Bad trip

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Classification according to ICD-10
F16.0 Acute intoxication (acute intoxication) (hallucinogens)
ICD-10 online (WHO version 2019)

As a horror trip or fear travel ( Engl. Bad trip ) is an acute intoxication (acute intoxication) by hallucinogenic substances referred to that experienced negative to be very strong and anxiety is accompanied. This acute intoxication can occur under the influence of various psychotropic substances , especially hallucinogens such as psychedelics , delirium and dissociatives in high doses. Individuals who are experiencing a bad trip, have panic attacks , feeling of loneliness, loss of self-perception , depersonalization , derealization , crying spells, paranoia or fear of death.

Substances

Psychedelics (e.g. LSD , psilocybin , DMT , etc.), delirium ( anticholinergics , such as DPH , scopolamine , atropine , angel's trumpet , thorn apple , etc.) and dissociatives ( ketamine , PCP , MXE , DXM , etc.), which are generally classified under the The term hallucinogens are summarized, can trigger a bad trip (usually in high doses). Experiencing a bad trip after consuming high doses of ketamine is called a k-hole .

Horror trip-like conditions can also be caused by the consumption of cannabis - here v. a. triggered by unusual amounts or forms of administration (e.g. space cookies ), synthetic cannabinoids , ecstasy or mixed consumption . As a result of the consumption of excitatory substances ( amphetamine , cocaine , even coffee in excessive doses), bad trip states can occur, e.g. B. if the person has been without sleep for an extended period of time; here the substance effect and sleep deprivation work together. However, the International Classification of Diseases (ICD-10) only assigns acute intoxication of hallucinogens to the concept of the horror trip or the fear trip .

Triggering factors

The occurrence of bad trips depends to a large extent on the mood of the person as well as on the environment ( set and setting ). For example, non-smoking drug inexperienced drug users often experience long-lasting effects that are extremely unpleasant when they first try oral cannabis, which can be classified under this category. "Real" horror trips occur v. a. after consumption under "unfavorable" circumstances: for example, if the person using is already in a psychological problem, if the drug was consumed in an "inappropriate" environment (party or disco or other highly frequented places) or if unforeseen things happen while being intoxicated . As early as 1982, the US scientist Richard Bunce explained how, in the aftermath of the first “drug wave”, the increase in subcultural knowledge about “favorable” conditions for hallucinogen consumption significantly reduced the number of bad trips within a few years, although LSD consumption stagnated overall .

An increased neuroticism score can encourage difficult experiences while under the influence of psilocybin.

Countermeasures

In the case of strong arousal from psychedelic substances, medical treatment is indicated, among other things. "Goodman & Gilman's The Pharmacological Basis of Therapeutics" suggests 20 mg diazepam orally . Soothing conversations have been shown to be effective and are therefore an appropriate first step. Antipsychotics can enhance the experience and are therefore contraindicated.

literature

  • HD Abraham, AM Aldridge: Adverse consequences of lysergic acid diethylamide. In: Addiction. Volume 88, Number 10, October 1993, pp. 1327-1334. PMID 8251869 (Review).
  • RJ Strassman: Adverse reactions to psychedelic drugs. A review of the literature. In: The Journal of nervous and mental disease. Volume 172, Number 10, October 1984, pp. 577-595, PMID 6384428 (Review).

Individual evidence

  1. a b DIMDI - ICD-10-WHO Version 2016. (No longer available online.) In: dimdi.de. July 17, 2015, archived from the original on August 12, 2017 ; Retrieved August 19, 2017 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.dimdi.de
  2. L. Muetzelfeldt, SK Kamboj, H. Rees, J. Taylor, CJ Morgan, HV Curran: Journey through the K-hole: phenomenological aspects of ketamine use. In: Drug and alcohol dependence. Volume 95, Number 3, June 2008, pp. 219-229, doi : 10.1016 / j.drugalcdep.2008.01.024 , PMID 18355990 .
  3. Headache from the cup. ( Memento of the original from April 12, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. In: Medical Tribune. 38/2002.  @1@ 2Template: Webachiv / IABot / www.medical-tribune.de
  4. ^ Richard Bunce: Social and political sources of drug effects: The case of bad trips on psychedelics. ( Memento of October 20, 2002 in the Internet Archive ) In: E. Zinberg, WM Harding: Control Over Intoxicant Use: Pharmacological, Psychological, and Social Considerations. In: Human Sciences Press. 1982, pp. 105-125.
  5. Frederick S. Barrett, Matthew W. Johnson, Roland R. Griffiths: Neuroticism is associated with challenging experiences with psilocybin mushrooms. In: Personality and Individual Differences. 117, 2017, p. 155, doi : 10.1016 / j.paid.2017.06.004 .
  6. Christiane Gelitz: Psilocybin: Who is threatened with a bad trip ? In: Spektrum.de. June 12, 2017. Retrieved August 19, 2017 .
  7. "Severe agitation may respond to diazepam (20 mg orally). “Talking down” by reassurance is also effective and is the management of first choice. Antipsychotic medications may intensify the experience and thus are not indicated. "Laurence Brunton, Bruce A. Chabner, Bjorn Knollman: Goodman and Gilman's Manual of Pharmacology and Therapeutics . 12th edition. McGraw-Hill, 2011, ISBN 978-0-07-176939-6 , p. 1537.