“I can objectively view my trauma without feeling like I'm there”: Reddit discussions on self-reported use of psychedelics to address co-occurring substance use and mental health needs

Abstract Introduction While the relationship between substance use disorders (SUD) and mental health conditions is well established, treatment for these co-occurring conditions is difficult to manage. Research on the potential for psychedelic treatments to address SUD and mental health conditions has recently seen a resurgence. This study aimed to explore narratives on the influence of psychedelics on mental health needs among people who use opioids.

Methods: We conducted a qualitative study of self-reported experiences and perspectives on using psychedelics to address mental health needs among people participating in opioid-use-related Reddit community forums. We extracted posts that contained key psychedelic terms from the two most subscribed to subreddits dedicated to discussions of opioid use disorder treatment and recovery: r/OpiatesRecovery and r/Methadone from 2018–2021. Content of 113 relevant posts and their comments was analyzed thematically.

Results: Thematic analysis revealed positive experiences with psychedelics, including symptom relief for anxiety, depression, and PTSD, along with enhanced mood, inner peace, emotional healing, and shifts in perspective. These experiences were linked to reprocessing trauma and disrupting negative thought cycles. Users highlighted the potential for psychedelics to support long-term recovery from opioid use by fostering emotional resilience and clarity. However, concerns were noted regarding the risks of self-administered psychedelic use.

Conclusion: Self-reported experiences of using psychedelics were generally positive among Reddit users reporting co-occurring opioid use and mental health needs. These findings should be considered exploratory given the unique sample and context of an internet forum. Further research is needed to determine the safety, efficacy, and appropriate integration of psychedelics into treatment to address co-occurring mental health and substance use disorders.