Nichols David E, Grob Charles S
Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599, USA.
Department of Psychiatry, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA 90509, USA.
Forensic Sci Int. 2018 Mar;284:141-145. doi: 10.1016/j.forsciint.2018.01.006. Epub 2018 Feb 2.
LSD (lysergic acid diethylamide) was discovered almost 75 years ago, and has been the object of episodic controversy since then. While initially explored as an adjunctive psychiatric treatment, its recreational use by the general public has persisted and on occasion has been associated with adverse outcomes, particularly when the drug is taken under suboptimal conditions. LSD's potential to cause psychological disturbance (bad trips) has been long understood, and has rarely been associated with accidental deaths and suicide. From a physiological perspective, however, LSD is known to be non-toxic and medically safe when taken at standard dosages (50-200μg). The scientific literature, along with recent media reports, have unfortunately implicated "LSD toxicity" in five cases of sudden death. On close examination, however, two of these fatalities were associated with ingestion of massive overdoses, two were evidently in individuals with psychological agitation after taking standard doses of LSD who were then placed in maximal physical restraint positions (hogtied) by police, following which they suffered fatal cardiovascular collapse, and one case of extreme hyperthermia leading to death that was likely caused by a drug substituted for LSD with strong effects on central nervous system temperature regulation (e.g. 25i-NBOMe). Given the renewed interest in the therapeutic potential of LSD and other psychedelic drugs, it is important that an accurate understanding be established of the true causes of such fatalities that had been erroneously attributed to LSD toxicity, including massive overdoses, excessive physical restraints, and psychoactive drugs other than LSD.
麦角酸二乙酰胺（LSD）于近75年前被发现，自那时起便一直是间歇性争议的对象。虽然最初它被作为一种辅助性精神治疗药物进行探索，但公众对其娱乐性使用一直存在，并且偶尔会与不良后果相关联，尤其是当药物在不理想的条件下服用时。长期以来，人们都明白LSD有引发心理困扰（“糟糕体验”）的可能性，并且它很少与意外死亡和自杀相关。然而，从生理学角度来看，已知LSD在标准剂量（50 - 200微克）服用时无毒且医学上安全。不幸的是，科学文献以及近期的媒体报道将五例猝死病例归咎于“LSD毒性”。然而，仔细审查后发现，其中两例死亡与大量过量服用有关，两例显然是服用标准剂量LSD后出现心理激动的个体，随后被警方置于最大程度的身体约束姿势（捆绑），之后他们出现致命的心血管衰竭，还有一例是极端体温过高导致死亡，这可能是由一种替代LSD的药物引起的，该药物对中枢神经系统温度调节有强烈影响（例如25i - NBOMe）。鉴于对LSD和其他迷幻药物治疗潜力的重新关注，准确了解这些被错误归因于LSD毒性的死亡的真正原因很重要，这些原因包括大量过量服用、过度身体约束以及除LSD之外的精神活性药物。
