Extended difficulties following the use of psychedelic drugs: A mixed methods study.
Level 4 - case-series / case-control
Retrospective cross-sectional survey of self-selected individuals reporting adverse outcomes (case-series design)
PubMed 37874826 · doi:10.1371/journal.pone.0293349
What was done
A convergent mixed-methods study gathered quantitative and qualitative data via self-report from 608 participants who experienced extended difficulties following psychedelic drug use. The study assessed the context of use, nature, and duration of challenges, along with perceived risk factors and causes.
What was found
The most frequently reported difficulties were anxiety, fear, existential struggle, social disconnection, depersonalization, and derealization. Problems persisted for over a year in approximately one-third of participants and for more than three years in approximately one-sixth. A shorter duration of difficulties was predicted by knowledge of drug dose, specific drug type, and lower acute difficulty during the psychoactive experience. Taking the psychedelic in a guided setting predicted a narrower range of difficulties.
Why it matters
This study provides descriptive characterization of long-term adverse psychological reactions after psychedelic use, highlighting potential risk factors and harm-reduction targets such as dose awareness and guided settings.
Limits
The sample is self-selected and restricted only to individuals who experienced difficulties, preventing estimation of true incidence or prevalence. Data rely entirely on retrospective self-report, introducing recall bias, and specific drug purity and actual dosages were not objectively verified.