A review of protective behavioral strategies (PBS) for psychedelic use outside clinical settings found that a culture of harm reduction exists within psychedelic communities. Identified strategies include careful drug acquisition, dosing, managing set and setting, bodily nourishment, planning for challenging experiences, and post-use integration. Although research is limited, emerging evidence suggests that using these strategies may reduce negative consequences. The review calls for better measurement tools and more studies to understand how PBS can support the growing number of people—8.5 million Americans over 12 reported past-year use in 2022—who use psychedelics nonclinically.
People who use psilocybin outside of clinical settings show diverse patterns of consumption. Three distinct user profiles emerged, differing in how often and how much psilocybin they used, and these profiles were linked to specific demographic traits. The findings suggest that psilocybin use is not uniform and that future research should investigate what influences different use outcomes and explore the variability in how people use the substance.
American Indian (AI) and non-AI youth living on or near reservations show largely similar rates of using substances often grouped as 'other' (inhalants, MDMA, hallucinogens, prescription opioids, over-the-counter cold medicines), though some regional and sex-based differences emerge. In two regions, AI youth had higher odds of using any 'other' substance than non-AI youth, while in the Southeast and Northwest they were less likely to use prescription opioids and over-the-counter cold medicines, respectively. Males in the Southwest were more likely than females to use inhalants, hallucinogens, and tranquilizers. The Southern Plains region reported the highest prevalence of 'other' substance use overall. These patterns can guide targeted prevention and intervention.