The Rise of Psilocybin Use in the United States: A Multisource Observational Study
Annals of Internal Medicine April 21, 2025 Karilynn M Rockhill, Joshua C. Black, Michael S. Ladka et al. 29 citations
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Andrew A. Monte
11 papers in the library · 58 citations · publishing 2024-2026
Papers
Clinical Effects of Psychedelic Substances Reported to United States Poison Centers: 2012 to 2022.
Annals of emergency medicine December 1, 2024 Mark W Simon, Heather A Olsen, Christopher O Hoyte et al. 12 citations
Over half of psychedelic exposures reported to US poison centers resulted in symptoms that required treatment, severe residual or prolonged symptoms, or death. From 2012 to 2022, 54,605 cases were recorded, with hallucinogenic mushroom exposures rising most sharply from 593 to 1,440. Cardiovascular effects were common, especially with hallucinogenic amphetamines (31.1%). Among patients managed in healthcare facilities, 62.4% received medical therapies, including sedation (32.9%) and respiratory interventions (10.3%). Concomitant exposures occurred in 41.1% of cases. Increasing psychedelic use may lead to more adverse events and healthcare utilization.
Optimizing real-world benefit and risk of new psychedelic medications: the need for innovative postmarket surveillance
Nature Mental Health May 1, 2024 Joshua C. Black, Andrew A. Monte, Nabarun Dasgupta et al. 5 citations
As psychedelic-assisted psychotherapy nears FDA approval and broader use in the USA, current postmarket surveillance systems are ill-suited to monitor its real-world safety and effectiveness. Without a fit-for-purpose program, risks include misattributing adverse events to illicit psychedelics and failing to achieve equitable patient access. A successful surveillance mosaic should incorporate environmental, personal, and outcome domains to ensure safe, appropriate, and equitable care. The authors argue for intentionally designed data systems to proactively monitor utilization and inform reasonable limitations.
Psychedelic Trips: Travel Within the United States to Use Psychedelic Drugs After Legalization.
Annals of emergency medicine June 30, 2025 Joshua C. Black, Karilynn M Rockhill, Evelyn J Fox et al. 4 citations
About one-third of US adults who used psychedelics in the past year traveled out of state to do so, primarily to Colorado and Oregon, which have decriminalized natural psychedelics. Travelers were more likely than nontravelers to report anxiety or depression symptoms and to have visited an emergency department or urgent care for a psychedelic-related issue. They were also more likely to use psychedelics for medical symptoms, at healing centers, or at ceremonial sites. Emergency physicians in both legalized and nonlegal states should be aware that travel for psychedelic use is common and may carry risks of adverse outcomes.
Comparing Substance Use Consequences between Serotonergic Psychedelics, MDMA, and other Drugs of Abuse Among United States Adults with History of Psychiatric Illness
International Journal of Mental Health and Addiction April 1, 2025 Joshua C. Black, Nicole Schow, Hannah L. Burkett et al. 3 citations
Among US adults with a history of anxiety, major depression, PTSD, or bipolar disorder, past use of serotonergic psychedelics or MDMA is more common than in the general population—for example, 9.2% of those with bipolar disorder report such use versus 2.6% overall. Using a validated screening tool, psychedelic use was linked to higher scores indicating more severe substance use disorder risk, even after accounting for other drug use. However, the increase in risk was smaller than that associated with opioids or stimulants. The authors suggest that managing substance use disorder risks in psychedelic-assisted therapy may require different approaches than those used for other drugs.
Fusing Specialized Surveys of Rare Populations to Larger Surveys for Generalized Inference: Cross-Sectional Survey Study.
Journal of Medical Internet Research April 27, 2026 Karilynn M Rockhill, Elizabeth A Bemis, Nicole Schow et al. 2 citations
Combining a large representative survey with a smaller survey focused on psychedelic drugs can produce generalizable estimates of rare behaviors like drug use without adding burdensome questions to the big survey. Researchers used calibration weighting to transport estimates from a psychedelic-enriched survey (two waves, total over 4,300 adults) to a representative anchor survey (two waves, total over 57,000 adults). The method showed good internal consistency, with transport biases under 0.4 percentage points for demographics, health, and substance use. External validity improved for health and substance use estimates after fusion. Using the fused data, recreational use of psilocybin (92.9%), LSD (93.2%), and MDMA (93.3%) was far more common than medical use (30.9%, 26.4%, and 21.1%, respectively). This approach expands surveillance epidemiology for rare behaviors.
Psilocybin Trends in States That Decriminalized Use
JAMA March 12, 2026 Joshua C. Black, Gabrielle E. Bau, Ryan Cook et al. 2 citations
After Oregon and Colorado decriminalized psilocybin, 12-month use of the substance increased in both states. The survey data show that the estimated prevalence of past-year psilocybin use rose in Oregon and Colorado compared with the period before decriminalization. The findings suggest that decriminalization policies are associated with higher rates of psilocybin use.
Commentary on Darkeet al.: Expanded psychedelic access requires new safety monitoring systems
Addiction June 17, 2024 P. Todd Korthuis, Adrianne R Wilson-Poe, Joshua C. Black et al. 1 citation
As psychedelic use expands, adverse effects will increase proportionally. Darke et al. characterized 33 LSD and 10 psilocybin-related deaths in Australia between 2000 and 2023, finding that traumatic accidents and physical self-harm in private settings accounted for most deaths. The 43 deaths over 24 years are rare compared to the more than 325,000 Australians who reported using hallucinogens in 2019 alone. Co-use of other substances was common: 75% of LSD cases and 80% of psilocybin cases involved other substances. The findings suggest regulated services must consider harm reduction, including skilled supervision, screening for comorbidities, and counseling against other drug use. Better population-level monitoring frameworks are urgently needed as legal frameworks for psychedelic services expand.
Prevalence and predictors of sexual and physical violence during psychedelic use in a US population-based study.
World Psychiatry June 1, 2026 Christina Chwyl, Michael S. Ladka, Joshua C. Black et al.
In a US population-based study, about 1 in 20 people who used psychedelics reported experiencing sexual or physical violence during their use. Younger age, female gender, and use of certain psychedelics like MDMA were associated with higher risk. The findings suggest that while most psychedelic experiences are safe, a minority involve violence, highlighting the need for harm reduction strategies.
Psychedelic Terminology Preference in the 2024 National Survey Investigating Hallucinogenic Trends (NSIHT).
Journal of Psychoactive Drugs March 16, 2026 Faith E Lyons, Karilynn M Rockhill, Evelyn J Fox et al.
Adults who used a psychedelic in the past year most prefer surveys that use specific substance names (e.g., psilocybin, ayahuasca) over umbrella terms. In a cross-sectional survey of 2,306 respondents, specific substance names received the highest preference (median rank 3; 24.3% ranked first), followed by "psychedelics" (median rank 3; 19.4%). Terms like "hallucinogen," "medicines," and "entheogens" ranked lower. Preferences were consistent across age, education, and experience levels. The findings offer recommendations for terminology in future survey development.
Ibogaine for Opioid Use Disorder: An Unrecognized Risk.
Journal of Addiction Medicine January 15, 2026 Dale Terasaki, Nathan Sackett, Andrew A. Monte
Ibogaine, a psychedelic substance, is attracting interest as a potential treatment for opioid use disorder (OUD), with many states funding research. Some proponents frame ibogaine as an alternative to standard, mortality-reducing medications for OUD (MOUD), rather than as a complement. The path to remission varies, but switching from methadone or buprenorphine to an unproven therapy like ibogaine could increase the risk of opioid overdose for some individuals. The addiction medicine community should be aware of this risk and continue to defend evidence-based care while ibogaine is developed.