Naturalistic Psychedelic Use: A World Apart from Clinical Care
Nicolas G. Glynos, Christopher W. Fields, Julie Barron, Moss Herberholz, Daniel J. Kruger, Kevin F. Boehnke (2022)
Journal of Psychoactive Drugs
Interest in and availability of psychedelics for therapeutic purposes has increased in recent decades. In a large, anonymous, online survey, we investigated patterns of communication with healthcare providers and awareness and utilization of substance testing kits or services among people using psychedelics naturalistically. The sample population included attendees of a psychedelic activism event and users of psychedelic social media forums. Among 1,435 participants, 72.5% never discussed psychedelic use with their primary care provider (PCP). Only 4.4% reported using psychedelics with a therapist and 3% in clinical settings, although 77.8% were very or extremely likely to take psychedelics with a therapist if one were legally available. While 62.6% of participants were aware of substance testing services, 42.6% of these indicated never using them. Regression analyses identified several variables associated with disclosure to PCP and utilization of substance testing services including age, gender, frequency and number of psychedelics used, and likelihood of consuming psychedelics under the guidance of a therapist if one were legally available. Further research is necessary to investigate these findings among other groups. Our findings suggest that relevant training and education for healthcare providers is needed, along with more visible options for substance identity testing.
“How Do I Learn More About this?”: Utilization and Trust of Psychedelic Information Sources Among People Naturalistically Using Psychedelics
Daniel J. Kruger, Oskar Enghoff, Moss Herberholz, Julie Barron, Kevin F. Boehnke (2023)
Journal of Psychoactive Drugs
There is a surge of interest in psychedelics, including new stakeholders and greater media attention. There is a need to examine the information-seeking behavior of people using psychedelics naturalistically, given the importance of preparation and harm-reduction. We examined sources of information for people using psychedelics naturalistically, and the degree to which they are trusted in a large, anonymous, online survey (<i>N</i> = 1221). The most common source of participants' information on psychedelics was their own experimentation and experiences (79.52%). Most also sought information from Internet websites (61.67%), friends (61.02%), Internet discussion forums (57.08%), books (57%), and articles in peer-reviewed scientific journals (54.55%). Few sought information from their primary health care provider (4.83%). Articles published in scientific journals, psychedelic nonprofits, and researchers based in colleges or universities were the most trusted sources of psychedelic information. Government agencies and pharmaceutical companies were the least trusted. Few participants thought that the popular media accurately stated the benefits and risks of psychedelics and most thought that the popular media failed to distinguish between different types of psychedelics. Our results indicate a high level of information seeking among psychedelic users, with a diverse array of information sources typically outside of mainstream health and medical care systems.
Changed Substance Use After Psychedelic Experiences Among Individuals in Canada
Kevin F. Boehnke, Daniel J. Kruger, Philippe Lucas (2023)
International Journal of Mental Health and Addiction
We conducted a cross-sectional online survey of adults (n = 1639; 56.3% women) self-reporting past or current psychedelic use. We investigated whether psychedelic use was associated with self-reported changes in the use of other substances. Participants reported substantial changes, with 43.8% (n = 651/1488) decreasing or ceasing alcohol use, 42.5% (n = 272/640) ceasing or decreasing antidepressant use, and 42.4% (n = 200/471) decreasing or ceasing cocaine use. The highest rates of increased use were for cannabis (10.9%; n = 151/1383) and tobacco products (9.3%; n = 60/646). The most common reasons for substance use reductions were feeling more connected with self (73%; n = 632), nature (55%; n = 476), and others (54.6%; n = 473), as well as feeling less anxious or depressed (59.4%; n = 514). Factors associated with reduction in any substance use included motivation to treat a medical condition, number of psychedelics used, younger age, and using both microdoses and macrodoses. This real-world evidence should be rigorously investigated in future studies.
The Relationship Between Naturalistic Psychedelic Use and Clinical Care in Canada
Nicolas G. Glynos, Daniel J. Kruger, Nicholas Kolbman, Kevin F. Boehnke, Philippe Lucas (2023)
Journal of Psychoactive Drugs
Naturalistic psychedelic use among Canadians is common. However, interactions about psychedelic use between patients and clinicians in Canada remain unclear. Via an anonymous survey, we assessed health outcomes and integration of psychedelic use with health care providers (HCP) among Canadian adults reporting past use of a psychedelic. The survey included 2,384 participants, and most (81.2%) never discussed psychedelic use with their HCP. While 33.7% used psychedelics to self-treat a health condition, only 4.4% used psychedelics with a therapist and 3.6% in a clinical setting. Overall, 44.8% (<i>n</i> = 806) of participants were aware of substance testing services, but only 42.4% ever used them. Multivariate regressions revealed that therapeutic motivation, higher likelihood of seeking therapist guidance, and non-binary gender identification were significantly associated with higher odds of discussing psychedelics with one's primary HCP. Having used a greater number of psychedelics, lower age, non-female gender, higher education, and a therapeutic motivation were significantly associated with higher odds of awareness of substance testing. We conclude that naturalistic psychedelic use in Canada often includes therapeutic goals but is poorly connected to conventional healthcare, and substance testing is uncommon. Relevant training and education for HCPs is needed, along with more visible options for substance testing.
Preferences and Support for Psychedelic Policies and Practices Among Those Using Psychedelics
Daniel J. Kruger, Julie Barron, Moss Herberholz, Kevin F. Boehnke (2023)
Journal of Psychoactive Drugs
Legal, scientific, and social landscapes for psychedelics are changing rapidly. Differences of opinion exist among key stakeholders regarding regulatory control, models of provisioning psychedelic therapy, and medicalization, decriminalization, and/or legalization policies. We assessed the policy preferences of people using psychedelics naturalistically (<i>N</i> = 1221) to understand how they aligned and differed with institutional entities and existing psychedelic policies. Three quarters of participants would support decriminalization and legalization. On average, participants strongly supported individuals being legally able to grow and possess psychedelic plants and/or fungi for personal consumption. Trends included more support for natural over synthetic substances, self-production and consumption over gifting, gifting over sales, and administration of psychedelics with therapeutic support than without therapeutic support. Participants were concerned about pharmaceutical-like policy models, including patents of natural and synthetic psychedelic compounds. Participants were mostly from the State of Michigan, though geographical differences were minor. Those who identified as a psychedelic guide, educator, or therapist had small yet extensive differences from those who did not. As psychedelic liberalization continues to advance, it is critical for policymakers to consider these preferences to ensure laws provide safe and equitable access to these substances and appropriate medical support for their use.
Slouching towards engagement: interactions between people using psychedelics naturalistically and their healthcare providers
Kevin F. Boehnke, Kasey Cox, Cody Weston, Moss Herberholz, Nicolas Glynos, Nicholas Kolbman, Christopher W. Fields, Julie Barron, Daniel J. Kruger (2023)
Frontiers in Psychiatry
Introduction There is substantial public interest in psychedelics as potential treatments for psychiatric conditions. However, most psychedelics are criminalized under federal law in the USA, so it is unclear whether use occurs with clinical support. Our objective was to assess whether naturalistic psychedelic use occurs with clinical support, interactions between those using psychedelics and healthcare providers (psychiatrist, therapist, or primary physicians), and use characteristics. Methods We conducted an online, anonymous, confidential, cross-sectional survey of adults reporting psychedelic use ( N = 1221) through a psychedelics advocacy event and social media between 9/18/2022 and 11/5/2022. We assessed participant disclosure of psychedelic use with their psychiatric care provider (PsyCP) and/or primary care provider (PCP), desire for provider support, access to support, and rate of taking prescribed psychoactive medications alongside psychedelics. Results Among participants with such care providers, 22% disclosed psychedelic use to their PCP vs. 58% to their PsyCP. Participants were less confident in PCP vs. PsyCP ability to integrate psychedelics into treatment. Common reasons for nondisclosure included stigma, inadequate provider knowledge, and legal concerns. 23% reported taking psychedelics on the same day as potentially interacting psychiatric medications (e.g., anxiolytics, antidepressants). Despite 81% of participants desiring therapist support during psychedelic experiences, only 15% had received such support. Discussion Our results show that psychedelic use is generally disconnected from primary and psychiatric clinical care. This disconnection may result in safety issues, including inadequate screening for contraindicated conditions, lack of support during emergent adverse events, and drug interactions. Enhanced clinical education and orienting drug policy towards known harms and benefits of psychedelics is needed.
Psychedelic substitution: altered substance use patterns following psychedelic use in a global survey
Nicolas G. Glynos, Jacob S. Aday, Daniel J. Kruger, Kevin F. Boehnke, Stephanie Lake, Philippe Lucas (2024)
Frontiers in Psychiatry
Introduction Recent research suggests that psychedelics may have potential for the treatment of various substance use disorders. However, most studies to date have been limited by small sample sizes and neglecting to include non-North American and European populations. Methods We conducted a global, cross-sectional online survey of adults (n = 5,268, 47.2% women) self-reporting past or current psychedelic use and investigated whether psychedelic use was associated with changes in use of other substances. Results Nearly three-quarters (70.9%; n = 3,737/5,268) reported ceasing or decreasing use of one or more non-psychedelic substances after naturalistic psychedelic use. Among those with previous use, 60.6% (n = 2,634/4,344) decreased alcohol use, 55.7% (n = 1,223/2,197) decreased antidepressant use, and 54.2% (n = 767/1,415) decreased use of cocaine/crack. Over a quarter of the sample indicated that their decrease in substance use persisted for 26 weeks or more following use of a psychedelic. Factors associated with decreased use included a motivation to either decrease one’s substance use or self-treat a medical condition. Importantly, 19.8% of respondents also reported increased or initiated use of one or more other substances after psychedelic use, with illicit opioids (14.7%; n = 86/584) and cannabis (13.3%; n = 540/4,064) having the highest proportions. Factors associated with increased substance use included having a higher income and residing in Canada or the US. Discussion Although limited by cross-sectional study design, this large observational study will help inform future studies aiming to investigate the relationship between substance use patterns and psychedelic use.
Trainees Unprepared for Advances in Psychedelic Medicine: A Survey Study
Jamarie Geller, Nicolas G. Glynos, Andrew Lemmen, Rachel M. Pacilio, Daniel J. Kruger, Avinash Hosanagar (2024)
Journal of Psychoactive Drugs
This study aimed to characterize attitudes and identify gaps in trainee knowledge and education that may impact the field's readiness for the reemergence of psychedelic use in psychiatry. A two-part survey was sent out targeting medical and allied professional trainees who may interact with patients using or planning to use psychedelics therapeutically. Collected data for part one characterized demographics, sources of information, attitudes, experiences, and amount and type of education available about psychedelics in training programs. Part two was an assessment of psychedelic literacy, and predictors of trainee knowledge were analyzed. A total of 473 responses were obtained, 221 of which were unique, complete, thought to be authentic, and therefore included. Results indicated trainees had learned about psychedelics and related therapies from a wide variety of sources, most notably social media and word-of-mouth, which did not correlate with increased knowledge. There is limited structured education available, and although overall knowledge is low, participation in programming at home institutions did predict greater psychedelic literacy. As psychedelics are becoming increasingly available and research into their use in medicine advances, inclusion of relevant material in academic training programs will be essential to prepare future professionals to effectively educate and counsel patients.
Attitudes of psychedelic users regarding cost of treatment and non-hallucinogenic alternatives
Jacob S. Aday, Kevin F. Boehnke, Moss Herberholz, Daniel J. Kruger (2024)
Journal of Psychedelic Studies
Abstract Background and aims Psychedelic-assisted psychotherapy (PAP) is currently being studied as a possible treatment option for multiple disorders. Despite promising safety and efficacy findings, the high costs of the current PAP model makes it questionable if the treatment will be scalable. Non-hallucinogenic psychedelic analogs have been developed as a potential cost-effective alternative, but it is unclear what psychedelic users perceive as a reasonable cost for treatment and whether they would be open to trying a non-hallucinogenic analog. Methods We queried a large sample of people using psychedelics naturalistically ( N = 1,221) about their attitudes regarding the role of altered states of consciousness in PAP outcomes, costs of treatment, and their openness to trying a non-hallucinogenic psychedelic analog for treating a mental health condition. Results We found that most (76%) participants considered altered states of consciousness as very or extremely important to the therapeutic effects of psychedelics. Despite this, most (61%) were also moderately, very, or extremely likely to try a non-hallucinogenic substance if given the chance. Lastly, participants considered approximately $70–80 per hour to be a reasonable cost for various aspects of psychedelic services (e.g., preparation, integration, and dosing sessions). Conclusions Participants valued the role of altered states of consciousness in therapeutic changes attributed to psychedelics, but were still open to trying a non-hallucinogenic analog. Notably, the price participants considered to be a reasonable amount for PAP is well below current market projections. Future research is needed to address limitations of the study as well as to identify ways of lowering treatment costs.
Going Underground: Demographics, Services, and Best Practices Endorsed by Practitioners Providing Support for Naturalistic Psychedelic Use
Nicolas G. Glynos, Anne Baker, Jacob S. Aday, Niloufar Pouyan, Julie Barron, Moss Herberholz, Daniel J. Kruger, Kevin F. Boehnke (2024)
Journal of Psychoactive Drugs
Psychedelic-assisted therapy (PAT) has shown preliminary efficacy for psychiatric and physical health conditions. Although some people report naturalistic psychedelic use with so-called "underground" practitioners, little is known about PAT that occurs outside of controlled clinical settings or perspectives of these practitioners. We conducted an anonymous online survey of individuals who reported providing psychedelic support services (e.g. trip sitting and/or preparatory/follow-up psychotherapy) in naturalistic settings. We investigated demographics, including education and licensing, details about services provided, and reported client outcomes. Among 107 participants, 40.2% held a full or in-progress license and 44.9% had not obtained a relevant graduate degree. Almost all participants reported pre-screening clients before treatment, offering preparation, integration, and trip-sitting services, and most employed a range of therapeutic modalities, centering primarily on non-directive approaches. Participants reported that clients most commonly consumed psilocybin, and treated numerous conditions, primarily aligning with indications targeted in psychedelic clinical research. Perceptions of clients' symptom changes were largely positive, although a small proportion reported worsened personality disorder symptoms. Further research delineating client and practitioner perspectives of naturalistic PAT services is warranted, and such work may shed light on the benefits and risks specific to naturalistic PAT as well as inform best practices for practitioners.
Psychedelic Therapist Sexual Misconduct and Other Adverse Experiences Among a Sample of Naturalistic Psychedelic Users
Daniel J. Kruger, Jacob S. Aday, Christopher W. Fields, Nicholas Kolbman, Nicolas Glynos, Julie Barron, Moss Herberholz, Kevin F. Boehnke (2024)
Psychedelic Medicine
Introduction: Psychedelic substances have been used for centuries in various cultural and religious contexts, and more recently, in clinical research and therapy. There is a surge of interest in psychedelics, and psychedelic-assisted psychotherapy is becoming increasingly accessible. However, most individuals using psychedelics do so outside of therapeutic contexts. It is important to understand the adverse experiences that may occur with psychedelic use, as well as adverse events that may happen even in therapeutic contexts. Materials and Methods: We conducted an anonymous online survey of individuals who self-reported past psychedelic use. We asked about the frequency of experiencing 12 different adverse experiences when using psychedelics, and if they or someone they know was the victim of inappropriate sexual contact by a psychedelic sitter, guide, or practitioner. Participants could also describe other adverse experiences. Results: Among 1,221 participants, most reported having adverse experiences such as being frightened (74.3%), sadness (58.6%), feeling their body shake or tremble (54.3%), and loneliness (51.6%) during their psychedelic experiences. About half of participants reported having some other adverse experience, and one in ten participants had adverse physical reactions. About one-third of participants knew someone who was arrested for possession or use of psychedelics; 8% reported that they or someone they know was the victim of inappropriate sexual contact by a psychedelic sitter, guide, or practitioner; and one-quarter of participants knew someone who experienced a severe adverse event other than inappropriate sexual contact or arrest. Conclusion: Despite beneficial effects, psychedelic experiences can also be challenging, distressing, or even harmful. Adverse events can increase the risks of psychological harm, legal problems, stigma, and public health issues. Therefore, it is essential to prevent, identify, manage, and treat adverse events during psychedelic experiences to ensure the safety and well-being of the participants and the facilitators, and create opportunities for “integration” even with unguided sessions.
Psychedelics and chronic pain: self-reported outcomes on changed substance use patterns and health following naturalistic psychedelic use
Nicolas G. Glynos, Anne Baker, Jacob S. Aday, Daniel J. Kruger, Kevin F. Boehnke, Stephanie Lake, Philippe Lucas (2025)
British Journal of Pain
Psychedelic substances have shown preliminary efficacy for several neuropsychiatric disorders and are currently being investigated for chronic pain conditions. However, few studies have investigated outcomes of naturalistic psychedelic use among individuals with chronic pain, and none have assessed psychedelic-related changes in substance use patterns in this population. In a cross-sectional survey of adults who reported using psychedelics to self-treat a chronic pain condition ( n = 466; 46.1% women), we investigated changed substance use patterns and self-reported outcomes on physical and mental health following use of a psychedelic. Most (86.3%; n = 391/453) indicated that they ceased or decreased use of one or more non-psychedelic substances “as a result of” psychedelic use, and 21.2% ( n = 83/391) indicated that the decrease in use persisted for more than 26 weeks after psychedelic use. Alcohol (71.1%; n = 226/318) and prescription opioids (64.1%; n = 100/156) had the highest proportions for ceased/decreased use. Illicit opioids (27.8%; n = 22/79) and cannabis (21.5%; n = 78/362) had the highest proportions for increased/initiated use. In multivariate regression modeling, having a motivation to reduce one’s substance use was positively associated with ceasing/decreasing substance use ( p < .001). Perceptions of health outcomes following psychedelic use were broadly positive, and psilocybin was reported to be the most effective substance for both physical and mental health symptoms. Although limited by a cross-sectional study design, findings from this large sample merit future investigation into the benefits and risks of naturalistic psychedelic use among individuals with chronic pain.
Pictorial representation of illness and self measure (PRISM): A putative transdiagnostic tool for evaluating therapeutic effects of psychedelic treatments
Niloufar Pouyan, Jacob S. Aday, Steven E. Harte, Chelsea Kaplan, David A. Williams, Nicolas G. Glynos, Moss Herberholz, Daniel J. Kruger, Julie Barron, George A. Mashour, Daniel J. Clauw, Katrin H. Preller, Andrew Schrepf, Kevin F. Boehnke (2025)
Journal of Psychopharmacology
Background: Patients with refractory conditions often identify themselves with their illness, which affects multiple aspects of their lives. The pictorial representation of illness and self measure (PRISM) is a tool used to assess the enmeshment of individuals’ perception of self with a particular medical condition, broadly termed self-condition enmeshment. Aims: This study aimed to evaluate changes in PRISM scores and how these changes relate to symptom changes following naturalistic psychedelic use. Methods: In this survey, we retrospectively assessed changes in PRISM scores in 297 individuals who self-engaged in naturalistic psychedelic use for therapeutic purposes. Participants also completed the Patient Global Impression of Change (PGIC) scale to report symptom changes resulting from their perceived most salient psychedelic experience (MSPE). Results: PGIC scores indicated that the majority of participants with depression (95.4%), posttraumatic stress disorder (98.36%), and anxiety (94.87%) reported symptom improvement following naturalistic psychedelic use. There was a significant decrease ( p = 4.65 × 10 −25 ) in PRISM scores after MSPE compared to their PRISM scores before MSPE, indicating that individuals experienced a reduced identification of their identity with their condition following psychedelic use. PRISM change scores were also correlated with PGIC scores across all conditions (ρ = 0.41, p = 1.64 × 10 −11 ), indicating that reductions in self-condition enmeshment were associated with symptom improvement. Conclusions: Our results suggest that PRISM has transdiagnostic sensitivity for investigating the effects of psychedelics on self-perception. Interpretation is limited by convenience sampling, potential positive bias, retrospective reporting, and unclear doses and settings with natural psychedelic use.
Racial Differences in Naturalistic Psychedelic Use — Motivations for Use, Communication with Health Care Providers, and Outcomes
Nicolas G. Glynos, Mallet R. Reid, Jacob S. Aday, Daniel J. Kruger, Kevin F. Boehnke, Stephanie Lake, Philippe Lucas (2025)
Journal of Psychoactive Drugs
People of Color have been under-included in psychedelic-assisted therapy (PAT) research. Researchers have argued that systemic issues resulting in harms to communities of color like the War on Drugs and recurrent exposure to discrimination in healthcare settings may reduce their willingness to engage in PAT research. However, there are no empirical data regarding People of Color's trust or willingness in using psychedelics with support of trained healthcare providers. Therefore, we analyzed data from a large-scale survey of people using psychedelics to explore interactions between People of Color and healthcare providers in North America. The sample included 3,547 White people, 448 People of Color, and 377 Multiracial people. A lower proportion of People of Color consumed psychedelics with the support of a trained provider but an equal proportion had disclosed psychedelic use to primary care providers. Further, People of Color were equally motivated to use psychedelics with a trained healthcare provider, used psychedelics to treat similar issues, and similarly reported psychedelics as effective with other groups. Our findings suggest that lack of trust may not fully explain the underrepresentation of People of Color in PAT research, and future studies should investigate other barriers to People of Color's inclusion in PAT research.
Tripping into Treatment: Comparing Initial and Current Motivations for Psychedelic Use
Daniel J. Kruger, Janice K. Albrecht, Jacob S. Aday, Julie Barron, Moss Herberholz, Kevin F. Boehnke (2025)
Journal of Psychoactive Drugs
Psychedelic drugs are currently being explored for their therapeutic potential for a variety of health conditions. The recent increased public interest in psychedelics necessitates empirical investigation into motivations for use among users as well as how motivations may change over time. We asked a large sample of participants reporting naturalistic psychedelic use (<i>N</i> = 1221) about their motivations for using psychedelics initially (i.e. their first time) as well as currently. We found that motivations for psychedelic use change substantially over time, with initial use typically for recreation or exploration, and later use more for therapeutic or personal growth reasons, including managing mental health conditions, growing spiritually, connecting with nature, improving creativity, and managing trauma. These results highlight the distinct and shifting motivations for engaging in psychedelic use. Although the study was limited by a retrospective design, it is the first to show that motivations for using psychedelics may change over time, with initial use focused on recreation and curiosity but subsequent use more motivated by self-improvement (e.g. enhancing relationships and health). Future prospective designs and qualitative interviews may aid in further elucidating the mechanisms underlying these shifts in motivations over time.
Perceived Impact of Psychedelics on Sexual, Gender, and Intimate Relationship Dynamics: A Mixed-Methods Investigation
Daniel J. Kruger, Eirini K. Argyri, Justin K. Mogilski, Moss Herberholz, Julie Barron, Jacob S. Aday, Kevin F. Boehnke (2025)
The Journal of Sex Research
Systematic research on the impact of psychedelic use on sexuality and intimacy remains limited. This study investigated reported effects of psychedelic use on various aspects of sexuality, gender, and relationships through an online survey of individuals who had used psychedelics (<i>N</i> = 581). Most participants (70.2%) reported perceived impacts of psychedelic experiences on their sexuality and/or sexual experiences, with 65.4% noting short-term effects during psychedelic experiences and 52.8% reporting long-term effects, although no individual effect was endorsed by most participants. A higher proportion of participants indicated that psychedelic experiences enhanced, rather than diminished, relationship quality, attraction to current partners, and sexual activities. Approximately 10% of participants reported that psychedelic experiences influenced their gender identity and/or expression, reporting increased authenticity, self-acceptance, openness, and freedom in self-expression, as well as altered experiences of sexuality and gender. One-quarter of women and one-eighth of men reported heightened same-sex attraction following psychedelic use, and one-third of those with other gender identities reported changes in sexual attraction. Higher proportions of participants reported dating multiple people, being polyamorous or in an open relationship, or being committed to only one person after their psychedelic experiences compared to before. Regression models identified various perceived effects associated with using large psychedelic doses, more frequent psychedelic use, lower household income, identifying as gender diverse, and especially younger age and identifying as women. Psychedelics may facilitate these changes via self-insight, greater connectedness with others, and increases in self-compassion, though further research is needed.
Best practices for first psychedelic experiences: harm reduction advice from the psychedelic community
Daniel J. Kruger, Gina Mersereau, Ashley F. Sullivan, Julie Barron, Moss Herberholz, Niloufar Pouyan, Jacob S. Aday, Kevin F. Boehnke (2025)
Harm Reduction Journal
Abstract Background The use of psychedelics is currently increasing in the United States. Awareness of clinical trials investigating the therapeutic applications of psychedelics may result in a record number of people who use psychedelics for the first-time. This study aimed to develop a harm-reduction resource to facilitate safe and successful psychedelic experiences outside of regulated clinical and research settings. We employed a community-based approach to crowdsource practical recommendations for first-time psychedelic experiences from the psychedelic community. Methods We conducted an online survey with 581 individuals who reported psychedelic use ( N = 581) on recommendations for people using psychedelics for the first-time, following the principles of community-based collaborative research. The survey assessed recommendations for and against specific psychedelics for first-time experiences, recommendations for and against combinations of psychedelics, and other advice for first-time experiences. Open-ended follow-up questions were included to understand participants' reasons for their recommendations. An experienced qualitative researcher and two qualitative coders analyzed responses to open-ended items. Results Most participants recommended psilocybin for first-time psychedelic experiences, approximately half recommended cannabis, and a third recommended MDMA/MDA (3,4-methylenedioxymethamphetamine/3,4-methylenedioxyamphetamine, ecstasy, molly). These substances were favored for their moderate intensity, dose-dependent effects, precise dosing, and relatively short duration of effects. Conversely, substances such as ayahuasca, DMT ( N , N -dimethyltryptamine), 5-MeO-DMT (5-methoxy- N , N -dimethyltryptamine), and Salvia divinorum or salvinorin A were not recommended due to their intensity, mental and physical health risks, and safety concerns. Participants advised against mixing psychedelics with alcohol, stimulants, antidepressants, and narcotics/opiates. Additional recommendations included embracing the experience, learning about the substance and its effects, and setting intentions for the experience. Conclusions Given the growing interest in psychedelics despite limited legal access and systematic education available, it is crucial to inform the public about practices that minimize risks. This project compiled recommendations from individuals who self-identified being experienced with psychedelics. The active involvement of the psychedelic community may enhance research quality and public trust in the findings.
How do psychedelics work?
Robin Carhart‐Harris (2018)
Current Opinion in Psychiatry
KEY FINDING
Psychedelics initiate neurobiological changes leading to the relaxation of high-level beliefs, potentially enabling a healthy revision of pathological beliefs.
It is proposed that psychedelics initiate a cascade of neurobiological changes that manifest at multiple scales and ultimately culminate in the relaxation of high-level beliefs. The purpose of psychedelic therapy is to harness the opportunity afforded by this belief-relaxation to achieve a healthy revision of pathological beliefs.
Psychedelics
David E. Nichols (2016)
Pharmacological Reviews
KEY FINDING
Psychedelics, particularly psilocybin, show promise in treating cancer-related psychosocial distress and addiction in clinical trials.
Psychedelics (serotonergic hallucinogens) are powerful psychoactive substances that alter perception and mood and affect numerous cognitive processes. They are generally considered physiologically safe and do not lead to dependence or addiction. Their origin predates written history, and they were employed by early cultures in many sociocultural and ritual contexts. After the virtually contemporaneous discovery of (5R,8R)-(+)-lysergic acid-N,N-diethylamide (LSD)-25 and the identification of serotonin in the brain, early research focused intensively on the possibility that LSD and other psychedelics had a serotonergic basis for their action. Today there is a consensus that psychedelics are agonists or partial agonists at brain serotonin 5-hydroxytryptamine 2A receptors, with particular importance on those expressed on apical dendrites of neocortical pyramidal cells in layer V. Several useful rodent models have been developed over the years to help unravel the neurochemical correlates of serotonin 5-hydroxytryptamine 2A receptor activation in the brain, and a variety of imaging techniques have been employed to identify key brain areas that are directly affected by psychedelics. Recent and exciting developments in the field have occurred in clinical research, where several double-blind placebo-controlled phase 2 studies of psilocybin-assisted psychotherapy in patients with cancer-related psychosocial distress have demonstrated unprecedented positive relief of anxiety and depression. Two small pilot studies of psilocybin-assisted psychotherapy also have shown positive benefit in treating both alcohol and nicotine addiction. Recently, blood oxygen level-dependent functional magnetic resonance imaging and magnetoencephalography have been employed for in vivo brain imaging in humans after administration of a psychedelic, and results indicate that intravenously administered psilocybin and LSD produce decreases in oscillatory power in areas of the brain's default mode network.
