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Alan K. Davis

Johns Hopkins University, Behavioral Pharma (United States)

77 papers in the library · 5,924 citations · publishing 2015-2026

Papers

Knowledge, Perceptions, and Use of Psychedelics among Individuals with Fibromyalgia

Journal of Psychoactive Drugs January 10, 2022 Nicolas G. Glynos, Jennifer Pierce, Alan K. Davis et al. 39 citations

In a survey of 354 North American adults with fibromyalgia, nearly 30% reported having used a psychedelic, most commonly LSD or psilocybin mushrooms. Most users rated their experience as neutral (59.4%) or positive (36.8%), and fewer than 3% reported negative effects on health or pain. Among the 12 participants who used a psychedelic specifically to treat chronic pain, 11 said their symptoms improved. Regardless of past use, most respondents believed psychedelics could help treat chronic pain and would join a clinical trial for such a treatment. The findings support further research into psychedelic-based therapies for fibromyalgia.

Effects of Psychedelic Use on Racial Trauma Symptoms and Ethnic Identity among Asians in North America

Journal of Psychoactive Drugs January 11, 2022 Terence H. W. Ching, Alan K. Davis, Yitong Xin et al. 34 citations

Among 92 Asian adults in North America who used psychedelics in response to racial discrimination, racial trauma symptoms improved moderately (d = 0.52) from 30 days before to 30 days after their most meaningful psychedelic experience. Higher-intensity insightful experiences were linked to stronger ethnic identity through reductions in trauma symptoms, while lower-intensity challenging experiences also contributed to symptom improvement and identity strengthening. The findings suggest that both insightful and challenging psychedelic experiences may help alleviate racial trauma and support ethnic identity in this population.

A Mixed-Method Analysis of Persisting Effects Associated with Positive Outcomes Following Ibogaine Detoxification.

Journal of Psychoactive Drugs January 1, 2018 Alan K. Davis, Elise Renn, Austin-Marley Windham-Herman et al. 34 citations

Most people who underwent ibogaine detoxification for chronic opioid use reported lasting positive changes, including enhanced gratitude, authenticity, and appreciation for life. Those who responded well to treatment showed greater improvements in tolerating difficult feelings, coping with stress, reduced unhealthy anger, and increased inner peace, joy, love, and a sense of sacredness in life. They also reported heightened spiritual awareness and stronger connections in relationships. Challenges included psychological and health difficulties during treatment and problems with post-treatment integration. The findings point to the need for more integration and aftercare resources. Further rigorous experimental research is needed.

Use of Benefit Enhancement Strategies among 5-Methoxy-N,N-Dimethyltryptamine (5-MeO-DMT) Users: Associations with Mystical, Challenging, and Enduring Effects

Journal of Psychoactive Drugs March 9, 2020 Rafael Lancelotta, Alan K. Davis 32 citations

A survey of 515 people who used the psychedelic 5-MeO-DMT found that most employed strategies to enhance benefits and reduce challenging effects. Among a subset of 116 one-time users, those who used such strategies reported more intense mystical-type experiences and greater lasting personal meaning and spiritual significance, while some strategies were linked to less challenging experiences. The findings suggest benefit-enhancement strategies are common and may boost positive acute and persisting effects, though causal relationships require further longitudinal study.

An international Delphi consensus for reporting of setting in psychedelic clinical trials.

Nature Medicine June 3, 2025 Chloé Pronovost-Morgan, Kyle T. Greenway, Leor Roseman et al. 26 citations

A Delphi consensus study with 89 experts from 17 countries identified 30 extra-pharmacological variables that are important or very important for reporting the setting in psychedelic clinical trials. These variables, forming the ReSPCT guidelines, cover physical environment, dosing session procedure, therapeutic framework and protocol, and subjective experiences. The findings reveal significant ambiguities in current conceptualizations of set and setting. The guidelines provide a new standard for designing and documenting contextual factors in psychedelic research.

Reactivations after 5-methoxy-N,N-dimethyltryptamine use in naturalistic settings: An initial exploratory analysis of the phenomenon’s predictors and its emotional valence

Frontiers in Psychiatry November 29, 2022 Ana María Ortiz Bernal, Charles L. Raison, Rafael Lancelotta et al. 26 citations

Reactivations—similar to flashbacks—are common after using the psychedelic 5-MeO-DMT and are often neutral or positive rather than distressing. Analysis of survey data from 513 people who used 5-MeO-DMT outside clinical settings found that women, older age at first dose, higher education, and dosing in a structured group setting were linked to higher odds of reporting a reactivation. Higher mystical experience scores, greater personal wellbeing, and having had a non-substance-induced non-dual awareness experience were associated with neutral or positive emotional valence of the reactivation. The findings suggest reactivations are typically a benign byproduct of the experience, but more research is needed to identify those at risk for negative reactivations.

A comparison of reactivation experiences following vaporization and intramuscular injection (IM) of synthetic 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) in a naturalistic setting

Journal of Psychedelic Studies March 25, 2020 Malin V. Uthaug, Rafael Lancelotta, Ana María Ortiz Bernal et al. 25 citations

Among 27 respondents who used the psychedelic drug 5-MeO-DMT, those who received it by intramuscular injection (IM) reported a lower rate of reactivations (21%) compared to those who vaporized it (69%). The IM group also required fewer redoses, experienced release of physical tension more consistently, and had a slower onset of acute effects (1–6 minutes) versus the vaporization group (1–50 seconds). These findings suggest that the route of administration influences the frequency of reactivations, dosing patterns, physical sensations, and the timing of the drug's effects.

Assessing the risk of symptom worsening in psilocybin-assisted therapy for depression: A systematic review and individual participant data meta-analysis

Psychiatry Research July 23, 2023 Otto Simonsson, Per Carlbring, Robin Carhart-Harris et al. 24 citations

In a meta-analysis of three psilocybin trials for depression involving 102 participants, clinically significant symptom worsening occurred for a minority of those receiving psilocybin or escitalopram (about 10%) and for a majority of those in the waitlist condition (63.6%). The psilocybin arm showed a lower likelihood of symptom worsening compared to waitlist and no difference compared to escitalopram. The authors note the limitation of a relatively small sample size.

Subtypes of the psychedelic experience have reproducible and predictable effects on depression and anxiety symptoms.

J Affect Disord December 27, 2022 Aki Nikolaidis, Rafaelle Lancelotta, Natalie Gukasyan et al. 24 citations

Three reproducible subtypes of psychedelic experience were identified in a large sample of 985 people using machine learning. Subtypes differed in baseline demographics, mental health measures, and drug type and dose. Experiences linked to enduring improvements in anxiety, depression, and psychological wellbeing were characterized by greater personal and mystical insight. The subtypes were consistent across multiple psychedelic substances. Findings suggest that fostering insight experiences may be key to maximizing clinical benefits.

Inhaled 5-methoxy-N,N-dimethyltryptamine: Supportive context associated with positive acute and enduring effects

Journal of Psychedelic Studies December 27, 2019 Nathan D. Sepeda, John Clifton, Laura Y. Doyle et al. 23 citations

People who used inhaled synthetic 5-MeO-DMT in a structured, supportive setting reported significantly more intense mystical experiences and enduring positive effects—such as greater meaningfulness, spirituality, and well-being—and fewer challenging experiences than those who used it in a non-structured context. In the structured context group, 83% had a complete mystical experience compared to 54% in the non-structured group. The findings suggest that a safe and supportive environment enhances the positive acute and lasting outcomes of 5-MeO-DMT.

Specific harm reduction strategies employed by 3,4-methylenedioxymethamphetmine/ ecstasy users in the United States and the United Kingdom

Drug Science Policy and Law January 1, 2017 Alan K. Davis, Harold Rosenberg 22 citations

Both recreational and problematic MDMA/ecstasy users could benefit from harm reduction interventions. A web-based survey assessed how often 104 American and 80 British ecstasy users employed 19 self-initiated harm reduction strategies over two months. At least 75% of participants used 11 of the 19 strategies at least once, regardless of country or frequency of use. When differences occurred, larger proportions of Americans used the strategies. Many less-used strategies are not applicable every time. Testing ecstasy for MDMA, other stimulants, and adulterants is recommended for all users, as it is not a diverted pharmaceutical of known quality.

Applying Lessons From Cannabis to the Psychedelic Highway

JAMA Health Forum June 17, 2022 Kevin F. Boehnke, Alan K. Davis, Jenna McAfee 20 citations

Oregon's 2020 decriminalization of psilocybin and other illicit substances mirrors the trajectory of cannabis liberalization over the past 25 years, driven by arguments for compassionate use, personal freedom, and frustration with federal drug policy. The authors argue that psychedelics are poised to follow a similar pattern, reinforced by FDA breakthrough therapy designations for psilocybin and MDMA. They caution that medical cannabis policies expanded access and industry power but failed to integrate cannabis into medical practice, track health outcomes, or promote safe use, leading to increased emergency department visits and highly concentrated products. Extrapolating to psychedelics, they find this lack of integration troubling because oversight by trained monitors in clinical trials likely decreases adverse reactions and enhances treatment success.

Race, Ethnic, and Sex Differences in Prevalence of and Trends in Hallucinogen Consumption Among Lifetime Users in the United States Between 2015 and 2019

Frontiers in Epidemiology March 23, 2022 Alan K. Davis, Brooke J. Arterberry, Yitong Xin et al. 20 citations

Asian females had the highest prevalence of past-year hallucinogen use (35.06%), two or more times that of White males and females and Native American males. More than half of White males and females, Multiracial males, and Hispanic males had ever used psilocybin or LSD, while less than a quarter of Black males and females reported lifetime psilocybin use. Native American males had the lowest lifetime MDMA use (17.62–33.30%) but the highest lifetime peyote use (40.37–53.24%). Pacific Islander males had the highest lifetime mescaline use (28.27%), and Pacific Islander males and females had the highest lifetime DMT use (15.68–38.58%).

Prospective associations of psychedelic treatment for co-occurring alcohol misuse and posttraumatic stress symptoms among United States Special Operations Forces Veterans.

Military psychology : the official journal of the Division of Military Psychology, American Psychological Association January 1, 2024 Stacey B. Armstrong, Yitong Xin, Nathan D. Sepeda et al. 19 citations

Among 45 U.S. Special Operations Forces Veterans with risky alcohol use who completed ibogaine and 5-MeO-DMT treatment in Mexico, alcohol use dropped substantially from an average of 7.2 drinks per drinking day before treatment to 3.6 at one month and 4.0 at six months post-treatment. At one month, 24% were abstinent, 33% were non-risky drinkers, and 42% still risky drinkers; by six months, 16% were abstinent, 31% non-risky, and 53% risky. Responders (abstinent or non-risky) showed very large improvements in PTSD symptoms and cognitive functioning compared to non-responders, while demographics did not differ. The findings suggest psychedelic-assisted therapy may help those with complex trauma and alcohol misuse who have not responded to traditional treatments.

Study protocol of an open-label proof-of-concept trial examining the safety and clinical efficacy of psilocybin-assisted therapy for veterans with PTSD

BMJ Open May 1, 2023 Alan K. Davis, Adam W. Levin, Paul Nagib et al. 19 citations

Psilocybin-assisted therapy may help treat post-traumatic stress disorder (PTSD), which current treatments often fail to relieve, especially in U.S. military veterans. This open-label pilot study will test two psilocybin doses (15 mg and 25 mg) combined with psychotherapy in 15 veterans with severe, treatment-resistant PTSD. The primary safety outcome tracks adverse events and suicidal ideation; the primary PTSD outcome uses the Clinician Administered PTSD Scale-5. Follow-up continues for 6 months after the second session. Results will be published in a peer-reviewed journal.

Preliminary safety and effectiveness of psilocybin-assisted therapy in adults with fibromyalgia: an open-label pilot clinical trial

Frontiers in Pain Research March 18, 2025 Jenna McAfee, Avinash Hosanagar, Vijay Tarnal et al. 18 citations

In a small open-label pilot trial, five people with fibromyalgia received two doses of psilocybin (15 mg and 25 mg) along with psychotherapy. The treatment was well-tolerated: there were temporary increases in blood pressure or heart rate during dosing that returned to normal, no serious adverse events, and four of five participants had short-lived headaches. One month after the second dose, participants reported large reductions in pain severity, pain interference, and sleep disturbance. One participant rated their symptoms as very much improved, two as much improved, and two as minimally improved. Recruitment stopped early due to generalizability concerns and changing FDA guidance, but the results suggest psilocybin-assisted therapy is safe for fibromyalgia and warrants larger trials.

Psychedelic treatment for co-occurring alcohol misuse and post-traumatic stress symptoms among United States Special Operations Forces Veterans

Journal of Psychedelic Studies November 19, 2021 Pratheek Mangini, Lynnette A. Averill, Alan K. Davis 18 citations

Among 27 Special Operations Forces Veterans who reported risky drinking before a psychedelic clinical program in Mexico, retrospective reports showed very large reductions in alcohol use and post-traumatic stress symptoms from before to after treatment, with 85% reducing drinking to non-risky levels (33% abstinent, 52% non-risky drinking). Psychological flexibility increased substantially and was strongly associated with both reductions. The authors call for rigorous longitudinal studies to determine whether psychedelic-assisted therapy holds promise for this population.

Effects of Ayahuasca on Gratitude and Relationships with Nature: A Prospective, Naturalistic Study.

Journal of Psychoactive Drugs January 1, 2025 Jacob S. Aday, Emily K. Bloesch, Alan K. Davis et al. 16 citations

People who attended an ayahuasca retreat reported lasting increases in gratitude, feeling connected to nature, and appreciating nature. Surveys of 54 participants taken one week before, one week after, and one month after the retreat showed significant improvements at both follow-ups compared to baseline. The intensity of mystical-type experiences and awe during ayahuasca sessions weakly to moderately correlated with these increases, while the number of ceremonies attended did not. Older participants reported less intense mystical and awe experiences. The findings suggest that the quality of psychedelic experiences, particularly mystical and awe states, may foster prosocial changes in gratitude and nature connection.

Psilocybin for the Treatment of Depression: A Promising New Pharmacotherapy Approach.

Current Topics in Behavioral Neurosciences January 1, 2022 Gabrielle Agin-Liebes, Alan K. Davis 16 citations

Depression is the leading cause of global disability and a major contributor to the global burden of disease. Early experimental trials suggest that psilocybin, a serotonergic psychedelic, combined with therapeutic support shows promise for treating depression, with large effect sizes. Neuroimaging reveals dynamic effects of psilocybin on brain functional activity. This chapter reviews methods and findings from three small clinical trials examining psilocybin therapy for major depressive disorder and treatment-resistant depression, presenting insights from functional magnetic resonance imaging and qualitative analyses, along with study limitations and future directions.

Application of the Passionate Attachment Model to Recreational Use of MDMA/Ecstasy

Journal of Psychoactive Drugs January 1, 2015 Alan K. Davis, Harold Rosenberg 15 citations

People who persistently use ecstasy without being addicted may have a passionate attachment to the activity. In a community sample of ecstasy users, both obsessive and harmonious passion scores were linked to lower self-efficacy to refuse the drug and greater use of ecstasy to cope with worries. Obsessive passion was partially associated with more frequent use, more lifetime uses, and more pills consumed per occasion, whereas harmonious passion was not tied to those consumption measures. The modified Passion Scale could supplement assessments of the psychology behind ecstasy use.

Predictors of attitudes toward psychedelics among psychologists in the USA

Drugs Education Prevention and Policy September 4, 2022 Jason B. Luoma, Brian Pilecki, Alan K. Davis et al. 13 citations

Psychologists' attitudes toward psychedelics vary with individual characteristics. Men, younger psychologists, those living in the West or Northeast US, those with greater knowledge of risks and benefits, those who are religiously unaffiliated, and those with direct or indirect experience with psychedelics report more positive attitudes. Previous addiction treatment training was not associated with more positive attitudes. These findings can help inform efforts to improve attitudes, such as using case studies in public education.

Differences in attitudes and beliefs about psychedelic-assisted therapy among social workers, psychiatrists, and psychologists in the United States

Journal of Psychedelic Studies August 21, 2023 Stacey B. Armstrong, Adam W. Levin, Yitong Xin et al. 12 citations

Among 856 U.S. mental health professionals—social workers, psychiatrists, and psychologists—there were no differences in confidence that psychedelic-assisted therapy (PAT) would be effective. However, psychiatrists showed a better understanding of PAT than social workers. Psychologists rated PAT as more acceptable than social workers did, and psychologists also rated it as a more reasonable treatment approach than both social workers and psychiatrists. Social workers perceived greater disadvantages of PAT than psychologists and psychiatrists, and they were less likely than both other groups to believe PAT could permanently improve clients' lives. The findings indicate a need for education and training across professions as PAT moves toward approval.

Investigating the associations of acute psychedelic experiences and changes in racial trauma symptoms, psychological flexibility, and substance use among People with Racial and Ethnic Minoritized Identities in the United States and Canada.

Journal of Substance Use and Addiction Treatment June 1, 2023 Angela M Haeny, Joel A Lopez, Pamela A Colón Grigas et al. 10 citations

Among 211 racially and ethnically minoritized (REM) adults in the US and Canada, retrospective reports indicated that after their most memorable psychedelic experience, alcohol use and drug use were perceived to have decreased. The reduction in alcohol use was greater for Indigenous participants, those who took a high dose, those with a stronger ethnic identity, and those who reported fewer depressive symptoms. Perceived increases in psychological flexibility and reductions in racial trauma symptoms appeared to mediate the link between acute psychedelic effects and reduced substance use. The authors suggest psychedelic experiences may help REM people reduce alcohol and drug use by increasing psychological flexibility and easing racial trauma, but call for longitudinal replication.

Ketamine-assisted psychotherapy for trauma-exposed patients in an outpatient setting: A clinical chart review study

Journal of Psychedelic Studies October 1, 2021 Alan K. Davis, Pratheek Mangini, Yitong Xin 10 citations

Trauma exposure across the lifespan increases risks for PTSD, depression, anxiety, and disability. In a retrospective chart review of 18 patients (average age 45) who completed six sessions of sublingual ketamine-assisted body-centered psychotherapy in an outpatient clinic, improvements in depression were statistically significant and meaningful, with a medium effect size. Improvements in PTSD symptoms and global disability were meaningful but not statistically significant. No improvements in anxiety were observed. The study was underpowered and unrepresentative, requiring replication with larger, more diverse samples.

A Field-Wide Review and Analysis of Study Materials Used in Psilocybin Trials: Assessment of Two Decades of Research

Psychedelic Medicine January 20, 2025 Marianna Graziosi, Gabrielle Agin-Liebes, Mary P Cosimano et al. 9 citations

Psilocybin and other serotonergic psychedelics are used in research settings with safety measures including controlled environments, staff presence, screening, and psychoeducation. An analysis of study materials from psilocybin trials over the past two decades found that psychoeducation documents varied but commonly emphasized biological and physical safety, psychological safety and well-being, aspects of setting, and the potential for expectancies. The materials prioritized biological and psychological safety across all sites. The authors also identified elements unrelated to safety that may contribute to participant expectancies and suggest these extrapharmacological factors be studied systematically to maximize safety while minimizing extraneous expectancies.