Other hallucinogen use disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]

Overview

According to the DSM-V, non-specified hallucinogen use disorder (other hallucinogen use disorder) is a condition characterized by hallucinogen use (other than phencyclidine) for at least a period of 12 months that may be associated with signs of tolerance, dependence, and abuse.

Differential Diagnosis

• Alcohol withdrawal
• Bipolar disorders
• Central nervous system tumors
• Depressive disorder
• Hypoglycemia
• Panic disorder
• Schizophrenia
• Sedative withdrawal
• Seizure disorder
• Stroke
• Ophthalmological disorder
• Other substance use disorders

Risk Factors

• Alcohol intake
• Tobacco usage
• Cannabis usage
• Major depressive disorder

Epidemiology and Demographics

Prevalence

The 12-month prevalence is 500 per 100,000 (0.5%) among 12- to 17-year-olds and 100 per 100,000 (0.1%) among adults age 18 and older in the United States.

Risk Factors

• Younger age than 30-year-old
• Female gender

Natural History, Complications and Prognosis

Prognosis

Poor prognostic factors includes:

• Increasing in dose intake
• Impairment in daily activities

Diagnostic Criteria

DSM-V Diagnostic Criteria for Other Hallucinogen Use Disorder

“

A. A problematic pattern of hallucinogen (other than phencyclidine) use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period: The hallucinogen is often taken in larger amounts or over a longer period than was intended. There is a persistent desire or unsuccessful efforts to cut down or control hallucinogen use. A great deal of time is spent in activities necessary to obtain the hallucinogen, use the hallucinogen, or recover from its effects. Craving, or a strong desire or urge to use the hallucinogen. Recurrent hallucinogen use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences from work or poor work performance related to hallucinogen use; hallucinogen-related absences, suspensions, or expulsions from school; neglect of children or household). Continued hallucinogen use despite having persistent or recurrent social or inter personal problems caused or exacerbated by the effects of the hallucinogen (e.g., arguments with a spouse about consequences of intoxication; physical fights). Important social, occupational, or recreational activities are given up or reduced be cause of hallucinogen use. Recurrent hallucinogen use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by the hallucinogen). hallucinogen use is continued despite knowledge of having a persistent or recur rent physical or psychological problem that is likely to have been caused or exacerbated by the hallucinogen. Tolerance, as defined by either of the following: A need for markedly increased amounts of the hallucinogen to achieve intoxication or desired effect. A markedly diminished effect with continued use of the same amount of the hallucinogen. Note: Withdrawal symptoms and signs are not established for hallucinogens, and so this criterion does not apply. Specify the particular hallucinogen. Specify if: In early remission: After full criteria for other hallucinogen use disorder were previously met, none of the criteria for other hallucinogen use disorder have been met for at least 3 months but for less than 12 months (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the hallucinogen,” may be met). In sustained remission: After full criteria for other hallucinogen use disorder were previously met, none of the criteria for other hallucinogen use disorder have been met at any time during a period of 12 months or longer (with the exception that Criterion A4, “Craving, or a strong desire or urge to use the hallucinogen,” may be met). Specify if: In a controlled environment: This additional specifier is used if the individual is in an environment where access to hallucinogens is restricted. Specify current severity: Mild: Presence of 2-3 symptoms. Moderate: Presence of 4-5 symptoms. Severe: Presence of 6 or more symptoms.

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