Psychedelic substitution: altered substance use patterns following psychedelic use in a global survey.
Nicolas G. Glynos, Jacob S. Aday, Daniel J. Kruger, Kevin F. Boehnke, Stephanie Lake, Philippe Lucas
Frontiers in Psychiatry 2024 DOI: 10.3389/fpsyt.2024.1349565 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Sample size | 5,268 |
| Population | Adults self-reporting past or current psychedelic use globally |
| Topics | MDMA Psilocybin |
| Keywords | Recovery Sud Substance use Psychedelics hallucinogens Entheogens Drug dependence Drug safety |
| Citations | 15 |
| Key findings | Nearly three-quarters of respondents reported ceasing or decreasing use of one or more non-psychedelic substances after naturalistic psychedelic use, though nearly one-fifth reported increased or initiated use of other substances. |
Abstract
Recent research suggests that psychedelics may have potential for the treatment of various substance use disorders. However, most studies to date have been limited by small sample sizes and neglecting to include non-North American and European populations. We conducted a global, cross-sectional online survey of adults (n = 5,268, 47.2% women) self-reporting past or current psychedelic use and investigated whether psychedelic use was associated with changes in use of other substances. Nearly three-quarters (70.9%; n = 3,737/5,268) reported ceasing or decreasing use of one or more non-psychedelic substances after naturalistic psychedelic use. Among those with previous use, 60.6% (n = 2,634/4,344) decreased alcohol use, 55.7% (n = 1,223/2,197) decreased antidepressant use, and 54.2% (n = 767/1,415) decreased use of cocaine/crack. Over a quarter of the sample indicated that their decrease in substance use persisted for 26 weeks or more following use of a psychedelic. Factors associated with decreased use included a motivation to either decrease one's substance use or self-treat a medical condition. Importantly, 19.8% of respondents also reported increased or initiated use of one or more other substances after psychedelic use, with illicit opioids (14.7%; n = 86/584) and cannabis (13.3%; n = 540/4,064) having the highest proportions. Factors associated with increased substance use included having a higher income and residing in Canada or the US. Although limited by cross-sectional study design, this large observational study will help inform future studies aiming to investigate the relationship between substance use patterns and psychedelic use.
Comparable studies
Other cross-sectional and survey studies on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Recreational MDMA use in Sydney: a profile of ‘Ecstasy’ users and their experiences with the drug Recreational Ecstasy users recruited via snowball peer network | 1992 | Cross-sectional survey | n = 100 |
| Reducedin vivobinding to the serotonin transporter in the cerebral cortex of MDMA (‘ecstasy’) users Male regular ecstasy users and well-matched controls | 1999 | Cross-sectional association study | n = 20 |
| Patterns of simultaneous polysubstance use in drug using university students Drug-using university students | 2006 | Cross-sectional survey | n = 149 |
| Patterns of recreational drug use at dance events in Edinburgh, Scotland Drug users at dance events in Edinburgh, Scotland, UK, aged 16-47, 80% between 18 and... | 2001 | Cross-sectional survey | n = 122 |
| Acute, sub‐acute and long‐term subjective consequences of ‘ecstasy’ (MDMA) consumption in 430 regular users Regular MDMA users | 2003 | Cross-sectional study | n = 466 |
Citations in the library
Cited by 16
- Global Trends in Psychedelic Microdosing: Demographics, Substance Testing Behavior, and Patterns of Use Journal of Psychoactive Drugs November 6, 2024
- Psychedelics and chronic pain: self-reported outcomes on changed substance use patterns and health following naturalistic psychedelic use British Journal of Pain February 11, 2025
- Racial Differences in Naturalistic Psychedelic Use - Motivations for Use, Communication with Health Care Providers, and Outcomes. Journal of Psychoactive Drugs April 22, 2025
- Preferences, Perceptions, and Environmental Considerations of Natural and Synthetic Psychedelic Substances: Findings from the Global Psychedelic Survey Journal of Psychoactive Drugs December 24, 2024
- Pictorial representation of illness and self measure (PRISM): A putative transdiagnostic tool for evaluating therapeutic effects of psychedelic treatments. Journal of Psychopharmacology May 1, 2025
and 11 more in the library
Cites 45
- Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder JAMA Psychiatry November 4, 2020
- Human hallucinogen research: guidelines for safety. Journal of Psychopharmacology July 1, 2008
- Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction Journal of Psychopharmacology September 11, 2014
- Long-term follow-up of psilocybin-facilitated smoking cessation The American Journal of Drug and Alcohol Abuse July 21, 2016
- Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder JAMA Psychiatry August 24, 2022
and 40 more in the library