Longitudinal associations between psychedelic use and meditation practices in the United States and the United Kingdom

Meditation has been extensively investigated, with mindfulness meditation—practices designed to cultivate non-judgemental, present-moment awareness—being the most studied. There is also a growing literature on loving-kindness and compassion practices, which aim to cultivate positive emotions toward oneself and others; these traditions target different psychological processes but both report benefits for mental health. Previous work indicates that the amount of meditation practice yields small but meaningful effects on outcomes, yet many people face psychological barriers (for example, low perceived benefit) that limit regular practice. Non-pharmacological adjuncts such as neurofeedback have been explored to support practice, and recent research has raised the possibility that psychedelics may similarly facilitate meditation engagement. Simonsson and colleagues note limitations in the existing evidence — much of it cross-sectional or limited to specialised samples — and therefore set out to examine longitudinal associations between self-reported psychedelic use and subsequent meditation practice in broadly representative samples of adults in the United States and the United Kingdom. The primary hypothesis was that respondents who reported psychedelic use during a 2-month study period would show greater increases in days per week of mindfulness meditation and loving-kindness/compassion meditation than those who did not. Exploratory analyses considered whether the subjective experience of psychological insight during the most intense psychedelic episode predicted increases in meditation practice, and whether baseline meditation practice predicted less severe challenging psychedelic experiences.

The investigators implemented a preregistered longitudinal observational design with baseline (T1) and follow-up (T2) surveys approximately two months apart (August to October 2022). Participants were recruited via Prolific Academic and stratified to reflect the US and UK adult populations on sex, age, and ethnicity. The baseline sample comprised 9,732 adults (US N = 4,867; UK N = 4,865) aged 18 or older. Recruitment materials did not mention psychedelics to reduce self-selection bias. The baseline and follow-up surveys included demographics, lifetime and recent substance use, psychedelic use during the study period, and measures of meditation practice. Participants received modest payments for completing each survey. Psychedelic use assessments queried lifetime use of substances such as ayahuasca, DMT, LSD, mescaline, peyote, San Pedro, and psilocybin, and whether any psychedelic was used in the preceding 2 months. Those reporting psychedelic use during the study period provided a retrospective rating of dose (categorical) for their most intense experience and completed two standardised instruments about that episode: the Psychological Insight Questionnaire (PIQ), assessing subjective psychological insight on a 0–5 Likert scale (total score = mean of items; Cronbach's alpha = 0.97), and the Challenging Experiences Questionnaire (CEQ), assessing difficult acute experiences (0–5 scale; alpha = 0.97). Meditation measures distinguished mindfulness meditation and loving-kindness/compassion meditation. At baseline, respondents who had ever tried each practice estimated lifetime hours of practice using ordinal categories and reported days of practice in the past week (0–7); those who had never tried a practice were coded as 0 days. At follow-up, all respondents reported days of practice in the past week (0–7). The past-week reference period was chosen to increase the likelihood of detecting post-psychedelic changes. Statistical analysis followed the preregistration: multiple linear regression models compared change scores in past-week days of meditation between those who did versus did not report psychedelic use in the 2-month period, adjusting for age, gender, educational attainment, religiosity, political affiliation, past-2-month use of a range of other substances at T2, and psychedelic use in the past 2 months at T1. Sensitivity analyses used zero-inflated negative binomial models. Exploratory regressions among the subsample reporting psychedelic use tested associations of PIQ scores with changes in meditation practice, and whether baseline meditation predicted severity of challenging experiences (CEQ), controlling for similar covariates plus dose and lifetime substance use as appropriate. Missing T2 data were handled with Multivariate Imputation by Chained Equations (MICE), using random forest imputations across 20 datasets and pooling results.

Of the 9,732 baseline respondents, 7,667 completed the follow-up survey (79% retention). One hundred follow-up respondents (1.3% of completers) reported psychedelic use during the 2-month study period. Descriptive comparisons indicated that among those who used psychedelics during the study period, 36% had never tried mindfulness meditation before baseline and 66% had never tried loving-kindness or compassion meditation; these proportions were lower than among non-users (59% and 89% respectively), indicating that psychedelic users were more likely to have prior meditation experience. In preregistered, covariate-adjusted multiple linear regression models, psychedelic use during the 2-month study period was associated with greater increases in days per week of mindfulness meditation. The paper reports an unstandardised coefficient of B = 0.40 with p = 0.004 for the association between psychedelic use and change in mindfulness practice. No significant association was observed between psychedelic use and change in days of loving-kindness or compassion meditation in the primary analyses; sensitivity analyses produced broadly similar results. Among the 100 respondents who reported psychedelic use in the study period, exploratory adjusted models found that higher PIQ (greater subjective psychological insight during the most intense psychedelic experience) was associated with greater increases in days per week of both mindfulness and loving-kindness/compassion meditation (reported B = 0.42, p = 0.021 for mindfulness; B = 0.38, p = 0.017 for loving-kindness/compassion). In exploratory analyses testing whether baseline meditation practice predicted the severity of challenging experiences, more days of loving-kindness or compassion practice at baseline were associated with lower severity of subjective feelings of death or dying during the most intense psychedelic experience (B = -0.29, p = 0.037). No other reliable associations between baseline meditation practice and overall severity of challenging psychedelic experiences were observed. The authors note that the exploratory findings would not have survived Bonferroni-type correction for multiple comparisons.

Simonsson and colleagues interpret the findings as consistent with the hypothesis that psychedelic use may facilitate greater engagement with mindfulness meditation: psychedelic use in the 2-month window predicted a modest increase in the number of days participants practised mindfulness. They suggest several potential mechanisms, including reduced perceived barriers to meditation, provision of a transient phenomenological reference of non-judgemental present-moment awareness that could orient future practice, and the role of psychological insight during psychedelic episodes in highlighting unhelpful patterns that impede meditation. The absence of a main effect for loving-kindness or compassion meditation is discussed in light of prior research and possible explanations. The investigators propose that either a larger sample would be required to detect effects for this less commonly practised form, or that standard psychedelic experiences may not reliably evoke phenomenological states similar enough to loving-kindness or compassion meditation to prompt uptake. They note that MDMA—associated with positive interpersonal emotions—could be more relevant to changes in loving-kindness practice and suggest it as a focus for future studies. The authors highlight a potentially protective role for pre-existing loving-kindness or compassion practice: more days of such practice at baseline were associated with reduced severity of subjective feelings of death or dying during intense psychedelic experiences. They propose that the positive emotions cultivated by these practices may serve as internal psychological support during challenging episodes. Limitations acknowledged by the study team include sample representativeness beyond the stratified variables (income and education may differ), potential unmeasured confounding (for example personality or mental health motivations), attrition bias given the 79% retention rate, reliance on retrospective self-report for substance use and meditation practice, and a measurement inconsistency whereby only respondents who reported prior meditation at baseline were asked about past-week practice at T1 whereas all respondents answered this question at T2. The authors also caution that exploratory results did not survive correction for multiple comparisons and that causal inference is precluded by the observational design; they recommend randomised controlled trials and further mechanistic work to evaluate causal pathways and to test whether psychedelics might be used to support sustained engagement with meditation-based interventions.