The dearth of reports in the medical literature about problems with hallucinogens is perhaps unsurprising, given their long history of apparently safe ritual use in many traditional societies. For example, of the 982,856 drug-related emergency room visits reported in 1998, fewer than 5,000 involved LSD, compared to 172,000 related to cocaine (1). However, use of hallucinogens may continue in the United States and elsewhere in larger numbers than we might think. As one authority has commented, "Large numbers of people, mostly young, male and with high intelligence and creative ability are taking hallucinatory drugs without the medical profession being much aware of it. It is only when something goes wrong that the doctor is involved" (2).