Past-year hallucinogen use in relation to psychological distress, depression, and suicidality among US adults.
Kevin H. Yang, Benjamin H Han, Joseph J Palamar
Addictive Behaviors September 1, 2022 DOI: 10.1016/j.addbeh.2022.107343 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 241,675 |
| Population | US noninstitutionalized adults from the 2015-2020 National Survey on Drug Use and Health |
| Topics | Depression LSD MDMA |
| Keywords | Hallucinogens Psychedelics Suicidality Psychological distress Suicidal thoughts Mental well-being Mental health Explored Linked Reduced Decreased Distinct impacts Risks |
| Citations | 30 |
| Key findings | LSD use was associated with increased likelihood of major depressive episode and suicidal thinking, while ecstasy use was associated with decreased likelihood of serious psychological distress, major depressive episode, and suicidal thinking. |
Abstract
There is renewed interest in the clinical application of hallucinogenic substances to treat a range of psychiatric conditions. However, there is mixed evidence regarding how use of such substances outside of medical settings relates to psychological distress, depression, and suicidality. We examined data from a US representative sample of noninstitutionalized adults from the 2015-2020 National Survey on Drug Use and Health (N = 241,675). We evaluated whether past-year use of specific hallucinogens (i.e., LSD, DMT/AMT/Foxy, salvia divinorum, ecstasy [MDMA/Molly], ketamine) is associated with reporting past-year serious psychological distress (SPD), major depressive episode (MDE), and suicidality. Generalized linear models using Poisson and log link were used to estimate adjusted prevalence ratios (aPRs), controlling for sociodemographic characteristics and past-year use of various other illegal drugs. LSD use was associated with an increased likelihood of MDE (aPR = 1.23, 95% CI: 1.10-1.37) and suicidal thinking (aPR = 1.21, 95% CI: 1.09-1.34). Similar associations were observed between salvia divinorum use and suicidal thinking (aPR = 1.41, 95% CI: 1.00-1.97) and between DMT/AMT/Foxy use and suicidal planning (aPR = 1.81 95% CI: 1.17-2.81). On the other hand, ecstasy use was associated with a decreased likelihood of SPD (aPR = 0.83, 95% CI: 0.77-0.89), MDE (aPR = 0.91, 95% CI: 0.83-1.00), and suicidal thinking (aPR = 0.86, 95% CI: 0.75-0.99). Findings suggest there are differences among specific hallucinogens with respect to depression and suicidality. More research is warranted to understand consequences of and risk factors for hallucinogen use outside of medical settings among adults experiencing depression or suicidality.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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Past-year ecstasy use was associated with lower likelihood of serious psychological distress, major depressive episode, and suicidal thinking, while LSD showed the opposite pattern.
Synthesized
Comparable studies
Other observational and cohort studies on MDMA for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Symptoms of anxiety and depression in childhood and use of MDMA: prospective, population based study Children and adolescents from the Dutch province of Zuid-Holland | 2006 | Prospective longitudinal population-based study | n = 1,580 |
| Ecstasy (MDMA) and its Relationship with Self- Report Depression, Anxiety and Schizotypy Participants divided into three groups: no ecstasy use, light ecstasy users (fewer than... | 2010 | Observational cohort | |
| The relationship between 3,4-methylenedioxymethamphetamine (MDMA) use in young adulthood and anxiety or depressive disorders in the mid-30s: Findings from the Victorian Adolescent Health Cohort Study. Year 9 students (aged 14-15) from 44 Victorian schools in Australia, followed to age 35 | 2025 | Longitudinal population-based cohort study | n = 1,943 |
| Psychiatric profiles of mothers who take Ecstasy/MDMA during pregnancy: reduced depression 1 year after giving birth and quitting Ecstasy. Young women who used recreational drugs during pregnancy: 28 who used Ecstasy/MDMA and... | 2014 | Prospective observational cohort study | n = 96 |
| Anxiety, depression, and behavioral symptoms of executive dysfunction in ecstasy users: contributions of polydrug use. Men and women with a wide range of ecstasy use, including 17 marijuana-using controls | 2007 | Observational study | n = 65 |
Citations in the library
Cited by 25
- Are you tripping comfortably? Investigating the relationship between harm reduction and the psychedelic experience Harm Reduction Journal July 24, 2022
- Role of the gut-brain axis via the subdiaphragmatic vagus nerve in stress resilience of 3,4-methylenedioxymethamphetamine in mice exposed to chronic restrain stress. Neurobiology of Disease December 1, 2023
- Use of Lysergic Acid Diethylamide by Major Depression Status. JAMA Psychiatry 2024
- Prevalence and Correlates of Past Year Ecstasy/MDMA Use in the United States. Journal of Addiction Medicine
- Use of psychedelic treatments in psychiatric clinical practice: an EPA policy paper European Psychiatry 2025
and 20 more in the library
Cites 28
- Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial American Journal of Psychiatry August 28, 2013
- MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine June 1, 2021
- Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial Psychological Medicine June 15, 2018
- Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population. Journal of Psychopharmacology March 1, 2015
- Psychedelics and Mental Health: A Population Study PLoS One August 19, 2013
and 23 more in the library