A Review of LSD : Still With Us After All These Years
by Neal M. Goldsmith, Ph.D.*
LSD: Still With Us After All These Years
Leigh A. Henderson and William J. Glass, Editors
NY: Lexington Books, 1994
This is a remarkable book. Epidemiologist Leigh A. Henderson, as a
consultant to the National Institute on Drug Abuse (NIDA) and NIDA Project
Officer William J. Glass started with the government's own survey data,
worked with the authors of a new, individual and community-level
ethnographic study, analyzed and interpreted these half-dozen data sets
very conservatively, and ended up concluding that LSD is relatively safe
and the laws far too severe. Some would say that these conclusions are
still too conservative. Perhaps that's the point: Even a conservative
reading of government data will not support today's absolutist attitudes
and draconian laws.
The authors Henderson and Glass seem somewhat embarrassed by their
conclusions. After all, the government looks at the same National
Institute of Mental Health (NIMH) and NIDA data and concludes that LSD is
very dangerous and severe laws are justified. Henderson and Glass,
employed by or closely associated with NIDA and near the peaks of their
careers, have nonetheless directly contradicted NIDA policy. In choosing
to publish anyway (even without any direct references to the authors' NIDA
employment on the dust jacket or promotional literature - only in later
conversations with this reviewer was the NIDA connection mentioned) they
have chosen bravery over fear, and facts over shouts in a courageous
contribution to rational, data-based policy making.
The book is really Henderson's baby; she is the author of four of its
seven chapters and co-author of the Introduction and the "Summary and
Implications" chapter. "I started out not knowing anything about
LSD, except its public reputation," she said in our recent telephone
conversation. "As my research proceeded, I became fascinated by the
facts. It's clear that policy on LSD is out of line with the data."
Henderson shares authorship with Glass and law enforcement and health
researchers, yet the book retains a strong unity of theme: triangulating
in on the truth about LSD use. The result is a methodologically innovative
integration of quantitative and qualitative data - of emergency room
admission statistics and a profile of a twenty-something LSD ring leader;
of "national lifetime usage" data and quotes from interviews
with experienced adolescents and hand-wringing parents.
The case studies
In Chapter 1, "What is a Trip - and Why Take One?"
anthropologists James MacDonald and Michael Agar describe data they
gathered through in-depth, ethnographic interviews with six adolescent LSD
users and their parents in a community that had recently uncovered a major
LSD distribution ring. (It's a shame that MacDonald and Agar's excellent
chapter does not include the authors' biographies or institutional
affiliations.) [Editorial note: James MacDonald was an ethnographic and computer consultant and Michael Agar was Professor Emeritus of Anthropology at the University of Maryland.] Parental attitudes of concern contrast strikingly with the
teens' knowing discussions of their good and bad experiences with LSD.
Even though these interviews ring true, they are still a biased sample -
all of the kids interviewed were enrolled in a drug rehabilitation
program; all claimed that frequent ingestion can lead to social and
The history of LSD
In Chapter 2, "About LSD," Henderson provides an excellent,
data-based, and quite favorable review of the history, pharmacology, and
clinical and therapeutic research, concluding with a factual review of the
manufacturing and marketing of LSD. It is refreshing that Henderson
allocates only three sentences to "the '60s;" rather, her focus
is on safety, efficacy, and policy.
Henderson continues her review in Chapter 3, at this point focusing on the
literature on "Adverse Reactions to LSD." She finds them real,
but rare and spends 20 pages adroitly separating myth from fact.
Analyzing the government's data
In Chapter 4, "LSD Use and LSD Users: Questions and Answers About
LSD," Henderson analyzes the wide panoply of government survey data.
Unfortunately, these data are generally derived from the tragic negative
consequences of drug abuse - emergency room admissions or arrest
statistics and the like - or are biased by the requirement to self-report
illegal behavior, which is much more likely among those in treatment than
"successful" users. Even by these biased standards, LSD emerges
here as a remarkably safe "drug of abuse" that in no way can be
A middle class drug ring
In a fascinating inside account of a middle-class drug distribution ring,
clinical psychologist and forensic examiner Cynthia Favret's "An LSD
Distribution Network" (Chapter 5) takes us back to the community
discussed in Chapter 1, this time, through interviews with an undercover
narcotics investigator familiar with the exposed network and its 22-year
old head. In addition to a very close rendering of the mind set of its
protagonist, this chapter provides poignant quotes from friends and family
that drive home the brutal reality of the government's legal position on
LSD. Favret's treatment is especially effective coming after the
relatively benign picture that emerges from Henderson's chapters on the
research and usage data.
Detection and the law
Chapter 6, "Legal Issues," discusses detection, possession, and
distribution issues in light of the debate over mandatory sentencing for
drug offenders. Henderson discusses developments in detection technology
since the 1970s, when inaccurate and expensive fluorescent spectroscopy
and high-performance liquid chromatography (HPLC) detection tests were
developed, and describes inexpensive and effective radioimmunoassay (RIA)
tests that have recently become commercially available. Henderson also
lists and discusses the wide range of federal and state (all 50 are
listed) penalties for possession and sale of LSD, and in a devastatingly
matter-of-fact way, compares these penalties with those governing similar
doses of cocaine or heroin.
The key findings
Chapter 7, "Summary and Implications," attempts to bring
together all of the data sets described in the previous chapters and draw
conclusions for policy on LSD for the 1990s. There is also a spectacular
258-item reference list containing within it the classic evidence - the
bulwark of the logical argument - for the safety of LSD and, perhaps, for
its efficacy as a psychiatric tool. Is the use of LSD increasing? What are
the major issues with which a logical, fact-based LSD policy should be
concerned? Marshalling all their logic and data together, Henderson,
Glass, and Favret conclude:
- LSD use is relatively uncommon in comparison with use of alcohol,
marijuana, or cocaine and misuse of prescription drugs. Long-term trends
in LSD use show stability over the last fifteen years in both proportion
(roughly 5% annually) and age (generally, 16-23) of users.
- LSD is primarily used by suburban white males in their late teens
and early 20s. A shift in use from the upper level of this band to the
lower level could contribute to the perception that use has increased
among young adolescents.
- LSD is characterized by infrequent episodic use culminating in
"maturing out" after two to four years.
- Adverse health consequences of LSD are comparatively rare, with
"bad trips" being the most common adverse reaction.
Nonetheless, severe bad trips are one of the primary reasons youths
discontinue LSD use.
- Although some health consequences may be related to length of use,
size of dose, and the interaction of other drugs, there is considerable
uncertainty over why LSD adversely affects some individuals more
severely than others.
- Despite dire warnings, LSD use doesn't result in mental illness and
does not damage genes or chromosomes.
- Black market LSD remains generally unadulterated, although
manufacturing by-products do appear. In the 1960s, doses were reported
to have ranged from 200 to 1000 micrograms; in the 1970's, street
samples ranged from 30 to 300 mcg; in the mid-1980s, the average was
about 100 to 125 mcg; in the 1990s it is 20 to 80 mcg. Lower doses
generally mean fewer bad trips.
The authors point out the reasons why people like LSD: the perceptual
intensity without a clouding of consciousness; the "compelling
immediacy;" the "intensification of mood and emotions."
Others enjoy the group aspect of the drug; still others view LSD as an
"emotional fitness test." These motivations haven't changed
since the 1960s, according to studies cited by Henderson in Chapter 2.
Adolescents are also attracted to LSD because it is physically easy to
deal with - colorless, odorless, small and easy to conceal, inexpensive,
until recently, hard to detect in blood or urine. LSD is also viewed as
semi-natural and users tend to look down on users of "dangerous"
drugs, such as cocaine and heroin.
Who takes LSD?
The LSD user differs from the typical opiate user "in that LSD
appeals to individuals who are often socio-economically advantaged, who
have the opportunity for higher education and successful careers, yet who
choose - at least for a time - not to follow societal norms." The
authors associate a number of traits - low self-esteem, rebelliousness,
depression, aggressiveness, for example - with the use of LSD, but stress
that they precede, rather than result from the use of drugs.
Adolescent users indicated that they used LSD because it was fun and
because they were bored. "As a drug that tends to promote
introspection and to heighten the senses, it has more to offer those in
the relatively safe and pleasant surroundings [of the middle-class] than
those in the more dangerous and unpleasant inner-city environment. In
fact, the suburban youths interviewed seemed to take LSD as a controlled
means of losing control. Riding a roller coaster may be an appropriate
analogy; the ride is safe, but contains enough sense of danger to be
According to the authors, LSD "seems to appeal to a limited group of
adolescents and an even smaller group of older persons who may still seek
to identify with a particular subculture." One major problem with the
data used to support Henderson and Glass' conclusions is their
representativeness - did the sample that responded to the various surveys
actually reflect the entire population? It is important to note that the
divinity graduate student using a low dose to meditate or the quiet,
45-year old systems analyst using LSD "to think" are likely to
be significantly underrepresented subsets of the data. In fact, the
authors' observation of a "maturing out" of LSD use might just
as easily been interpreted as a "shrinking away" from the rigors
of aggressive introspection.
According to Henderson, the literature shows that the factors contributing
to higher risk of a bad reaction to LSD are "a preexisting
psychiatric disorder, and the use [of LSD] in conjunction with other
drugs." Under these circumstances "LSD may precipitate a more
prolonged or severe psychotic reaction."
While the authors aptly point out that we do not know the precise
mechanism of LSD's action, they also state outright that the research thus
far clearly shows that LSD does not cause "organic damage,
chromosomal damage, cancer, or birth defects. It is not particularly
toxic..." The authors conclude that, "viewed strictly in the
context of traditional drug-induced health consequences (measured in
injury and death), LSD is less dangerous than most other illegal
drugs." Use by adolescents, they point out, "carries additional
risks to psychologic maturation and academic performance much the same as
do marijuana and other drugs typically used at this stage of life."
(The authors do note that "among younger students, inhalation of
potentially lethal substances such as solvents and butane exceeds LSD
That the authors do not build on the data and their own analysis and
conclude here that teen use of psychoactive drugs may reflect a
non-pathological desire for rites of passage, should not detract from the
value of their work in the current cultural context. One day, such a
conclusion may guide government policy, but given the fragility of the
support for today's renewed research with psychedelics, the authors may
have put together just the right book for the times. "We wanted to
write a boring book about LSD, if that's possible," said Henderson,
"we wanted to review the evidence, but not necessarily come down on
any side of the issue. The facts speak loudly for themselves."
The data sets
Even so, the fact base must be valid to be useful. Particularly in Chapter
4, Henderson and colleagues rely on a set of much-debated, yet much-cited
government surveys of drug abuse. While it is beyond the scope of this
review, to analyze in detail the validity of each data source used by the
authors, we can review the major sources of bias (most of which are
identified by the authors themselves) in the government data sets that
The National Household Survey of Drug Abuse (NHSDA) is a series of surveys
designed to measure the use of alcohol, tobacco, and other drugs in the
U.S. over time. Periodically conducted by NIDA since 1974, the survey was
recently turned over to the newly-created Substance Abuse and Mental
Health Services Administration (SAMHSA). Lead author Leigh Henderson,
provided secondary analysis of these and other data sets under contract to
NIDA and, after 1992, to SAMHSA.
In the NHSDA, information on illicit drug use is collected in the user's
home and so, despite an elaborate anonymity procedure, respondents may not
tell the whole truth. At home data collection also under-represents the
homeless, prison populations, people in nursing homes and treatment
facilities, and the military, groups that might raise the statistics on
use. As the book points out, with drugs that are less frequently used,
such as LSD, this systematic under counting is even more likely.
The Monitoring the Future (High School Senior Survey) is designed to
characterize use, trends, attitudes and beliefs among high school seniors.
Since 1975, it has been conducted annually by the University of Michigan
for NIDA. The survey does not include school dropouts (or truants on the
day of the survey) and so likely underestimates school-age drug use.
The Drug Abuse Warning Network (DAWN) is sponsored by SAMHSA (previously
by NIDA) and collects data from coroners, medical examiners and emergency
room admissions, primarily to identify drug dangers and emerging trends.
The DAWN statistics are controversial and Henderson systematically lays
out the major threats to the validity of the data. For example, suicide
attempts are included in DAWN statistics, but alcohol (without the
presence of other drugs) is not. Mention of a particular drug does not
mean the episode was caused by that drug. In fact, since half of the
drug-related emergency room visits entail more than one drug, cause and
effect generally cannot be established by DAWN data.
The Drug Use Forecasting (DUF) project, sponsored by the National
Institute of Justice, tracks drug use among arrestees in 21
(non-representative) U.S. cities. DUF data are not meant to be normative.
For example, male arrestees for drug offenses are under-counted in order
to provide a broader sample of (drug use during the commission of) a wider
range of offenses. Females are included regardless of the crime. Henderson
points out that these data are nonetheless "frequently reported in
the substance abuse literature, although [the full] reports are not
published." The Community Epidemiology Work Group (CEWG) was
established by NIDA in 1976 to track rapidly changing patterns of drug
use. The CEWG meets twice a year and publishes the proceedings. The CEWG
uses a wide range of data sources and focuses "primarily on the
harmful effects of drug use."
Overall, the data sets upon which the government's "war on
drugs" is built come off here as woefully inadequate - subject to
political agendas and thus miscontructed and misdirected from the start.
The sense here is of researchers groping in a vast blackness by the light
of a flickering match - not much is illuminated, but there is still enough
heat to burn the fingertips of the unwary.
Other than the quality of the government's data, there is little to
detract from this dogged book. (Only Chapter 4 relies heavily on
government statistics and Henderson spends much of this chapter teasing
the truest interpretations out of the data.) Some may wish the authors had
gone further in detailing the positive implications of the data. Yet, the
book is likely to have even more impact precisely because it was authored
"from within the belly of the beast" and, even without going
that last 10% of the way, still draws sharply different conclusions from
those of NIDA.
It was irksome that, beside Henderson and Glass, there were no biographies
for the excellent co-contributors, James MacDonald, Michael Agar and
Cynthia Favret. Were they separately hired by Henderson and Glass to
gather qualitative data? Were they NIDA employees who couldn't list their
employer? - we are not told. (But they turn out to be academic colleagues
working under sub-contract to Henderson and Glass and the omission a
However, these complaints are minor. Henderson's accomplishment with, LSD:
Still With Us After All These Years, is, as a de facto representative of
NIDA, to give us back the facts, the truth. She shines the light of 45
years of laboratory and clinical research onto a half-dozen venerable
government surveys of dubious validity and finds the outlines of reality.
Henderson then triangulates on this devil's hybrid of lab research and
survey data, by breathing life into it through real-world, contemporaneous
interviews with those most affected by LSD use: the users, the dealers,
and their families.
We need more such analyses of government data, not mere condemnation of
their flaws, and we need more government researchers like Leigh Henderson
and her "let-the-chips-fall-where-they-may" colleagues.
*Neal M. Goldsmith, Ph.D. is a social psychologist and expert on policy
research utilization. Trained as a research methodologist, he conducted
early studies on ways to increase the use of research findings in mental
health policy making. Goldsmith now heads Tribeca Research, a New
York-based policy research and consulting firm.