Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population

This large survey study (analysis) (n=191.382 total, n=27.235) of US adults found that lifetime classic psychedelic use was associated with a significantly reduced odds of past month psychological distress, past year suicidal thinking, planning & attempt.

Abstract

“Mental health problems are endemic across the globe, and suicide, a strong corollary of poor mental health, is a leading cause of death. Classic psychedelic use may occasion lasting improvements in mental health, but the effects of classic psychedelic use on suicidality are unknown. We evaluated the relationships of classic psychedelic use with psychological distress and suicidality among over 190,000 USA adult respondents pooled from the last five available years of the National Survey on Drug Use and Health (2008–2012) while controlling for a range of covariates. Lifetime classic psychedelic use was associated with a significantly reduced odds of past month psychological distress (weighted odds ratio (OR)=0.81 (0.72–0.91)), past year suicidal thinking (weighted OR=0.86 (0.78–0.94)), past year suicidal planning (weighted OR=0.71 (0.54–0.94)), and past year suicide attempt (weighted OR=0.64 (0.46–0.89)), whereas lifetime illicit use of other drugs was largely associated with an increased likelihood of these outcomes. These findings indicate that classic psychedelics may hold promise in the prevention of suicide, supporting the view that classic psychedelics’ most highly restricted legal status should be reconsidered to facilitate scientific study, and suggesting that more extensive clinical research with classic psychedelics is warranted.”

Authors: Peter S. Hendricks, Christopher B. Thorne, C. Brendan Clark, David W. Coombs & Matthew W. Johnson

Analysis

“Of the 191,382 respondents, 27,235 reported lifetime classic psychedelic use (13.6% weighted). Of these, 391 reported lifetime DMT use (0.1% weighted), 26 reported lifetime ayahuasca use (0.008% weighted), 18,152 reported lifetime LSD use (10.2% weighted), 4687 reported lifetime mescaline use (3.5% weighted), 3540 reported lifetime peyote or San Pedro use (2.4% weighted), and 20,274 reported lifetime psilocybin use (8.9% weighted). In addition, 12,657 of the respondents reported past month psychological distress (4.8% weighted), 10,445 reported past year suicidal thinking (3.8% weighted), 3157 reported past year suicidal planning (1.1% weighted), and 1716 reported past year suicide attempt (0.5% weighted).”

It’s interesting to note the very big differences in prevalence of use of these different psychedelics.

Summary

Introduction

Almost half a billion people worldwide suffer from mental health problems, and suicide is among the deleterious consequences of poor mental health. Despite advances in mental health treatment over the past 60 years, suicide rates have not significantly declined.

Classic psychedelics, such as DMT, LSD, mescaline, and psilocybin, can occasion mystical-type experiences and have been used in sacramental healing contexts across cultures since time immemorial. Modern analysis suggests that classic psychedelics are among the least harmful of misused drugs, with limited dependence potential.

We examined the relationships between classic psychedelic use and psychological distress and suicidality among over 190,000 USA adult respondents pooled from the last five available years of the National Survey on Drug Use and Health. We found that classic psychedelic use was associated with a significantly reduced odds of these outcomes.

Classic psychedelics may warrant the attention they received five decades ago because they appear to target a number of factors that modulate suicide risk, including affective disturbance, which is one of the most prominent contributors to suicidality. Substance misuse is robustly related to suicide risk, and several lines of research suggest that classic psychedelics have antiaddictive effects. For example, a single dose of LSD reduced the probability of alcohol misuse almost two-fold relative to comparison conditions. Additional suicide risk factors include impulsive-aggressive personality characteristics and early traumatic life events. Psilocybin may occasion enduring improvements in inner peace, patience, good-natured humor/playfulness, interpersonal regard, anger, and compassion, and may boost spirituality, which may protect against suicidality.

The prefrontal cortex is associated with suicide risk factors and suicidal behavior, and classic psychedelic use down-regulates 5-HT2A receptors in the prefrontal cortex.

Classic psychedelic use may reduce markers of central nervous system inflammation, which are implicated in a host of mental health conditions and suicidal behavior. This may be because psychedelics alter the activity of the default mode network (DMN), which is hyperactive and hyperconnected among those with affective disorders.

Despite evidence suggesting safety and efficacy, classic psychedelics remain Schedule I substances, making clinical research with these drugs extremely difficult to conduct. Therefore, population-based survey studies represent one means of examining the relationships of classic psychedelic use with mental health and suicidality. To our knowledge, the population-level associations of classic psychedelic use with mental health have not been evaluated. The current study examined the relationships of lifetime classic psychedelic use with past month psychological distress and past year suicidality using data from the last five available years.

We hypothesized that lifetime classic psychedelic use would be associated with decreased likelihood of mental health problems and suicide attempts.

Methods

The NSDUH survey was conducted annually by interviewers in the home of individuals who listened to prerecorded survey questions on headphones and provided responses via computer. The current study used data from years 2008 – 2012 and was approved by the institutional review board.

Data analysis

We created a unique identifier for each unique NSDUH respondent from years 2008 – 2012 using the Cantor pairing function. Individuals who had used DMT, ayahuasca, LSD, mescaline, peyote or San Pedro were coded as positive for lifetime classic psychedelic use, and those who had never used any of these substances were coded as negative.

The primary outcome variables included past month psychological distress, past year suicidal thinking, past year suicidal planning, and past year suicide attempt. Multivariate logistic regression was used to test the associations between lifetime classic psychedelic use and the primary outcomes. Annual household income, marital status, self-reported risky behavior, and lifetime illicit use of cocaine, other stimulants, sedatives, tranquilizers, heroin, pain relievers, marijuana, 3,4-methylenedioxymethamphetamine (MDMA)/ecstasy, phencyclidine (PCP), and inhalants were all considered in the analysis.

Results

Of the 191,382 respondents, 27,235 reported lifetime classic psychedelic use, 12,657 reported past month psychological distress, 10,445 reported past year suicidal thinking, 3157 reported past year suicidal planning, and 1716 reported past year suicide attempt.

Lifetime classic psychedelic use is more common among 26-64 year olds, men, non-Hispanic Whites and Native Americans/Alaska Natives, individuals with greater educational attainment and income, and those who report greater self-reported engagement in risky behavior. Multivariate logistic regression models showed that lifetime classic psychedelic use was associated with a decreased likelihood of past month psychological distress, past year suicidal thinking, past year suicidal planning, and past year suicide attempt.

Discussion

Classic psychedelic use was associated with decreased psychological distress, suicidal thinking, planning, and attempt in a large sample generalizable to the USA adult population. Non-psychedelic substance use was associated with increased psychological distress and suicidality at or above the trend level.

The current research may have been biased by self-report, and the analyses were limited to the available data. Additionally, the associations reported here may not necessarily indicate causation, and a shared underlying factor may have contributed to both classic psychedelic use and decreased psychological distress and suicidality.

Classic psychedelic drug users reported higher levels of mysticism, spirituality, and concern for others than non-classic psychedelic drug users. However, classic psychedelic users also reported higher levels of risky behavior and illicit substance use.

We cannot rule out the possibility that classic psychedelic use caused harm at the individual level, but the results suggest that classic psychedelic use may have a protective effect on psychological distress and suicidality at the population level.

Given the grave and chronic nature of suicide, more extensive clinical research with classic psychedelics is needed. This research should focus on suicidality as well as pathologies associated with increased suicide risk.

Conclusion

Classic psychedelics carry a contentious recent history, but growing evidence suggests that they may alleviate human suffering associated with mental illness.

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