LSD and the Dental Patient

Lysergic acid diethylamide – or LSD – has emerged in conversations about medical and psychological benefits in recent years. But is it all hype or help for many on the horizon?

By Susan Richards

It's been a very strange trip indeed for the synthetic compound known as LSD or "acid" since it was first discovered in 1938 by Albert Hofmann. The Swiss chemist was working to create a pharmaceutical product that would stimulate circulation, so it seems fitting that LSD is returning to its roots as a potential tool for health and wellness in mainstream medical conversations.

It wasn't until a few years after his clinical discovery that Hofmann realized the compound had psychoactive properties. This helped launch an era of research into the potential therapeutic benefits of LSD and other psychedelics like psilocybin (mushrooms). Brain scientists began looking at doses of psychedelics for treating mental disorders like depression, anxiety, and alcoholism, and for providing palliative care.

Researchers were haling LSD and psilocybin for their psychiatric advantages when the turmoil of the late 1960s upended everything. Cultural and political unrest, opposition to the Vietnam War, and popular media sensationalizing "bad trips" in recreational use eventually resulted in all classical psychedelics, including LSD, being classified as Schedule I drugs in 1971. After the Drug Enforcement Administration (DEA) was established in 1973, criminalization and stigmatization of psychedelics virtually shut down ongoing clinical research.

Fast forward, and we see the emergence of mainstream medicinal marijuana and researchers renewing their efforts to explore the practical advantages of psychedelics.

LSD and Psychedelics in Medicine

The past few decades have given way to a juggernaut of change in the research, medicalization, and in some cases, the legalization of multiple drugs that were or are outlawed. Marijuana has dominated this progress, seeing legal acceptance for medical purposes in 39 states and the District of Columbia (D.C.), and recreational use in 21 states plus D.C., even though federal law still classifies it as a Schedule I narcotic.

It's up for debate if the marijuana movement helped open the doors for psychedelics in medicine again. Either way, advocates – sometimes called "psychonauts" in the research community – continue advancing new studies and awareness. In fact, one of the most well-attended presentations at last year's Society for Neuroscience symposium was called Psychedelics and Neural Plasticity, according to an NPR report.

A recent National Library of Medicine article analyzed currently registered psychedelic studies for treating medical conditions. The significant number of clinical trials and various narcotics and conditions indicate the growing interest in medical applications.

Most widely known for their hallucinogenic effects, psychedelic drugs like LSD can alter perception and emotions when it interacts with serotonin receptors on the surface of brain cells. This connection leads to the understanding that psychedelics could potentially treat substance addictions, depression, PTSD, and more.

In addition to LSD research, there are a growing number of studies into the medical benefits of:

  • Psilocybin for depression, obsessive-compulsive disorder, and anxiety in terminal patients.
  • Ketamine therapy for treatment-resistant depression.
  • MDMA (also known as ecstasy or molly) for PTSD symptoms.
  • DMT (a component of ayahuasca, a natural psychedelic) for depression.

What's notably missing from the recent influx of psychedelic research are detrimental psychotic reactions. Researchers consider LSD and its hallucinogenic relatives to have the least adverse side effects for a Schedule I class of drugs and low addiction potential.

Microdosing Goes Mainstream

Natural psychedelics have long been a part of indigenous cultures around the world. In addition to treating mental issues, ayahuasca, mushrooms, and peyote have historically been incorporated into prayer and community rituals.

Therefore, it's no surprise that psychedelic devotees have embraced the practice of microdosing – typically 1/5 to 1/20 of a recreational dose – LSD or psilocybin to enhance mood or stimulate creativity, as well as the mental health benefits researchers are more focused on.

In one microdosing study conducted by the University of Chicago, results were "a little bit disappointing," according to the lead researcher. Participants seemed to build a tolerance to the small doses of LSD with diminished stimulation over time, and the placebo effect was considered a possible factor. However, anecdotal results by those who self-administer are much more positive.

While clinical research into microdosing is still limited and shows mixed results, several states have already legalized the practice for therapeutic use under certain conditions, and others are sure to follow.

LSD and the Dental Patient

As more recreational drugs undergo decriminalization, if not legalization, dental teams must be aware of their patients' usage, especially when sedation is involved. DOCS Education's co-founder, Dr. Anthony Feck, recently addressed what dentists need to know to keep patients safe and how certain recreational drugs could affect that effort.

While the side effects of LSD are minimal, it does have a long duration of action. It can cause cardiovascular stimulation, respiratory impairment, and nausea, impacting sedation dentistry. Providing sedation to any patient under the influence of a psychedelic is contraindicated, so open communication with patients about their usage before treatment is critical.

In Conclusion

The exciting advances in neuroscience provide hope for many affected by everything from depression to Parkinson's Disease. Yet, many frontiers in the brain still have yet to be mapped. And while there is the obvious potential for abuse with "illicit" drugs, the decrease in stigmatization and increase in psychedelic therapy research is encouraging.

Meanwhile, no dosing is necessary to open our minds to the possibilities.

If you're not yet subscribed to receive the Incisor newsletter, filled with cutting-edge dental news sent directly to your inbox twice a month, you can do so here.

Note: If you want to learn more about The Impact of Recreational Drugs on Dentistry, you'll find Dr. Feck's home study course here.

Author: Susan Richards is a staff writer at DOCS Education. With over 20 years of experience in local journalism and business marketing, Susan's career includes award-winning feature writing, as well as creating content with context for a wide variety of industries.

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