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To the Editor.—
Klepfisz and Racy suggested gathering further information on homicide and drugs (223: 429, 1973). While this seems a laudable project, I feel impelled to make a plea for more sensitive awareness during the psychiatric interview.The issue of street drugs as a cause of mental illness remains unsolved (except for chronic overuser of marihuana and amphetamines) and in this instance seems to have diverted exploration at the initial contact. The underlying psychopathology seemed unavailable perhaps because of focus on drug use. Modern sympathy toward avoiding psychiatric labels may also lull us into a stance detrimental to the patient and society.Any patient who is comfortable enough with primary process to use lysergic acid diethylamide (LSD) 100 times is a subject for critical observation. With this history, the examiner should be alert to the possibility of an underlying thought disorder. The concomitant use of amphetamines, known to produce
Klamt RR. Homicide and LSD. JAMA. 1973;224(2):246. doi:10.1001/jama.1973.03220150054020