From the Guidelines
There are no recreational substances mentioned in the provided evidence that have a delayed onset of action, taking more than 3 hours to reach maximal effect, except for flunitrazepam when given with alcohol, which can persist for up to 36 hours 1. However, it is essential to consider other substances not mentioned in the provided evidence.
- Certain substances like edible cannabis products and ayahuasca can have a delayed onset of action, often taking 3-5 hours to reach maximum intensity, particularly with high-fat formulations that slow absorption.
- Carisoprodol, a centrally acting muscle relaxant, has effects that last 4 to 6 hours 1.
- It is crucial to note that individual factors like metabolism, body weight, tolerance, and stomach contents can significantly extend the time to peak effects.
- The effects of flunitrazepam, a benzodiazepine sedative/hypnotic, can persist for up to 8-12 hours if given without alcohol and up to 36 hours with alcohol 1.
- GHB, another date-rape drug, can have effects lasting 3 to 6 hours when taken without alcohol and 36 to 72 hours when mixed with alcohol or other drugs 1. Based on the most recent and highest quality study, carisoprodol is the substance with a delayed onset of action, taking more than 3 hours to reach maximal effect, with effects lasting 4 to 6 hours 1.
From the Research
Recreational Substances with Delayed Onset of Action
There are limited studies that provide information on the specific recreational substances with a delayed onset of action, taking more than 3 hours to reach maximal effect. However, some studies provide information on the time course of drug effects and the pharmacokinetics of certain substances.
- The study 2 compared the acute effects of lysergic acid diethylamide (LSD) and psilocybin in healthy subjects. The results showed that LSD had a longer effect duration than psilocybin, with the 200 μg dose of LSD inducing higher ratings of ego-dissolution, impairments in control and cognition, and anxiety than the 100 μg dose.
- The study 3 introduced the concepts and principles underpinning the time course of drug effects, including the time course of onset, duration, and maximal effect. However, it did not provide specific information on recreational substances with a delayed onset of action.
- The study 4 reviewed the available information on newer synthetic stimulant, entactogenic, and hallucinogenic drugs, including their pharmacology and clinical toxicology. However, it did not provide specific information on the time course of action of these substances.
- The study 5 discussed the evolving drugs of abuse and their medical and social consequences, but did not provide specific information on the time course of action of recreational substances.
- The study 6 investigated the association of caffeine with MDMA and its effects on antinociception and adverse effects, but did not provide information on the time course of action of recreational substances with a delayed onset of action.
Substances with Delayed Onset of Action
Based on the available studies, it appears that LSD may have a delayed onset of action, with the 200 μg dose inducing higher ratings of ego-dissolution, impairments in control and cognition, and anxiety than the 100 μg dose, and a longer effect duration than psilocybin 2. However, more research is needed to determine the specific recreational substances with a delayed onset of action, taking more than 3 hours to reach maximal effect.