Prevalence and associations of challenging, difficult or distressing experiences using classic psychedelics.
Otto Simonsson, Peter S. Hendricks, Richard Chambers, Walter Osika, Simon B. Goldberg
Journal of Affective Disorders April 1, 2023 DOI: 10.1016/j.jad.2023.01.073 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Sample size | 2,822 |
| Population | US adult population |
| Topics | LSD Psilocybin |
| Keywords | Adverse Ceq Psychedelics hallucinogens Entheogens Negative reactions Challenging experiences Difficult trips Harm reduction safety Risk management Preparation Set an |
| Citations | 124 |
| Key findings | Among lifetime classic psychedelic users, 59.1% reported no challenging experience, but 8.9% had functional impairment lasting over a day and 2.6% sought professional help; co-use of lithium or other mood stabilizers and several set and setting factors were associated with greater difficulty and harm risk. |
Abstract
Previous studies have investigated challenging, difficult, or distressing classic psychedelic experiences, but little is known about the prevalence and associations of such experiences. Using nationally representative data of the US adult population (N = 2822), this study examined the prevalence and associations of challenging, difficult, or distressing experiences using classic psychedelics, in a subsample of respondents who reported lifetime classic psychedelic use (n = 613). Of the 613 respondents who reported lifetime classic psychedelic use, the majority of them (59.1 %) had never had a challenging, difficult, or distressing experience using a classic psychedelic, but 8.9 % of respondents reported functional impairment that lasted longer than one day as a result of such experiences. Notably, 2.6 % reported seeking medical, psychiatric, or psychological assistance in the days or weeks following their most challenging, difficult, or distressing classic psychedelic experience. In covariate-adjusted regression models, co-use of lithium, co-use of other mood stabilizers, and six set and setting variables (no preparation, disagreeable physical environment, negative mindset, no psychological support, dose was too large, major life event prior to experience) were associated with the degree of difficulty; and co-use of lithium, co-use of other mood stabilizers, and three set and setting variables (negative mindset, no psychological support, major life event prior to experience) were associated with overall risk of harm. In summary, this study provides insight into the prevalence and associations of challenging, difficult, or distressing classic psychedelic experiences. The findings broadly correspond with findings from previous studies and can inform harm reduction efforts and future experimental research designs.