Past-Year Hallucinogen Use in Relation to Psychological Distress, Depression, and Suicidality among US Adults

Background

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 the use of such substances outside of medical settings relates to psychological distress, depression, and suicidality.

Methods

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.

Results

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: 1.00-1.98) 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: 0.83-0.99), and suicidal thinking (aPR=0.86, 95% CI: 0.75-0.99).

Conclusion

Findings suggest there are differences among specific hallucinogens with respect to depression and suicidality. More research is warranted to understand the consequences of and risk factors for hallucinogen use outside of medical settings among adults experiencing depression or suicidality.