Difficulties following naturalistic psychedelic use and associations with adverse childhood experiences
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Naturalistic psychedelic use can result in a range of difficulties that impair social, occupational, and other important areas of functioning. Yet, the prevalence, phenomenology, and etiology of these outcomes remain poorly understood. Recent qualitative research has shown that individuals with long-term difficulties after psychedelic use sometimes attribute their challenges to childhood trauma. Further studies are needed to investigate these relationships.
Methods
In this cross-sectional mixed-methods study of U.S. adults with lifetime psychedelic use (n = 3168), we examined the prevalence, duration, and nature of psychedelic-related difficulties, as well as associations with adverse childhood experiences (ACEs).
Results
Of all participants (n = 3168), most (n = 2785, 87.9 %) reported no difficulties; 6.4 % (n = 203) reported post-acute difficulties that lasted for more than one day, and 1.3 % (n = 40) for more than one year. Among those who reported difficulties (n = 383), 47 % (n = 180) reported that their difficulties resolved in one day or less. The most frequently reported post-acute difficulties were general anxiety (33.9 %), negative changes in self-concept (25.9 %), and social disconnection (23.0 %). In covariate-adjusted regression models, 2 ACEs (aOR: 2.24, p = 0.007), 3 ACEs (aOR: 2.27, p = 0.006), and ≥4 ACEs (aOR: 2.84, p < 0.001) were associated with higher odds of psychedelic-related difficulties compared to 0 ACEs. ≥4 ACEs were also associated with higher odds of difficulties that lasted more than one day (aOR: 2.37, p = 0.015) and more than one week (aOR: 2.89, p = 0.042).
Conclusion
There are a range of difficulties that can follow psychedelic use and childhood adversity may represent a risk factor for persistent adverse effects.
Naturalistic psychedelic use can result in a range of difficulties that impair social, occupational, and other important areas of functioning. Yet, the prevalence, phenomenology, and etiology of these outcomes remain poorly understood. Recent qualitative research has shown that individuals with long-term difficulties after psychedelic use sometimes attribute their challenges to childhood trauma. Further studies are needed to investigate these relationships.
Methods
In this cross-sectional mixed-methods study of U.S. adults with lifetime psychedelic use (n = 3168), we examined the prevalence, duration, and nature of psychedelic-related difficulties, as well as associations with adverse childhood experiences (ACEs).
Results
Of all participants (n = 3168), most (n = 2785, 87.9 %) reported no difficulties; 6.4 % (n = 203) reported post-acute difficulties that lasted for more than one day, and 1.3 % (n = 40) for more than one year. Among those who reported difficulties (n = 383), 47 % (n = 180) reported that their difficulties resolved in one day or less. The most frequently reported post-acute difficulties were general anxiety (33.9 %), negative changes in self-concept (25.9 %), and social disconnection (23.0 %). In covariate-adjusted regression models, 2 ACEs (aOR: 2.24, p = 0.007), 3 ACEs (aOR: 2.27, p = 0.006), and ≥4 ACEs (aOR: 2.84, p < 0.001) were associated with higher odds of psychedelic-related difficulties compared to 0 ACEs. ≥4 ACEs were also associated with higher odds of difficulties that lasted more than one day (aOR: 2.37, p = 0.015) and more than one week (aOR: 2.89, p = 0.042).
Conclusion
There are a range of difficulties that can follow psychedelic use and childhood adversity may represent a risk factor for persistent adverse effects.
Date Issued
2026-02-01
Date Acceptance
2025-12-01
Citation
International Journal of Drug Policy, 2026, 148
ISSN
0955-3959
Publisher
Elsevier
Journal / Book Title
International Journal of Drug Policy
Volume
148
Copyright Statement
© 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41389560
PII: S0955-3959(25)00401-3
Subjects
Adverse
Challenging experiences
CHALLENGING EXPERIENCES
Childhood
Life Sciences & Biomedicine
Psilocybin
PSILOCYBIN
Psychedelics
Science & Technology
Substance Abuse
Trauma
Publication Status
Published
Coverage Spatial
Netherlands
Article Number
105105
Date Publish Online
2025-12-13