LSD and Injectable opiates
LSD (lysergic acid diethylamide) exerts its effects by interacting with the brain’s neurotransmitter systems, primarily the serotonin system. Serotonin, or 5-hydroxytryptamine (5-HT), is involved in regulating mood, perception, and cognition. LSD's action is particularly focused on the 5-HT2A receptor, a subtype of serotonin receptors found in high concentrations in the cortex and other brain regions involved in sensory perception and higher-order thinking.
When LSD enters the brain, it binds to and activates 5-HT2A receptors. This activation does not simply mimic serotonin’s normal effects; instead, it disrupts the usual signaling pathways in complex ways. The result is a significant alteration in perception, thought, and emotion. This disruption can be understood in several key ways:
1. Sensory Processing and Perception: The 5-HT2A receptors are heavily involved in sensory information processing, particularly in areas like the visual cortex and auditory centers. When LSD binds to these receptors, it changes how sensory input is interpreted. This leads to vivid visual distortions or hallucinations, altered auditory experiences, and a shift in the perception of space and time.
2. Increased Cortical Excitation: LSD stimulates a release of glutamate, which is the brain's primary excitatory neurotransmitter. This leads to an increase in cortical activity, especially in areas related to visual and sensory processing. The brain becomes hyperactive in terms of the way it processes stimuli. This is one reason for the heightened awareness or magnification of details that users often report.
3. Altered Connectivity Between Brain Regions: LSD promotes increased communication between brain regions that don’t usually interact as directly. Studies using functional MRI (fMRI) have shown that during an LSD experience, brain networks that are typically segregated start to interact more freely. For instance, the visual cortex may communicate more with the default mode network (DMN), which is involved in self-referential thought and ego. This might explain why users often experience a sense of ego dissolution, where the boundaries between themselves and the external world seem to blur, leading to a sense of oneness or unity with their surroundings.
4. Effects on the Default Mode Network (DMN): The DMN is a set of brain regions that are active when we're not focused on the outside world, such as during daydreaming, introspection, and self-reflection. LSD disrupts the normal functioning of the DMN, which is thought to contribute to the experience of ego dissolution or loss of self-identity. Users often report feeling like they’ve transcended their sense of self, experiencing a connectedness with everything around them.
5. Dopamine and Norepinephrine Activity: While LSD’s primary effects are mediated through serotonin, it also interacts with dopamine and norepinephrine receptors. Dopamine is involved in the brain’s reward and pleasure pathways, and norepinephrine affects arousal and alertness. These interactions may explain some of the stimulating and euphoric effects of LSD, as well as the increased emotional intensity and energy levels during a trip.
Injectable opiates, such as heroin, morphine, and fentanyl, work by interacting with the brain's opioid receptors, which are part of the body's natural pain and reward systems. These receptors are located throughout the central nervous system and are normally activated by endorphins, the body’s natural pain-relieving chemicals. When opiates are injected, they flood the brain and body with powerful synthetic or natural compounds that bind to these opioid receptors, causing a range of physiological and psychological effects.
Once opiate reaches the brain, it crosses the blood-brain barrier and binds primarily to mu-opioid receptors. These receptors are concentrated in areas of the brain that regulate pain, reward, and emotional response, such as the brainstem, limbic system, and spinal cord. By binding to these receptors, opiates inhibit the transmission of pain signals, leading to an analgesic (pain-relieving) effect. This is why injectable opiates are used medically for severe pain relief, as in the case of morphine, which is often administered in hospitals for acute pain following surgery or injury.
Beyond pain relief, opiates also trigger the release of large amounts of dopamine in the brain’s reward circuitry, particularly in the nucleus accumbens. Dopamine is the neurotransmitter associated with pleasure and reward, and this surge of dopamine creates intense feelings of euphoria and well-being.
Each opiate has a slightly different profile. Heroin, for example, is rapidly converted into morphine once it enters the brain, but because it crosses the blood-brain barrier more quickly, the effects are felt more intensely and immediately compared to other opiates. Fentanyl, on the other hand, is far more potent than heroin or morphine—about 50 to 100 times stronger than morphine. Even a small amount of fentanyl can cause profound pain relief and euphoria, but it also carries a much higher risk of overdose because it suppresses the brain’s ability to regulate breathing.
Combining LSD and injectable opiates introduces a wide range of complex and potentially dangerous effects.
One significant risk is respiratory depression. Opiates suppress breathing by acting on the brainstem, and high doses or potent opioids like fentanyl can lead to fatal respiratory failure. While LSD does not directly affect respiration, it can distort perception and judgment, potentially masking the warning signs of an impending overdose. A person under the influence of both substances may not recognize or react to the dangerous levels of sedation caused by opiates, making overdose far more likely.
Additionally, because LSD can cause hyperactivity or restlessness, this might paradoxically mask the sedative effects of the opiate temporarily, giving a false sense of safety before a sudden crash into overdose.
Psychologically, LSD’s hallucinogenic properties can profoundly affect mood and thought patterns. When combined with opiates, the intense euphoria from the opiate might lead to heightened emotional or even spiritual experiences. However, there is also the risk of emotional dysregulation, where the dissociative or hallucinatory effects of LSD combine with the opiate-induced numbness, creating extreme emotional swings or confusion. Users may feel detached from reality, undergo terrifying delusions, exacerbating anxiety and panic.
Moreover, polysubstance use involving these drugs is linked to a higher risk of long-term mental health problems. Chronic users may develop hallucinogen-persisting perception disorder (HPPD) or persistent psychosis, which can be worsened by the psychological withdrawal symptoms associated with opiate use.
Combining LSD with injectable opiates thus amplifies the dangers of both drugs, creating an unpredictable mixture of hallucinogenic overstimulation and opioid-induced sedation that dramatically increases the risk of overdose, mental health crises, and long-term damage to brain function.
We have not come across confirmed data on acute and fatal conditions associated with this combination. At the same time, there are no signs of worthwhile positive recreational effects that could cover the risks of this combination.
Considering the above, we recommend treating this combination with great caution.
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