LSD Rehab

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KEY TAKEAWAYS

LSD (lysergic acid diethylamide) rehab helps to overcome addiction by: 

  • Providing CBT with coping skills training and mindfulness to manage anxiety/panic attacks triggered by memories of ‘bad trips’
  • Facilitating long-term psychiatric care post-rehab (e.g. 1-year course of 200mg lamotrigine + 12 weeks of CBT) to manage persisting visual hallucinations and depression
  • See the Abbeycare programme for LSD Rehab
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When Is Rehab For LSD Addiction Needed?

Psychological Addiction

Psychological addiction to LSD means rehab is needed because some users consume 1250 μg doses (standard dose = 25 – 150 μg) after becoming reliant on the drug to overcome anxiety and feelings of inferiority, despite having ‘bad trips’ and feeling out of control [1].

LSD rehab provides five 1-hour group sessions per week focused on developing skills for managing emotional triggers (e.g. anxiety) instead of re-dosing with 100 – 150 μg LSD every hour to remain in a “carefree” and “happy-go-lucky” state by [1][2]:

  • Administering the Internal Trigger Questionnaire to identify emotions that previously triggered LSD use (e.g. anxious, insecure), followed by the Internal Trigger Chart to categorise the emotions into 4 groups (safe, low-risk, high-risk, complete avoidance) [2]
  • Practising thought-stopping techniques to manage psychological LSD cravings triggered by emotional states (e.g. feeling inadequate), including lightly ‘snapping’ a rubber band against the wrist to disrupt the Trigger–Thought–Craving–Use sequence [2]
  • Encouraging patients to engage in 1-2 self-care practices per week (e.g. eating a balanced diet) as a person who is “healthy, abstinent, and recovering” rather than a person who engages in harmful drug-taking (e.g. staying up for 3 days after dosing) [2][3]
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Escalating Mental Health Concerns

Escalating depressive symptoms (e.g. persistent sadness) mean LSD rehab is necessary to mitigate the 25-fold increased risk of suicide caused by disrupted 5-HT2A receptor signalling in the brain (e.g. reduced by 36% in the prefrontal cortex) after daily LSD use [4][5]:

  • Counsellors help patients to identify depressive symptoms (e.g. low energy, crying spells), people (e.g. an abusive parent), events (e.g. job loss), and feelings (e.g. incompetent) that contribute to the depressive state during 90-minute sessions [2] 
  • Patients practice distraction techniques (e.g. taking a walk) and establish 1 or 2 ‘safe’ people to confide in when feeling low during 60-minute coping skills training sessions, rather than using 100 μg LSD to conceal "tension and feelings of depression.” [1][6]
  • Rehab links patients to mutual help groups to receive 4 types of social support (e.g. emotional = expressions of empathy, informational = providing life skills) because having social support decreases the risk of suicide by 12% in depressed patients [5][6]

LSD Rehabilitation provides SSRIs (e.g. citalopram) if required, to manage depression by increasing 5-HT synthesis in the frontal cortex by 20% within 14 days, alongside CBT to modify negative thoughts (e.g. “I must die” to “The idea of suicide now seems abhorrent.”) [1][7].

Hospitalisation with 24-hour monitoring is arranged for the safety of patients who are actively suicidal during LSD addiction treatment, and GPs are consulted to provide medical advice and treatment (e.g. antidepressants) to manage suicidal ideation.

Trauma From Bad Trips

Trauma from bad LSD trips means rehab is needed because some users have daily flashbacks for 4+ weeks after a trip, with recurrent feelings of panic that lead to thoughts of self-harm, nighttime awakenings, and repeated attempts to flee an imagined threat [8]:

  • The Trauma Symptom Inventory (TSI) is administered in rehab to measure the severity of trauma symptoms (e.g. anxiety attacks, sudden, vivid memories) in the last 6 months, as some patients claim “I have PTSD” after recalling bad trip experiences [3][9]
  • Counsellors use grounding techniques to help patients regulate emotions (e.g. fear) by becoming ‘aware of the here and now’ after having 'frightening memories' of a trip, using guided imagery, distraction (e.g. naming red objects in a room), and deep breathing [9]
  • Some rehabs provide 90-minute exposure therapy sessions that enable patients to process trauma-related emotions (e.g. anxiety) and memories (e.g. a ‘distressing’ trip that resulted in sensations of choking to death) using imagery and in vivo exposure [9][10]
  • 60-minute mindfulness sessions with education about relaxation strategies (e.g. “Take 3 slow, deep breaths") are provided to minimise stress in those who feel “unable to relax” due to hyperarousal after bad trip experiences [2][3]

Abbeycare does not offer PTSD counselling or specialised therapies (e.g. EMDR) to manage trauma from bad LSD trips, although referrals to GPs and mental health services are initiated during or after rehab if required.

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How Is Detox Done In LSD Rehab?

LSD detox is done in rehab by:

  • Medically managing withdrawal symptoms (e.g. 500mg paracetamol for headaches) for around 7 days as part of a full 28-day programme, although there are no specific medications used, and detox is managed on a case-by-case basis
  • Having addiction-trained staff monitor patient progress every 15 – 30 minutes whilst regularly conducting physical exams and psychological assessments to establish whether individual treatment plans require modifications (e.g. 20 to 80mg propranolol)
  • Liaising with GPs to provide medical advice and long-term treatment strategies (e.g. SSRIs or weekly talking therapy) for the management of depression and visual disturbances (e.g. hallucinations) that persist after rehab

How Does Therapeutic Content Deal With The Needs Of LSD Patients?

Addressing Anxiety From Past Bad LSD Trips

Therapeutic approaches in LSD rehabilitation address anxiety from past bad LSD trips because, without intervention, some users experience ‘suicidal despair’ after being “unable to move” due to "sinking feelings and paralysis" caused by 6+ months of constant panic/fear [8].

The State-Trait Anxiety Inventory is administered during LSD rehabilitation to distinguish between temporary anxiety triggered by traumatic memories of bad trips and chronic anxiety (e.g. 6+ months of excessive worrying) unrelated to LSD use, and therapy is adapted to [11]:

  • Normalise LSD-induced anxiety symptoms (e.g. panicking due to persistent visions of crawling bugs or ‘frightening’ flashbacks) as counsellors reassure patients that symptoms begin to subside after refraining from using psychedelic drugs [8]
  • Minimise anxiety whilst falling asleep, nightmares, and nighttime awakenings caused by sudden feelings of panic by developing healthy sleep habits that promote relaxation (e.g. having a bedroom temperature ≤18 °C or a hot shower before bed) [6][8]
  • Assist the patient in developing skills to manage negative/traumatic memories (e.g. forgetting how to eat or urinate during a trip) and emotions (e.g. anxiety, fear, shame) using cognitive restructuring and anxiety monitoring during weekly therapy [10]

Beta-blockers (e.g. 40mg propranolol) may be required alongside therapy during LSD treatment to manage panic attacks that last up to 4 hours at a time and related symptoms (e.g. sweating, palpitations) triggered by memories of bad trips during early recovery (0-6 weeks) [2][12].

Addressing Patient Memory Gaps And Concentration Fluctuations

LSD rehabilitation provides therapeutic approaches to address memory gaps/concentration fluctuations because up to 27% of patients experience “moments of confusion”, "blank spots" in memory, and have an “inability to concentrate” for 1+ month after last using [1][13]:

  • A less intensive level of care is provided, e.g. 1 hour of group therapy and 30 minutes of individual counselling per week, rather than 3-hour group sessions 3 times weekly to improve focus during early abstinence (4 weeks post-detox) [2][11]
  • Content is repeated and presented in multiple formats (e.g. verbally, visually, using stories, music), and patients are encouraged to engage in experiential activities (e.g. role play) to practice real-life situations using a prepared script to refer back to [11]
  • All therapy sessions begin and end with a 5-minute review of the previous and current session, and counsellors set homework tasks (e.g. write 3 alternatives to using LSD in a journal) to aid recall between sessions [2][11]

How Does Aftercare Planning Deal With The Needs Of LSD Patients? 

Hallucinogen Persisting Perception Disorder Symptoms

Lysergic Acid Diethylamide rehab adapts aftercare planning to address HPPD symptoms because up to 45% of daily users seek emergency medical treatment due to constant visual disturbances (e.g. faces changing shape) and claims of being “brain damaged” or “going crazy” [8][14]:

  • 30-minute discussions about “Body Chemistry in Recovery” educate patients about healthy sleep habits (e.g. limiting naps to ≤ 30 min) because sleep difficulties (e.g. taking >1 hour to fall asleep) increase the frequency of visual hallucinations by 3-fold [2][6][15]
  • Clinicians teach patients how to avoid triggers (e.g. dehydration, flickering lights) of visual disturbances (where possible) during weekly skills sessions and regularly ask questions (e.g. Does the light appear to be too bright?) to monitor patient progress
  • Psychoeducation informs patients about aspects of HPPD and/or its treatment (e.g. “You may experience flashes of green in your peripheral vision, but studies show that taking 50mg lamotrigine daily can resolve perceptual distortions within 1 week) [16]

LSD rehabs liaise with GPs to establish post-rehab treatment options for patients with HPPD, including a 2-month course of 0.025 mg clonidine three times a day to reduce HPPD symptoms (e.g. macropsia) by 50% from baseline [17].

Follow-Up Mental Health Care

LSD rehabilitation adapts aftercare planning to include liaising with follow-up psychiatric care because up to 68% experience depression, anxiety, and panic attacks for 12 – 18 months after cessation, and without continued care may lead to “suicidal despair” [8][18]:

  • Rehab counsellors coordinate referrals with primary care physicians, CBT-trained therapists, and sleep medicine specialists to address negative thoughts (e.g. a fear of death) that contribute to persistent nightmares, low mood, and panic attacks [6]
  • Linkages to recovery services (e.g. up to 36-weekly relapse prevention groups) take place, enabling patients to strengthen skills (e.g. exercise to enhance mood vs taking LSD) for managing ‘emotional buildups’ during recovery [2]
  • Rehabs liaise with GPs to provide medical advice, regular check-ins, and pharmacological interventions (e.g. SSRI treatment, beta-blockers) because some users claim “my anxiety is so high I physically shake” for up to 18 months after abstaining [3]

Ayyub et al. (2023) studied a 28-year-old past LSD user who required psychiatric care for over 7 months after abstaining because regular assessments using the MMSE were required, alongside medication (e.g. 50mg trazodone) to manage suicidal ideation, anxiety, and intrusive thoughts [16]. 

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How Does LSD Rehab Adapt To High-Functioning Users?

LSD Rehabilitation adapts to high-functioning users because up to 33% micro-dose with ≤20 μg LSD to improve focus, and tend to deny having a drug addiction whilst attributing LSD misuse to sources other than the addiction itself (e.g. needing to be productive at work) [11][19]:

LSD addiction counsellors help patients who mask LSD abuse as “using 'really' small amounts for cognitive enhancement” shift from “It’s a waste of time thinking about my LSD use because I don't have a problem” to recognising the addiction and initiating change by [20][21]:

  • Administering the URICA to assess motivation for change using a 5-point scale (1 = strongly disagree vs 5 = strongly agree) to rate statements such as “It doesn’t make sense for me to be here” or “Maybe this place will be able to help me” 
  • Using motivational interviewing and incorporating OARS (Open questions, affirmations, reflective listening, summarisation) during 30-minute sessions to engage the patient and evoke change talk, e.g. “Tell me about the last time you used LSD” [20]
  • Using psychoeducational reframing to emphasise that LSD addiction is a disease, similar to diabetes or arthritis, rather than listing negative consequences of LSD abuse (e.g. chronic migraines) that reinforce denial, defensiveness, and feelings of guilt/shame [20]

LSD addiction counsellors may need additional training to use the Elicit-Provide-Elicit method and give appropriate medical advice about the biology of addiction to patients who justify taking 6 - 20 μg microdoses every 3 days because “It doesn’t jeopardise my work” [20][21].

How Does LSD Rehabilitation Adapt To Patients Experiencing Psychosis/ Hallucinogen Persisting Perception Disorder?

LSD rehabilitation adapts to patients experiencing psychosis/HPPD because, despite abstaining, some patients experience symptoms (e.g. visual hallucinations) for over 7 months, and in some cases, psychiatric hospitalisation is more appropriate than rehab due to [16]:

  • Requirements for chest x-rays, MRIs, and ECGs to rule out infections (pneumonia), epilepsy, or lesions on the brain as the cause of “serial killer fantasies”, suicidal ideation, and visual disturbances (e.g. flashes of green) following LSD cessation [16]
  • HPPD patients who appear psychotic or aggressive during treatment, as rehabs make referrals to appropriate psychiatric care when necessary, including 4 – 16 hours of contact per week with a psychiatrist in an intensive outpatient setting [11]
  • A medication regimen agreed by the psychiatric team is tailored to the patient’s presenting symptoms (e.g. 50mg trazodone to manage anxiety caused by ‘scary hallucinations’ or 25mg lamotrigine for visual disturbances, i.e. halos around objects) [16]
  • A risk of harm to the patient, other patients, and staff members, as some HPPD patients claim others are “messing with them psychologically” and need to be placed in a locked ward for up to 2 weeks due to paranoia, intrusive thoughts, and delusions [16]

LSD Rehabilitation Outcomes

Hallucinogen Persisting Perception Disorder (HPPD) Symptoms

Lysergic acid diethylamide rehab reduces HPPD symptoms (e.g. macropsia, visual hallucinations) by 89% within 3 months of treatment because [22]:

  • Medication (e.g. 50mg lamotrigine or 4mg clonazepam daily) is provided to control geometric hallucinations, flashes of colour, and halos around objects by stabilising glutamate-mediated excitatory neurotransmission in the brain [16][22]
  • Counsellors provide psychoeducation to inform patients about avoiding HPPD triggers (e.g. flickering lights, poor sleep), and GPs are contacted to provide medical advice and treatment recommendations for persisting symptoms (e.g. macropsia)  
  • Hospital care is arranged for up to 14 days, if necessary, for specialised procedures (e.g. MRIs) to establish whether HPPD is being exacerbated by co-occurring conditions (e.g. epilepsy, schizophrenia), then medication (e.g. risperidone) is provided if needed [16]

Ayyub et al. (2023) found that an ex-LSD using 28-year-old with HPPD no longer had visual disturbances (e.g. flashes of green, hallucinations) after 11 days of receiving mental status examinations (MMSE) and medication (e.g. 25mg lamotrigine) during inpatient treatment [16].

Reduction In Mood Swings

Lysergic acid diethylamide rehab reduces mood swings by 23% within 1 week, as some patients claim, “I am optimistic about the future. I have better control over my thoughts,” after experiencing dysphoria and panic attacks during the first 24 hours of treatment [12][16][23].

LSD rehabilitation provides SSRI’s (e.g. 10mg citalopram) if needed, to manage suicidal ideation by increasing 5-HT synthesis in the brain by up to 67% within 2 weeks, alleviating feelings of being “really down afterwards” within 24 hours of last taking LSD [3][7]. 

In a 2023 study by Ayyub et al., a man claimed “I have no negative thoughts. I'm feeling much better” on the 8th day of inpatient treatment for LSD, and by the 11th day, provided a mood score of 6/10 after taking 50mg trazodone daily for suicidal thoughts and blunted mood [16].  

LSD Rehab At Abbeycare

LSD addiction treatment at Abbeycare is a 28-day inpatient rehab programme that provides: 

  • A 7-day medically managed detox with regular monitoring and symptomatic treatment  to mitigate physical (e.g. migraines) and psychological (e.g. panic attacks) withdrawal symptoms 
  • Structure and routine for patients who feel “shaken up for days/weeks” or like “the whole world is simply not real” after stopping LSD use, e.g. 7 am: breakfast, 8:30 am: 40mg propranolol for panic attacks/palpitations, 9:30 am: feelings check in 
  • Up to 18 months of aftercare, including telephone check-ins 2 times daily during week 1, then 2 times weekly in the following months, weekly family support groups, and after-care groups every Monday in Erskine, Wednesday in Edinburgh, and online on Thursdays 
  • Liaison with GPs and mental health services for continuing therapy post-rehab for patients experiencing depression, “ego death”, or existential struggles to strengthen skills for managing internal (e.g. feeling insecure) and external (e.g. home alone) triggers
  • All as client-appropriate, and decided by our medical team.
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About the author

Mischa Ezekpo

Mischa Ezekpo has a Bachelors degree in Psychology from Northumbria
University, and a Masters degree in Childhood Development and
Wellbeing, from Manchester Metropolitan University. Since 2018, Mischa
has written and published work on Addiction, Mental Health, Depression, and Eating Disorders. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: October 30, 2025