Naturalistic use of psychedelics is associated with longitudinal improvements in anxiety and depression during global crisis times.

Abstract

Mental health implications of COVID-19 drug use patterns are still unclear. We used data-driven clustering in a large citizen science cohort recruited agnostically to an interest in drug-use to categorise people according to common patterns of drug use and analysed their mental health symptoms (GAD-7 and PHQ-9 items), from recruitment prior to COVID-19 restrictions in 2020 (N = 242,260) to three follow-ups in 2020-2022 (N = 68,416). Mixed effects modelling examined how mental health scores related to drug-use clusters cross-sectionally and how changes in those scores longitudinally related to changes in consumption frequencies. We identified six common patterns of drug use during the COVID-19 pandemic, with cannabis cross cutting most of them. The majority of drug use clusters had worse average mental health scores relative to drug-naive individuals at all timepoints. The average mental health scores of those who used more drugs during the pandemic worsened over time relative to individual baselines. However, psychedelics and cannabis users showed average improvements in depression (β = -0.26 SD, 95% CI: -0.44, -0.08, p = 0.003), anxiety (β = -0.24 SD, 95% CI: -0.41, -0.06, p = 0.007) and overall mental health (β = -0.2 SD, 95% CI: -0.35, -0.04, p = 0.01) from pre-pandemic to January 2022, becoming on par with the drug-naive group. This was not the case for cannabis-only users, whose worse mental health scores persisted. Those who used psychedelics may have experienced some improvements in mental health across the pandemic timeframe, which supports the idea that beneficial effects on mood and anxiety associated with these substances may extend beyond controlled conditions.