The uncontrolled experiment – Psychedelic use in the wild

Abstract

Psychedelics are widely used outside clinical settings.We need psychedelic epidemiology to learn more about the risks and benefits of recreational use.In their article titled 'Persistent Altered States: Psychological Treatment of Psychedelic Adverse Effects' , Holmøy and Andersen (2025) present a clinically focused overview of the phenomenology and symptoms of mental health problems a er psychedelic use, as well as challenges in and recommendations for psychotherapeutic work on such problems.As a researcher in psychedelic epidemiology, I wish to comment on their important article by taking a wider view, from the clinical difficulties they describe to the millions of people who use psychedelics every year in the wild; an uncontrolled experiment on a vast scale, outside the clinic and without the guardrails of clinical trials.