Mental health of a self-selected sample of psychedelic users and self-medication practices with psychedelics

The observational survey study (n=1,967) investigated the frequency and efficacy of self-medication practices amongst psychedelic users and found that the prevalence of lifetime psychopathologies amongst psychedelic users was higher than in the general population. Although psychedelics were seldom used for self-medication, those who did use psychedelics in this manner reported it to be more effective than the current lines of treatment for mental illness.

Abstract

“Background: A substantial number of people worldwide suffer from mental health problems during their lifetime. First-line treatments are not effective for everybody. Recent studies suggest that psychedelic drugs have high therapeutic potential for a variety of mental disorders.

Aims: This survey study aimed to assess the tendency of psychedelic users to self-medicate with psychedelics and to compare the effectiveness of self-administered psychedelics to treat their disorder and the treatment offered by a medical professional.

Methods and results: In total, 1,967 respondents consented were ≥18 years and completed the questionnaire. The mean (±SD) age was 25.9 (8.7); 79% were males, 20% females, and 1% classified themselves as “other.” Almost half of the respondents (46%) indicated to have suffered/to be suffering from a mental disorder, with 77% being diagnosed by a medical professional. In 99% of the diagnosed cases, the treatment was offered; 77% searched for treatments outside a medical professional’s recommendation with 81% who had used/were using psychedelics to treat/cure symptoms. Self-administered psychedelic treatment had a higher likelihood of being efficacious, with higher symptoms reduction and larger quality of life improvement compared to treatment offered by a medical professional.

Conclusions: Lifetime prevalence of psychopathologies in the current sample of psychedelic drug users seemed to be higher than in the general population. Self-medication with psychedelics was not highly frequent; although when it occurred, it was rated as significantly more effective as treatment offered by a medical professional. Current findings support research exploring the potential of psychedelics in the treatment of psychopathologies.“

Authors: Natasha L. Mason & Kim P. C. Kuypers

Summary

INTRODUCTION

People worldwide suffer from mental health problems, and standard treatments like cognitive behavioral therapy or psychiatric drugs are often efficient means to reduce symptoms or even lead to remission. However, some patients never reach the stage of remission, and there is a need for new therapeutic targets and agents.

Psilocybin, lysergic acid diethylamide, ayahuasca, and 3,4,-methylenedioxymethamphetamine (MDMA) are the primary psychoactive compounds of hallucinogenic mushrooms and a prototypical example of a classical psychedelic compound. These compounds have been shown to be effective in the treatment of psychiatric conditions.

European drug surveys have reported last year prevalence rates of less than 1% for LSD and hallucinogenic mushrooms among young adults, aged between 15 and 34 years, and lifetime prevalence rates between 0.1% and 5.4% for psilocybin.

Despite the number of people having used psychedelics, population studies have shown that the use of these substances is not associated with higher rates of mental health problems.

The aim of this study was to investigate whether psychedelic users self-medicate with these substances, and whether self-rated treatment effectiveness was different for treatment offered by a medical professional compared to a self-administered psychedelic.

METHODS

A survey was launched on several websites and fora between May and July 2017. 1,967 respondents consented, were 18 years or older, and completed the questionnaire.

Demographic information

Demographic details include age, gender, continent of origin, and highest level of education. The number of different countries will be reported.

History of drug use

Respondents were asked if they had used or were currently using alcohol, nicotine, cannabis, MDMA/ Ecstasy, psilocybin, LSD, ayahuasca, or any stimulant, hallucinogenic, or cannabinoid novel psychoactive substance.

Question 2A was open-ended and respondents were able to write down the disorder(s) they had. Mental disorders were clustered afterward into 20 DSM-5 categories, and physical disorders were not categorized.

Question 2C asked about medication, therapy, or other treatments, and question 2D asked if they had ever used psychedelics to treat or cure this disorder.

Statistics

Data were entered into the statistical program SPSS (version 24.0) and the mean (SD) was calculated for age (per gender and the total sample), drug use history, and self-rated effectiveness of treatment.

To compare the effectiveness of traditional treatments offered by a medical professional and the self-sought treatment with psychedelics, binary logistic regression was conducted for the three “effectiveness” questions.

Demographic information

The mean age of respondents was 25.9 (8.7) years, and the highest educational attainment was lower than high school for 21.1% of respondents. They came from five continents: Africa, America, Asia, Australia and Oceania, and Europe.

Drug use history

Table 1 shows that cannabis, alcohol, and LSD are the three most used substances, followed by ayahuasca, cannabinoid NPS, and stimulant NPS.

Mental and physical health

The respondents rated their mental health to be 74.8% and their physical health to be 74.4% on a VAS with a range from 0 to 100.

Mental health and treatment

99% of diagnosed cases received some kind of treatment, including medication, therapy, or both. Five respondents refused treatment, eight were committed to a mental health treatment facility or hospitalized, and six self-managed their disease with the help of psychedelics, education, and self-awareness.

When asked whether they searched for treatments outside a medical professional’s recommendation, 77% of diagnosed respondents answered affirmative, and 81% answered they used or have used psychedelics to treat or cure symptoms. They rated the effectiveness of the treatment at 49%, 48%, and 54%.

Psychedelics were significantly more effective than self-rated treatment for mental disorder in improving symptoms and QOL.

Physical health

21% of the participants indicated they were or had been suffering from a physical disorder, and 85% were offered some kind of treatment. Half sought treatment outside of a medical professional’s recommendation.

When asked if the treatment they were offered worked, 70% felt it worked, 66% said it disappeared their symptoms, and 69% said their quality of life improved.

DISCUSSION

This study investigated whether psychedelic users with diagnosed mental problems self-medicated with psychedelics to alleviate psychological or physical suffering.

Almost half of the included respondents indicated to have suffered from or to be currently suffering from a mental disease, with depression and anxiety being the most prevalent diseases. The prevalence of mental disorders in psychedelic users is higher than in the general population.

Psychedelic users who seek to self-medicate with psychedelics perceive, this as efficient and not eliciting a worsened mental condition. This is in line with reports from people who used ayahuasca to induce life changes or some kind of healing.

This study examined the association between psychedelic use and a range of mental disorders. It was difficult to determine whether certain types of drugs were associated with specific disorders, and it was apparent that users combined different types of drugs. The current findings suggest that psychedelics can be used without some kind of therapy and be effective, and that set and setting may influence an enhanced sense of meaning induced by the substance.

Participants under the influence of MDMA had higher confidence levels when this was administered in a social group setting, whereas these ratings were not increased compared to placebo in single-person sessions. This suggests that psychedelic treatment may be more effective than current lines of treatment.