Hallucinogen use and intimate partner violence: Prospective evidence consistent with protective effects among men with histories of problematic substance use

This prospective survey study (n=302) investigated whether prior hallucinogen use (i.e. psilocybin, LSD, mescaline, MDMA, ketamine, or PCP) among incarcerated men with substance use disorders would predict a reduced likelihood of intimate partner violence after their release. Results indicated substantial differences across individuals who reported lifelong hallucinogen use, who were less than two-thirds as likely to be arrested for intimate partner violence, as those who did not report having used hallucinogens. This suggests that hallucinogenic substances may have the potential to protect against behaviors associated with externalizing psychopathology.

Abstract

“Introduction: Evidence suggests that hallucinogens may have therapeutic potential for addressing a variety of problem behaviors related to the externalizing spectrum of psychopathology, such as substance misuse and criminality. Intimate partner violence (IPV) is a prevalent form of criminal violence that is related to externalizing pathology. However, the association between hallucinogen use and IPV has not been comprehensively examined.

Methods: In this prospective study, we examined the association between IPV and naturalistic hallucinogen use among 302 inmates at a US county jail.

Results: Cox regression analyses indicated that hallucinogen use predicted reduced arrest for IPV independently (β=−0.54, SE=0.20, χ²=7.19, exp(B)=0.58, p<0.01) and after accounting for covariates (β=−0.48, SE=0.23, χ²=4.44, exp(B)=0.62, p<0.05).

Discussion: These results add to a growing literature suggesting distinct therapeutic potential for hallucinogens to assist in the attenuation of problematic behavior.”

Authors: Zach Walsh, Peter S. Hendricks, Stephanie Smith, David S. Kosson, Michelle S. Thiessen, Philippe Lucas & Marc T. Swogger

Summary

Recidivism

The medical, spiritual, and social use of psychoactive substances generally classified as hallucinogens can be traced to antiquity. However, the extent to which hallucinogen use might influence risk for externalizing behavior has not been definitively determined.

Hallucinogens include substances that affect cognition and perception, including serotonin 2A (5-HT2A) receptor agonists such as lysergic acid diethylamide (LSD) and psilocybin, as well as less widely used substances such as mescaline and dimethyltryptamine (DMT).

Diverse cultural groups have long-standing traditions of incorporating hallucinogens into the care of mental and physical health. However, Western medicine is relatively new to the use of hallucinogens, and the therapeutic potential of these substances has been hampered by strict legal limitations on research.

Intimate partner violence is a prevalent form of criminal violence that is related to externalizing pathology. Hallucinogen use predicted reduced arrest for IPV independently and after accounting for covariates.

Recent studies have found that hallucinogens may reduce problematic substance use, partner conflict, and substance misuse. Ayahuasca use may also reduce criminality, as evidenced by a decreased likelihood of supervision failure among individuals with a history of substance use.

Intimate partner violence, also labeled “domestic violence,” is a substantial proportion of all interpersonal violence and constitutes a major public health concern. Substance use has been identified as an important predictor of IPV perpetration, but the relationship between substance use and violence appears to vary across psychoactive substances.

Research suggests that hallucinogens may improve interpersonal functioning and thus decrease aggression and conflict between intimate partners. Specifically, hallucinogens may increase intimacy and affection, and increase interpersonal regard, which may be important in decreasing violence.

Although the research is inconsistent and substantial gaps remain, preliminary evidence suggests that hallucinogen use may attenuate externalizing behaviors and increase positive interpersonal functioning, particularly among those with problematic substance use.

Participants

Participants were 302 male inmates, aged 17 – 40 years, serving sentences of one year or less for felony or misdemeanor convictions at a county jail in Illinois, USA. They provided written informed consent and were paid to participate.

Hallucinogen use

We assessed hallucinogen use in incarceration using the substance use disorder module of the Structured Clinical Interview for the DSM-IV and supplemented our analyses with the secondary index of lifetime presence of a DSM-IV hallucinogen use disorder.

We assessed whether individuals were arrested for an offence related to IPV subsequent to release from incarceration. The data were collected prospectively and adjusted to reflect incarceration for reasons other than IPV.

Covariates

Psychopathic personality has been identified as one of the most robust individual-level predictors of interpersonal violence, and is also associated with diverse forms of substance use. Cannabis use has also been noted as a potentially important correlate of IPV.

Alcohol and cannabis dependence were derived from dependence symptoms from the SCID-I, and ethnicity was considered as a covariate. Economic and educational disadvantage were also considered as covariates, and were included in the analyses if preliminary analyses identified associations with both IPV and hallucinogen use.

Analysis

Survival analyses were conducted using Cox regression, and the mean follow-up time was 82.24 months. Participants who had used hallucinogens were followed for a slightly longer time than the non-user group.

Results

55.63% of participants reported lifetime use of hallucinogens, and 86.90% of those who reported classic psychedelic use also reported using atypical hallucinogens. Individuals with a lifetime presence of a hallucinogen use disorder were more predominantly European American and had higher levels of psychopathy and more symptoms of cannabis dependence.

Any lifetime use of hallucinogens was associated with lower rates of IPV, and the association was maintained after controlling for ethnicity, psychopathic personality, and alcohol use disorder.

Supplementary analyses examined the predictive power of lifetime presence of a hallucinogen use disorder for IPV arrest. This index was associated with lower rates of arrest at the trend level.

Discussion

This prospective study is the first to test the predictive power of hallucinogen use for IPV. The results suggest that hallucinogen use is protective for arrest for IPV perpetration across both an inclusive index of any lifetime use and a more exclusive index of lifetime presence of a hallucinogen use disorder.

We used a forensic sample, a prospective design, and institutional records of arrest to examine the relationship between hallucinogen use and violence. Our findings suggest that hallucinogenic substances may have potential to protect against behaviors associated with externalizing psychopathology.

Although the study is prospective, naturalistic design prohibits causal inference, and the study did not examine the relationship between hallucinogen use and IPV, it is possible that hallucinogen use counteracts the misuse of other substances, such as alcohol, that have pronounced violence-provoking effects.

In our study, the survival rates of IPV were consistent with official estimates of national rates, and the positive associations among IPV and alcohol use, psychopathy, and ethnicity were consistent with prior research. The prevalence of hallucinogen use disorder among hallucinogen users was within the range of disorders found in the community.

Future research should examine the effects of hallucinogens on the critical period in which participants were at liberty to use subsequent to release, and should control for polysubstance use to avoid misattributing the increased risk associated with the use of other substances to the use of hallucinogens.

These findings challenge the stigmatization of hallucinogens due to putatively harmful social effects, and add to the literature on the therapeutic potential of these ancient medicines.