Association between lifetime hallucinogen use and psychological distress varies by sexual identity in a nationally representative sample

Background: Clinical trials demonstrate that psychedelic-assisted therapy can improve mental health outcomes; however, few studies have recruited sexually diverse samples or reported information on sexual identity.

Aims: The purpose of this analysis was to examine the relationship between hallucinogen use and mental health outcomes with respect to sexual identity.

Methods: We conducted a cross-sectional analysis using data from the 2021 National Survey on Drug Use and Health to examine the relationship between hallucinogen use and psychological distress.

Results: In a sample representative of 253,824,662 U.S. adults, the majority was heterosexual (92%), aged 50-64 (25%), women (51%), non-Hispanic White (62%), college educated (31%), and had an annual household income of $75,000 or higher (39%). The majority reported no lifetime hallucinogen use (82%) and no past month severe psychological distress (93%). Sexual identity modified the relationship between hallucinogen use and psychological distress. After stratifying by sexual identity and adjusting for covariates, hallucinogen use was associated with reduced odds of psychological distress in the heterosexual population (OR = 0.76, 95% CI: 0.59, 0.96) but the relationship was not significant in the sexual minority population.

Conclusion: We found that in a nationally representative sample, psychedelic use was associated with reduced odds of psychological distress in heterosexual individuals only. Future research should investigate why hallucinogen use was not protective in sexual minority groups given their disproportionate burden of poor mental health outcomes.