Exploring psychedelic experiences among people who regularly use methamphetamine: Findings from an international...

Methamphetamine use disorder, associated with significant morbidity and mortality, has limited effective treatments. Psychedelic-assisted psychotherapy shows promise, but data on its safety and efficacy in this population are limited. This exploratory study describes the demographic, substance use, and mental health characteristics of people who used methamphetamine and psychedelics and the context and outcomes of their psychedelic experiences.

A retrospective survey collected data on demographics, substance use patterns, mental health, and psychedelic use. Binomial logistic regression explored associations of post-psychedelic positive mood and social functioning ('increased'/'not increased') and substance use ('reduced'/'not reduced') with demographics, psychosocial factors, mental health, substance use patterns, and psychedelic use context.

Among 268 participants, 48.5 % had a diagnosed mental illness, 45.1 % were at risk of suicide, 61.2 % reported psychotic symptoms, 45.1 % had high-risk methamphetamine use, and 82.1 % had taken substances other than methamphetamine and psychedelics. Most psychedelic experiences were unplanned (52.6 %), recreationally motivated (73 %), and combined with other drugs (52.6 %). Post-experience, participants reported improved mood (59.3 %) and social functioning (49.6 %), and reduced use of methamphetamine (34.0 %) and other substances (35.1 %). Forward planning and less challenging experiences were linked to improved mood (aOR 1.84, p = 0.048; aOR 2.21, p = 0.012) and reduced substance use (aOR 2.27, p = 0.008; aOR 3.58, p < 0.001).

Psychedelic use among people who use methamphetamine may improve mood and social function, and reduce substance use. The complex findings highlight the potential importance of psychosocial and environmental factors ("set and setting") in determining outcomes, underscoring the need for controlled clinical trials and tailored harm reduction strategies.