Mental health conditions and receipt of mental health care by illicit lysergic acid diethylamide (LSD) use status among young adults in the United States

Aim: To examine prevalence of mental health conditions and receipt of mental health care (MHC) by illicit lysergic acid diethylamide (LSD) use status (past-year; lifetime without-past-year; never) among young adults.

Design: Cross-sectional, annual survey data from 2015 to 2019 National Surveys on Drug Use and Health (NSDUH).

Setting: United States.

Participants: A total of 69 916 NSDUH participants ages 18 to 25.

Measurements: Outcomes included past-year serious psychological distress (SPD), suicidal ideation, Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV major depressive episode (MDE), any mental illness, serious mental illness, receipt of mental health care (MHC, inpatient/outpatient or receipt of prescription medications), and number of days of being unable to work or attend normal activities because of mental health conditions.

Findings: Multivariable analyses found that compared with those who never used illicit LSD, adults with past-year illicit LSD use had greater risk of suicidal ideation (adjusted risk ratio [ARR] = 1.2, 95% CI = 1.06-1.41), SPD (ARR = 1.2, 95% CI = 1.04-1.28), MDE (ARR = 1.3, 95% CI = 1.17-1.52), and any/serious mental illness (ARRs = 1.2-1.3, 95% CI = 1.02-1.41) and reported missing more days because of mental health conditions (adjusted incidence rate ratio = 1.6, 95% CI = 1.31-1.86). Lifetime (without past-year) use showed similar, although less consistent, associations. Compared with those never using illicit LSD, adults with past-year use were less likely to receive prescription medications for MHC (ARR = 0.7, 95% CI = 0.60-0.84) and to receive overall MHC (ARR = 0.7, 95% CI= 0.64-0.84). Compared with those using in the past-year, adults with lifetime (without past-year) use were more likely to receive prescription medications for MHC (ARR = 1.2, 95% CI = 1.01-1.46) and receive overall MHC (ARR = 1.2, 95% CI = 1.03-1.45).

Conclusions: Young adults with past-year illicit lysergic acid diethylamide use have elevated prevalence of mental health conditions and are less likely to receive prescription medications for mental health care and overall mental health care. Regardless of past-year use status, young adults with lifetime illicit lysergic acid diethylamide use may benefit from mental illness prevention and interventions.