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Eight patients were seen within 15 minutes of intranasal self-administration of large amounts of pure D-lysergic acid diethylamide (LSD) tartrate powder. Emesis and collapse occurred along with signs of sympathetic overactivity, hyperthermia, coma and respiratory arrest. Mild generalized bleeding occurred in several patients and evidence of platelet dysfunction was present in all. Serum and gastric concentrations of LSD tartrate ranged from 2.1 to 26 nanograms per ml and 1,000 to 7,000 mug per 100 ml, respectively. With supportive care, all patients recovered. Massive LSD overdose in man is life-threatening and produces striking and distinctive manifestations.

Abuse of drugs "for kicks" is becoming more common in Great Britain. This article reviews 252 consecutive cases of drug abuse admitted to the Regional Poisoning Treatment Centre, Royal Infirmary, Edinburgh, during 1971 and 1972. Of the 189 patients (146 males and 43 females; mean age 20 years) 72% of admissions occurred between 6 p.m. and 8 a.m., and Saturday was the most common day for admissions. The commonest source of referral was via the police or ambulance service. Barbiturates were the drugs most often abused, followed by LSD (lysergide) and Mandrax (methaqualone and diphenhydramine). Sixty-five per cent. of patients had previously abused drugs. Medical care was required in 45% of the admissions. Sixty per cent. were in social class 4 or 5 and psychiatric and social support was required in only a small minority of patients.

These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California Medical Center, San Francisco. Taken from transcriptions, they are prepared by Drs. Martin J. Cline and Hibbard E. Williams, Associate Professors of Medicine, under the direction of Dr. Lloyd H. Smith, Jr., Professor of Medicine and Chairman of the Department of Medicine.

A significant increase of chromosomal abnormalities was found in leukocytes from LSD-25 users (six out of eight) compared to nonuser controls (one out of nine). The two LSD-25 users showing no damage reported the lowest estimated average dose. The subjects whose cells showed damage were tested between 1 day and 6 months after their last LSD-25 dose.