Comparing Substance Use Consequences between Serotonergic Psychedelics, MDMA, and other Drugs of Abuse Among United States Adults with History of Psychiatric Illness
Joshua C. Black, Nicole Schow, Hannah L. Burkett, Morgan Pena, Jennifer S. Jewell, Annika Czizik, Andrew A. Monte, Richard C. Dart
International Journal of Mental Health and Addiction April 1, 2025 DOI: 10.1007/s11469-023-01163-2 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Population | US adults with psychiatric illness history (anxiety disorder, major depressive disorder, post-traumatic stress disorder, bipolar disorder) |
| Topics | LSD MDMA Psilocybin Serotonin |
| Keywords | Psychedelics Psychiatric illness Us population |
| Citations | 3 |
| Key findings | Psychedelic or MDMA use among adults with psychiatric illness is more prevalent than in the general population and is associated with more severe substance use disorder risk, though the increase is smaller than for opioids or stimulants. |
Abstract
Psychedelic-assisted therapy could transform treating psychiatric illness, but harms from exacerbating substance use disorder (SUD) among adults with psychiatric illness using psychedelics have not been studied. A cross-sectional survey in the US was used to test whether Drug Abuse Screening Test scores (DAST-10, validated instrument predicting SUD) were more severe when psychiatric illnesses (anxiety disorder, major depressive disorder [MDD], post-traumatic stress disorder [PTSD], and bipolar disorder) and serotonergic psychedelic or MDMA use were combined. Any psychedelic use among adults with psychiatric illness history (anxiety: 5.1% [95% CI: 4.7, 5.6]; MDD: 5.1% [4.3, 5.8]; PTSD: 6.9% [5.9, 7.9]; bipolar: 9.2% [8.0, 10.5]) was more prevalent than the general population (2.6% [2.5, 2.8]). Significant increases in scores were associated with psychedelic use independent of other concurrent drug use, but increases were smaller than for opioids or stimulants. Approaches to managing SUD risks with psychedelics should differ from past approaches for other drugs.
Comparable studies
Other cross-sectional and survey studies on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Recreational MDMA use in Sydney: a profile of ‘Ecstasy’ users and their experiences with the drug Recreational Ecstasy users recruited via snowball peer network | 1992 | Cross-sectional survey | n = 100 |
| Reducedin vivobinding to the serotonin transporter in the cerebral cortex of MDMA (‘ecstasy’) users Male regular ecstasy users and well-matched controls | 1999 | Cross-sectional association study | n = 20 |
| Patterns of simultaneous polysubstance use in drug using university students Drug-using university students | 2006 | Cross-sectional survey | n = 149 |
| 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 |
| Acute, sub‐acute and long‐term subjective consequences of ‘ecstasy’ (MDMA) consumption in 430 regular users Regular MDMA users | 2003 | Cross-sectional study | n = 466 |
Citations in the library
Cited by 2
Cites 25
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
- Psilocybin induces schizophrenia-like psychosis in humans via a serotonin-2 agonist action Neuroreport December 1, 1998
- MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine June 1, 2021
- Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial Psychological Medicine June 15, 2018
and 20 more in the library