LSD and salvia divinorum use linked to an increased likelihood of depression and suicidal thinking

People who report past-year use of the psychedelic drugs LSD (more commonly known as “acid”) and salvia divinorum are more likely to report experiencing depression and/or suicidality in the same year, according to new research published in the journal Addictive Behaviors.

Some hallucinogenic substances have shown promise in the treatment of various mental health issues when combined with psychotherapy in a highly controlled setting. But studies that have examined the relationship between hallucinogenic drug use and psychiatric symptoms at the population level have produced mixed results.

The authors of the new research noted that most prior studies evaluated the lifetime use of hallucinogens. They argued that examining the past-year use of hallucinogenic drugs might allow for a more accurate analysis of potential associations.

“In the last several years, we’ve seen a huge increase in clinical research on the mental health benefits of various hallucinogens,” explained study author Kevin Yang, a 4th year medical school student and incoming psychiatry resident physician at UC San Diego.

“Most of these studies have been conducted in clinically-supervised settings with promising results. However, hallucinogens can be used in risky ways outside of medical settings, so we were interested in looking at the associations between recreational or non-clinical use of various hallucinogens and mental health outcomes on a population level.”

For their study, the researchers analyzed data collected by the 2015–2020 National Survey on Drug Use and Health (NSDUH), a nationally representative annual cross-sectional survey of non-institutionalized individuals in the United States. The sample included 241,675 adults.

As part of the survey, participants were asked about the use of AMT (α-Methyltryptamine), DMT (dimethyltryptamine), “Foxy” (5-MeO-DIPT), ketamine, LSD, salvia divinorum, and ecstasy or “Molly” (MDMA). The NSDUH also assessed whether the participants had experienced depressive symptoms or seriously considered suicide during the past 12 months.

The researchers found that several of the substances were associated with an increased risk for depression and/or suicidality.

“We found that adults who use LSD, salvia divinorum, and/or DMT/AMT/Foxy were more likely to experience depression and/or suicidality in the same year. On the other hand, the opposite was observed for ecstasy/MDMA (also known as Molly) use. This indicates that there may be different consequences of use among various hallucinogens and/or different risk factors for use outside of medical settings among adults.”

But as with any study, the new research includes some caveats. Yang and his colleagues were unable to examine past-year use of psilocybin, peyote, or mescaline because the NSDUH only asked about lifetime use of these substances. In addition, the findings are only correlational.

“Since this was a cross-sectional study, we cannot infer causality or temporality, which brings up the question of ‘the chicken or the egg,'” Yang explained. “For example, we estimated that LSD use was associated with an increased likelihood of past-year depression. Is it that LSD use causes depression or are adults experiencing depression simply more likely to use LSD (e.g., for self-medication)? This would be an important area of research to investigate further, in addition to whether the frequency or intensity of hallucinogen use might affect the associations observed.”

“In the context of increased clinical research, media attention, and even decriminalization of certain hallucinogens in cities and states throughout the United States, more research is necessary to understand the long-term effects of recreational hallucinogen use as there may be shifts in acceptance and use of these substances,” he added.

The study, “Past-year hallucinogen use in relation to psychological distress, depression, and suicidality among US adults“, was authored by Kevin H. Yang, Benjamin H. Han, and Joseph J. Palamar.

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