This year’s PolDrugs survey is significant in two ways. First, it presents the latest demographic–epidemiological data on recreational users of psychoactive substances, which in itself is of value, as there are no similar studies on the Polish population. Moreover, the above data were collected from the same groups as the data collected in “PolDrugs 2021”, which allows for a fair comparison and evaluation of the data. However, they were collected over a longer period of time (four weeks instead of one week) and the number of responses collected was more than half the number collected in “PolDrugs 2021”. This can be explained by the fact that the data for the previous project were collected during the nationwide lockdown due to the COVID-19 pandemic, which might have led to greater activity by respondents on social media and, thus, provided more opportunity to view the survey. In addition, the fact that places associated with daily leisure activities (such as movie theaters, restaurants, and gyms) were closed may have led to more people being willing to participate in the survey.

The most surprising observation is the significant increase in the use of hallucinogenic mushrooms. In this year’s edition of PolDrugs, 57.6% of respondents reported having used hallucinogenic mushrooms in their lifetime and 42% in the past 12 months, while the figures from the 2021 edition were 42.7% and 28.9%, respectively. Thus, hallucinogenic mushrooms have overtaken amphetamines to become the third most commonly used stimulant after marijuana and MDMA, along with alcohol and nicotine. This is probably due to the increasing popularization of psychedelics in the media and the organization of various scientific and popular science conferences, including in Poland, where the first national conference on “Psychedelic Science” was held in September 2022, an interdisciplinary event organized by the Polish Psychedelic Society, the Polish Drug Policy Network, and the Faculty of Law and Administration of the University of Warsaw [6]. Media coverage on the topic is no accident, as scientific interest in the topic of psychedelics is noticeably increasing. For example, according to the PubMed Central database of medical publications from the U.S. National Institutes of Health’s National Library of Medicine, 141 publications were published on the keyword “psilocybin” in 2020, while in 2022 there were already 342 publications (data checked on 15 February 2023). Given the considerable public interest in the topic of psychedelics, as an increase in the use of DMT and a decrease in the use of LSD can be observed, the use of which remains objectively high anyway, it seems extremely important to consider comprehensive education in this area as one of the priorities in the field of public health, not only in Poland, as the topic is being covered by major international media [7,8,9]. In the survey, we asked about hallucinogenic mushrooms in the sense of psilocybin-containing mushrooms. According to the activists from the Social Drug Policy Initiative, it is reasonable to ask in the future not only about psilocybin-containing mushrooms, but also about other potentially hallucinogenic mushrooms, such as Amanita muscaria, since the activists have noticed an increase in the number of people who want to consume preparations of this type of mushrooms for recreational purposes in recent years. However, we could not find any reports on this phenomenon in the scientific literature, except for a brief report that shamans in eastern Siberia used this mushroom as an intoxicant and hallucinogen [10]. It is possible that this is a relatively new phenomenon that is just gaining momentum, and physicians may soon be confronted with its complications.

It was found that the surveyed users now most often earn more than PLN 5000, while previously the salary earnt was PLN 2000–3000. This fact can be explained by the unstable economic situation in Europe, the exchange rate of the Polish currency against the dollar and inflation, which gained momentum around the world during the COVID-19 pandemic and was accelerated by Russia’s attack on Ukraine, which led to some macroeconomic uncertainty around the world [11,12].

Interestingly, the proportion of people vaporizing tobacco has increased, while the proportion of people smoking classic cigarettes has decreased. In 2021, 37.4% of respondents resorted to classic cigarettes and 8.9% to vaporized tobacco, compared to 27.8% and 15.4% of respondents, respectively, in the current survey. It would be advisable to investigate this issue, because given the widespread marketing of such solutions in Polish stores where tobacco products can be purchased, it is doubtful that it is limited to this group of respondents. The COVID-19 pandemic may have affected the popularity of new forms of tobacco use. Many traditional cigarette stores closed or had limited hours, forcing many people to seek alternative sources of nicotine. In addition, many people who worked from home may have found themselves in a situation where they could consume heated tobacco products at home, which could have also increased their popularity. Finally, the pandemic may also have led to increased interest in health and ways to improve it, with some claiming that heated tobacco products are less harmful than conventional cigarettes, which is not clearly supported by scientific research. Little is known about the long-term health effects of tobacco vaporization. Jankowski et al. reported in their systematic review that more than half of the available data on the harms of tobacco vaporization systems come from the manufacturers, and Bravo-Gutiérrez et al. argued in their systematic review that the harms from using these devices include mechanisms that have already been reported for conventional cigarettes, as well as new mechanisms specific to these devices, concluding that these devices pose a significant public health problem and should be regulated or avoided [13,14]. Further research on heated tobacco products is important because the effects of their long-term consumption, including possible serious health risks, may still be unknown. In addition, it is important to understand the impact of their use on the younger generation, who are particularly at risk of developing a nicotine use disorder.

The results on respondents measuring the doses of their psychoactive substances before consumption or testing such substances in a laboratory or the use of colorimetric reagents seem to be comparable. The question is whether current harm reduction and drug education efforts are sufficient. The fewer the people that measure and test their substances before use, the greater the risk of accidental intoxication and the higher the social costs associated with sudden hospitalization or death. The construction of economic models that clearly describe this phenomenon could be an important tool in the discussion with decision-makers on the financing of preventive measures. This type of research should be conducted in a multidisciplinary manner, as economists have an important role to play.

The percentage of individuals most likely to use psychoactive substances in clubs and bars has increased slightly, and the percentage of those most likely to use these substances at music festivals has increased significantly (more than doubled). It is possible that this increase is due to the complete lifting of restrictions as a result of the COVID-19 pandemic. However, it is worth monitoring the situation over the next few years to see if these levels continue to change; education efforts may need to be adjusted by changing the target audiences. In addition, it is worthwhile studying the wellbeing of specific groups. Such multidirectional studies are regularly conducted and published, and should be continued in the future [15,16].

Overall, 58.3% of those surveyed this year have ever sought psychiatric treatment. In 2021, this figure was 31.9% of respondents, i.e., the percentage has almost doubled. This is alarming, but not surprising, as there is no doubt that the COVID-19 pandemic had a devastating impact on the mental health of the population [17]. The COVID-19 pandemic has affected many aspects of life, including people’s mental health. Psychoactive substance users are particularly vulnerable to emotional and psychological problems, which can be exacerbated by social isolation, limited access to medication, and difficulty in getting help. In addition, the pandemic has led to increased stress and uncertainty, which can increase the risk of addiction or lead to a relapse into mental illness for people with pre-existing health problems. All of these factors may contribute to an increase in the number of psychoactive substance users who need mental health care. In addition, there is currently a war going on at Poland’s eastern border, which is certainly not without impact on the mental wellbeing of the region’s inhabitants [18,19]. It seems important to monitor the state of mental health in the group of psychoactive substance users and conduct further research to determine the exact causes of such a phenomenon, taking into account as many factors as possible that could cause such a sharp increase.