Past-Year Psilocybin and Alcohol Co-Use: Associations With Mental Health Symptoms

Abstract

Interest has grown in the effects of psilocybin on mental health, but little is known about its naturalistic use alongside alcohol and its relationship to depression and/or anxiety symptoms. Data from the nationally-representative 2024 National Survey Investigating Hallucinogenic Trends of participants who did ( n = 1234) or did not ( n = 1607) report past-year psilocybin and alcohol co-use were compared on depressive and anxiety symptoms and poor mental health days. Weighted regressions adjusted for age, sex, survey collection period, race, ethnicity, and past-year cannabis and other psychedelic use. Individuals with psilocybin and alcohol co-use had fewer depressive symptoms ( B (SE) = −.57(.28), β = −.04, p = .043) than those who used alcohol without psilocybin, suggesting potential benefits of psilocybin in individuals with co-use. After removing cannabis and other psychedelic use covariates, psilocybin use was also related to lower anxiety symptoms. However, given the observational and self-report study design, causal inferences cannot be made. Thus, longitudinal and experimental studies are needed.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

• State of the evidence: Psilocybin for anxiety ↕Mixed

  Past-year psilocybin and alcohol co-use was associated with fewer depressive symptoms, and psilocybin use was related to lower anxiety symptoms only after removing other substance covariates.

  Synthesized October 22, 2026

Comparable studies

Other observational and cohort studies on cannabis for anxiety, most cited first.