Perspectives on Trauma Treatment, Self-Management Strategies, and Attitudes Toward Psychedelic Therapies in Individuals with Psychological Trauma Symptoms
1The Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
2South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
3Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Brain Health Center, Atlanta, United States
4King’s Centre for Military Health Research, King’s College London, UK
5Department of Psychology, University of Bath, Claverton Down, Bath, UK
Corresponding author: Nadav Liam Modlin, e-mail: nadav.modlin@kcl.ac.ukAbstract
Background:
Current trauma treatment options often fail to meet patients' needs. Despite the availability of established interventions, many trauma treatments fail to adequately meet patients’ needs. In parallel, there has been renewed scientific and public interest in the therapeutic potential of psychedelics and related compounds, accompanied by increasing unsupervised use. This underscores the need to examine patients’ willingness to engage with these therapies should they receive regulatory approval and to better characterize patterns of self-administration in order to inform patient-centered care and harm reduction strategies.
Methods:
An online survey recruited individuals with self-reported trauma symptoms or a formal diagnosis of post-traumatic stress disorder (PTSD)/complex post-traumatic stress disorder (CPTSD). Participants were asked about their treatment history, satisfaction with current treatments, and use of illicit substances for symptom management. Further, after receiving psychoeducation on 3,4-methylenedioxymethamphetamine (MDMA) and psilocybin therapies, participants’ perceptions and willingness to participate in these treatments were assessed.
Results:
Of the 873 respondents, 94.8% reported experiencing psychological trauma, with 73.4% diagnosed with PTSD or CPTSD. Many had attempted multiple treatments, predominantly medications and various psychotherapies, but reported high dissatisfaction. Significant rates of marijuana, psychedelics, and MDMA use for self-management of trauma symptoms were reported, with minimal physical and psychological complications. Willingness to try MDMA and psilocybin therapies was high (0.81 and 0.83, respectively). Notably, women and heterosexual individuals showed lower willingness, while younger respondents and those with higher education levels showed greater willingness to try these treatments.
Conclusion:
High willingness to try MDMA and psilocybin therapies among trauma-exposed individuals highlights the need for further research and clinical trials. Understanding demographic variations in willingness can guide the development of accessible and effective treatment options for PTSD and CPTSD. Public education about potential risks and harm reduction strategies is crucial to promote safe and informed use of these emerging therapies.
Boxed Text
Main Points
- Dissatisfaction with standard treatments: Participants engaged in a median of 4 treatment modalities (Q1–Q3 = 3–5), most often medications (72.7%) and psychotherapy (44.4%). Nearly 60% were dissatisfied, and over half (50.6%) said treatments met only “a few” of their needs.
- High self-management using illicit substances: 41.7% reported using illicit substances, most commonly marijuana (38.5%), psychedelics (26.0%), and MDMA (23.5%). Psychedelics and MDMA were rated highly effective (median = 0.91 and 0.76) with most users reporting no or minimal complications.Strong willingness for psychedelic therapies: Median willingness scores (≥0.75, n ≈ 520–537) to join MDMA- and psilocybin-assisted therapy trials or access treatment if approved were high. Younger age, higher education, bisexual identity, and male gender predicted greater willingness; women and heterosexual participants were less willing.Need for harm reduction and equity: Trauma-informed harm reduction, public education, stigma reduction, and targeted outreach to less willing groups are essential, given current self-use trends.
- Policy and implementation priorities: Healthcare systems should prepare for possible future implementation of psychedelic-assisted therapies—if approved—through clinician training, trauma-informed protocols, accessible delivery models, and safety monitoring.
Introduction
Lifetime trauma exposure is widespread1,2 and may lead to serious adverse health outcomes and psychosocial dysfunction3 including complex post-traumatic stress disorder or post-traumatic stress disorder (CPTSD/PTSD), personality and affective disorders, and suicidal ideation.4 Recommended first-line psychotherapies in traumatic-stress are exposure-based, cognitive behavioral therapies (CBTs) such as prolonged exposure, trauma-focused CBT and Eye Movement Desensitization and Reprocessing (EMDR).5 Despite their effectiveness, many patients do not improve, and dropout rates are high.6 Despite small effect sizes and unfavorable side effects, selective serotonin reuptake inhibitors sertraline and paroxetine, are recommended in PTSD7 with the treatment aimed primarily at symptomatic management. Taken together, there is an urgent need to develop new treatment paradigms for this common and highly disabling disorder.8 Correspondingly, there has been a resurgence in scientific inquiry exploring the therapeutic application of classical psychedelics and 3,4-methylenedioxy-methamphetamine (MDMA) for PTSD treatment.9,10,11 Within these medically supervised clinical trials, participants are medically screened, and psychedelics are delivered alongside psychological support or psychotherapy, including the provision of preparation and integration sessions.12
Due to the dearth of efficacious treatments, individuals afflicted with trauma-related conditions may pursue alternative therapeutic modalities and self-management approaches. Within illegal psychoactive substances, despite the lack of robust evidence demonstrating the causal positive effects of cannabis preparations in PTSD cannabis is widely perceived to hold some therapeutic value.13 Further, recent evidence suggests increasing use of psychedelics to help manage adverse mental and physical health conditions,14 and for self and spiritual development purposes.15 In online surveys and qualitative studies investigating self-medication strategies and symptoms management for refractory cluster headaches,16 chronic pain,17 and functional neurological disorder,18 respondents disclosed the utilization of illicit substances (including cannabinoids, cocaine, heroin, lysergic acid diethylamide, and psilocybin) for the alleviation of acute symptoms and as a prophylactic measure. The majority of respondents reported moderate effectiveness and minimal physical and psychological side effects.
Despite the increasing use of psychedelics,19,20 there is a lack of research investigating the use of psychedelics to self-manage trauma-related mental health conditions. Notably, the Global Drugs Survey found increasing rates of psychedelic use, and that a significant amount report using psilocybin for “well being” or “medication.”21 Around 40% reported doing so without psychological support. Another recent study found that 64% of psilocybin users reported doing so for “general mental health and well-being.”22 Given the growing use of psychedelics illicitly for mental health purposes, research is needed to understand this practice and promote harm reduction strategies for traumatized individuals utilizing illegal substances to manage symptoms.
The MDMA-assisted therapy and psilocybin treatment may receive regulatory approval in the coming years.23 Therefore, research investigating perceptions of these treatments specifically in those who could potentially benefit from them is needed. Perceptions of psychedelic treatment in more general groups has been investigated. About 35% of US college students reported that psychedelics can be a therapeutic tool for depression, and 84% reported support for future research.24 In a survey of mental health users broadly, 72% supported further research, 59% reported support for psilocybin as a medical treatment, and 27% reported recreational use of psilocybin.25 There has also been research in demographic populations of those with disproportionate risk of trauma exposure, including in veterans, which found that overall positive views of MDMA and psilocybin therapy with many reporting concerns of long-term effects,26 and in Black Americans, who reported overall positive views of these treatments, with higher levels of baseline depression and PTSD being associated with greater baseline interest.27
The present study involved an anonymous, online survey recruiting an international sample of individuals who self-reported as suffering from trauma symptoms and/or having received a formal diagnosis of PTSD or CPTSD to investigate 1) treatment history, including history and satisfaction of engagement in clinical treatments as well as prevalence of use of illicit substances for self-management of trauma symptoms, perceived effectiveness, and adverse effects 2) after providing brief psychoeducation on MDMA-assisted therapy and psilocybin therapy, to assess perceptions of the interventions, including willingness to participate, and views on potential risks and benefits within mental health treatment.
Material and Methods
Ethics and Informed Consent
The study conformed with the ethical principles of the World Medical Association Declaration of Helsinki. The study was approved by King’s College London Research Ethics Committee (HR-19/20-20712). To ensure informed consent and voluntary participation, participants were provided with detailed information about the study’s purpose, procedures, potential risks and discomforts, confidentiality measures, and the investigator’s contact information before beginning the survey. They were then asked to acknowledge that they had read and understood this information and to consent to participate in the survey.
Participants
The survey was open to individuals with self-reported past and current symptoms of psychological trauma or a current or past diagnosis by a mental health professional of PTSD or CPTSD. Respondents were recruited through relevant groups on social media (i.e., Twitter, Reddit, and Facebook) and patient support groups (e.g., PTSD UK). Participation in the survey was voluntary, and respondents could quit the survey at any time.
Materials
The questionnaire link access lasted for a period of approximately 12 months. Survey questions were written in English, avoiding medical jargon where possible. Questions consisted of multiple choice, visual analogue scales, and some free-test fields. For the purpose of this research, only responses from multiple choice questions were used, which could be coded numerically for later analysis. Prior to responding to questions evaluating willingness to participate in MDMA-assisted or psilocybin therapy, participants were provided with a brief psychoeducation document highlighting the interventions’ procedures, safety, and efficacy data reported in clinical trials. (Supplementary Material).
Demographics
In total, 873 respondents took part in the study (Table 1). Some respondents did not complete the survey fully, but 605 (69.3%) completed every section. The greatest proportion of respondents were aged 35-44 years old (30.1%). Of the respondents, 608 (69.8%) were female. A total of 672 respondents (77%) resided in the UK, with responses received from 38 different countries. The majority of the respondents were white (88%). Most respondents (93.4%) reported completing high school, 34.3% were in full-time employment, and approximately half (51%) had a household income ranging from less than £10,000-£29,999. Over a third of the respondents were single (39.2%), 27% were married and 48.9% had children.
Data Analysis
Data were analyzed with IBM SPSS Statistics, version 29.0.1.0 (IBM SPSS Corp.; Armonk, NY, USA). Where respondents were given the option to select more than 1 answer, mutually incompatible answers were removed from the analysis. Descriptive statistics—including frequencies and proportions/percentages—were used to summarize the data. For continuous variables, normality was assessed by applying the Kolmogorov–Smirnov test and by visually inspecting Q–Q plots. For variables that were found to be normally distributed, data are presented as mean ± standard deviation; for non-normally distributed data, medians with Q1-Q3 are provided. Between-group comparisons of continuous variables were conducted using Mann–Whitney U and Kruskal–Wallis H with Dunn-Bonferroni post-hoc tests. Only significant post-hoc test results are included in the table, full post-hoc test results are shown in Supplementary Table 1. Associations between ordinal and continuous variables were assessed using Spearman’s rank order correlation. Additionally, chi-square tests were employed to compare between-group frequencies, and odds ratios were calculated to explore the strength of associations between variables.
Results
Trauma Exposure
A total of 858 respondents answered the question “Have you experienced psychological trauma?” Of these, 94.8% answered yes. Additionally, 848 respondents answered the question “Have you been formally diagnosed with PTSD?” Among them, 622 (73.4%) had a formal diagnosis of either PTSD (n = 327, 38.6%) or CPTSD (n = 295, 34.8%). Of 803 respondents, 236 (29.4%) first experienced their symptoms over 20 years ago, while 208 (25.9%) reported symptoms lasting 10 to 20 years. Respondents were asked to select out of 21 experiences (see supplementary material). Of these, the most common, self-reported traumatic experiences were bullying (n = 520, 59.6%), childhood emotional abuse (n = 490, 56.1%), break up (n = 463, 53.0%), and sexual assault (n = 446, 51.1%) (Table 2), and on average, respondents self-reported having experienced 7 of the 21 traumatic events.
Management
Treatments Reported:
A total of 694 respondents answered questions about the treatments they had received for psychological trauma. The average number of treatments attempted was 4 (Median (Q1-Q3) =4 (3-5)). These included medication, various psychotherapies and online self-help methods. The 3 most received/sought treatments were “medications” (n = 445, 72.7%), “online self-help” (n = 336, 60%), and “other psychotherapies” (n = 293, 51%) (Table 3).
Pharmacotherapies
Respondents reported using a range of medications to manage symptoms. The most common medications used currently or in the past were antidepressants (n = 283, 63.6%), analgesics (n = 176, 39.6%), and benzodiazepines (n = 160, 35.9%) (Table 4). Most respondents found these medications unhelpful in managing their symptoms (71%, 69.3%, and 51.3% respectively). Of interest, 152 (22.5%) of 675 respondents reported having used prescription medications without a prescription from a medical prescriber, with the proportion of those answering yes increasing as the number of therapies attempted increased.
Psychological Therapies
A total of 527 respondents reported having attempted one or more of form of psychological therapy. The median (Q1-Q3) number of psychotherapies tried was 2 (1-3). The most used psychotherapy was cognitive therapy for PTSD with 275 (44.4%) out of 620 respondents, followed by group therapy at 213 (35.5%) out of 600 respondents.
Satisfaction with Treatments Received
A total of 651 respondents answered the question, “Have the treatments you received helped you to deal more effectively with your trauma-related problems/difficulties?” Of these, 303 (46.5%) respondents felt the treatments helped somewhat, 119 (18.3%) responded with “yes, a great deal,” 179 (27.5%) responded “no, not really,” while 50 (7.7%) felt treatments made their difficulties worse.
Out of 656 respondents who answered the question, “To what extent have the treatments you have been offered met your needs?”, 332 (50.6%) respondents felt treatments met “a few” of their needs, 155 (23.6%) reported that most of their needs were met, while 124 (18.9%) felt none of their needs were met (Figure 1).
A total of 651 respondents answered the question, “How satisfied are you with the treatments you have received?” Of these, 387 (59.4%) respondents felt “Indifferent” to “Very dissatisfied”, while 66 (10%) felt “Very satisfied.” Among 648 respondents, 311 (48%) were unsure if they would recommend received treatments to a friend with a similar trauma-related difficulty. In contrast, 191 (29.5%) stated they would “definitely” recommend the treatments, while 146 (22.5%) said they would “definitely not” (Table 5).
Self-Management
Legal Substances:
Up to 190 respondents indicated they had used a range of 17 legal substances to manage symptoms (Table 6). The average effectiveness for these substances ranged from 0.21 (poppers, n = 31, (Q1-Q3) = (0.04-0.37)) to 0.64 (other, n = 28, SD = 0.27). Among the most used substances, the highest rated were Cannabidiol (CBD) (n = 93, median (Q1-Q3) = 0.51 (0.25-0.75)), tobacco (n = 91, mean = 0.52, SD = 0.29), alcohol (n = 123, median (Q1-Q3) = 0.38 (0.20-0.62)) and caffeine (n = 81, mean = 0.35, SD = 0.22).
Illicit Substances
Prevalence and Effectiveness:
A total of 364 respondents completed questions addressing the use and perceived effectiveness for 13 illicit substances to manage trauma-related symptoms. The most commonly used illicit substances were marijuana (n = 336, 92.3%), psychedelics (n = 227, 62.4%), and MDMA (n = 205, 56.3%) (Table 6).
Reported average effectiveness was highest for psychedelics (Median (Q1-Q3) = 0.91 (0.72-1.00)), followed by MDMA (Median (Q1-Q3) = 0.76 (0.59-0.95)), marijuana (Median (Q1-Q3) = 0.75 (0.45-0.89)), and ketamine (Median (Q1-Q3) = 0.60 (0.25-0.82)) (Table 6).
The most common context in which respondents reported using illicit substances was at home at 180 (74.1%), followed by parties/festivals at 107 (44.0%). Additionally, 46 (19%) respondents reported using substances in nature, while only 9 (3.7%) and 8 (3.3%) reported using substances in retreats and trials respectively (n = 243 for the number of people reporting illicit substance use in any context). This pattern was consistent for marijuana use. However, ketamine and MDMA use were proportionally higher in party or festival settings—reported by 50 respondents (67.6%) for ketamine and 80 (58.8%) for MDMA. While most psychedelic users also reported use primarily at home (n = 122, 73.5%), a higher proportion used them in natural settings (n = 41, 24.7% of 166), compared to 19% across all substances (Table 7).
When analyzing the association between prescription medication use and illicit substance use, marijuana, speed, psychedelics, cocaine, and nitrous were significantly associated with prescription medication usage. Respondents who reported using prescription medications had an over 3 times greater likelihood of using marijuana (OR = 3.18, 95% CI (2.38, 4.23)), over 2 times greater likelihood of using psychedelics (OR = 2.05, 95% CI (1.50, 2.81)), and MDMA (OR = 2.19, 95% CI (1.58, 3.03)), but no association found for ketamine (OR = 1.34, 95% CI (0.90, 2.00)). Furthermore, 155 (37.7%) out of 305 respondents had considered using illicit substances to treat PTSD symptoms but had not done so due to illegality or safety concerns.
Complications
Most respondents who had used illicit substances reported no or minimal psychological and medical complications from use. The highest rates of no or minimal psychological complications (PCs) were for ketamine (92.7%, n = 124), nitrous (96.9%, n = 97), and psychedelics (88.8%, n = 259). The highest rates of no or minimal medical complications were khat (100%, n = 11), PCP (100%, n = 18), psychedelics (98.1%, n = 259), nitrous (93.7%, n = 95), and MDMA (93.4%, n = 212), closely followed by marijuana (93%, n = 327) (Table 8).
Rates of severe PCs on average across the 13 substances was 4.3%. Substances with the highest rates of severe PCs were cocaine (11.6%, n = 155) and synthetic cannabinoids (10%, n = 30). Average rates of severe medical complications across substances were 2.4%, with highest rates for synthetic cannabinoids (10%, n = 3), mephedrone (7.1%, n = 3), and cocaine (6.5%, n = 10).
More specifically, for respondents reporting use of MDMA, ketamine, psychedelics, and marijuana, rates of no or minimal psychological and medical complications were all higher than the average except for ketamine which reported 109 (65.7%) no or minimal medical complications. Similarly, rates of severe PCs for ketamine, MDMA, and marijuana were lower than the average of PC rate for all substances combined (4.3%), except for psychedelics, which had a self-reported severe PC rate of 6.6% (n = 17). Conversely, rates for severe medical complications psychedelics were 0, reaching 0.5% (n = 1), 0.9% (n = 3), and 1.8% (n = 3) for MDMA, marijuana, and ketamine respectively.
When analyzing complications by context, rates of none or minimal PCs were unchanged by context for marijuana and ketamine. For MDMA, rate of none/minimal PCs was highest in nature (n = 31, 94%) compared to parties and festivals (n = 65, 81%). For psychedelics, none/minimal PC rate was highest for home (n = 113, 93%) and lowest for parties/festivals (n = 66, 83%). This was further supported by the rate of severe PCs which was highest for parties/festivals (n = 8, 10%) compared to home (n = 6, 5%) (Table 9).
No differences were noted for medical complications across contexts except for ketamine, where rate of medical complications was 4% (n = 2) for parties and festivals compared to 0% for remaining contexts. Trials/clinics and retreats were excluded from this comparison due to count of less than 10.
Willingness
Over 500 study respondents responded to a series of questions evaluating respondents’ willingness to volunteer for clinical trials investigating the safety and efficacy of MDMA-assisted therapy (n = 526) and psilocybin therapy (n = 537) to treat PTSD. Similarly, over 500 responded to a series of questions evaluating respondents’ willingness to seek treatment with MDMA-assisted therapy (n = 517) and psilocybin therapy for PTSD (n = 523), if licensed (Figure 2).
Average willingness to partake in trials was high for bother psilocybin (median = 1.00 (0.75-1.00)) and MDMA (median = 1.00 (0.75-1.00)). Average willingness to access the treatment if approved was median = 1.00 (0.75-1.00) for psilocybin therapy and median = 1.00 (0.69-1.00) for MDMA-assisted therapy.
More specifically, findings are presented across demographic subsets.
Gender
Kruskal–Wallis H test showed significant differences between gender for willingness to partake in psilocybin trials (P = <.001), MDMA trials (P = <.001), psilocybin-assisted-therapy when approved (P = .002) and MDMA-assisted-therapy when approved (P = .001) (Table 10a). Dunn’s post-hoc test with Bonferroni correction for multiple comparisons further demonstrated that the difference consistently was between male and female respondents, where females reported lower levels of willingness for psilocybin (P = .002) and MDMA (P = .002) when approved. All post-hoc test results are reported in Supplementary Table 1.
Age
Spearman’s rank correlation showed a significant negative association between age and willingness for psilocybin treatment (P = .020), indicating older participants were less willing to try psilocybin once approved. No significant correlation was observed between age and the other willingness variables (Table 10b).
Education
Education level showed weak positive correlation with willingness to participate in psilocybin trials (P = .001), MDMA trials (P = .050), psilocybin therapy once approved (P = .002), and MDMA therapy once approved (P = .017) using Spearman’s rank correlation (Table 10b).
Sexual Orientation
Significant differences in willingness were noted in Kruskal–Wallis H test for trial participation of both psilocybin (P = .002) and MDMA (P = .007) (Table 10c). Post-hoc tests revealed differences specifically between bisexual and heterosexual respondents for both substances (P = .008 and P = .003 respectively), with heterosexual respondents being less willing on average to engage in either treatment. All post-hoc test results are reported in Supplementary Table 1.
Trauma Types
Willingness to try various substances varied across different trauma types. Notably, those reporting physical assault and witnessed violence were significantly more willing to attempt both psilocybin and MDMA trials and treatments (Table 11).
Previous Experience of Psychological Therapy
Willingness and attitude to psychedelics was also influenced by whether or not respondents had attempted any psychological therapies (n = 527). When asked whether respondents would be willing to volunteer for psilocybin and MDMA trials, those who had reported attempting any form of psychotherapy were less likely to volunteer for psilocybin trials (P = .036), but no difference was noted for MDMA trials. Similarly, respondents with previous psychotherapy exposure rated themselves more likely to try psilocybin treatments once approved (P = .005) but not MDMA-assisted therapy once approved (Table 12a).
Furthermore, those reporting use of psychological therapies were less likely to disagree with the statement “psilocybin and MDMA are generally harmful and addictive” (P = .033). The psychological therapy group was also less positive regarding statements that psilocybin and MDMA show promise (P = .029) and should be researched (P = .032) (Table 12b).
Discussion
To the best of knowledge, this is the first large-scale survey in individuals reporting illicit substance use to self-manage PTSD symptoms. This study investigated perceptions of standard trauma treatments, the use of illicit substances for self-management, and attitudes toward MDMA-assisted and psilocybin therapies after a brief psychoeducation on these novel treatment options.
Clinical Treatment History and Satisfaction
Notably, this sample exhibited high levels of trauma, with respondents reporting an average of 7 lifetime trauma events and 73.4% receiving a formal PTSD diagnosis. Regarding clinical treatment history, most respondents had tried various standard treatments, with medication being the most common (73%). Consistent with empirical literature,8,28 the majority found medication treatment for trauma symptoms to be unhelpful. For instance, previous research found that trauma-focused psychological therapies resulted in greater and longer-lasting improvements than medications, which showed insignificant to small/moderate effects.29 This suggests that while medications for PTSD are the most accessible treatment, many patients do not experience significant improvement, highlighting substantial dissatisfaction with current PTSD treatments. Echoing empirical data on high dropout rates associated with standard PTSD interventions,30 these findings underscore the urgent need for qualitative studies investigating the experiences of non-responders to standard treatments.
Illicit Substance Use for Trauma Symptom (Self-Management)
Potentially associated with high rates of reported dissatisfaction with standard treatments, the findings indicate that individuals with trauma symptoms demonstrate high rates of using illicit substances of self-management of symptoms, with the most commonly used substances for this purpose being marijuana (41%), psychedelics (28%), and MDMA (25%). This is even higher than a previous study by Corrigan and colleagues who found a rate of 27% of use of illicit substances for self-management in a sample of general mental health users, suggesting that use of illicit substances for symptom management may be even higher in those with trauma symptoms. Notably, respondents found psychedelics to be most effective for managing symptoms, and overall reported all 3 drug categories as having above average effectiveness. It is important to note that generally rates of psychedelic use are increasing,21,31 and rates of psychedelic use for mental health management is increasing.22 These findings echo how prevalent this practice is, highlining the importance of additional epidemiological and qualitative studies exploring the risk/benefit profile associated with illicit substance use for self-management.
“Set and setting” are critical factors in the context of drug use.32 The environmental conditions and individuals’ internal states significantly influence the effects of the substance and the overall experience. As such, the contexts for use were also queried. The most common context for use was parties/festivals (74%), with 19% being nature, 4% retreats, and 3% clinical trials. This suggests that the majority of illicit substance use occurs in non-clinical settings such as retreats, parties, and festivals, underscoring the need for specialist, trauma-informed psychoeducation and support systems to help manage potential emergent adverse events. Correspondingly, most respondents reported none or minimal complications from illicit substance abuse, with psychedelics showing less complications than other illicit substances (e.g., cocaine). Notably, context was associated with adverse effects, with lower adverse events reported when substances were used in a nature setting compared to parties or festivals. These findings are consistent with research suggesting that, broadly, use of psychedelics in non-clinical contexts is associated with improved mental health functioning33,34and reduced levels of daily opioid use35 especially when harm reduction approaches are available.36 However, psychedelics are also associated with a range of behavioral and psychological risks, including paranoia, panic, and confusion.37 Correspondingly, traumatized individuals, already burdened by symptoms such as dissociation, depersonalization, and hyperarousal, may be at heightened risk for drug-related psychiatric destabilization.38 Therefore, harm reduction approaches and services would benefit from specialist education and training to better support traumatized individuals experiencing adverse effects related to psychedelic use. Further, these findings also demonstrate the need for additional research and transparent public education on psychedelics to inform individuals about potential risks and mitigating factors, ensuring safer use, and promoting informed decision-making to protect public health.
Perceptions of Psychedelic Forms of Therapy
Respondents overall reported strong willingness to consider MDMA (median (Q1-Q3) = 1 (0.75-1.00)) and psilocybin therapy (median (Q1-Q3) = 1 (0.75-1.00)). This finding aligns with previous research indicating favorable views and high levels of interest in MDMA-assisted and psilocybin therapy among Black Americans,27 veterans, and service members.26 The strong willingness is also consistent with previous research in a broader sample of mental health users, finding that 55% would accept these treatments whereas 20% would not, and 72% supported future research.25 The study expands on these findings by demonstrating strong interest among individuals with trauma symptoms. Notably, respondents received brief psychoeducation concerning MDMA and psilocybin, highlighting current research findings suggesting preliminary safety and efficacy. These results are consistent with research studies26,27 in showing that brief psychoeducation on psychedelic therapies is associated with positive views of these approaches. These findings highlight the potential of psychoeducation campaigns and community engagement to inform various patient populations about novel treatments. However, trauma exposure may also include elements of secrecy and betrayal.39 Therefore, to promote enhanced informed consent, psychoeducation efforts should highlight the potential risks associated with psychedelic forms of therapy, and more research is needed assessing the more expanded adverse effects that may occur within psychedelic therapy.40
Females reported significantly lower willingness for both psilocybin and MDMA therapies. Future research could explore underlying reasons, such as safety concerns or stigma, and develop interventions to address these barriers. Additionally, exploring the role of gender-specific therapeutic benefits could enhance acceptance among women. Similarly, higher education was associated with greater openness to novel therapies. Future research should investigate the role of educational interventions in increasing acceptance and participation rates among less-educated populations.
Limitations, Conclusions, and Future Directions
The present study has several limitations. Firstly, limiting the generalizability of the findings, respondents were required to have a strong command of English and self-selected for participation, potentially introducing bias favoring psychedelics. Second, the majority of the respondents were white (88%), further limiting the generalizability. This may result from biased survey accessibility, socioeconomic factors, or topic relevance. To address this, outreach efforts, using multilingual surveys, and incentivizing participation may have improved accessibility. Additionally, the respondents self-identified as having trauma symptoms or unverifiable PTSD/CPTSD diagnoses, and the results reflect their perceptions.
Conversely, clinical assessments might have suggested higher rates of complications and reduced rates of effectiveness than those reported by respondents. However, it is crucial to amplify patient voices and views, particularly in the context of novel interventions for those with trauma histories. This study also highlights that individuals with trauma symptoms are engaging in significant amounts of treatment, predominantly medication, and are largely dissatisfied with these treatments. There is a clear need for novel, effective, and trauma-informed interventions that take into account patients’ perceptions of trauma-focused standard treatments to guide the development of psychedelic forms of therapy.
Respondents generally reported positive experiences with minimal or no complications when using psychedelics for symptom management. These findings are consistent with other research indicating increasing use of psychedelics.21 However, these findings, especially those concerning reported safety and effectiveness of psychedelics should be approached with caution due to the strong likelihood of selection bias and the known heterogeneity associated with trauma-stress psychopathology,41 impacting the generalizability of the findings. Moreover, this study suggests that a proportion of individuals with trauma symptoms may be using illicit substances, for self-management. This underscores the importance of harm reduction approaches and the need for the field to support more beneficial self-management and non-clinical psychedelic use, incorporating patient autonomy and preferences.42 The results also suggest the importance of educating mental health providers about psychedelic substances, interventions, and harm reduction approaches. Providers caring for traumatized individuals using psychedelics or other substances outside of clinical settings would benefit from specialist training and education. Enhanced provider education can help bridge the gap between patient practices and clinical support, promoting safer and more effective care for individuals managing trauma symptoms through unconventional means.
Supplementary Materials
Data Availability Statement:
The data that support the findings of this study are available on request from the corresponding author.
| n | % | |
|---|---|---|
| Gender | ||
| Female | 608 | 69.8 |
| Male | 242 | 27.8 |
| Other | 15 | 1.7 |
| Prefer not to say | 6 | 0.7 |
| Country of residence* | ||
| Australia | 11 | 1.3 |
| Canada | 16 | 1.8 |
| New Zealand | 2 | 0.2 |
| United Kingdom | 672 | 77 |
| USA | 96 | 11 |
| Asia (2) | 3 | 0.3 |
| Europe (17) | 54 | 6.2 |
| South America (3) | 6 | 0.7 |
| Africa (4) | 5 | 0.7 |
| Caribbean (3) | 4 | 0.4 |
| Middle East (3) | 4 | 0.4 |
| Age | ||
| 18-24 | 118 | 13.6 |
| 25-34 | 228 | 26.2 |
| 35-44 | 262 | 30.1 |
| 45-54 | 176 | 20.3 |
| 55-64 | 70 | 8.1 |
| 65-74 | 12 | 1.4 |
| Ethnicity | ||
| Any other | 13 | 1.5 |
| Arab | 5 | 0.6 |
| Asian/Pacific Islander | 17 | 1.9 |
| Black/African | 6 | 0.7 |
| Hispanic/Latino | 10 | 1.1 |
| Mixed | 37 | 4.2 |
| Native American | 2 | 0.2 |
| Prefer not to say | 15 | 1.7 |
| Caucasian | 768 | 88.0 |
| Religion | ||
| Agnostic | 116 | 13.4 |
| Atheist | 291 | 33.7 |
| Buddhist | 20 | 2.3 |
| Christian | 185 | 21.4 |
| Hindu | 6 | 0.7 |
| Jewish | 8 | 0.9 |
| Muslim | 6 | 0.7 |
| Other | 104 | 12 |
| Prefer not to say | 66 | 7.6 |
| Traditional/folk religion/spiritist | 62 | 7.2 |
| Sexual orientation | ||
| Bisexual | 134 | 15.3 |
| Gay/lesbian | 44 | 5 |
| Heterosexual/straight | 613 | 70.2 |
| Not sure | 31 | 3.6 |
| Other | 30 | 3.4 |
| Prefer not to say | 21 | 2.4 |
| Educational level | ||
| Associate degree in college | 77 | 8.8 |
| Bachelor’s degree in college | 245 | 28.2 |
| Doctoral degree | 23 | 2.6 |
| High school graduate | 82 | 9.4 |
| Less than high school | 57 | 6.6 |
| Master’s degree | 141 | 16.2 |
| Professional degree | 17 | 2 |
| Some college but no degree | 226 | 26 |
| Relationship status | ||
| Civil partnership | 19 | 2.2 |
| Cohabiting | 144 | 16.5 |
| Divorced | 61 | 7 |
| Married | 236 | 27.1 |
| Other | 59 | 6.8 |
| Prefer-not-to-say | 11 | 1.3 |
| Single | 341 | 39.2 |
| Living situation | ||
| Alone | 231 | 26.7 |
| Friends | 45 | 5.2 |
| Other | 117 | 13.5 |
| Parents | 85 | 9.8 |
| Partner | 190 | 21.9 |
| Partner-and-children | 192 | 22.2 |
| Supported housing | 4 | 0.5 |
| Without-partner-but-with-children | 2 | 0.2 |
| Children? | ||
| Yes | 425 | 48.9 |
| No | 444 | 51.1 |
| Employment-status | ||
| Full-time | 294 | 34.3 |
| Other | 85 | 9.9 |
| Part-time | 98 | 11.4 |
| Prefer-not-to-say | 11 | 1.3 |
| Retired | 44 | 5.1 |
| Self-employed | 77 | 9 |
| Student | 108 | 12.6 |
| Unemployed | 141 | 16.4 |
| Annual-household-income ($/€/£) | ||
| Less-than-10 000 | 131 | 15.3 |
| 10 000-19 999 | 178 | 20.8 |
| 20 000-29,999 | 127 | 14.9 |
| 30 000-39 999 | 97 | 11.4 |
| 40 000-49 999 | 71 | 8.3 |
| 50 000-59 999 | 44 | 5.2 |
| 60 000-69 999 | 31 | 3.6 |
| 70 000-79 999 | 23 | 2.7 |
| 80 000-89 999 | 20 | 2.3 |
| 90 000-99 999 | 20 | 2.3 |
| 100 000-149 999 | 34 | 4 |
| 150 000+ | 25 | 2.9 |
| Prefer-not-to-say | 53 | 6.2 |
| Political views | ||
| Conservative/Republican | 87 | 10.2 |
| Democrat/labour | 179 | 21 |
| Green | 80 | 9.4 |
| Liberal-Democrat | 68 | 8 |
| Moderate | 60 | 7 |
| Other | 131 | 15.4 |
| Prefer-not-to-say | 135 | 15.8 |
| Socialist | 112 | 13.1 |
| Veteran status | ||
| Yes | 119 | 14 |
| No | 734 | 86 |
| Which veteran category? | ||
| Armed forces | 82 | 68.9 |
| Medical services | 14 | 11.8 |
| Police | 15 | 12.6 |
| Other emergency service | 8 | 6.7 |
| Trauma-diagnosis | ||
| PTSD | 327 | 38.6 |
| CPTSD | 295 | 34.8 |
| No-trauma-diagnosis** | 226 | 26.7 |
| n | % | % of Total | |
|---|---|---|---|
| Legal Substances (n = 190 of 873) | |||
| Caffeine | 107 | 56.3 | 12.3 |
| Alcohol | 151 | 79.5 | 17.3 |
| Tobacco | 113 | 59.5 | 12.9 |
| E-cigarettes/nicotine | 61 | 32.1 | 7.0 |
| Melatonin | 63 | 33.2 | 7.2 |
| Liquorice | 22 | 11.6 | 2.5 |
| Kudzu | 2 | 1.1 | 0.2 |
| CBD | 99 | 52.1 | 11.3 |
| Poppers | 31 | 16.3 | 3.6 |
| Glue | 11 | 5.8 | 1.3 |
| Eleuthero | 1 | 0.5 | 0.1 |
| Wild yam | 3 | 1.6 | 0.3 |
| Schisandra | 1 | 0.5 | 0.1 |
| Oat tops | 4 | 2.1 | 0.5 |
| Valerian root | 50 | 26.3 | 5.7 |
| Holy basil | 12 | 6.3 | 1.4 |
| Rhodiola | 11 | 5.8 | 1.3 |
| Other | 28 | 14.7 | 3.2 |
| Illicit substances (n = 364 of 873) | |||
| Marijuana | 336 | 92.3 | 38.5 |
| Ketamine | 111 | 30.5 | 12.7 |
| MDMA | 205 | 56.3 | 23.5 |
| Speed | 145 | 39.8 | 16.6 |
| Psychedelics | 227 | 62.4 | 26.0 |
| Cocaine | 163 | 44.8 | 18.7 |
| Nitrous | 79 | 21.7 | 9.0 |
| Mephedrone | 0 | 0.0 | 0.0 |
| SynCannab | 0 | 0.0 | 0.0 |
| Meth | 0 | 0.0 | 0.0 |
| Khat | 0 | 0.0 | 0.0 |
| Psychological Complications | Physical Complications | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| None | % | Minimal | % | Some | % | Severe | % | None | % | Minimal | % | Some | % | Severe | % | |
| Marijuana | 205 | 62.7 | 72 | 22 | 39 | 11.9 | 11 | 3.4 | 237 | 72.5 | 67 | 20.5 | 20 | 6.1 | 3 | 0.9 |
| Synthetic cannabinoid | 23 | 76.7 | 2 | 6.7 | 2 | 6.6 | 3 | 10 | 19 | 63.3 | 6 | 20 | 2 | 6.7 | 3 | 10 |
| Ketamine | 98 | 79 | 17 | 13.7 | 4 | 3.23 | 5 | 4 | 99 | 59.3 | 10 | 6 | 54 | 32.5 | 3 | 1.8 |
| MDMA | 144 | 67.9 | 38 | 17.9 | 23 | 10.9 | 7 | 3.3 | 166 | 78.3 | 32 | 15.1 | 13 | 6.1 | 1 | 0.5 |
| Amphetamine | 94 | 61.4 | 28 | 18.3 | 20 | 13.1 | 11 | 7.2 | 107 | 69.9 | 25 | 16.3 | 16 | 10.5 | 5 | 3.3 |
| Psychedelics | 185 | 71.7 | 45 | 17.4 | 11 | 4.3 | 17 | 6.6 | 222 | 85.7 | 32 | 12.4 | 5 | 1.9 | 0 | 0 |
| Cocaine | 83 | 53.54 | 26 | 16.8 | 28 | 18.1 | 18 | 11.6 | 98 | 63.3 | 31 | 20 | 16 | 10.3 | 10 | 6.4 |
| Meth | 22 | 68.8 | 3 | 9.4 | 6 | 18.8 | 1 | 11.6 | 25 | 78.1 | 3 | 9.4 | 4 | 12.5 | 0 | 0 |
| Khat | 11 | 100 | 0 | 0 | 0 | 0 | 0 | 0 | 11 | 100 | 0 | 0 | 0 | 0 | 0 | 0 |
| Nitrous oxide | 89 | 91.7 | 5 | 5.2 | 3 | 3.1 | 0 | 0 | 84 | 88.4 | 5 | 5.3 | 6 | 5.3 | 1 | 1 |
| Mephedrone | 27 | 64.3 | 6 | 14.3 | 6 | 14.3 | 3 | 7.1 | 30 | 71.5 | 3 | 7.1 | 5 | 14.3 | 3 | 7.1 |
| PCP | 17 | 94.4 | 1 | 5.6 | 0 | 0 | 0 | 0 | 17 | 94.4 | 1 | 5.6 | 0 | 0 | 0 | 0 |
| Other | 18 | 62.01 | 6 | 20.7 | 5 | 17.2 | 0 | 0 | 23 | 79.3 | 0 | 0 | 6 | 20.7 | 0 | 0 |
| Medication | n | % |
|---|---|---|
| Antidepressants | 283 | 32.4 |
| Benzodiazapines | 160 | 18.3 |
| Antipsychotics | 102 | 11.7 |
| Mood stabilizers | 56 | 6.4 |
| Hypnotics | 140 | 16.0 |
| Opioids | 132 | 15.1 |
| Analgesics | 176 | 20.2 |
| Cardiac medications | 95 | 10.9 |
| Legal cannabis | 65 | 7.4 |
| Other | 51 | 5.8 |
| Q1. Have the treatments you received helped you to deal more effectively with your trauma-related problems/difficulties? | |||||||||||
| Yes, a great deal | Yes, somewhat | No, not really | No, made it worse | ||||||||
| n | % | n | % | n | % | n | % | ||||
| 119 | 18.3 | 303 | 46.5 | 179 | 27.5 | 50 | 7.7 | ||||
| Q2. To what extent have the treatments you have been offered met your needs? | |||||||||||
| Met almost all my needs | Met most of my needs | Met a few of my needs | Met none of my needs | ||||||||
| n | % | n | % | n | % | n | % | ||||
| 45 | 6.9 | 155 | 23.6 | 332 | 50.6 | 124 | 18.9 | ||||
| Q3. How satisfied are you with the treatments you have received? | |||||||||||
| Very satisfied | Mostly satisfied | Indifferent/Mildly dissatisfied | Very dissatisfied | ||||||||
| n | % | n | % | n | % | n | % | ||||
| 66 | 10.1 | 198 | 30.4 | 252 | 38.7 | 135 | 20.7 | ||||
| Q4. Would you recommend these treatments to someone else? | |||||||||||
| Yes, definitely | Maybe | No, definitely not | |||||||||
| n | % | n | % | n | % | ||||||
| 191 | 29.5 | 311 | 48.0 | 146 | 22.5 | ||||||
| n | % | % of Total | Effectiveness Mean ± SD/Median (Q1, Q3)* | |
|---|---|---|---|---|
| Legal Substances (n = 190 of 873) | ||||
| Caffeine | 107 | 56.3 | 12.3 | 0.35 ± 0.22 |
| Alcohol | 151 | 79.5 | 17.3 | 0.38 (0.20, 0.62)* |
| Tobacco | 113 | 59.5 | 12.9 | 0.52 ± 0.29 |
| E-cigarettes/nicotine | 61 | 32.1 | 7.0 | 0.45 ± 0.24 |
| Melatonin | 63 | 33.2 | 7.2 | 0.33 (0.12, 0.55)* |
| Liquorice | 22 | 11.6 | 2.5 | 0.26 ± 0.20 |
| Kudzu | 2 | 1.1 | 0.2 | – |
| CBD | 99 | 52.1 | 11.3 | 0.51 (0.25, 0.75)* |
| Poppers | 31 | 16.3 | 3.6 | 0.21 (0.04, 0.37)* |
| Glue | 11 | 5.8 | 1.3 | 0.31 ± 0.26 |
| Eleuthero | 1 | 0.5 | 0.1 | – |
| Wild yam | 3 | 1.6 | 0.3 | – |
| Schisandra | 1 | 0.5 | 0.1 | – |
| Oat tops | 4 | 2.1 | 0.5 | – |
| Valerian root | 50 | 26.3 | 5.7 | 0.41 ± 0.24 |
| Holy basil | 12 | 6.3 | 1.4 | 0.39 ± 0.22 |
| Rhodiola | 11 | 5.8 | 1.3 | 0.34 ± 0.27 |
| Other | 28 | 14.7 | 3.2 | 0.64 ± 0.27 |
| Illicit substances (n = 364 of 873) | ||||
| Marijuana | 336 | 92.3 | 38.5 | 0.75 (0.45, 0.89)* |
| Ketamine | 111 | 30.5 | 12.7 | 0.60 (0.25, 0.82)* |
| MDMA | 205 | 56.3 | 23.5 | 0.76 (0.59, 0.95)* |
| Speed | 145 | 39.8 | 16.6 | 0.26 (0.19, 0.60)* |
| Psychedelics | 227 | 62.4 | 26.0 | 0.91 (0.72, 1.00)* |
| Cocaine | 163 | 44.8 | 18.7 | 0.28 (0.21, 0.55)* |
| Nitrous | 79 | 21.7 | 9.0 | 0.38 ± 0.27 |
| Mephedrone | 0 | 0.0 | 0.0 | – |
| Synthetic cannabinoids | 0 | 0.0 | 0.0 | – |
| Meth | 0 | 0.0 | 0.0 | – |
| Khat | 0 | 0.0 | 0.0 | – |
| Substance (n) | Home n = 180 | Parties/Festivals n = 107 | Nature n = 46 | Retreats n = 9 | Trials/Clinics n = 8 | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |
| Marijuana (224) | 168 | 75.0 | 98 | 43.8 | 46 | 20.5 | 7 | 3.1 | 8 | 3.6 |
| Ketamine (74) | 54 | 73.0 | 50 | 67.6 | 17 | 23.0 | 3 | 4.1 | 2 | 2.7 |
| MDMA (136) | 92 | 67.6 | 80 | 58.8 | 33 | 24.3 | 3 | 2.2 | 4 | 2.9 |
| Speed (100) | 68 | 68.0 | 60 | 60.0 | 21 | 21.0 | 3 | 3.0 | 1 | 1.0 |
| Psychedelics (166) | 122 | 73.5 | 80 | 48.2 | 41 | 24.7 | 9 | 5.4 | 7 | 4.2 |
| Cocaine (102) | 64 | 62.7 | 66 | 64.7 | 20 | 19.6 | 4 | 3.9 | 1 | 1.0 |
| Nitrous (60) | 41 | 68.3 | 35 | 58.3 | 15 | 25.0 | 3 | 5.0 | 3 | 5.0 |
| Drug | Psychological Complications | Medical Complications | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| None (n) | Minimal (n) | Subtotal (n) | % of Total | Severe (n) | % | Total (n) | None (n) | Minimal (n) | Subtotal (n) | % of Total | Severe (n) | % | Total (n) | |
| Marijuana | 205 | 72 | 277 | 84.7 | 11 | 3.4 | 327 | 237 | 67 | 304 | 93.0 | 3 | 0.9 | 327 |
| Synthetic cannabinoids | 23 | 2 | 25 | 83.3 | 3 | 10.0 | 30 | 19 | 6 | 25 | 83.3 | 3 | 10.0 | 30 |
| Ketamine | 98 | 17 | 115 | 92.7 | 5 | 4.0 | 124 | 99 | 10 | 109 | 65.7 | 3 | 1.8 | 166 |
| MDMA | 144 | 38 | 182 | 85.8 | 7 | 3.3 | 212 | 166 | 32 | 198 | 93.4 | 1 | 0.5 | 212 |
| Amphetamine | 94 | 28 | 122 | 79.7 | 11 | 7.2 | 153 | 107 | 25 | 132 | 86.3 | 5 | 3.3 | 153 |
| Psychedelics | 185 | 45 | 230 | 88.8 | 17 | 6.6 | 259 | 222 | 32 | 254 | 98.1 | 0 | 0.0 | 259 |
| Cocaine | 83 | 26 | 109 | 70.3 | 18 | 11.6 | 155 | 98 | 31 | 129 | 83.2 | 10 | 6.5 | 155 |
| Meth | 22 | 3 | 25 | 78.1 | 1 | 3.1 | 32 | 25 | 3 | 28 | 87.5 | 0 | 0.0 | 32 |
| Khat | 11 | 0 | 11 | 100.0 | 0 | 0.0 | 11 | 11 | 0 | 11 | 100.0 | 0 | 0.0 | 11 |
| Nitrous | 89 | 5 | 94 | 96.9 | 0 | 0.0 | 97 | 84 | 5 | 89 | 93.7 | 1 | 1.1 | 95 |
| Mephedrone | 27 | 6 | 33 | 78.6 | 3 | 7.1 | 42 | 30 | 3 | 33 | 78.6 | 3 | 7.1 | 42 |
| PCP | 17 | 1 | 18 | 100.0 | 0 | 0.0 | 18 | 17 | 1 | 18 | 100.0 | 0 | 0.0 | 18 |
| Home | Parties/Festivals | Nature | Retreat | Trials/Clinics | Any Context | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Psychological complications | ||||||||||||
| Marijuana | None | 11 | 76% | 60 | 41% | 25 | 17% | 2 | 1% | 7 | 5% | 146 |
| Minimal | 33 | 72% | 20 | 43% | 14 | 30% | 4 | 9% | 1 | 2% | 46 | |
| Subtotal | 144 | 86% | 80 | 82% | 39 | 85% | 6 | 86% | 8 | 100% | ||
| Severe | 6 | 4% | 3 | 3% | 2 | 4% | 0 | 0% | 0 | 0% | 7 | |
| Total | 168 | 75% | 98 | 44% | 46 | 21% | 7 | 3% | 8 | 4% | 224 | |
| Ketamine | None | 43 | 74% | 39 | 67% | 15 | 26% | 1 | 2% | 2 | 3% | 58 |
| Minimal | 8 | 80% | 6 | 60% | 1 | 10% | 2 | 20% | 0 | 0% | 10 | |
| Subtotal | 51 | 94% | 45 | 90% | 16 | 94% | 3 | 100% | 2 | 100% | ||
| Severe | 2 | 4% | 2 | 4% | 1 | 6% | 0 | 0% | 0 | 0% | 2 | |
| Total | 54 | 73% | 50 | 68% | 17 | 23% | 3 | 4% | 2 | 3% | 74 | |
| MDMA | None | 64 | 70% | 54 | 59% | 23 | 25% | 0 | 0% | 3 | 3% | 91 |
| Minimal | 18 | 72% | 11 | 44% | 8 | 32% | 1 | 4% | 0 | 0% | 25 | |
| Subtotal | 82 | 89% | 65 | 81% | 31 | 94% | 1 | 33% | 3 | 75% | ||
| Severe | 2 | 2% | 3 | 4% | 1 | 3% | 0 | 0% | 1 | 25% | 5 | |
| Total | 92 | 68% | 80 | 59% | 33 | 24% | 3 | 2% | 4 | 3% | 136 | |
| Psychedelics | None | 91 | 73% | 55 | 44% | 29 | 23% | 4 | 3% | 6 | 5% | 124 |
| Minimal | 22 | 85% | 11 | 42% | 8 | 31% | 3 | 12% | 1 | 4% | 26 | |
| Subtotal | 113 | 93% | 66 | 83% | 37 | 90% | 7 | 78% | 7 | 100% | ||
| Severe | 6 | 5% | 8 | 10% | 3 | 7% | 0 | 0% | 0 | 0% | 8 | |
| Total | 121 | 73% | 80 | 48% | 41 | 25% | 9 | 5% | 7 | 4% | 165 | |
| Medical complications | ||||||||||||
| Marijuana | None | 122 | 74% | 69 | 42% | 33 | 20% | 6 | 4% | 7 | 4% | 164 |
| Minimal | 33 | 75% | 22 | 50% | 10 | 23% | 1 | 2% | 1 | 2% | 44 | |
| Subtotal | 155 | 92% | 91 | 93% | 43 | 93% | 7 | 100% | 8 | 100% | ||
| Severe | 2 | 1% | 1 | 1% | 0 | 0% | 0 | 0% | 0 | 0% | 2 | |
| Total | 168 | 75% | 98 | 44% | 46 | 21% | 7 | 3% | 8 | 4% | 224 | |
| Ketamine | None | 44 | 75% | 38 | 64% | 14 | 24% | 2 | 3% | 1 | 2% | 59 |
| Minimal | 4 | 80% | 4 | 80% | 1 | 20% | 1 | 20% | 0 | 0% | 5 | |
| Subtotal | 48 | 89% | 42 | 84% | 15 | 88% | 3 | 100% | 1 | 50% | ||
| Severe | 0 | 0% | 2 | 4% | 0 | 0% | 0 | 0% | 1 | 50% | 3 | |
| Total | 54 | 73% | 50 | 68% | 17 | 23% | 3 | 4% | 2 | 3% | 74 | |
| MDMA | None | 71 | 66% | 63 | 59% | 26 | 24% | 2 | 2% | 4 | 4% | 107 |
| Minimal | 14 | 74% | 11 | 58% | 6 | 32% | 1 | 5% | 0 | 0% | 19 | |
| Subtotal | 85 | 92% | 74 | 93% | 32 | 97% | 3 | 100% | 4 | 100% | ||
| Severe | 0 | 0% | 1 | 1% | 0 | 0% | 0 | 0% | 0 | 0% | 1 | |
| Total | 92 | 68% | 80 | 59% | 33 | 24% | 3 | 2% | 4 | 3% | 136 | |
| Psychedelics | None | 106 | 75% | 66 | 47% | 38 | 27% | 7 | 5% | 5 | 4% | 141 |
| Minimal | 15 | 71% | 11 | 52% | 3 | 14% | 1 | 5% | 2 | 10% | 21 | |
| Subtotal | 121 | 99% | 77 | 96% | 41 | 100% | 8 | 89% | 7 | 100% | ||
| Severe | 0 | 0% | 0 | 0% | 0 | 0% | 0 | 0% | 0 | 0% | 0 | |
| Total | 122 | 73% | 80 | 48% | 41 | 25% | 9 | 5% | 7 | 4% | 166 | |
| Gender | n | Median | Q1, Q3 | Mean Rank | df | H | Post-hoc results (Dunn-Bonferroni) | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sample 1-Sample 2 | z | P | |||||||||||
| Willingness Psilocybin trial | Female | 373 | 1.00 | 0.69, 1.00 | 251.48 | 2 | 17.389 | .000 | Female-Male | −4.094 | <.000 | ||
| Male | 149 | 1.00 | 0.90, 1.00 | 306.72 | |||||||||
| Other | 13 | 1.00 | 0.87, 1.00 | 298.19 | |||||||||
| Willingness MDMA trial | Female | 364 | 0.95 | 0.64, 1.00 | 246.04 | 2 | 17.229 | <.000 | Female-Male | −1.189 | <.000 | ||
| Male | 148 | 1.00 | 0.80, 1.00 | 297.44 | |||||||||
| Other | 12 | 1.00 | 0.94, 1.00 | 330.83 | |||||||||
| Willingness Psilocybin once approved | Female | 362 | 1.00 | 0.68, 1.00 | 247.55 | 2 | 12.295 | .002 | Female-Male | −3.360 | .002 | ||
| Male | 147 | 1.00 | 0.80, 1.00 | 292.52 | |||||||||
| Other | 13 | 1.00 | 0.85, 1.00 | 299.12 | |||||||||
| Willingness MDMA once approved | Female | 355 | 0.98 | 0.63, 1.00 | 243.69 | 2 | 13.672 | .001 | Female-Male | −3.414 | .002 | ||
| Male | 149 | 1.00 | 0.80, 1.00 | 289.33 | |||||||||
| Other | 12 | 1.00 | 0.91, 1.00 | 313.96 | Male-Other | −0.599 | <.000 | ||||||
|
Age | Education | |||||
|---|---|---|---|---|---|---|
| R | P | n | R | P | n | |
| Willingness Psilocybin trial | −0.052 | .233 | 535 | 0.152 | <.001 | 537 |
| Willingness MDMA trial | −0.060 | .172 | 523 | 0.086 | .050 | 526 |
| Willingness Psilocybin once approved | −0.102 | .020 | 521 | 0.137 | .002 | 523 |
| Willingness MDMA once approved | −0.071 | .108 | 516 | 0.105 | .017 | 517 |
| Post-hoc Results (Dunn-Bonferroni) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Sexual Orientation | n | Median | Q1, Q3 | Mean Rank | df | H | P | Sample1-Sample2 | z | P* | |
| Willingness Psilocybin trial | Bisexual | 96 | 1.00 | 0.85, 1.00 | 298.49 | 4 | 17.017 | .002 | |||
| Gay or lesbian | 22 | 1.00 | 1.00, 1.00 | 320.43 | |||||||
| Heterosexual | 359 | 1.00 | 0.65, 1.00 | 246.04 | Heterosexual—bisexual | 3.358 | .008 | ||||
| Unsure | 24 | 1.00 | 0.78, 1.00 | 286.71 | |||||||
| Other | 22 | 1.00 | 0.80, 1.00 | 277.77 | |||||||
| Willingness MDMA trial | Bisexual | 96 | 1.00 | 0.84, 1.00 | 299.90 | 4 | 14.009 | .007 | |||
| Gay or lesbian | 24 | 1.00 | 0.71, 1.00 | 284.27 | |||||||
| Heterosexual | 350 | 0.98 | 0.66, 1.00 | 243.65 | Heterosexual—bisexual | 3.578 | .003 | ||||
| Unsure | 23 | 0.92 | 0.65, 1.00 | 245.96 | |||||||
| Other | 20 | 0.95 | 0.80, 1.00 | 264.73 | |||||||
| Willingness Psilocybin once approved | Bisexual | 94 | 1.00 | 0.89, 1.00 | 294.53 | 4 | 18.575 | .001 | |||
| Gay or lesbian | 20 | 1.00 | 0.92, 1.00 | 309.78 | |||||||
| Heterosexual | 353 | 1.00 | 0.65, 1.00 | 239.59 | Heterosexual—bisexual | 3.533 | .004 | ||||
| Unsure | 24 | 1.00 | 0.89, 1.00 | 289.48 | |||||||
| Other | 21 | 1.00 | 0.83, 1.00 | 282.02 | |||||||
| Willingness MDMA once approved | Bisexual | 96 | 1.00 | 0.81, 1.00 | 295.72 | 4 | 17.124 | .002 | |||
| Gay or lesbian | 20 | 1.00 | 0.98, 1.00 | 309.05 | |||||||
| Heterosexual | 350 | 0.99 | 0.60, 1.00 | 238.93 | Heterosexual—bisexual | 3.663 | .002 | ||||
| Unsure | 22 | 0.96 | 0.71, 1.00 | 251.36 | |||||||
| Other | 19 | 1.00 | 0.75, 1.00 | 266.00 | |||||||
| Trauma Experience | Significant Willingness Variable | n | Median | Q1, Q3 | Mean Rank | z | P | |
|---|---|---|---|---|---|---|---|---|
| Workplace accidents | Willingness Psilocybin trial | No | 396 | 1.00 | 0.71, 1.00 | 261.83 | −1.994 | .046 |
| Yes | 141 | 1.00 | 0.80, 1.00 | 289.13 | ||||
| Willingness Psilocybin once approved | No | 384 | 1.00 | 0.72, 1.00 | 254.33 | −2.127 | .033 | |
| Yes | 139 | 1.00 | 0.77, 1.00 | 283.18 | ||||
| Willingness MDMA once approved | No | 378 | 1.00 | 0.62, 1.00 | 250.38 | −2.355 | .019 | |
| Yes | 139 | 1.00 | 0.76, 1.00 | 282.45 | ||||
| Vehicle Accidents | Willingness Psilocybin trial | No | 320 | 1.00 | 0.73, 1.00 | 259.19 | −1.977 | .048 |
| Yes | 217 | 1.00 | 0.78, 1.00 | 283.46 | ||||
| Willingness MDMA trial | No | 309 | 0.95 | 0.71, 1.00 | 252.71 | −2.109 | .035 | |
| Yes | 217 | 1.00 | 0.76, 1.00 | 278.87 | ||||
| Willingness Psilocybin once approved | No | 310 | 1.00 | 0.73, 1.00 | 250.17 | −2.383 | .017 | |
| Yes | 213 | 1.00 | 0.76, 1.00 | 279.22 | ||||
| Willingness MDMA once approved | No | 303 | 0.97 | 0.63, 1.00 | 246.90 | −2.384 | .017 | |
| Yes | 214 | 1.00 | 0.75, 1.00 | 276.13 | ||||
| Natural Disasters | Willingness Psilocybin once approved | No | 467 | 1.00 | 0.75, 1.00 | 257.54 | −2.148 | .032 |
| Yes | 56 | 1.00 | 0.89, 1.00 | 299.17 | ||||
| Military Combat | Willingness Psilocybin trial | No | 489 | 1.00 | 0.73, 1.00 | 265.08 | −2.077 | .038 |
| Yes | 48 | 1.00 | 0.90, 1.00 | 308.94 | ||||
| Physical Assault | Willingness Psilocybin trial | No | 251 | 1.00 | 0.61, 1.00 | 247.09 | −3.408 | .001 |
| Yes | 286 | 1.00 | 0.79, 1.00 | 288.23 | ||||
| Willingness MDMA trial | No | 239 | 0.95 | 0.61, 1.00 | 248.48 | −2.244 | .025 | |
| Yes | 287 | 1.00 | 0.75, 1.00 | 276.01 | ||||
| Willingness Psilocybin once approved | No | 237 | 0.98 | 0.65, 1.00 | 242.76 | −2.923 | .003 | |
| Yes | 286 | 1.00 | 0.77, 1.00 | 277.94 | ||||
| Willingness MDMA once approved | No | 237 | 0.90 | 0.59, 1.00 | 238.91 | −3.061 | .002 | |
| Yes | 280 | 1.00 | 0.75, 1.00 | 276.01 | ||||
| Domestic Violence | Willingness Psilocybin once approved | No | 267 | 1.00 | 0.65, 1.00 | 246.22 | −2.690 | .007 |
| Yes | 256 | 1.00 | 0.78, 1.00 | 278.46 | ||||
| Willingness MDMA once approved | No | 264 | 0.98 | 0.63, 1.00 | 244.71 | −2.418 | .016 | |
| Yes | 253 | 1.00 | 0.75, 1.00 | 273.91 | ||||
| Witnessed Violence | Willingness Psilocybin trial | No | 264 | 1.00 | 0.69, 1.00 | 255.26 | −2.244 | .025 |
| Yes | 273 | 1.00 | 0.78, 1.00 | 282.29 | ||||
| Willingness MDMA trial | No | 260 | 0.93 | 0.64, 1.00 | 247.24 | −2.632 | .008 | |
| Yes | 266 | 1.00 | 0.76, 1.00 | 279.39 | ||||
| Willingness Psilocybin once approved | No | 255 | 0.98 | 0.65, 1.00 | 242.22 | −3.220 | .001 | |
| Yes | 268 | 1.00 | 0.78, 1.00 | 280.82 | ||||
| Willingness MDMA once approved | No | 254 | 0.92 | 0.60, 1.00 | 239.35 | −3.198 | .001 | |
| Yes | 263 | 1.00 | 0.76, 1.00 | 277.97 | ||||
| Break-up | Willingness Psilocybin trial | No | 226 | 1.00 | 0.67, 1.00 | 249.42 | −2.771 | .006 |
| Yes | 311 | 1.00 | 0.79, 1.00 | 283.23 | ||||
| Willingness MDMA trial | No | 225 | 0.90 | 0.64, 1.00 | 245.83 | −2.502 | .012 | |
| Yes | 301 | 1.00 | 0.75, 1.00 | 276.71 | ||||
| Willingness Psilocybin once approved | No | 219 | 0.98 | 0.65, 1.00 | 238.74 | −3.294 | <.001 | |
| Yes | 304 | 1.00 | 0.80, 1.00 | 278.75 | ||||
| Migration | Willingness Psilocybin once approved | No | 487 | 1.00 | 0.75, 1.00 | 258.58 | −2.099 | .036 |
| Yes | 36 | 1.00 | 0.94, 1.00 | 308.25 | ||||
| Sports Injuries | Willingness Psilocybin once approved | No | 421 | 1.00 | 0.74, 1.00 | 256.14 | −1.986 | .047 |
| Yes | 102 | 1.00 | 0.84, 1.00 | 286.18 | ||||
| CH Physical Abuse | Willingness MDMA trial | No | 313 | 0.97 | 0.64, 1.00 | 250.64 | −2.553 | .011 |
| Yes | 213 | 1.00 | 0.78, 1.00 | 282.4 | ||||
| CH Emotional Abuse | Willingness Psilocybin trial | No | 194 | 0.98 | 0.61, 1.00 | 243.09 | −3.235 | .001 |
| Yes | 343 | 1.00 | 0.78, 1.00 | 283.66 | ||||
| Willingness MDMA trial | No | 193 | 0.85 | 0.60, 1.00 | 229.68 | −4.216 | <.001 | |
| Yes | 333 | 1.00 | 0.77, 1.00 | 283.1 | ||||
| Willingness Psilocybin once approved | No | 183 | 0.90 | 0.60, 1.00 | 230.12 | −3.903 | <.001 | |
| Yes | 340 | 1.00 | 0.78, 1.00 | 279.16 | ||||
| Willingness MDMA once approved | No | 183 | 0.85 | 0.56, 1.00 | 228.92 | −3.688 | <.001 | |
| Yes | 334 | 1.00 | 0.75, 1.00 | 275.48 | ||||
| CH Neglect | Willingness MDMA trial | No | 297 | 0.95 | 0.70, 1.00 | 252.56 | −2.041 | .041 |
| Yes | 229 | 1.00 | 0.75, 1.00 | 277.69 | ||||
| Willingness Psilocybin once approved | No | 291 | 1.00 | 0.72, 1.00 | 249.25 | −2.384 | .017 | |
| Yes | 232 | 1.00 | 0.77, 1.00 | 278 | ||||
| Willingness MDMA once approved | No | 288 | 0.97 | 0.63, 1.00 | 246.91 | −2.246 | .025 | |
| Yes | 229 | 1.00 | 0.74, 1.00 | 274.21 |
| Any Psychotherapy Tried? | n | Median | Q1, Q3 | Mean Rank | z | P | |
|---|---|---|---|---|---|---|---|
| Willingness Psilocybin trial | No | 110 | 1.00 | 0.81, 1.00 | 285.09 | −2.096 | .036 |
| Yes | 411 | 1.00 | 0.73, 1.00 | 254.55 | |||
| Willingness MDMA trial | No | 109 | 1.00 | 0.78, 1.00 | 273.16 | −1.528 | .127 |
| Yes | 401 | 1.00 | 0.70, 1.00 | 250.70 | |||
| Willingness Psilocybin once approved | No | 107 | 1.00 | 0.85, 1.00 | 286.34 | −2.783 | .005 |
| Yes | 401 | 1.00 | 0.74, 1.00 | 246.00 | |||
| Willingness MDMA once approved | No | 108 | 1.00 | 0.78, 1.00 | 273.31 | −1.866 | .062 |
| Yes | 395 | 1.00 | 0.64, 1.00 | 246.17 | |||
| Any Psychotherapy Tried? | |||||||
|---|---|---|---|---|---|---|---|
| Yes (n) | % | No (n) | % | χ2 | P | ||
| Psychedelics are generally harmful and addictive | Strongly agree | 28 | 5.8 | 9 | 7 | 10.518 | .033 |
| Agree | 67 | 13.9 | 12 | 9.3 | |||
| Neutral | 164 | 34 | 38 | 29.5 | |||
| Disagree | 98 | 20.3 | 19 | 14.7 | |||
| Strongly disagree | 126 | 26.1 | 51 | 39.5 | |||
| Psychedelics show promise | Strongly agree | 160 | 33.1 | 62 | 48.1 | 10.785 | .029 |
| Agree | 128 | 26.5 | 28 | 21.7 | |||
| Neutral | 171 | 35.4 | 32 | 24.8 | |||
| Disagree | 12 | 2.5 | 3 | 2.3 | |||
| Strongly disagree | 12 | 2.5 | 4 | 3.1 | |||
| Psychedelics should be researched | Strongly agree | 201 | 41.7 | 73 | 56.6 | 10.590 | .032 |
| Agree | 130 | 27 | 21 | 16.3 | |||
| Neutral | 119 | 24.7 | 29 | 22.5 | |||
| Disagree | 11 | 2.3 | 2 | 1.6 | |||
| Strongly disagree | 21 | 4.4 | 4 | 3.1 | |||