https://sunybuffalo.qualtrics.com/jfe/form/SV_et9vbgM6SmVM07k
We greatly appreciate your input!
Lisa Bieberman was a pioneer of psychedelic harm reduction education. She established the Psychedelic Information Center in Cambridge, MA and published a nationwide newsletter on LSD. In February 1967, she published Session Games People Play: A Manual for the Use of LSD, which recommended best practices for psychedelic use. We conducted an online survey of individuals who reported psychedelic use (N = 581) to assess contemporary agreement with the advice Bieberman provided over half a century earlier. Most participants reported having a role requiring psychedelic expertise (54.7%; e.g., Guide/Sitter, Therapist, Indigenous facilitator) and most (86.4%) had taken psychedelics in the past year. We found general agreement with most of the specific advice (18/19 items), with minor variation. There was consensus on statements such as “Be with people who all know, like, and trust each other,” and “Recognize that the experience will eventually end.” “Clear your mind of negative emotions” and “Do not go out in public” received moderate support. Participants neither uniformly agreed nor disagreed on “Avoid looking in the mirror.” Given the high and growing interest in psychedelics, it is critical to provide harm reduction guidance to individuals contemplating psychedelic use outside of regulated environments. The current project recognizes and validates the advice in underground literature from a previous psychedelic era.
Psychedelic decriminalization has moved from the margins of drug-policy discourse to a mainstream public health and equity conversation. This community survey reveals that people with psychedelic experience who live in areas that have decriminalized psychedelics report greater benefits of psychedelic decriminalization than adverse outcomes. In decriminalized zones, most (84.0%) participants (N = 163) reported feeling improvements in one of the following areas because of decriminalization: legal risks, social acceptance, substance availability, substance safety, diversity of available products, and overall substance quality. Only 5.5% of participants reported worsened conditions in any category. Most (74.8%) participants also reported decriminalization-related improvements related to psychedelic therapy, such as social acceptance, availability, legal risks, safety, and diversity of services available. Notably, no participant reported that legal risk had worsened. Post decriminalization, most (72.4%) participants reported improvements in life conditions including stress and anxiety, worry, depressive symptoms, physical health, addiction, family relationships, other relationships, connection to community, working conditions, and financial status. Only 8.6% of participants reported declines in any category regarding psychedelic therapy or life conditions (2.5%). Although our methodology precludes attributions of causality, this initial study may inspire research with more sophisticated methodologies.
Most academic psychedelic research is clinically oriented, with industry research primarily focusing on the medicalization of these substances. Given the rapid policy changes and the surge in interest among researchers and the public, it is imperative to assess and document the research priorities of the broader psychedelic community. This study aimed to identify these priorities through an anonymous online survey conducted in 2022 among U.S. adults who self-reported past psychedelic use. A trained team coded the responses of 1,192 participants to an open-ended question regarding their views on the priorities for psychedelic research. Emerging themes and sub-themes were compared to research topics discussed during a National Institutes of Health (NIH) Workshop on future psychedelic research directions held in the same year. Participants identified seven major domains for future research: 1) therapeutic efficacy for treating health and medical conditions; 2) best practices for non-clinical psychedelic use; 3) general safety and adverse experiences; 4) promoting a broad understanding of psychedelics, including indigenous traditions and community impacts; 5) desirable outcomes for non-medical psychedelic use, such as increases in creativity and spiritual awakening; 6) best practices for psychedelic-assisted therapy; and 7) best practices for psychedelic research. Although there was some overlap between the research priorities of psychedelic users and those of influential institutional researchers, notable differences were observed. Institutional researchers emphasized molecular, neurological, and clinical research, whereas psychedelic users prioritized best practices for non-clinical use and broader societal and cultural issues.
Psychedelic drugs show promise in facilitating a variety of long-term psychological changes, but they may also lead to unexpected major life changes that have not been captured by measures typically used in clinical trials. The Psychedelic-related Major Life Changes Questionnaire (P-MLCQ) was created to assess psychedelic-related major life changes across 10 different domains and evaluated in a sample reporting naturalistic psychedelic use (N = 581). 482/581 participants (82.96%) reported at least one major life change influenced by their psychedelic use (M = 3.29, SD = 2.60), including changes in Goals (53.70%), Values (53.53%), Religion/spirituality (49.05%), Social activities (37.01%), Eating habits/diet (34.08%), Occupation/Line of work (32.36%), Hobbies (29.43%), Political views (14.97%), Sexuality (13.08%), and Marital status/non-marital partner change (12.22%). Major life changes were rated highly positively (M = 4.64, SD = 0.61 on a 5-point scale). There was a positive relationship between frequency of psychedelic use over the last five years and total number of psychedelic-related major life changes (r = 0.34, p < 0.001). Women were 21% more likely than men to report major life changes, whereas age and education-level were negatively related to major life changes. Although our results support that psychedelic use can be followed by major life changes, future research is needed to examine the generalizability of these results in representative samples that are less susceptible to positive bias.
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.
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 have used psychedelics (N = 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.
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 (N = 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.
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.
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.
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.
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. 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. 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. 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.
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 (N = 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 completely 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.
There is a remarkable 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 (N = 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 (57.00%), 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 non-profits, 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.
Identifying gaps and strengths in psychedelic-related knowledge is key to developing effective, evidence-based education to inform appropriate use of and harm reduction practices for psychedelics in the naturalistic use landscape. The current study piloted an assessment instrument with questions on legal status, therapeutic potential, and side effects of psychedelics among people reporting current psychedelic use. We recruited participants (N = 1435) at a psychedelic advocacy event and through psychedelic interest groups on social media. Respondents completed a brief survey of psychedelic use and psychedelic knowledge. Items assessed basic knowledge of various topics surrounding psychedelics, such as legal status, active compounds, and known therapeutic efficacy based on the clinical trial literature. Respondents who had used greater numbers of different psychedelics, with higher levels of education, lower age, greater frequency of psychedelic use, identifying as male, used high doses (vs. microdosing only), identifying as Caucasian/White, and with greater annual household income answered more questions correctly. Most respondents exhibited high knowledge of psychedelics, though there is also a demonstrated need for education and outreach, especially in under-represented communities.
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.