Extended Difficulties Following the Use of Psychedelic Drugs: A Mixed Methods Study

Abstract

The long-term adverse effects of psychedelic use, which can persist for weeks, months, or even years, is a significant but relatively unexplored area in psychedelic research. Our mixed-method study gained quantitative and qualitative data from 608 participants who reported extended difficulties following psychedelic experiences. Data was gathered on the context of use, the nature and duration of the challenges they experienced (including a written description of these), plus a range of possible risk factors and perceived causes. The most common forms of extended difficulty were feelings of anxiety and fear, existential struggle, social disconnection, depersonalization and derealization. For approximately one-third of the participants, problems persisted for over a year, and for a sixth, they endured for more than three years. It was found that a shorter duration of difficulties was predicted by knowledge of dose, drug type and lower levels of difficulty reported during the psychoactive experience, while a narrower range of difficulties was predicted by taking the drug in a guided setting. Implications for psychedelic harm reduction are discussed.

Note:
Funding Information: This research was funded by Emergence Benefactors, a 501c charity based in the USA

Declaration of Interests: The authors declare that they have no conflict of interest with the funder or the subject matter.

Ethics Approval Statement: Ethical approval for the study from the University of Greenwich was gained prior to data collection commencing (application ref: 21.5.7.20). Data was collected anonymously via an online survey created in the online survey platform Qualtrics.

Keywords: psychedelics, harm reduction, integration, adverse event, psychedelic therapy, challenging experiences, difficult experiences