Broad Support for Psychedelics as Medicine from ACX Reader Survey

This summer, Scott Alexander (of Astral Codex Ten, ACX) opened up his readership to be queried in a host of surveys. We took him up on the offer and asked 1580 respondents about their views on psychedelics as medicine. Next to broad support for psychedelics as medicines, we found above average experience with psychedelics, and maybe unsurprisingly that they would be most likely to trust a psychiatrist when asked who could inform them about psychedelics as medicine.

KEY FINDINGS

• Nearly everyone (96%) was familiar with the use of psychedelics for the treatment of mental health conditions
• Most (91%) supported the legalization of psychedelics for medical use
• A small half of them (44%) had tried psychedelics, defined to include also MDMA and ketamine

The participants of our ACX readership survey

In our recent ACX survey, the average age of respondents was 34 years old, with a majority aged between 25 and 34 years old. Respondents were based all over the world, from Europe to Asia to South America and beyond. However, over 60% of the survey’s 1580 respondents were based in the United States. An overwhelming majority were male (86%) and identified as white (non-Hispanic). Respondents of this survey tended to be well educated, with 40% educated to Bachelor’s level and an additional 26% held Master’s degrees. A total of 17 qualified physicians took part in the survey as did 168 doctoral scholars. Interestingly, 38% of respondents worked in the practical side of the IT sector i.e programming, while others were employed in engineering (6%), other computer applications (4,7%) and mathematics (4,5%). When asked about their religious views, over half of the survey’s respondents identified as being atheists and not spiritual. Overall, respondents had an interest in politics. The majority affiliated with social democrats (35%) while the remaining majority were either liberal or libertarian, at 29% and 22%, respectively. Given that a large of this survey’s respondents were based in the United States, it is worth noting that the significant majority of this section of respondents associated with the Democratic Party at 34%, while only 6% affiliated with the Republican Party. Also worth noting is that 34% of participants were not registered for any political party.

In the ACX survey, respondents were also asked about their personal mental health status as well as if any of their family members have difficulties with their mental health. The majority of respondents (65%) had no formally diagnosed mental health disorder, while 20% had one formally diagnosed disorder (15% two or more). Those with one or multiple diagnoses were more likely to use psychedelics, but without further information, we are not able to make claims about causal effects here. The mental disorder about which respondents were queried included; depression, anxiety, OCD, eating disorders, PTSD, substance use disorders, autism, ADHD, and schizophrenia. In terms of depression and anxiety, 24% and 19% of respondents had a family member with these conditions, respectively. These disorders were also the most formally diagnosed disorders in our survey population. When asked if they think they might have a mental disorder, 17% of respondents believed they might have anxiety while 16% believed they might be depressed. These findings are interesting when we think of psychedelics. Although the majority of studies exploring the potential of psychedelics focus on depression and anxiety disorders, such findings from this survey emphasize the prevalence of these disorders and the need for more effective treatments.

Note: the respondents to this survey were all readers of ACX and self-selected to fill in surveys. They were asked to start filling in a survey based on a (semi)random number and fill in as many as they liked. We have checked for nonsensical responses and by using an identifier number were able to link 1474 participants (93%) to their demographic data.

ACX readership survey vs general population survey

Our previously completed representative consumer survey, detailed in the Psychedelics as Medicine Report: Third Edition, had a total of 3046 respondents. This survey was relatively gender-balanced with 51% of respondents female. Most of the respondents in this survey were older than those in the ACX survey however, age groups were relatively well balanced. The largest age group was those 65 years and older, which had 575, or 19%, of respondents, compared to only 22 (1,5%) in the ACX survey. Those aged between 35-44 and 45-54, accounted for 18 and 19% respectively. This survey had less global reach than the ACX survey. Just over 600 respondents came from each country including; the United States, United Kingdom, Germany, France and Canada. In this consumer survey, 25% of participants held a Bachelor’s degree while 14% were educated to Master’s level. Additionally, 582, or 19%, of respondents held a professional school degree.

In this consumer survey, the majority of respondents (74%) had no experience with drugs nor did they know other people who had. These findings are different to the ACX survey wherein, 56% of respondents had no experience with psychedelics. Noteworthily, in both the consumer and ACX surveys, 4% and 12% of the samples respectively had more than 20 experiences with psychedelics. Respondents in the consumer survey were asked their reasons for taking psychedelics, 19% chose recreational purposes while 12% separately took them for both creative inspiration and therapeutic purposes.

Which statement best describes your awareness of the use of psychedelics for the treatment of mental health conditions?

I have heard about this, and I am well-educated on the topic
I have heard about this, and I am curious to know more
I have heard about this, but it doesn’t interest me
I haven’t heard about this, but I am curious to know more
I haven’t heard about this, and it doesn’t interest me

In both surveys, respondents were asked similar questions regarding psychedelics as medicine, 62% had heard and were curious in the ACX survey compared to 36% in the consumer survey. 17% of respondents considered themselves well educated on the topic in the ACX survey whereas, this number was 14% in the consumer survey.  Additionally, 15% of consumer survey respondents had heard of psychedelics but had no interest in pursuing any further information. This number was 18% in the ACX survey. Despite these people who have no interest in learning more about psychedelics as medicine, the figures suggest the most people are aware of the potential psychedelics have and would like to learn more. This could be achieved by making findings of trials and studies involving psychedelics more publicly accessible in a manner that relates to the general public.

Support for psychedelics as medicine

In the ACX survey, 1431 respondents (91%) (strongly) supported the implementation of legislation for the medicalization of psychedelics. Furthermore, the majority of participants (74%) supported the idea that psychedelic therapies should be covered by health insurance. In comparison to the ACX survey, the consumer survey found that 47% supported the implementation of legislation for the medicalization of psychedelics. Similarly, the consumer survey found that the majority of respondents (59%) supported psychedelic therapies being covered by health insurance.

In terms of being open to undergoing treatment using psychedelics, 92% of respondents in the ACX survey would consider treatment whereas, 65% of respondents in the consumer survey were open to the idea. In both surveys, 34% of respondents agreed that they knew someone who could benefit from psychedelic therapy. However, most people either were not sure or disagreed they knew someone who could benefit. These findings suggest that people want therapies involving psychedelics to be treated just like any other medication, having the necessary legislation and covered by health insurance providers.

Considering the use of psychedelic-assisted therapy to treat mental health conditions, to what extent do you agree with each of the following statements

I support the legalisation of psychedelics for medicinal use
I support the coverage by health insurance of psychedelics for medicinal use
If faced with a medical condition for which a psychedelic medicine was shown to be safe and effective, I would consider using this treatment option
I know someone who would benefit from psychedelic therapy

After asking participants about the above views, we presented them with a small piece of information. The goal of the information was to put them in a state of mind where psychedelics as medicines, in combination with talk therapy, were already approved. We hypothesized that this would improve their scores when asking them the same questions again. In the consumer survey, which was translated for each country, we changed the FDA for the relevant health agency/body.

Imagine that psychedelics were shown to be safe and effective in the treatment of certain mental health conditions such as PTSD and depression. And that the FDA has approved certain psychedelics as medicines, when used in conjunction with talk therapy. And that their medical use is safe for patients and has a high chance of them finding significant relief from a mental health condition.

For both populations, we analysed if presenting this information had a significant effect on their responses to their level of support for legal medical use and coverage by insurance. For both questions, we saw a significant effect (p < .001) yet both also with a small effect size (respectively η2 = 0.10 and η2 = 0.13). In both groups, the support on these two questions went up, but also noted should be that in both cases the support from the ACX survey was (much) higher than in the general population. Still, this gives us a good signal that presenting people with this information, if/when psychedelics are approved by the FDA, will sway them towards more support.

Well-informed ACX readers are ahead of the game when it comes to psychedelics as medicine

The support from the ACX readers was greater on nearly every dimension, as well as their likeliness to having tried psychedelics. Although Scott Alexander doesn’t touch upon the topic often (1,2,3,4,5,6), it is a hot topic in San Francisco and tech circles (both heavily overrepresented in the survey). It is comforting to see that in both surveys only a small percentage of people are opposed to psychedelics for medical use, something that might be unthinkable if we go back only a few decades.

Psychedelics as medicine still have a long way to go. Research is going through a ‘renaissance’ but next to ketamine for depression, no other full Phase III trials have been finished (though MDMA for PTSD has finished the first half). Removing barriers to research is one of the steps that could make things go faster, having health insurance cover the therapy when approved will be the next major hurdle.

The team at Blossom thanks Scott Alexander for generously opening up his readership to be surveyed.