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.
Comparable studies
Other cross-sectional and survey studies on LSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 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 |
| 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 |
| Development of the Psychological Insight Questionnaire among a sample of people who have consumed psilocybin or LSD Psilocybin and LSD users | 2021 | Cross-sectional survey study | n = 1,661 |
| Trends in LSD use among US adults: 2015-2018. US adults ages 18 and older | 2020 | Secondary analysis of cross-sectional survey data | n = 168,562 |
| Acute Adverse Reactions to Lsd in Clinical and Experimental use in the United Kingdom Subjects in LSD or mescaline sessions | 1971 | Survey | n = 5,000 |
Citations in the library
Cited by 120
- Extended difficulties following the use of psychedelic drugs: A mixed methods study PLoS One October 24, 2023
- Therapeutic mechanisms of psychedelics and entactogens. Neuropsychopharmacology July 24, 2023
- Essentials of Informed Consent to Psychedelic Medicine JAMA Psychiatry April 10, 2024
- Longitudinal associations between psychedelic use and psychotic symptoms in the United States and the United Kingdom Journal of Affective Disorders January 26, 2024
- Set and setting predict psychopathology, wellbeing and meaningfulness of psychedelic experiences: a correlational study. Expert Review of Clinical Pharmacology 2024
and 115 more in the library
Cites 20
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- 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
- Global Street Food: la cocina de la calle Diseño interior 2009
- Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences Journal of Psychopharmacology August 31, 2016
and 15 more in the library