hallucinogen use is becoming problematic, if you experience lingering perceptual changes after use, or if use brings persistent fear, paranoia or unusual thoughts. Seek urgent help for severe distress or any psychotic symptoms.
Sources
- American Psychiatric Association. (2022). DSM-5-TR.
- Johnson, M. W., et al. (2018). The abuse potential of medical psilocybin according to the 8 factors of the US Controlled Substances Act. Neuropharmacology, 142, 143-166.
- Halpern, J. H., et al. (2018). Hallucinogen persisting perception disorder: A review. Therapeutic Advances in Psychopharmacology, 8(1), 3-9.