Classic psychedelic and cannabis use among U.S. cancer survivors aged ≥ 50 years: nationally representative estimates...

To examine the prevalence of lifetime ("ever") cannabis and classic psychedelic use, and their co-use among U.S. adults aged ≥ 50 years with versus without a lifetime history of cancer, and to describe variation by cancer type/site among survivors.

We analyzed pooled 2015-2019 and 2021-2022 National Survey on Drug Use and Health (NSDUH) data of U.S. adults aged ≥ 50 years (Unweighted; n = 42,815 for 2015-2019; n = 21,144 for 2021-2022). Lifetime cannabis and classic psychedelic (LSD, psilocybin, peyote/mescaline) use and cancer history (physician-diagnosed, self-reported) were assessed. Weighted prevalence estimates and 95% CIs were computed, and subgroup analyses by cancer type/site were conducted.

Between 2015 and 2019, cannabis use was similar among cancer survivors (41.6%, 95% CI 40.0-43.2) and individuals without cancer (42.6%, 95% CI 42.0-43.2, p = 0.21). LSD (8.9, 95% CI 8.1-9.7 vs 10.3, 95% CI 9.8-10.8) and psilocybin (6.4, 95% CI 5.6-7.3 vs 7.7, 95% CI 7.4-8.1) were lower among cancer survivors. Any classic psychedelic use was 11.6% (95% CI 10.6-12.5) among cancer survivors versus 12.9% (95% CI 12.4-13.3) among those without cancer (p < 0.01). Lifetime use of both cannabis and classic psychedelics was lower in cancer survivors (11.2%, 95% CI 10.3-12.1) than in individuals without cancer (12.6%, 95% CI 12.2-13.1, p < 0.01). Between 2021 and 2022, overall group differences were not statistically significant. Across both periods, prevalence varied by cancer type/site, with head and neck, cervical, and hepatobiliary/pancreatic cancer survivors having the highest co-use.

Lifetime cannabis, classic psychedelic, and co-use patterns showed modest differences by cancer history and meaningful variation across cancer type/site. Overall, these findings suggest that substance use patterns among cancer survivors are not uniform and may differ across survivor subgroups.