Mental health problems are endemic across the globe, and suicide, a strong corollary of poor mental health, is a leading cause of death. Classic psychedelic use may occasion lasting improvements in mental health, but the effects of classic psychedelic use on suicidality are unknown. We evaluated the relationships of classic psychedelic use with psychological distress and suicidality among over 190,000 USA adult respondents pooled from the last five available years of the National Survey on Drug Use and Health (2008–2012) while controlling for a range of covariates. Lifetime classic psychedelic use was associated with a significantly reduced odds of past month psychological distress (weighted odds ratio (OR)=0.81 (0.72–0.91)), past year suicidal thinking (weighted OR=0.86 (0.78–0.94)), past year suicidal planning (weighted OR=0.71 (0.54–0.94)), and past year suicide attempt (weighted OR=0.64 (0.46–0.89)), whereas lifetime illicit use of other drugs was largely associated with an increased likelihood of these outcomes. These findings indicate that classic psychedelics may hold promise in the prevention of suicide, supporting the view that classic psychedelics’ most highly restricted legal status should be reconsidered to facilitate scientific study, and suggesting that more extensive clinical research with classic psychedelics is warranted.

References

American Psychiatric Association ( 1994 ) Diagnostic and statistical manual of mental health disorders. 4th ed. Washington, DC : American Psychiatric Association .

Google Scholar

Baumeister, D, Barnes, G, Giaroli, G. ( 2014 ) Classical hallucinogens as antidepressants? A review of pharmacodynamics and putative clinical roles . Ther Adv Psychopharmacol 4: 156 – 169 .

Google Scholar SAGE Journals

Bhagwagar, Z, Hinz, R, Taylor, M. ( 2006 ) Increased 5-HT 2A receptor binding in euthymic, medication-free patients recovered from depression: A positron emission study with [11C] MDL 100,907 . Am J Psychiatry 163: 1580 – 1587 .

Google Scholar Crossref | Medline

Black, C, Miller, JM ( in press ) Meta-analysis of cytokines and chemokines in suicidality: Distinguishing suicidal versus non-suicidal patients . Biol Psychiatry. doi: 10.1016/j.biopsych.2014.10.014 Available online 30 October 2014

Google Scholar Crossref

Bogenschutz, MP, Pommy, JM ( 2012 ) Therapeutic mechanisms of classic hallucinogens in the treatment of addictions: From indirect evidence to testable hypotheses . Drug Test Anal 4: 543 – 555 .

Google Scholar Crossref | Medline | ISI

Borges, G, Walters, EE, Kessler, RC ( 2000 ) Associations of substance use, abuse, and dependence with subsequent suicidal behavior . Am J Epidemiol 151: 781 – 789 .

Google Scholar Crossref | Medline | ISI

Britton, PC, Conner, KR ( 2010 ) Suicide attempts within 12 months of treatment for substance use disorders . Suicide Life Threat Behav 40: 14 – 21 .

Google Scholar Crossref | Medline

Carballo, JJ, Akamnonu, CP, Oquendo, MA ( 2008 ) Neurobiology of suicidal behavior. An integration of biological and clinical findings . Arch Suicide Res 12: 93 – 110 .

Google Scholar Crossref | Medline

Carhart-Harris, RL, Erritzoe, D, Williams, T. ( 2012b ) Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin . Proc Natl Acad Sci U S A 109: 2138 – 2143 .

Google Scholar Crossref | Medline | ISI

Carhart-Harris, RL, Leech, R, Williams, TM. ( 2012a ) Implications for psychedelic-assisted psychotherapy: Functional magnetic resonance imaging study with psilocybin . Br J Psychiatry 200: 238 – 244 .

Google Scholar Crossref | Medline | ISI

Carhart-Harris, RL, Leech, R, Hellyer, PJ. ( 2014 ) The entropic brain: A theory of conscious states informed by neuroimaging research with psychedelic drugs . Front Hum Neurosci 8: 20 .

Google Scholar Crossref | Medline | ISI

Center for Substance Abuse Treatment ( 2008 ) Substance abuse and suicide prevention: Evidence and implications—A white paper. DHHHS Pub. No. SMA-08–4352. Rockville, MD : Substance Abuse and Mental Health Services Administration .

Google Scholar

Dwivedi, Y ( 2010 ) Brain-derived neurotrophic factor and suicide pathogenesis . Ann Med 42: 87 – 96 .

Google Scholar Crossref | Medline

Dwivedi, Y, Rizavi, HS, Conley, RR. ( 2003 ). Altered gene expression of brain-derived neurotrophic factor and receptor tyrosine kinase B in postmortem brain of suicide subjects . Arch Gen Psychiatry 60: 804 – 815 .

Google Scholar Crossref | Medline

Gasser, P, Holstein, D, Michel, Y. ( 2014 ) Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases . J Nerv Ment Dis 202: 513 – 520 .

Google Scholar Crossref | Medline | ISI

Gasser, P, Kirchner, K, Passie, T ( in press ) LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects . J Psychopharmacol 29: 57 – 68 .

Google Scholar SAGE Journals

Griffiths, RR, Johnson, MW, Richards, WA. ( 2011 ) Psilocybin occasioned mystical-type experiences: Immediate and persisting dose-related effects . Psychopharmacology 218: 649 – 655 .

Google Scholar Crossref | Medline | ISI

Griffiths, RR, Richards, WA, Johnson, MW. ( 2008 ) Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later . J Psychopharmacol 22: 621 – 632 .

Google Scholar SAGE Journals | ISI

Griffiths, RR, Richards, WA, McCann, U. ( 2006 ) Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance . Psychopharmacology 187: 268 – 283 .

Google Scholar Crossref | Medline | ISI

Grob, CS, Danforth, AL, Chopra, GS. ( 2011 ) Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer . Arch Gen Psychiatry 68: 71 – 78 .

Google Scholar Crossref | Medline

Hawton, K, van Heeringen, K ( 2009 ) Suicide . Lancet 373: 1372 – 1381 .

Google Scholar Crossref | Medline | ISI

Hendricks, PS, Clark, CB, Johnson, MW. ( 2014 ) Hallucinogen use predicts reduced recidivism among substance-involved offenders under community corrections supervision . J Psychopharmacol 28: 62 – 66 .

Google Scholar SAGE Journals | ISI

Johnson, MW, Garcia-Romeu, A, Cosimano, MP. ( 2014 ) Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction . J Psychopharmacol 28: 983 – 992 .

Google Scholar SAGE Journals | ISI

Johnson, MW, Richards, WA, Griffiths, RR ( 2008 ) Human hallucinogen research: Guidelines for safety . J Psychopharmacol 22: 603 – 620 .

Google Scholar SAGE Journals | ISI

Kashdan, TB, Rose, P, Fincham, FD ( 2004 ) Curiosity and exploration: Facilitating positive subjective experiences and personal growth opportunities . J Pers Assess 82: 291 – 305 .

Google Scholar Crossref | Medline

Kelley, K, Clark, B, Brown, V. ( 2003 ). Good practice in the conduct and reporting of survey research . Int J Qual Health Care 15: 261 – 266 .

Google Scholar Crossref | Medline | ISI

Kessler, RC, Andrews, G, Colpe, LJ. ( 2002 ) Short screening scales to monitor population prevalences and trends in non-specific psychological distress . Psychol Med 32: 959 – 976 .

Google Scholar Crossref | Medline | ISI

Kessler, RC, Green, JG, Gruber, MJ. ( 2010 ) Screening for serious mental illness in the general population with the K6 screening scale: Results from the WHO World Mental Health (WMH) survey initiative . Int J Methods Psychiatr Res 19: 4 – 22 .

Google Scholar Crossref | Medline | ISI

Khan, A, Chien, CW, Burton, NW ( 2014 ) A new look at the construct validity of the K6 using Rasch analysis . Int J Methods Psychiatr Res 23: 1 – 8 .

Google Scholar Crossref | Medline

Kraehenmann, R, Preller, KH, Scheidegger, M. ( in press ) Psilocybin-induced decrease in amygdala reactivity correlates with enhanced positive mood in healthy volunteers . Biol Psychiatry. doi:10.1016/j.biopsych.2014.04.010 Available online 26 April 2014

Google Scholar Crossref

Krebs, TS, Johansen, PØ ( 2012 ) Lysergic acid diethylamide (LSD) for alcoholism: Meta-analysis of randomized controlled trials . J Psychopharmacol 26: 994 – 1002 .

Google Scholar SAGE Journals | ISI

Krebs, TS, Johansen, PØ ( 2013 ) Psychedelics and mental health: A population study . PLoS One 8: e63972 .

Google Scholar Crossref | Medline | ISI

Lerner, M, Lyvers, M ( 2006 ) Values and beliefs of psychedelic drug users: A cross-cultural study . J Psychoactive Drugs 38: 143 – 147 .

Google Scholar Crossref | Medline | ISI

Lyvers, M, Meester, M ( 2012 ) Illicit use of LSD or psilocybin, but not MDMA or nonpsychedelic drugs, is associated with mystical experiences in a dose-dependent manner . J Psychoactive Drugs 44: 410 – 417 .

Google Scholar Crossref | Medline | ISI

MacLean, KA, Johnson, MW, Griffiths, RR ( 2011 ) Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness . J Psychopharmacol 25: 1453 – 1461 .

Google Scholar SAGE Journals | ISI

Meyer, JH, McMain, S, Kennedy, SH. ( 2003 ) Dysfunctional attitudes and 5-HT2 receptors during depression and self-harm . Am J Psychiatry 160: 90 – 99 .

Google Scholar Crossref | Medline | ISI

Móró, L, Simon, K, Bárd, I. ( 2011 ) Voice of the psychonauts: Coping, life purpose, and spirituality in psychedelic drug users . J Psychoactive Drugs 43: 188 – 198 .

Google Scholar Crossref | Medline | ISI

Muthukumaraswamy, SD, Carhart-Harris, RL, Moran, RJ. ( 2013 ) Broadband cortical desynchronization underlies the human psychedelic state . J Neurosci 33: 15171 – 15183 .

Google Scholar Crossref | Medline | ISI

National Action Alliance for Suicide Prevention: Research Prioritization Task Force ( 2014 ) A prioritized research agenda for suicide prevention: An action plan to save lives. National Institute of Mental Health and the Research Prioritization Task Force, Rockville , Maryland .

Google Scholar

Nichols, DE ( 2004 ) Hallucinogens . Pharmacol Ther 101: 131 – 181 .

Google Scholar Crossref | Medline | ISI

Nutt, DJ, King, LA, Nichols, DE ( 2013 ) Effects of Schedule I drug laws on neuroscience research and treatment innovation . Nature Rev Neurosci 14: 577 – 585 .

Google Scholar Crossref | Medline | ISI

Nutt, DJ, King, LA, Phillips, LD ( 2010 ) Drug harms in the UK: A multicriteria decision analysis . Lancet 376: 1558 – 1565 .

Google Scholar Crossref | Medline | ISI

Nutt, D, King, LA, Saulsbury, W. ( 2007 ) Development of a rational scale to assess the harm of drugs of potential misuse . Lancet 369: 1047 – 1053 .

Google Scholar Crossref | Medline | ISI

Rasic, DT, Belik, SL, Elias, B. ( 2009 ) Spirituality, religion and suicidal behavior in a nationally representative sample . J Affect Disord 114: 32 – 40 .

Google Scholar Crossref | Medline | ISI

Rasic, D, Robinson, JA, Bolton, J. ( 2011 ) Longitudinal relationships of religious worship attendance and spirituality with major depression, anxiety disorders, and suicidal ideation and attempts: Findings from the Baltimore epidemiologic catchment area study . J Psychiatr Res 45: 848 – 854 .

Google Scholar Crossref | Medline

Roseman, L, Leech, R, Feilding, A. ( 2014 ) The effects of psilocybin and MDMA on between-network resting state functional connectivity in healthy volunteers . Front Hum Neurosci 8: 204 .

Google Scholar Crossref | Medline | ISI

Segal, DL, Marty, MA, Meyer, WJ. ( 2012 ) Personality, suicidal ideation, and reasons for living among older adults . J Gerontol B Psychol Sci Soc Sci 67: 159 – 166 .

Google Scholar Crossref | Medline

Shelton, RC, Sanders-Bush, E, Manier, DH. ( 2009 ). Elevated 5-HT 2A receptors in postmortem prefrontal cortex in major depression is associated with reduced activity of protein kinase A . Neuroscience 158: 1406 – 1415 .

Google Scholar Crossref | Medline | ISI

Szabo, A, Kovacs, A, Frecska, E. ( 2014 ) Psychedelic N, N-dimethyltryptamine and 5-methoxy-N, N-dimethyltryptamine modulate innate and adaptive inflammatory responses through the sigma-1 receptor of human monocyte-derived dendritic cells . PLoS One 9: e106533 .

Google Scholar Crossref | Medline

Tagliazucchi, E, Carhart-Harris, R, Leech, R. ( 2014 ) Enhanced repertoire of brain dynamical states during the psychedelic experience . Human Brain Mapp 35: 5442 – 5456 .

Google Scholar Crossref | Medline

United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality ( 2009 ) National Survey on Drug Use and Health, 2008. Ann Arbor, MI : Inter-university Consortium for Political and Social Research .

Google Scholar

United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality ( 2010 ) National Survey on Drug Use and Health, 2009. Ann Arbor, MI : Inter-university Consortium for Political and Social Research .

Google Scholar

United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality ( 2011 ) National Survey on Drug Use and Health, 2010. Ann Arbor, MI : Inter-university Consortium for Political and Social Research .

Google Scholar

United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality ( 2012 ) National Survey on Drug Use and Health, 2011. Ann Arbor, MI : Inter-university Consortium for Political and Social Research .

Google Scholar

United States Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Center for Behavioral Health Statistics and Quality ( 2013 ) National Survey on Drug Use and Health, 2012. Ann Arbor, MI : Inter-university Consortium for Political and Social Research .

Google Scholar

Varnik, P ( 2012 ) Suicide in the world . Int J Environ Res Public Health 9: 760 – 771 .

Google Scholar Crossref | Medline | ISI

Vollenweider, FX, Kometer, M ( 2010 ) The neurobiology of psychedelic drugs: Implications for the treatment of mood disorders . Nature Rev Neurosci 11: 642 – 651 .

Google Scholar Crossref | Medline

Weber, SR, Pargament, KI ( 2014 ) The role of religion and spirituality in mental health . Curr Opin Psychiatry 27: 358 – 363 .

Google Scholar Crossref | Medline

Whitfield-Gabrieli, S, Ford, JM ( 2012 ) Default mode network activity and connectivity in psychopathology . Annu Rev Clin Psychol 8: 49 – 76 .

Google Scholar Crossref | Medline | ISI

Wilcox, HC, Conner, KR, Caine, ED ( 2004 ) Association of alcohol and drug use disorders and completed suicide: An empirical review of cohort studies . Drug Alcohol Depend 76: S11 – S19 .

Google Scholar Crossref | Medline