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.
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.