Examining associations between MDMA/ecstasy and classic psychedelic use and impairments in social functioning in a U.S. adult sample
In a nationally representative US sample (N = 214,505), lifetime MDMA/ecstasy use was associated with lower odds of three of four past‑year social‑functioning impairments (difficulty dealing with strangers, difficulty participating in social activities, and being prevented from participating), and lifetime mescaline use was associated with lower odds of difficulty dealing with strangers, whereas other substances showed no protective association or higher odds. These cross‑sectional findings cannot establish causality and indicate the need for experimental studies to test whether MDMA or mescaline can causally improve social functioning.
Abstract
Impairment in social functioning is a common source of morbidity across many mental health disorders, yet there is a dearth of effective and easily implemented interventions to support social functioning. MDMA/ecstasy and classic psychedelics (psilocybin, LSD, peyote, mescaline) represent two potential treatments for impairments in social functioning, as evidence suggests these compounds may be supportive for alleviating social difficulties. Using a nationally representative sample of U.S. adults from the National Survey on Drug Use and Health (2015–2019) (N = 214,505), we used survey-weighted multivariable ordinal and logistic regression to examine the associations between lifetime use of the aforementioned compounds and impairments in social functioning in the past year. Lifetime MDMA/ecstasy use was associated with lowered odds of three of our four social impairment outcomes: difficulty dealing with strangers (aOR 0.92), difficulty participating in social activities (aOR 0.90), and being prevented from participating in social activities (aOR 0.84). Lifetime mescaline use was also associated with lowered odds of difficulty dealing with strangers (aOR 0.85). All other substances either shared no relationship with impairments in social functioning or conferred increased odds of our outcomes. Future experimental studies can assess whether these relationships are causal.
Research Summary of 'Examining associations between MDMA/ecstasy and classic psychedelic use and impairments in social functioning in a U.S. adult sample'
Introduction
Impairments in social functioning are a prominent source of morbidity across many mental health disorders and contribute substantially to societal burden, yet treatments that effectively and easily improve social functioning are limited. Previous experimental and clinical research suggests that MDMA/ecstasy and classic psychedelics (psilocybin, LSD, peyote, mescaline) have prosocial effects and may reduce social difficulties; MDMA in particular has been linked to increased sociability, disinhibition, fear extinction and has shown efficacy in MDMA-assisted psychotherapy for PTSD. A meta-analysis of controlled experimental studies reported a moderate-to-large effect of MDMA on self-reported sociability-related measures. Jones and colleagues set out to examine whether lifetime use of MDMA/ecstasy and selected classic psychedelics is associated with impairments in social functioning in a large, nationally representative sample of U.S. adults. The study aimed to test for protective or harmful associations in naturalistic use data, using population survey measures of social functioning and controlling for demographic and other substance-use covariates. This investigation seeks to inform whether observed population-level associations warrant further experimental study to test causality and mechanisms.
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Study Details
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Jones, G., Lipson, J., & Wang, E. (2023). Examining associations between MDMA/ecstasy and classic psychedelic use and impairments in social functioning in a U.S. adult sample. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-29763-x
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