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For centuries, humans have purposefully ingested naturally occurring mind-altering substances to achieve mystical or religious enlightenment (Table 182-1). The use of psilocybin-containing mushrooms and the peyote cactus in Native American rites dates back before recorded time.1,2 The era of modern interest in synthetic hallucinogenic drugs began in 1943 when Swiss chemist Albert Hofmann discovered the properties of lysergic acid diethylamide (LSD).

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Table 182-1 Commonly Abused Hallucinogens
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Fueled by pop culture as well as drug accessibility, recreational use of hallucinogenic substances peaked in the U.S. during the 1960s. LSD was one of the first drugs popularized in the American drug epidemic, with a second resurgence of use in the 1990s, but its use has fallen precipitously since 2001.3 Except for ethanol, marijuana (cannabis) is currently the most prevalent psychoactive substance abused by young people. The use of other hallucinogens by U.S. youth either dropped significantly (e.g., 3,4-methylenedioxymethamphetamine, or MDMA) or remained at a low level (e.g., phencyclidine, or PCP) between 2000 and 2007.3,4 Interestingly the use of other hallucinogens such as mushrooms, Salvia divinorum, and the tryptamine drugs (dimethyltryptamine, α-ethyltryptamine, and 5-methoxy-diisopropyltryptamine) increased during these years.4

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In 2007, only 3.4% of high school seniors reported that they had used LSD at least once in their lives.3 In 2007, 41.8% of high school seniors and 47.5% of college students reported using marijuana or hashish at least once in their lives.3 In this same year, more than 1 in 20 of all 12th-graders and 1 in 6 college students reported daily use of marijuana at some time for at least a month.3 In 2000, 8.2% of 12th-graders and 9.1% of college students reported MDMA use. In contrast, by 2007, use of MDMA dropped to 4.5% for high school seniors and to 2.2% among college students.3,4 The use of PCP has been steady, reported at 1% to 2% over the past ...

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