The Relationship Between Psychedelic Use and Alcohol Use Disorder in a Nationally Representative Sample

Psychedelic-assisted interventions are emerging as potential treatments for substance use disorders, including alcohol use disorder (AUD). While recent randomized controlled trials suggest efficacy for certain psychedelics and related compounds in treating AUD, the impact of naturalistic psychedelic use on problematic alcohol consumption remains underexplored. This study examines associations between psychedelic use and AUD in a nationally representative sample (N = 139,524). Logistic regression was used to examine the association between AUD and past-year use of LSD, MDMA, and ketamine, controlling for demographics and comorbid substance use. Past-year LSD use was significantly associated with lower odds of AUD (adjusted odds ratio [aOR] = 0.70, p = .006). However, use of MDMA (aOR = 1.17, p = .229) and ketamine (aOR = 1.28, p = .235) was not associated with AUD. In a quasi-Poisson regression analysis, past-year LSD use was found to be associated with 15.7% fewer AUD symptoms (IRR = 0.84, 95% CI: 0.72 - 0.98, p = .033), but neither past-year MDMA nor past-year ketamine use were significantly associated with AUD symptoms (MDMA: IRR = 0.97, 95% CI: 0.83 - 1.13, p = .731; ketamine: IRR = 1.21, 95% CI: 0.93 - 1.57, p = .139). Taken together, these findings indicate differential associations between specific psychedelics and AUD, with LSD use linked to a reduced risk of AUD. The results underscore the need for further research into the mechanisms by which LSD may influence alcohol use and AUD risk.