Journal of Psychoactive Drugs
January 1, 2023
Daniel J. Kruger, Oskar Enghoff, Moss Herberholz et al.
24 citations
In a large online survey of 1,221 people who use psychedelics naturalistically, the most common source of information was their own experimentation and experiences (79.52%). Many also sought information from internet websites (61.67%), friends (61.02%), internet discussion forums (57.08%), books (57%), and peer-reviewed journal articles (54.55%). Few consulted their primary health care provider (4.83%). Scientific journals, psychedelic nonprofits, and university researchers were the most trusted sources; government agencies and pharmaceutical companies were the least trusted. Most participants felt popular media inaccurately stated psychedelics' benefits and risks and failed to distinguish between different types. The results indicate extensive information seeking outside mainstream health care.
Psychedelic medicine (New Rochelle, N.Y.)
March 1, 2025
Daniel J. Kruger, Jacob S. Aday, Christopher W Fields et al.
19 citations
In an anonymous online survey of 1,221 people who reported past psychedelic use, most described adverse experiences: 74.3% felt frightened, 58.6% sadness, 54.3% body shaking or trembling, and 51.6% loneliness. About half reported some other adverse experience, and one in ten had adverse physical reactions. One-third knew someone arrested for possession or use of psychedelics; 8% reported that they or someone they know was the victim of inappropriate sexual contact by a psychedelic sitter, guide, or practitioner; and one-quarter knew someone who experienced a severe adverse event other than inappropriate sexual contact or arrest. The findings indicate that despite beneficial effects, psychedelic experiences can be challenging, distressing, or harmful, highlighting the need to prevent, identify, manage, and treat adverse events.
Psychiatr Res Clin Pract
February 11, 2025
Jules Evans, Marc Aixalà, Brian T Anderson et al.
18 citations
Thirty psychedelic researchers identified critical gaps in knowledge about harms from psychedelic use, including how to define those harms, predict them, and treat them effectively. They recommend better online information, peer support groups, affordable therapy, and psychiatric consultation for people experiencing post-psychedelic difficulties. The researchers also call for improved funding for a psychedelic safety net, suggesting that psychedelic philanthropists, investors, and companies commit 1% of their investment to support safety measures such as research and support services. The article outlines practical steps to make the field of psychedelic medicine safer.
Frontiers in Psychiatry
January 1, 2024
Nicolas G. Glynos, Jacob S. Aday, Daniel J. Kruger et al.
15 citations
A large global survey of 5,268 adults who had used psychedelics found that nearly three-quarters (70.9%) reported ceasing or decreasing use of at least one non-psychedelic substance afterward. Among those who had previously used specific substances, 60.6% decreased alcohol use, 55.7% decreased antidepressant use, and 54.2% decreased cocaine or crack use. Over a quarter said the decrease lasted 26 weeks or longer. However, 19.8% reported increased or initiated use of other substances, most commonly illicit opioids (14.7%) and cannabis (13.3%). Factors linked to decreased use included motivation to reduce substance use or self-treat a medical condition; increased use was associated with higher income and residing in Canada or the US.
Cannabis (Albuquerque, N.M.)
January 1, 2023
Daniel J. Kruger, Karahmet Amila, Sydney M Kaplan et al.
15 citations
Online discussions about the semi-synthetic cannabinoid THC-O-acetate reveal key topics for future research, including product composition variability, user experiences, comparisons with other substances, potential psychedelic effects, adverse experiences, and harm reduction practices. Despite safety concerns about toxic ketene gas released when heated, the most common administration method reported was inhalation. The analysis of Reddit comments from June to November 2021 identified these themes through systematic coding by a team of researchers.
Journal of Psychoactive Drugs
October 10, 2023
Ashmita Grewal, Kalysha Closson, Gina Martin et al.
11 citations
People who experienced childhood adversity are more likely to suffer psychological distress. An online survey of adults who had used psilocybin in the past three months found that the link between adverse childhood experiences and current distress was weaker for those who had recently used psilocybin. Interest in and acceptance of psilocybin was high regardless of the severity of childhood adversity. The findings suggest psilocybin could be an acceptable and potentially helpful therapy for survivors of adverse childhood experiences, with the strongest benefits for those who faced the most severe adversity.
Journal of Psychoactive Drugs
January 1, 2023
Daniel J. Kruger, Nicolas G. Glynos, Christopher W Fields et al.
10 citations
People who use psychedelics and have higher education, lower age, greater frequency of use, male gender, White/Caucasian identity, higher income, and experience with more types of psychedelics tend to know more about legal status, active compounds, and therapeutic efficacy. A survey of 1,435 participants recruited at a psychedelic advocacy event and online showed overall high knowledge, but gaps remain, highlighting the need for targeted education and harm reduction outreach, especially in under-represented communities.
Journal of Psychoactive Drugs
September 19, 2024
Anne Baker, Niloufar Pouyan, Julie Barron et al.
9 citations
A survey of 107 people who provide psychedelic support services outside clinical trials found that 40.2% held a full or in-progress license and 44.9% lacked a relevant graduate degree. Almost all practitioners pre-screened clients, offered preparation, integration, and trip-sitting, and used primarily non-directive approaches. Clients most often consumed psilocybin for conditions similar to those in clinical research. Practitioners perceived mostly positive symptom changes, though a small proportion reported worsened personality disorder symptoms. Further research on naturalistic psychedelic-assisted therapy is needed.
Journal of Psychoactive Drugs
January 1, 2024
Daniel J. Kruger, Carlton Cb Bone, Meredith C Meacham et al.
9 citations
A survey of THC-O-acetate users found that the semi-synthetic cannabinoid produces low to moderate cognitive distortions—altered sense of time, concentration difficulties, and short-term memory problems—with few visuals or hallucinations. Scores on the Mystical Experience Questionnaire were significantly below the threshold for a complete mystical experience across all four dimensions. Users who had previously used classic psychedelics (5-HT2A agonists) scored lower on all dimensions. When asked directly, 79% of respondents said using THC-O-acetate is "not at all" or "a little" of a psychedelic experience. Some reports of psychedelic effects may stem from expectations or contaminants.
The Journal of Sex Research
March 28, 2025
Daniel J. Kruger, Eirini K. Argyri, Justin K. Mogilski et al.
7 citations
A survey of 581 participants found that most (70.2%) reported psychedelic experiences affected their sexuality or sexual experiences, with 65.4% noting short-term effects and 52.8% reporting long-term effects. Psychedelic experiences were more often associated with enhanced relationship quality, attraction to partners, and sexual activities than with diminished ones. About 10% reported influences on gender identity or expression, citing increased authenticity and openness. One-quarter of women and one-eighth of men reported heightened same-sex attraction after use. More participants reported being polyamorous or in open relationships after psychedelic experiences than before. Effects were linked to larger doses, more frequent use, younger age, and identifying as a woman or gender diverse.
British Journal of Pain
February 11, 2025
Anne Baker, Stephanie Lake, Philippe Lucas et al.
7 citations
Most people with chronic pain who use psychedelics to self-treat report ceasing or decreasing their use of other substances, especially alcohol and prescription opioids. In a survey of 466 adults, 86.3% said they stopped or reduced at least one non-psychedelic substance because of psychedelic use, with 21.2% reporting the decrease lasted over 26 weeks. Alcohol (71.1%) and prescription opioids (64.1%) were most often decreased or stopped. Illicit opioids (27.8%) and cannabis (21.5%) were more likely to be increased or initiated. Psilocybin was rated the most effective psychedelic for physical and mental health symptoms. Findings suggest potential benefits and risks of naturalistic psychedelic use for chronic pain.
Cannabis and Cannabinoid Research
October 1, 2024
Carlton Cb Bone, Charles Klein, Kaelas Munger et al.
6 citations
Most people who use THCO, a semisynthetic cannabinoid derived from hemp, vape it (74.9%), while about a quarter dab it (24.3%) and tend to use higher temperatures than those who vape. A small portion of users (12.0%) expressed concerns about the risk of ketene gas, which can form when THCO is heated and is harmful to the lungs. Because multiple factors influence ketene formation and consumer temperature choices may enable it, more research is needed to understand the harm profile of hemp-derived substances like THCO.
Journal of Psychoactive Drugs
April 22, 2025
Nicolas G. Glynos, Mallet R Reid, Jacob S. Aday et al.
4 citations
People of Color have been underrepresented in psychedelic-assisted therapy (PAT) research, and some have suggested that systemic harms like the War on Drugs and discrimination in healthcare might reduce their willingness to participate. A large-scale survey of people using psychedelics in North America compared 3,547 White people, 448 People of Color, and 377 Multiracial people. A lower proportion of People of Color used psychedelics with a trained provider, but equal proportions had disclosed psychedelic use to primary care providers, were equally motivated to use psychedelics with a trained provider, used psychedelics for similar issues, and reported similar effectiveness. The findings suggest that lack of trust may not fully explain underrepresentation, and other barriers should be investigated.
Journal of Psychoactive Drugs
January 1, 2023
Daniel J. Kruger, Julie Barron, Moss Herberholz et al.
4 citations
In a survey of 1,221 people who use psychedelics outside clinical settings, three-quarters supported decriminalization and legalization. Participants strongly favored allowing individuals to legally grow and possess psychedelic plants and fungi for personal use. Support was higher for natural over synthetic substances, for self-production and consumption over gifting, and for gifting over sales. Administration with therapeutic support was preferred over use without it. Participants worried about pharmaceutical-style policies, including patents on both natural and synthetic psychedelics. Most respondents lived in Michigan, but geographical differences were small. People who identified as psychedelic guides, educators, or therapists differed slightly but extensively from others. The authors suggest policymakers consider these preferences to ensure safe and equitable access and appropriate medical support.
Journal of Psychoactive Drugs
February 5, 2025
Daniel J. Kruger, Jeff Albrecht, Jacob S. Aday et al.
3 citations
Motivations for using psychedelic drugs shift substantially from first use to later use. Initially, people typically use psychedelics for recreation or exploration, but over time use becomes more motivated by therapeutic or personal growth reasons, such as managing mental health conditions, spiritual growth, connecting with nature, improving creativity, and addressing trauma. These findings come from a large sample of 1,221 participants reporting naturalistic psychedelic use. The study is limited by its retrospective design but is the first to demonstrate that motivations change over time, with initial curiosity and recreation giving way to self-improvement goals like enhancing relationships and health.
Research Square
April 8, 2026
Oliver Robinson, David Luke, Jules Evans et al.
1 citation
In a large global online survey of 6,476 people who have used psychedelics, nearly half (48.3%) reported at least one difficulty lasting 24 hours or more, and 9.9% experienced difficulties for over a year. The most common difficulties were existential struggle (36.6%), depression (34%), and derealization (29.4%). Existential struggle was rated as the most severe difficulty but also the one most linked to healing. Clinically relevant disruptive difficulties lasting at least a month and disrupting daily life were reported by 8% of participants and were associated with younger age, lower income, lack of family support, lower emotional stability, higher pre-existing anxiety or depression, and using psychedelics to treat mental health conditions. The findings highlight the need for education on risks and benefits, safety guidelines, and support services.
Harm Reduct J
November 25, 2025
Daniel J. Kruger, Gina Mersereau, Ashley Sullivan et al.
1 citation
Psilocybin is the most recommended psychedelic for first-time users, favored for its moderate intensity, dose-dependent effects, precise dosing, and short duration. Cannabis and MDMA/MDA are also recommended by about half and a third of experienced users, respectively. Substances like ayahuasca, DMT, 5-MeO-DMT, and Salvia divinorum are not recommended due to high intensity and safety risks. Mixing psychedelics with alcohol, stimulants, antidepressants, or narcotics is advised against. Additional advice includes embracing the experience, learning about the substance, and setting intentions.
Journal of psychopharmacology (Oxford, England)
May 1, 2025
Niloufar Pouyan, Jacob S. Aday, Steven E. Harte et al.
1 citation
People with treatment-resistant conditions often see their illness as part of their identity. The pictorial representation of illness and self measure (PRISM) gauges this self-condition enmeshment. In a survey of 297 individuals who used psychedelics therapeutically on their own, most reported symptom improvement: 95.4% with depression, 98.36% with posttraumatic stress disorder, and 94.87% with anxiety. PRISM scores dropped significantly after the most salient psychedelic experience, indicating reduced identification with the condition. The decrease in PRISM scores correlated with symptom improvement across all conditions. PRISM appears useful for tracking how psychedelics affect self-perception across diagnoses, though limitations include convenience sampling, potential positive bias, and retrospective reporting.
Journal of Psychiatric Research
June 2, 2026
Daniel J. Kruger, Audrey Czerew, Leigh Farquhar et al.
The research priorities of people who have used psychedelics differ from those of institutional researchers. An online survey of 1192 U.S. adults who reported past psychedelic use identified seven major domains for future research: therapeutic efficacy, best practices for non-clinical use, safety and adverse experiences, broader understanding including indigenous traditions, non-medical outcomes like creativity and spiritual awakening, best practices for therapy, and best practices for research. Institutional researchers emphasized molecular, neurological, and clinical topics, while users prioritized non-clinical use and societal and cultural issues.
Scientific Reports
April 15, 2026
Jacob S. Aday, Nicolas G. Glynos, Anne Baker et al.
A new questionnaire, the Psychedelic-related Major Life Changes Questionnaire (P-MLCQ), was developed to capture major life changes following psychedelic use that standard clinical measures miss. In a survey of 581 people who used psychedelics naturally, 83% reported at least one major life change influenced by their use, averaging 3.29 changes per person. The most common changes were in goals (54%), values (54%), and religion or spirituality (49%). These changes were rated highly positively on average. More frequent psychedelic use over the past five years was linked to more reported life changes. Women were 21% more likely than men to report changes, while older age and higher education were associated with fewer changes. The authors note that results may be influenced by positive bias and need replication in representative samples.
Universität Zürich, ZORA
May 1, 2025
Niloufar Pouyan, Jacob S. Aday, E Harte, Steven et al.
After naturalistic psychedelic use, people with depression, PTSD, or anxiety reported reduced identification of their identity with their illness, as measured by the pictorial representation of illness and self measure (PRISM). Among 297 individuals, the majority in each condition reported symptom improvement: 95.4% with depression, 98.36% with PTSD, and 94.87% with anxiety. PRISM scores significantly decreased after the most salient psychedelic experience, and larger reductions in self-condition enmeshment were associated with greater symptom improvement. The findings suggest PRISM can detect changes in self-perception across conditions, though limitations include retrospective reporting and unclear dosing.
Frontiers in Psychiatry
August 4, 2023
Kasey Cox, Cody Weston, Moss Herberholz et al.
A survey of 1,221 adults who use psychedelics found that most do so without clinical support. Only 22% disclosed their use to a primary care provider, while 58% told a psychiatric provider. Participants had less confidence in primary care providers' ability to integrate psychedelics into treatment. Common reasons for not disclosing included stigma, lack of provider knowledge, and legal concerns. 23% took psychedelics on the same day as potentially interacting psychiatric medications. Although 81% desired therapist support during experiences, only 15% had received it. The disconnection from clinical care may lead to safety issues such as inadequate screening, lack of support for adverse events, and drug interactions.
Journal of Psychoactive Drugs
January 1, 2025
Jamarie Geller, Nicolas G. Glynos, Andrew Lemmen et al.
Trainees in medical and allied professions learn about psychedelics and related therapies mainly from social media and word-of-mouth, sources that do not improve their knowledge. Structured education is scarce, and overall psychedelic literacy is low, but those who participate in programming at their own institutions show greater knowledge. As psychedelic therapies become more available and research advances, academic training programs must include relevant material to prepare future professionals to educate and counsel patients.
Cannabis & Cannabinoid Research
February 1, 2023
Daniel J. Kruger, Jessica S Kruger
A survey of delta-8-THC consumers found that about half used it to treat health conditions, primarily anxiety or panic attacks (69%), stress (52%), depression or bipolar disorder (46%), and chronic pain (41%). Administration was mainly edibles (64%) and vaping concentrates (48%). Most participants did not inform their primary care provider of their use (78%) and lacked confidence in their provider's ability to integrate medical cannabis into treatment (70%). Participants compared delta-8-THC favorably with delta-9-THC and pharmaceutical drugs, reporting substantial substitution. Knowledge of effective dosages was low, with information coming mostly from the Internet and personal experience.