Psilocybin, psychological distress, and suicidality

The study reviews/comments on the associations of lifetime psilocybin (alone, no other drugs) use with past month psychological distress, past year suicidal thinking, past year suicidal planning, and past year suicide attempt in the US adult population. It found that “lifetime use of psilocybin but no other classic psychedelic may be especially protective with regard to psychological distress and suicidality.”

Abstract/Introduction

“Hendricks et al. (2015) found that having ever used any classic psychedelic substance—namely, dimethyltryptamine (DMT), ayahuasca, lysergic acid diethylamide (LSD), mescaline, peyote or San Pedro, or psilocybin—was associated with a significantly reduced likelihood of past month psychological distress (weighted OR = .81 (.72–.91)), past year suicidal thinking (weighted OR = .86 (.78–.94)), past year suicidal planning (weighted OR = .71 (.54–.94)), and past year suicide attempt (weighted OR = .64 (.46–.89)) in the United States adult population. Although these findings comport with an emerging literature suggesting classic psychedelics may be effective in the treatment of mental health conditions and prevention of self-harm, they do not speak to the potential risk profile or therapeutic applications of psilocybin in particular, which is the most commonly examined classic psychedelic in contemporary clinical research. Considering that psilocybin may be a candidate for future approved medical use in the United States, the United Kingdom, and other nations (Bogenschutz et al., 2015; Grob et al., 2011; Johnson et al., 2014; see also Nutt et al., 2013), an analysis of the specific relationships of psilocybin use with psychological distress and suicidality may help inform decisions by the United States Food and Drug Administration and regulatory bodies of other nations. The objectives of the current research, therefore, were to extend the analysis of Hendricks et al. (2015) by evaluating the associations of lifetime psilocybin use, per se, with past month psychological distress, past year suicidal thinking, past year suicidal planning, and past year suicide attempt in the United States adult population.”

Authors: Peter S. Hendricks, Matthew W. Johnson & Roland R. Griffiths

Analysis

The study used the survey data from Hendricks et al. (2015).

Summary

Hendricks et al. (2015) found that having ever used any classic psychedelic substance was associated with a significantly reduced likelihood of psychological distress, suicidal thinking, suicidal planning, and suicide attempt. Although the findings of Hendricks et al. (2015) suggest that classic psychedelics may be effective in the treatment of mental health conditions and prevention of self-harm, they do not speak to the potential risk profile or therapeutic applications of psilocybin in particular.

Methods and data analysis were similar to those of Hendricks et al. (2015). Four mutually exclusive groups of respondents were examined: Psilocybin Only, Psilocybin & Other Psychedelics, Non-Psilocybin Psychedelics Only, and No Psychedelics.

Multivariate logistic regression was used to examine the relationships between group membership and outcome variables in a sample of people who had used psilocybin and other psychedelics.

A study by Johansen and Krebs (2015) investigated the relationships between psychedelic use and mental health problems. Nesvg et al. (2015) suggest that the analyses by Johansen and Krebs (2015) introduced overadjustment bias by controlling for lifetime other illicit substance use.

We are unaware of any data indicating that classic psychedelic or psilocybin use is a cause of other illicit substance use, but several lines of research indicate that psilocybin has anti-addictive effects. Therefore, we believe that including lifetime other illicit substance use is appropriate.

Of the 191,832 respondents, 7550 fell into the Psilocybin Only group, 12,724 fell into the Psilocybin & Other Psychedelics group, 6963 fell into the Non-Psilocybin Psychedelics Only group, and 164,595 fell into the No Psychedelics group. Group membership was significantly associated with past month psychological distress.

Psilocybin was associated with multiple significantly improved outcomes in the Psilocybin Only group and among those who have ever used psilocybin, suggesting that psilocybin may have the greatest therapeutic potential.

The current findings suggest that psilocybin use may have the most favorable safety profile of all classic psychedelic substances and may hold promise as an innovative mental health intervention and suicide prophylaxis.