Prevalence and epidemiological associates of novel psychedelic use in the United States adult population

Abstract

Background: Novel psychedelics approximate classic psychedelics, but unlike classic psychedelics, novel psychedelics have been used by humans for a shorter period of time, with fewer data available on these substances. Aims: The purpose of this study was to determine the prevalence of novel psychedelic use and the associations of novel psychedelic use with mental health outcomes. Methods: We estimated the prevalence of self-reported, write-in lifetime novel psychedelic use and evaluated the associations of novel psychedelic use with psychosocial characteristics, past month psychological distress, and past year suicidality among adult respondents pooled from years 2008–2016 of the National Survey on Drug Use and Health (weighted n=234,914,788). Results: A fraction (weighted n=273,720; 0.12%) reported lifetime novel psychedelic use. This cohort tended to be younger, male, and White, have greater educational attainment but less income, be more likely to have never been married, engage in self-reported risky behavior, and report lifetime illicit use of other drugs, particularly classic psychedelics (96.9%). (2-(4-Bromo-2,5-dimethoxyphenyl)ethanamine) (2C-B) (30.01%), (2,5-dimethoxy-4-iodophenethylamine) (2C-I) (23.9%), and (1-(2,5-dimethoxy-4-ethylphenyl)-2-aminoethane) (2C-E) (14.8%) accounted for the majority of lifetime novel psychedelic use. Although lifetime novel psychedelic use was not associated with psychological distress or suicidality compared to no lifetime novel psychedelic use or classic psychedelic use, relative to lifetime use of classic psychedelics but not novel psychedelics, lifetime novel psychedelic use was associated with a greater likelihood of past year suicidal thinking (adjusted Odds Ratio (aOR)=1.4 (1.1–1.9)) and past year suicidal planning (aOR=1.6 (1.1–2.4)). Conclusion: Novel psychedelics may differ from classic psychedelics in meaningful ways, though additional, directed research is needed.

Population Survey Data Informing the Therapeutic Potential of Classic and Novel Phenethylamine, Tryptamine, and Lysergamide Psychedelics

“…"; variable MHSUITRY; yes = 1 or no = 0) with the following independent variables: lifetime use of classic phenethylamines (yes = 1 or no = 0), lifetime use of classic tryptamines (yes = 1 or no = 0), lifetime use of classic lysergamides (yes = 1 or no = 0), lifetime use of novel phenethylamines (yes = 1 or no = 0), lifetime use of novel tryptamines (yes = 1 or no = 0), and lifetime use of novel lysergamides (yes = 1 or no = 0; all independent variables were entered simultaneously). Consistent with prior analyses making use of NSDUH data (8,15), the following covariates were included in the regression models to control for potential sources of confounding: age in years (12-17, 18-25, 26-34, 35-49, 50-64, or 65 or older); sex (male or female); ethnoracial identity (non-Hispanic White, non-Hispanic African American, non-Hispanic Native American/Alaska Native, non-Hispanic Native Hawaiian/ Pacific Islander, non-Hispanic Asian, non-Hispanic more than one race, or Hispanic); educational attainment (5th grade or less, 6th grade, 7th grade, 8th grade, 9th grade, 10th grade, 11th grade, 12th grade, freshman college year, sophomore or junior college year, or senior college year or more); annual household income (less than $20,000, $20,000-$49,999, $50,000-$74,999, or $75,000 or more); marital status (married, divorced/separated, widowed, or never married); self-reported engagement in risky behavior ("How often do you like to test yourself by doing something a little risky? "; never, seldom, sometimes, or always); and lifetime use of cocaine, other stimulants, sedatives, tranquilizers, heroin, pain relievers, marijuana, phencyclidine, 3,4-methylenedioxymethamphetamine (MDMA/ecstasy), and inhalants (each aforementioned drug category coded as separate covariates).…”

“…Respondents reporting they had ever, even once used DMT (code 616 from variables HALNEWA, HALNEWB, HALNEWC, HALNEWD, HALNEWE = 1), ayahuasca (an admixture that contains DMT; code 6103 from variables HALNEWA, HALNEWB, HALNEWC, HALNEWD, HALNEWE = 1), or psilocybin (PSILCY2 = 1 and code 604 from variables HALNEWA, HALNEWB, HALNEWC, HALNEWD, HALNEWE = 1) were coded as positive for lifetime classic tryptamine use. Respondents who reported using LSD (LSDFLAG = 1, and code 601 from variables HALNEWA, HALNEWB, HALNEWC, HALNEWD, HALNEWE = 1) were coded positive for lifetime classic lysergamide use, whereas those reporting they had never used any of the aforementioned substances were coded as negative for each respective drug category (8,9,15). Respondents were given the option to write-in other "hallucinogens" they had used, and novel psychedelics were gathered from write-in responses as per Sexton et al (15).…”

“…Respondents who reported using LSD (LSDFLAG = 1, and code 601 from variables HALNEWA, HALNEWB, HALNEWC, HALNEWD, HALNEWE = 1) were coded positive for lifetime classic lysergamide use, whereas those reporting they had never used any of the aforementioned substances were coded as negative for each respective drug category (8,9,15). Respondents were given the option to write-in other "hallucinogens" they had used, and novel psychedelics were gathered from write-in responses as per Sexton et al (15). Table 1 lists both classic and novel psychedelic compounds and their classification for the purposes of this analysis.…”

“…2,5-Dimethoxy-4-"X"-phenethylamine or 2C-X, N-Benzyl Derivatives or NBOME's) accounted for the majority of novel drug mentions in the National Survey on Drug Use and Health (NSDUH) (14), suggesting naturalistic use of these substances is on the rise. One population-level analysis found that lifetime novel psychedelic use is rare, accounted for primarily by phenethylamines, and associated with an increased likelihood of past month psychological distress and past year suicidality relative to lifetime use of classic psychedelics only (15). This suggests that novel psychedelics may be distinct from and carry reduced therapeutic potential relative to classic psychedelics.…”

“…Exploring the therapeutic potential of classic and novel phenethylamine, tryptamine, and lysergamide psychedelics is relevant considering that psychedelic research is experiencing a modest but growing resurgence. Whereas almost all contemporary research is accounted for by ayahuasca, LSD, and psilocybin (16), there are hundreds of novel psychedelic compounds that might have clinical utility (17,18), with population-based survey respondents reporting the use of over 40 such compounds (15). Winnowing down this extensive list of psychedelic substances to those most likely to carry therapeutic benefit would help direct future study.…”