The most comprehensive survey on psychedelic drug use to date has provided valuable insights into the frequency, reasons, and experiences associated with psychedelic use in Canada. The extensive findings, published in the journal Psychedelic Medicine, have the potential to inform future clinical studies and policy debates surrounding these substances.
There has been a growing interest in exploring the therapeutic potential of psychedelic drugs for various mental health conditions. However, due to legal restrictions and tight regulations on research involving these drugs, clinical studies have been limited since the mid-1960s.
The researchers were motivated to investigate the real-world use of psychedelic drugs in Canada because there is limited data available on this topic. They wanted to understand patterns, access, and experiences of psychedelic drug use among people who use these substances.
“As a community-based researcher, I’ve come to learn that consumers hold tremendous knowledge on how to reduce the potential harms and maximize the benefits of substance use,” said study author Philippe Lucas, the president of SABI Mind. “Ultimately, nearly everything we know about psychedelic substances we have learned because consumers using them in non-clinical settings have shared the positive and negative outcomes of their use, and now science is working hard to catch up via clinical trials.”
“However, there remain many gaps in the understanding of psychedelic use that only Real World Evidence of naturalistic patterns of use can help us understand, including optimization of set and setting, the co-use of psychedelics and other substances, peak positive and negative experiences, and self-reported therapeutic benefits. Informed by the principles of harm reduction/benefit maximization and cognitive liberty, my goal is to translate the voice and expertise of psychedelic consumers into data that can impact policy and improve safe, legal access.”
To conduct the study, Lucas and his colleagues developed a 655-question survey in collaboration with clinicians and academic researchers. The survey focused on 11 common psychedelic drugs, including MDMA, LSD, psilocybin, and others. They collected data on various aspects such as sociodemographic characteristics, general drug use, psychedelic drug-specific use, motivations for use, access sources, and intense positive and challenging psychedelic experiences.
The survey was distributed online from January 14 to 28, 2022, through NGOs, social media, and other channels. To participate, respondents had to be 19 years or older, have past or current use of psychedelic drugs, and be able to read, write, and speak English. The survey collected anonymous data, but participants had the option to provide an email address for a chance to win compensation.
The final sample of 2,384 individuals. The sample consisted of 56.2% women, and the average age of respondents was 38.4 years. Among the respondents, 85.8% provided information about past or current use of a specific psychedelic drug. Over 90% of the sample had used a dose of psychedelic drugs high enough to produce a “trip,” while 6.6% reported using microdoses. Psilocybin was the most commonly used psychedelic drug, followed by MDMA and LSD. Ibogaine was the least used psychedelic drug.
The main motivations reported for using psychedelic drugs were for fun, spiritual or personal exploration, mental well-being, and personal growth. Some respondents also reported using psychedelic drugs to reduce the use of prescription or nonprescription substances.
Regarding the experiences of respondents who had used psychedelics, about 82% of them reported having intense positive experiences, feeling a sense of connectedness. However, over half of the respondents (52%) also had intense challenging experiences, which included confronting difficult emotions, social paranoia, or troubling hallucinations. These challenging experiences posed existential threats to some participants, with concerns about not being the same or fearing death.
Interestingly, despite the challenging experiences, 55% of respondents found some good emerging from them. This included resolving challenging situations or emotions, gaining insights, overcoming personal fears, addressing trauma, and experiencing ego death. The study suggests that finding value in the challenging aspects of a psychedelic experience can serve as a coping and integration mechanism.
The researchers also observed that the motivations for using psychedelics influenced the type of experiences individuals had. Personal exploration was associated with intense positive experiences, while managing trauma, reducing substance use, and boredom were associated with intense challenging experiences.
“To the best of our knowledge, the Canadian Psychedelic Survey was the most comprehensive observational study of psychedelic use to date, and we were fortunate to gather a tremendous amount of granular data on patterns of psychedelic use, set and setting, and the co-use of other substances that may inform future policy developments,” Lucas told PsyPost.
“We gathered detailed patterns of use for 11 common psychedelic substances, and from my point of view the most striking finding is how individualistic psychedelic use is, which resists broad generalizations regarding what the impacts of micro or macro psychedelic use might be. Despite similarities in the pharmacokinetics of many psychedelics, patterns of use and associated outcomes differed considerably across substances and individual respondents, but overall most respondents reported a positive relationship with psychedelics.”
The majority of respondents who used drugs like 2C-B, ketamine, LSD, MDMA, mescaline, nitrous oxide, psilocybin, and salvia divinorum preferred to use these drugs with other people. They would typically take these drugs when they were with friends or companions. When it came to using DMT, some people used it with friends (35.5%), while others had someone who was not using the drug supervise their experience (35.0%).
A significant number of people who used salvia divinorum also preferred to use it with a friend who was not using the drug. On the other hand, ibogaine was most commonly used with the presence of an unlicensed therapist, shaman, or trip guide.
“I was fascinated to learn that some consumers report microdosing salvia divinorum or nitrous oxide, neither of which are commonly reported in the current academic literature,” Lucas said. “Additionally, we found that patterns of co-use of psychedelics and substances like alcohol and cannabis is extremely substance and setting-specific, with high rates of co-use with MDMA and psilocybin when the intent was recreational, and practically no co-use with ayahuasca or ibogaine which are typically used for either therapeutic purposes or spiritual development, or in some cases specifically to reduce the use of other substances.”
“This information may inform the development of harm reduction strategies focused on adjunct substances like alcohol rather than the psychedelics themselves, most of which are comparatively safer than many other licit and illicit substances.”
The researchers acknowledged some limitations, such as the self-selected sample and potential over-representation of people with positive experiences. Further investigation is needed to explore factors like frequency of use and social/environmental settings to better understand psychedelic experiences.
“Survey studies like CPS certainly have a number of limitations, including the potential for recruitment and recall bias, the lack of biological confirmation of substance use/non-use, and the inability to assign causality to self-reported positive or negative outcomes,” Lucas explained. “Additionally, since most of this psychedelic use involved unregulated sources and supply, it is very probable that some of the reported substances may have been contaminated or adulterated in some form or another.”
“However, the study also benefits from a very large cohort of respondents, and a detailed, consumer-centred, multidisciplinary approach. Nonetheless, it would be fantastic to have comparative data on psychedelic use from other jurisdictions as well, which is why we recently launched the Global Psychedelic Survey (GPS), which polled English-speaking adult psychedelic users from around the globe.
“GPS is co-sponsored by MAPS, SABI Mind, Mind Medicine Australia, and Tiny, and gathered data from over 7,000 international respondents at the end of May,” Lucas said. “We’re now analyzing this data in order to improve our understanding of cross-jurisdictional differences in patterns of psychedelic use around the globe. Ultimately, my goal is to run GPS every two years to assess the impact of international policy developments on consumers and patterns of use, and to translate the survey into additional languages to broaden the reach and scope of responses in future iterations of the survey.”
“I’d like to thank all the psychedelic consumers in Canada and around the world that took the time to share their experiences and expertise with us by participating in CPS/GPS, my co-investigator Stephanie Lake PhD (UCLA) and the many academic colleagues from Canada, the U.S. and abroad that contributed to the design and success of these broad surveys of global psychedelic use, and PsyPost for your interest in this work and research. To learn more about CPS/GPS, please check out www.sabimind.com; we look forward to sharing additional outcomes from these two important ecological studies of psychedelic use in the coming months!”
The study, “The Canadian Psychedelic Survey: Characteristics, Patterns of Use, and Access in a Large Sample of People Who Use Psychedelic Drugs“, was authored by Stephanie Lake and Philippe Lucas.
