There is great
variability in how drugs affect people, from person to person and from time
to time in the same person. This is due to the variabilities of set and setting.14
Set is the expectation of what the drug will do, in the context of personality.
For example, someone expecting to be out of control from taking a drug, probably
will be. Setting is the environment, physical and social, in which the drug
is taken. For example, someone trying out LSD in an unfamiliar group to which
there is no feeling of trust attached may feel paranoid and have a bad trip.
Occasionally, with less experienced users, one is given a substance that is
not an actual drug, but is believed to be. A placebo effect may occur, causing
the user to be "overdramatic" in his experience.
There are three types of drug-related psychological disasters a nurse may encounter: 14
1) a rare and temporary toxic psychosis that occurs in people predisposed to brain toxicity. It manifests as confusion, disorientation and unpleasant hallucinations,
2) a panic reaction interpreted that one is dying or losing ones mind, a self-perpetuating experience most likely in novices or those who have been given drugs involuntarily or unknowingly, and
3) a true psychosis that is precipitated by, rather than caused by, drug experience in people predisposed to schizophrenia.