Associations between lifetime classic psychedelic use and cardiometabolic diseases

Introduction

Cardiometabolic diseases such as heart disease and diabetes are major contributors to global morbidity and mortality. While traditional approaches—pharmacological treatments and intensive lifestyle programmes—can modify risk, long-term effects of classic psychedelics on cardiometabolic health have not been examined. Classic psychedelics are defined here as substances acting primarily as agonists at serotonin 2A receptors and include tryptamines (for example DMT, ayahuasca, psilocybin), the lysergamide LSD, and phenethylamines (for example mescaline and mescaline-containing cacti). Prior work has established a favourable safety profile for these compounds in psychiatric contexts and has suggested links to improved physical-health markers, including lower odds of overweight/obesity and hypertension; several mechanistic pathways are plausible, including facilitation of healthful lifestyle change, improvements in comorbid mental health, anti-inflammatory and immunomodulatory effects, and activity at serotonin receptor subtypes implicated in cardiometabolic regulation. Simonsson and colleagues set out to test whether lifetime use of classic psychedelics is associated with lower odds of two cardiometabolic outcomes: medically diagnosed heart disease in the past year and medically diagnosed diabetes in the past year. Using pooled data from the National Survey on Drug Use and Health (NSDUH) for 2005–2014, the investigators hypothesised that people reporting ever having used a classic psychedelic would show lower odds of both heart disease and diabetes within the prior 12 months.