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Respond to your colleagues. Compare the differential diagnostic features of opioid related disorders to the diagnostic features of Hallucinogen related disorders. What are their similarities and differences? How might you differentiate the two diagnoses?
Hallucinogens are a class of psychoactive drugs, synthetic or plant-based, that produce hallucinations auditory and or visual, thought, mood, and perceptual changes (Gabbard, 2014). According to Gabbard (2014), when used in the context of substance abuse, hallucinogens reference a compound that changes consciousness without producing delirium, sedation, hyperactivity, or cognitive impairment.
Frequently abused hallucinogens are LSD (D-lysergic acid diethylamide) and PCP (Phencyclidine). According to Sadock, Sadock, & Ruiz (2014), most hallucinogens are well absorbed despite the method of ingestion (p.650). Tolerance and dependence are not concerns generally associated with hallucinogen use. A user can develop a psychological dependence on hallucinogens’ effects (Sadock et al., 2014).
As with any substance introduced into the body, it affects each individual differently. Common clinical signs of hallucinogen use include pupillary dilation, tachycardia, sweating, palpitations, blurry vision, tremors, or incoordination (Sadock et al., 2014). Additional symptoms are confusion, poor memory, violence, self-destructive behavior, psychosis, paranoia, anxiety, and inability to speak (Anderson, Lake, Walterfang,2018).
Hallucinogen Persisting Perception Disorder is a syndrome that occurs after ceasing the use of hallucinogens. A visual disorder resulting from the assimilation of hallucinogens or drugs referred to as flashbacks (American Psychiatric Association, 2013). An individual experiencing Hallucinogen Persisting Perception Disorder may exhibit recurrent visual interferences such as haloes, flashes of colors, or moving objects in the visual field (Gabbard, 2014). Triggers for flashbacks include emotional stress, sensory deprivation, or another psychoactive substance (marijuana or alcohol) (Sadock et al., 2014). Intensity and frequency distinguish standard visualizations. The American Psychiatric Association (2013) note individuals with this disorder experience frequent and intense visualizations that interfere with their daily lives in other conditions changes are transient.
The use of hallucinogens can lead to intoxication, psychosis, mood disorders, or anxiety. In most events, when the hallucinogen wears off, the symptoms are resolved. Sadock et al.,2014 note in cases of hallucinogen intoxication, supportive care, verbal reassurance, time, and a quiet environment are sufficient (p.654). Benzodiazepines used in cases of severe anxiety. Individuals suffering from Hallucinogen Persisting disorder would adjust behaviors to avoid triggers of flashbacks and utilize a long-acting benzodiazepine (clonazepam) or carbamazepine (Sadock et al., 2014).
Anderson, L., Lake, H., & Walterfang, M. (2018). The trip of a lifetime: hallucinogen persisting perceptual disorder. Australasian Psychiatry, 26(1), 11–12
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author
Gabbard, G.O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
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