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Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences

Theresa M. Carbonaro, Matthew P. Bradstreet, Frederick S. Barrett, Katherine A Maclean, Robert L. Jesse, Matthew W. Johnson, Roland R. Griffiths

Journal of Psychopharmacology August 31, 2016 DOI: 10.1177/0269881116662634 (opens in new tab)

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AI-extracted from the abstract
Characteristics Cross-sectional survey Peer reviewed
Sample size 1,993
Population Individuals who had consumed psilocybin mushrooms and experienced a psychologically difficult or challenging experience
Intervention psilocybin mushrooms
Topics Psilocybin
Keywords Hallucinogen Distress Clinical psychology Incidence geometry Adverse effect Harm
Citations 541
Key findings Although 39% of respondents rated their worst psilocybin 'bad trip' among the top five most challenging experiences of their lives, 84% still reported benefiting from the experience, and the incidence of risky behavior or enduring psychological distress was low, especially in controlled settings.

Abstract

Acute and enduring adverse effects of psilocybin have been reported anecdotally, but have not been well characterized. For this study, 1993 individuals (mean age 30 yrs; 78% male) completed an online survey about their single most psychologically difficult or challenging experience (worst “bad trip”) after consuming psilocybin mushrooms. Thirty-nine percent rated it among the top five most challenging experiences of his/her lifetime. Eleven percent put self or others at risk of physical harm; factors increasing the likelihood of risk included estimated dose, duration and difficulty of the experience, and absence of physical comfort and social support. Of the respondents, 2.6% behaved in a physically aggressive or violent manner and 2.7% received medical help. Of those whose experience occurred >1 year before, 7.6% sought treatment for enduring psychological symptoms. Three cases appeared associated with onset of enduring psychotic symptoms and three cases with attempted suicide. Multiple regression analysis showed degree of difficulty was positively associated, and duration was negatively associated, with enduring increases in well-being. Difficulty of experience was positively associated with dose. Despite difficulties, 84% endorsed benefiting from the experience. The incidence of risky behavior or enduring psychological distress is extremely low when psilocybin is given in laboratory studies to screened, prepared, and supported participants.

Comparable studies

Other cross-sectional and survey studies on psilocybin, most cited first.

Study Year Design Participants
The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms Internet survey respondents reporting challenging experiences with psilocybin 2016 Questionnaire development and validation
Psychedelics and Mental Health: A Population Study Adult population in the United States 2013 Cross-sectional survey n = 130,152
Cessation and reduction in alcohol consumption and misuse after psychedelic use Individuals with prior alcohol use disorder who reported cessation or reduction in... 2019 Cross-sectional survey n = 343
Patterns of simultaneous polysubstance use in drug using university students Drug-using university students 2006 Cross-sectional survey n = 149
Survey of subjective "God encounter experiences": Comparisons among naturally occurring experiences and those occasioned by the classic psychedelics psilocybin, LSD, ayahuasca, or DMT Adults reporting a single most memorable God encounter experience, either nondrug or... 2019 Cross-sectional survey n = 4,285

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