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A recent study indicates that adults who use psilocybin alongside alcohol tend to report fewer depressive symptoms than adults who consume alcohol without psilocybin. The findings, published in the Journal of Drug Issues, suggest that real-world use of magic mushrooms may be linked to lower mood distress even among individuals who drink alcohol regularly. However, the researchers emphasize that these observational patterns do not prove psilocybin directly improves mental health.
Psilocybin is a naturally occurring psychedelic compound found in certain species of mushrooms that can alter perception, mood, and consciousness. When ingested, the body breaks down psilocybin into psilocin, a compound that binds to serotonin receptors in the brain. Serotonin receptors are specialized biological structures on nerve cells that help regulate emotional processing, anxiety, and general mood stability. Scientific interest in psilocybin has grown as clinical trials demonstrate its potential to assist in treating mood disorders when administered in therapeutic settings.
In contrast to psilocybin, alcohol is one of the most widely consumed substances globally and poses substantial risks to physical and psychological health. Frequent or heavy alcohol consumption is frequently linked to negative mental health outcomes, including heightened rates of anxiety and depression. Many individuals report drinking alcohol as a coping strategy to manage negative emotions, which can inadvertently increase emotional distress over time. Because alcohol and psychedelics both influence brain pathways responsible for mood regulation, studying how they interact in everyday life represents an important area of interest.
Much of the existing medical research on psilocybin has taken place in controlled clinical settings where patients receive precise doses alongside guided therapy. Less is known about naturalistic use, which refers to how individuals choose to consume substances in their everyday lives without medical supervision. Study author Anita Cservenka, an associate professor of psychological science at Oregon State University and director of the Substance Use & Neurocognition Lab, explained the rationale for evaluating this real-world behavior.
“There has been a growing interest in psilocybin for therapeutic purposes, and previous clinical research has indicated it has potential benefits for improving mental health,” Cservenka told PsyPost. “However, studies on the naturalistic use of psilocybin and its effects on mental health are limited. Given that alcohol is one of the most widely used substances in the world, it was our aim to determine whether mental health symptoms differ between psilocybin and alcohol co-users compared to individuals who use alcohol, but do not engage in psilocybin use.”
The researchers drew their data from the 2024 National Survey Investigating Hallucinogenic Trends. This nationally representative survey monitors substance use behaviors among adults aged 18 and older living in the United States. The dataset utilized information collected across two survey periods in 2024 and applied statistical weights to align the sample demographics with the broader national population. Data quality measures were implemented to exclude participants who completed the survey too quickly or provided contradictory answers.
To participate in the current analysis, adults had to report using at least one psychedelic substance and consuming alcohol on at least 12 occasions in the past year. This filtering process yielded a total sample size of 2,841 adult participants. Within this group, 1,234 participants reported co-using psilocybin and alcohol at least once in the past year. The remaining 1,607 participants reported drinking alcohol and using other psychedelics, such as LSD or ketamine, but did not use psilocybin during that period.
Mental health symptoms were evaluated using three widely recognized self-report measurement scales. Depressive symptoms were measured with the Patient Health Questionnaire-9, which scores symptoms over the previous two weeks on a scale ranging from 0 to 27. Anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item scale, which produces total scores ranging from 0 to 21. Poor mental health days were measured by asking participants how many days in the past 30 days their mental health was not good, on a scale from 0 to 30 days.
The authors used weighted linear regression models to analyze differences in mental health scores between the two groups. A linear regression is a statistical method that helps researchers evaluate the relationship between a specific behavior and an outcome while accounting for other influences.
The primary analysis adjusted for several background variables, including participant age, sex assigned at birth, race, ethnicity, and survey collection quarter. The researchers also controlled for whether participants had used cannabis or other non-psilocybin psychedelics in the past year to isolate the specific link to psilocybin co-use.
In the fully adjusted primary model, individuals who reported using both psilocybin and alcohol demonstrated lower depressive symptoms than those who consumed alcohol without psilocybin. The psilocybin co-use group scored an average of 0.57 points lower on the 27-point depression scale compared to the non-psilocybin group, representing a small statistical effect size.
“In line with clinical findings, we hypothesized that individuals who engage in co-use would report better mental health than those who use alcohol, but do not use psilocybin,” Cservenka noted. “Our hypotheses were supported, which adds to a growing literature on the potential positive effects of psilocybin on mental health among a non-clinical population.”
No statistically significant group differences were found for anxiety symptoms or poor mental health days in this initial fully controlled model.
Cservenka noted that “these findings are from data collected in a nationally representative sample of individuals and reflect more real-world, naturalistic use than use of psilocybin solely for therapeutic purposes.”
Secondary analyses were conducted after removing statistical controls for cannabis and other psychedelic drug use. This secondary approach allowed the researchers to examine real-world behavioral patterns without stripping away the influence of other commonly co-used substances. In this unadjusted substance model, the psilocybin co-use group showed lower depressive symptoms, scoring 1.08 points lower on the 27-point scale than non-users. Participants co-using psilocybin also scored 0.67 points lower on the 21-point anxiety scale, though poor mental health days remained similar between groups.
Exploratory analyses further evaluated how the frequency of psilocybin consumption related to mental health indicators. Participants were categorized into low-frequency users, who took psilocybin once or several times a year, and high-frequency users, who consumed it monthly, weekly, or daily.
When excluding cannabis and other psychedelic controls, the lower levels of depression and anxiety were primarily driven by low-frequency psilocybin co-use. Individuals who did not use psilocybin scored 1.17 points higher on depression and 0.73 points higher on anxiety compared to low-frequency users, whereas low-frequency and high-frequency users did not differ significantly from one another.
This pattern regarding consumption frequency was an unexpected outcome for the research team. “We were surprised to see that when we examined whether frequency of psilocybin use had an effect on the findings, low, rather than high frequency psilocybin use among those who use alcohol was associated with lower depression and anxiety symptoms compared to individuals who use alcohol without psilocybin use,” Cservenka shared. “This suggests that lower frequency psilocybin use appears to be driving the beneficial effects observed in the current study.”
As with all research, there are some limitations. A key aspect of the dataset is that it did not include any substance-naive individuals, a term researchers use to describe people who have never used drugs or alcohol. Cservenka highlighted these methodological constraints to help readers contextualize the findings.
“Several study limitations should be considered. Given the cross-sectional nature of the data, we cannot make causal conclusions,” Cservenka stated. “Longitudinal studies will be needed to determine the directionality of the relationship between psilocybin use and mental health. We did not have measures of psilocybin or alcohol use quantity, so we don’t know how different patterns of consumption may be related to these findings. Finally, there was no substance-naive group in this dataset, so we cannot determine if depression or anxiety symptoms differ between substance-naive individuals and the groups in the current study.”
The reliance on self-reported survey data also introduces potential recall errors, as participants may struggle to accurately remember their drug use over a 12-month period. Additionally, because the survey did not measure the specific dosages consumed, researchers could not distinguish between individuals taking small sub-perceptual microdoses and those taking large macrodoses. Mindset, physical setting, mushroom strain, and exact alcohol consumption volumes were similarly unmeasured.
To build upon these preliminary results, the authors outlined several key avenues for prospective research. Tracking participants longitudinally across extended timeframes will be essential to establish whether psilocybin use precedes improvements in mood or whether individuals with better mental health are simply more inclined to use psychedelics. Cservenka detailed the specific priorities her research team plans to focus on in future projects.
“We hope to conduct studies to understand motives for psilocybin use, adverse reactions or negative experiences related to use, and how different doses of psilocybin use are related to mental health symptoms,” Cservenka said. Understanding these individual motives and experiences will help public health experts determine how naturalistic psilocybin use differs from therapeutic settings.
The study, “Past-Year Psilocybin and Alcohol Co-Use: Associations With Mental Health Symptoms,” was authored by Haley M. Hummel, Alexia N. Obrochta, David C. R. Kerr, and Anita Cservenka.