Adults who microdose psychedelics report health related motivations and lower levels of anxiety and depression compared to non-microdosers

In this survey study (n=8703) the microdosing practices, motivations and mental health history of self-selected microdosers and non-microdosers via a mobile phone application. Psilocybin was the most commonly used psychedelic (85%) and stacking was frequently reported (e.g combining microdosed psilocybin with functional mushrooms like Lion’s Mane). Those who microdosed reported a higher history of mental health concerns and the majority were motivated to microdose to better their mental health.

Abstract

“The use of psychedelic substances at sub-sensorium ‘microdoses’, has gained popular academic interest for reported positive effects on wellness and cognition. The present study describes microdosing practices, motivations and mental health among a sample of self-selected microdosers (n = 4050) and non-microdosers (n = 4653) via a mobile application. Psilocybin was the most commonly used microdose substances in our sample (85%) and we identified diverse microdose practices with regard to dosage, frequency, and the practice of stacking which involves combining psilocybin with non-psychedelic substances such as Lion’s Mane mushrooms, chocolate, and niacin. Microdosers were generally similar to non-microdosing controls with regard to demographics, but were more likely to report a history of mental health concerns. Among individuals reporting mental health concerns, microdosers exhibited lower levels of depression, anxiety, and stress across gender. Health and wellness-related motives were the most prominent motives across microdosers in general, and were more prominent among females and among individuals who reported mental health concerns. Our results indicate health and wellness motives and perceived mental health benefits among microdosers, and highlight the need for further research into the mental health consequences of microdosing including studies with rigorous longitudinal designs.”

Authors: Joseph M. Rootman, Pamela Kryskow, Kalin Harvey, Paul Stamets, Eesmyal Santos-Brault, Kim P. C. Kuypers, Vince Polito, Francoise Bourzat & Zach Walsh

Notes

Microdosing is the practice of regularly using low doses of psychedelic drugs. This relatively recent phenomenon was made popular through the anecdotal reports of young professionals from all walks of life, taking sub-hallucinogenic doses of psychedelics for a variety of reasons.

In spite of the reported popularity of this practice, few scientific studies have explored the pharmacological effects of microdosing. Existing studies tend to be large-scale survey studies exploring why people microdose and the subsequent effects they experience after regularly consuming low doses of psychedelics.

The study at hand is not indifferent, it describes microdosing practices, motivations and mental health among a sample of self-selected microdosers (n = 4050) and non-microdosers (n = 4653). What makes this study unique is the manner through which data was collected; a mobile phone application.

Study participants downloaded the Quantified Citizen application to their iPhones and were instructed to complete a total of 123 questions surrounding their mental health and microdosing practices. While many companies are developing similar applications, this study is one of the first to quantify and analyse data collected in this manner.

Main findings:

• Psilocybin was the most commonly reported microdosed substance, with 85% of participants using psilocybin compared to 11% using LSD.
• Mental health or substance use concerns were reported by 29% of respondents, with the most frequently endorsed being anxiety, depression, and PTSD. Microdosers were more likely to report a history of mental health concerns compared to those who do not microdose.
• The most widely endorsed motivation for microdosing was Enhancing Mindfulness, followed by Improving Mood, Enhancing Creativity and Enhancing Learning.
• Psilocybin users were more likely than LSD users to combine psilocybin with other substances in the process referred to as stacking, combing substances such as Lion’s Mane, niacin and chocolate with their psychedelic of choice.

Overall, the study found that among individuals reporting mental health concerns, microdosers exhibited lower levels of depression, anxiety, and stress. While limitations do exist, particularly surrounding the manner in which participants were selected, the large sample size highlights that microdosing is common practice with a variety of motivations.

If it’s really the microdose that is doing the heavy lifting, or the expectancy effects surrounding it do remain elusive. A self-blinded experiment earlier this year found that all those who microdosed (so also those taking a placebo) improved. A study that combines the strength of both these studies, blinding participants and the large sample size, could provide more insights in the future.

Summary

Psychedelics have a long history of salutary use among Indigenous peoples of the Americas, including the Mazatec, Huichol, Shipibo, and other nations, as well as the pre-Columbian Maya, Olmec, Zapotec, and Aztec societies. They have reemerged as medicines with the potential to address mental illness and enhance well-being among largely non-Indigenous communities.

Psilocybin and LSD are the substances used by the vast majority of participants in observational and retrospective research on microdosing. Microdoses are typically used several times a week with various patterns of alternating days.

In addition to microdosing psychedelics alone, stacking involves combining microdoses of psychedelics with other substances that are proposed to accentuate salutary effects. This practice has a long history, and includes the use of cacao, Syrian rue, Lion’s Mane mushrooms and/or niacin.

The popularity of stacking substances with psilocybin likely stems from positive anecdotal reports, rather than from a strong empirical basis. However, since no studies have directly tested the synergistic effects of stacked substances with psilocybin in humans, caution is warranted when interpreting claims related to the synergistic effects of stacked substances.

Recent studies have begun to characterize individuals who microdose, and they report higher levels of past year substance use but lower levels of substance use disorders, anxiety disorders, and negative emotionality.

Surveys identify diverse motivations for microdosing, including reducing anxiety and depression, improving well-being, and enhancing cognitive performance. Many microdosers report reduced stress, improvements in mood, and attenuation of symptoms of depression, anxiety, post-traumatic stress disorder, and obsessive – compulsive disorder.

The present study reports baseline data from an ongoing longitudinal study of microdosing, which includes a detailed assessment of combining psychedelic and non-psychedelic substances (i.e., stacking). It also examines relationships between motivation for microdosing and mental health.

We collected cross-sectional data from self-selected respondents recruited via media related to psychedelic use between November 2019 and July 2020 using the Quantified Citizen (QC) application32, which was available on Apple iOS devices at the time of study. Data were drawn from baseline and supplementary questionnaires from a longitudinal study of microdosing and mental health. The questionnaire was developed based on previous research and consultations with experts.

Participants were classified as microdosers or non-microdosers based on the response to the question “Are you currently engaged in a regular practice of microdosing?”. Microdosers were asked to specify microdosing substance, dosage, stacking practice, timing protocol, quantity, duration since microdosing initiation, and motivations for microdosing.

Participants were asked to indicate whether they currently had any psychological, mental health or addiction concerns, and why they started microdosing. They were then invited to complete the Depression, Anxiety, Stress Scale-21 (DASS-21) to assess symptom severity during the past week.

We used X2 to compare demographic variables, substance use, and mental health conditions of microdosers and non-microdosers, and ANOVA to compare DASS-21 Depression, Anxiety and Stress subscale scores between microdosers and non-microdosers.

8703 respondents from 84 nations completed the baseline survey, and 4653 respondents reported microdosing. Microdosers were more likely to be older and live in an urban rather than a suburban area.

29% of respondents reported mental health or substance use concerns, with the most frequently endorsed concerns being anxiety, depression, and post-traumatic stress disorder (PTSD)/trauma-related symptoms. Microdosers were more likely to endorse any mental health or substance use concern, but did not differ from non-microdosers with regard to anxiety, problematic cannabis use, problematic alcohol use, problematic opioid use, problematic gambling, panic attacks, schizophrenia, bipolar disorder, eating disorder, learning disabilities, or autism spectrum disorder.

Among respondents who endorsed currently having a mental health or addiction concern and who completed the Depression, Anxiety, and Stress subscales of the DASS-21, microdosers demonstrated lower scores than non-microdosers on Anxiety, Depression, and Stress.

Most respondents reported lifetime use of larger doses of psilocybin or LSD, and respondents who microdosed reported higher levels of lifetime use than did non-microdosers. Microdosers demonstrated lower levels of depression, anxiety and stress relative to non-microdosing participants.

Motives for microdosing varied by group, with respondents without mental health concerns more likely to report microdosing to Enhance Learning, whereas respondents with mental health concerns were more likely to report microdosing to Reduce Anxiety, Decrease Substance Use, and Improve Mood.

Over 85% of respondents reported using psilocybin for microdosing, compared to 11% using LSD. Psilocybin users were more likely to use higher or medium-sized microdoses, and used them more frequently.

Psilocybin and LSD microdosers exhibited some differences with regard to motivation for microdosing, with psilocybin microdosers more likely to endorse Decreasing Anxiety and Improving Sleep as motives, and psilocybin users more likely to combine psilocybin with other substances in the process referred to as stacking.

Table 2 shows that microdosing was not associated with mental health, anxiety or stress. Respondents who reported stacking were more likely to endorse Enhancing Creativity and Enhancing Learning.

Discussion

Generally, psilocybin and LSD are the most frequently used microdosing substances, and the majority of participants report microdosing between 1 and 4 times per week. Moreover, more than half of the microdose sample combines their microdose substance with another substance such as Lion’s Mane mushrooms or chocolate.

The inclusion of a comparison group that was similar with regard to important demographics, substance use, and mental health factors suggests that a considerable proportion of those who microdose do so with therapeutic intent to treat mental health symptoms and conditions. Although the cross-sectional design of this study precludes causal inference, the findings suggest that microdosing may have salutary effects on mental health, and mandate further research with more rigorous longitudinal designs.

Microdosers were less likely to use alcohol regularly and more likely to abstain from alcohol entirely than non-microdosers, which is consistent with their motivation to reduce the harms associated with the use of psychoactive substances.

Microdosers were more likely to endorse frequent cannabis use, and although frequent cannabis use may be associated with the development of cannabis related problems, it is also a marker of therapeutic use. Moreover, future research should examine the interaction between large-dose and microdose psychedelics.

Among respondents without mental health conditions, the most highly endorsed motivation for microdosing was to promote mindfulness. Other prominent motives included facilitating learning and creativity, and promoting health behaviors.

Our study found that psilocybin use was more prevalent than LSD use among microdosers, and that psilocybin use was associated with more stacking with admixtures, intensive and frequent microdosing, and a greater focus on therapeutic intentions.

Microdosing psychedelics to address mental health concerns and enhance well-being has outpaced research on the risks and benefits of such use, and further research is required to confidently extrapolate safety data from infrequent use of large doses of psychedelics to the more consistent use of microdoses.

Our findings highlight the diversity of practices gathered under the umbrella of microdosing, and the need for more fine grained detail regarding stacking practices. Further, the literature on stacking substances independent of psychedelic substances is itself limited, and warrants cautious interpretation. Although we identified differences in dose and frequency across psilocybin and LSD, interpretation is limited by the lack of consistent parameters.

The present study has several limitations, including response bias and recruitment through venues favorable to psychedelic use. Additionally, the study was limited to those with access to Apple devices and should be interpreted with caution pending replication. The present study examined the associations between microdosing and mental health in a large sample of substance use disorder patients. The study used a bespoke, mobile application which allowed for anonymous participation, self-enrolment, and the completion of assessments over time.

Conclusion

A large international sample of adults microdosed psychedelic drugs. The microdosers had lower levels of anxiety and depression than controls, and used a variety of combinations of psychedelic and non-psychedelic substances.

Author contributions

J.R. designed the study, P.K. analyzed the data, P.S. wrote the first version of the manuscript, K.H., E.S.B. orchestrated data collection, K.P.C.K., V.P., F.B. edited the manuscript, and Z.W. edited the manuscript.

Competing interests

Joseph Rootman has received funding from Quantified Citizen Technologies, Pamela Kryskow is on the clinical advisory board of Numinus Wellness, Kalin Harvey is the CTO and co-founder of Quantified Citizen, Paul Stamets is a minority investor in Quantified Citizen, Eesmyal Santos-Brault is the CEO and co-founder of Quantified Citizen, Kim PC Kuypers is an investigator.

Additional information

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