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

Haley M Hummel, Alexia N Obrochta, David C. R. Kerr, Anita Cservenka

Journal of Drug Issues July 1, 2026 DOI: 10.1177/00220426261466154 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Observational study Longitudinal Peer reviewed
Sample size 2,841
Population U.S. adults from the 2024 National Survey Investigating Hallucinogenic Trends
Topics Anxiety Cannabis Psilocybin
Keywords Hallucinogen Mental health Depression economics Alcohol Clinical psychology Observational study Depressive symptoms Naturalistic observation Substance use
Key findings Individuals who co-used psilocybin and alcohol had fewer depressive symptoms than those who used alcohol without psilocybin.

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 Supports

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

    Synthesized

Comparable studies

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

Study Year Design Participants
Former chronic methylenedioxymethamphetamine (MDMA or ecstasy) users report mild depressive symptoms Former chronic ecstasy users 2001 Observational cohort n = 29
Rates and correlates of cannabis-associated psychotic symptoms in over 230,000 people who use cannabis International sample of people who use cannabis (PWUC) 2022 Observational cohort n = 233,475
Who Turns to Amazonian Medicine for Treatment of Substance Use Disorder? Patient Characteristics at the Takiwasi Addiction Treatment Center Patients with substance use disorders seeking treatment 2020 Observational study
Long-Term Mental Health and Wellbeing Outcomes Associated with Naturalistic Ayahuasca Consumption. Adults with no prior exposure to ayahuasca participating in neo-shamanic ayahuasca... 2025 Prospective cohort study n = 66
Naturalistic use of psychedelics is associated with longitudinal improvements in anxiety and depression during global crisis times. Citizen science cohort recruited agnostically to an interest in drug use 2025 Observational cohort n = 242,260

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