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Intrigued by all the headlines about the mental health benefits of psychedelics and thinking of giving them a try? You may want to think twice, according to a new study that found a link between bad psychedelic trips and a more than twofold increased risk of death within five years.
“There’s a lot of media buzz about how psychedelic-assisted therapy is really promising in clinical trials. However, we wondered how people who aren’t in those trials may react in a more real-world setting,” said lead study author Dr. Daniel Myran, a family, public health and preventative medicine physician and researcher at the University of Ottawa in Ontario.
“We looked at people who’ve had a very severe adverse reaction to a hallucinogen and needed emergency care at a hospital,” Myran said. “We found their risk of death was 2.6 times higher than a similar person without the hallucination emergency.”
Some people fail to find a psychedelic experience beneficial, said Dr. Charles Raison, a professor of psychiatry and human ecology at the University of Wisconsin School of Medicine and Public Health in Madison.
“Maybe one in 20 people report having ongoing difficulties they ascribe to the psychedelic technique,” said Raison, who was not involved in the new research.
“A year later, they say, ‘I had an experience that was so distressing to me that it messed up my ability to function, or alienated me from my family, or gave me post-traumatic stress disorder.’”
However, the new study, published Monday in the Canadian Medical Association Journal, can only show an association between an earlier death and a bad hallucinogenic trip, said Raison, who is also the director of the Vail Health Behavioral Health Innovation Center in Colorado where psilocybin is studied.
“These studies, by their design, cannot definitively establish whether it is the bad experience with the psychedelic that’s setting people up for increased mortality,” he said. “It could well be that the things that drove the person to have a bad psychedelic experience are the things that then also make them more likely to die.”
The study analyzed medical data captured by Canada’s universal health system to see how many people visit the emergency room due to bad psychedelic experiences.
“We estimate that about 97% of all people who use hallucinogens do not require care in an emergency room,” Myran said.
“However, those who visit the hospital may have psychosis, very intense and disturbing hallucinations, or an intense mental health crisis,” he said. “They may have a lot of concern about feelings of self-harm, be profoundly depressed or having a panic attack.”
The study found suicide to be the most common reason for an early death, along with unintentional drug poisoning, respiratory disease and cancer.
Risk of suicide has been an issue even in controlled clinical trials on various hallucinogens, Raison said.
“In one study on psilocybin, three people out of 79 people in the high dose psilocybin group made a suicide attempt,” he said. “These were in people who found no benefit from the treatment.”
This adverse outcome occurred despite the fact that major clinical trials on psychedelics have carefully chosen participants with no worrisome medical histories, Myran said.
“The clinical trials carefully select the patients they admit into the study — people with a history of schizophrenia or mania with bipolar disorder who may react poorly are kicked out,” he said.
Doses of psychedelic in clinical trials are carefully measured and pure, Myran added. Hallucinogens purchased on the street, however, can contain unknown amounts of the drug and be laced with dangerous impurities.
In addition, nearly all clinical trials on psychedelics have been done with the assistance of trained therapists ready to intervene if things go wrong.
“You’re in a controlled environment with help standing by. That is very different from the experience for people outside of these trials,” Myran said.
The use of hallucinogenic drugs such as ketamine, psilocybin and LSD has increased rapidly over the past few decades. Approximately 12%, or 31.5 million American adults, have used psilocybin or LSD over their lifetime, according to a 2024 report by RAND Corporation, a research think tank. Psilocybin use, especially microdosing, appears to be the most popular, with over 8 million people using the psychedelic in 2023, far above all other substances.
In Canada, nearly 6% of adults used a psychedelic in 2023, said Myran, adding that use could rise to about 14% for those between the ages of 20 and 24.
“I worry that people read these positive headlines and say ,‘Oh, I should start taking these, it’ll be excellent for my mental health.’ We actually don’t have particularly good evidence for that,” Myran said. “I worry that some individuals might experience adverse events and harms.”
