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Contextualizing Violence Risk Associated With Hallucinogens

Tyler Durns, Greg Iannuzzi

FOCUS The Journal of Lifelong Learning in Psychiatry 2026 DOI: 10.1176/appi.focus.20250027 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Population General population using hallucinogens
Topics LSD MDMA Psilocybin
Keywords Hallucinogen Aggression Poison control Harm Mental illness Suicide prevention Injury prevention Mental health Public health
Key findings The effect of psilocybin, LSD, and MDMA on aggression and violence risk remains inconclusive, and individual risk factors for violence among users need further study.

Abstract

Psilocybin, lysergic acid diethylamide (LSD), and 3,4-methylenedioxymethamphetamine (MDMA) have remerged as agents of psychiatric and cultural relevance. However, public discourse has outpaced empirical understanding of their effects. Although hallucinogens have demonstrated a potential to treat certain mental disorders, their effect on aggression and violence risk remains inconclusive. This article reviews the historical, medical, legal, and cultural contexts of these popular psychedelic and entactogenic compounds. The impact of substance type, dose, set and setting, psychiatric comorbidity, and environmental factors on violence is reviewed. Prevention and response strategies relevant to hallucinogenic compounds are discussed, including harm reduction, risk assessment, and treatment. Individual risk factors that mediate violence risk for people who consume psilocybin, LSD, and MDMA remain an area for further research.

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