The Health Outcomes of Psychedelics Use Survey (POCUS): a Nationally Representative Survey Study

About This Grant

Abstract The use of psychedelics such as psilocybin-containing mushrooms has increased dramatically in recent years, due to rapidly changing scientific evidence, public opinion, and regional policies. Although psychedelics remain Schedule I substances at the federal level, they are unevenly regulated by a patchwork of state and municipal policies. In addition to decriminalized naturalistic use, a growing number of states are creating legal frameworks for the provision of psychedelic services for adults, for any purpose. These environments differ greatly from rigorous clinical trials, where participants are highly screened and known doses of psychedelics are paired with extensive preparation and psychotherapy. Although clinical trial results for psychiatric conditions are promising, research on the use, safety, and health effects of psychedelics in community settings—where most psychedelic use occurs—remains scant. Understanding real-world trends in psychedelic use is of great public health importance given that the rapid speed at which these policies are changing far outpaces the research, with some analyses projecting over half of US states legalizing psychedelics by 2037. Drawing on our substantial expertise in conducting research focused on how and why people use psychedelics as well as associated health outcomes, our objective is to characterize national perceptions of risks and safety, use patterns, and safety outcomes associated with psychedelics. Our overarching hypotheses are: 1) interest in and use of psychedelics is rising–especially in jurisdictions with active psychedelic decriminalization policies, 2) policy changes will impact use patterns (e.g., at licensed centers vs. home) and substance sourcing (i.e., illicit vs. licit), and 3) psychedelic use impacts other drug use, either in polypharmacy or substitution contexts. To test these hypotheses, we propose two aims: 1) Conduct four annual waves of a nationally-representative, probability weighted survey (n=5,000 individuals per wave) via the National Opinion Research Center's Amerispeak Panel to characterize perceptions of harm and safety of psychedelics compared to other drugs, as well as psychedelic use prevalence, and; 2) Among individuals reporting past-year psychedelic use in Aim 1, we will further assess intention for use, use characteristics (e.g., substance used, use with or without a therapist), health outcomes (e.g., mood disorder symptoms), side effects, and impacts of psychedelic use on other substances. In both aims, we will assess relationships between existing psychedelic policies (e.g., decriminalization) and our findings. In the face of rapidly changing policies and public perception, our study will effectively monitor national trends detailing psychedelic safety in real-world contexts, how these substances are used, and their associated health outcomes, including on mood and substance use. We will directly disseminate our results to patient advocacy groups, clinicians, and policymakers, providing critical evidence to inform appropriate public health outreach and education efforts in the era of psychedelic policy reform.