Halpern John H
Biological Psychiatry Laboratory, Alcohol and Drug Abuse Research Center, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
Curr Psychiatry Rep. 2003 Oct;5(5):347-54. doi: 10.1007/s11920-003-0067-4.
Research of hallucinogen abuse rarely extends beyond epidemiology and observed pathology. Even less research has been completed on the special circumstances surrounding the religious use of hallucinogens or on potential therapeutic applications. Rather than offer another basic review on the well-known hazards of illicit hallucinogen use, this paper provides an overview and practice recommendations on compounds the clinician may be less familiar with, such as the botanical plant Salvia divinorum, the drug 3,4-methylenedioxymethamphetamine ("ecstasy") and synthetic hallucinogen analogs. The often-warned, but rarely occurring, hazard of hallucinogen persisting perception disorder ("flashbacks") is also reviewed with treatment recommendations provided. The current status of clinical research with the hallucinogens is presented, with case vignettes suggesting hallucinogens may have anti-addictive applications. The special circumstances surrounding the religious, nondrug use of hallucinogens as sacred sacraments in the US and elsewhere are also presented. It is hoped that the reader will gain a more nuanced understanding of how these physiologically nonaddictive drugs may offer legitimate benefits in modern society. By appreciating that such benefits may one day be borne out by careful, methodologically sound research, clinicians should be better armed in raising the topic of hallucinogen use and abuse with their patients.
对致幻剂滥用的研究很少超出流行病学和观察到的病理学范畴。对于围绕致幻剂宗教用途的特殊情况或潜在治疗应用的研究则更少。本文并非对非法使用致幻剂的已知危害进行又一次基础综述，而是对临床医生可能不太熟悉的化合物提供概述和实践建议，比如植物鼠尾草、药物3,4 - 亚甲基二氧甲基苯丙胺（“摇头丸”）以及合成致幻剂类似物。还对常被警告但很少发生的致幻剂持续性感知障碍（“闪回”）危害进行了综述并给出治疗建议。介绍了致幻剂临床研究的现状，通过病例 vignettes表明致幻剂可能具有抗成瘾应用。还介绍了在美国和其他地方将致幻剂作为神圣圣礼进行宗教性、非药物使用的特殊情况。希望读者能对这些生理上无成瘾性的药物如何在现代社会提供合理益处有更细致入微的理解。通过认识到这种益处可能有朝一日会被严谨、方法得当的研究所证实，临床医生在与患者讨论致幻剂使用及滥用话题时应能更有底气。
