A new analysis suggests that while the use of psychedelic substances appears to be increasing in the United States, this trend has not resulted in a corresponding surge in emergency room visits or hospitalizations. The findings indicate that severe adverse events requiring hospital care for hallucinogens remain comparatively rare when measured against other substances like alcohol and opioids. This research was published in JAMA Network Open.
The cultural landscape regarding psychedelics is shifting rapidly in the United States. Changes in state and local laws regarding decriminalization are occurring alongside increased media attention on the potential therapeutic benefits of drugs like psilocybin and MDMA. Government agencies have granted breakthrough therapy designations to some of these substances, acknowledging their potential medical utility.
This changing landscape raises important safety questions for public health officials. It is necessary to understand whether increased availability and reduced stigma are leading to more adverse health outcomes in the general population. Jacob Steinle, a psychiatry resident, and Kevin Xu, an assistant professor at Washington University in St. Louis, led an investigation to address this gap.
“Hallucinogen use is increasing in recreational settings, and legislation around clinical use is evolving,” explained Steinle. “Prior to the study, relatively little was known about the safety of these substances in real-world settings beyond small clinical trials or theoretical risk assessments. We wanted to investigate the prevalence of hospitalizations associated with hallucinogens to address this knowledge gap.”
To address this, the research team designed a retrospective cohort study using large-scale administrative data. They utilized records from the Merative MarketScan Commercial and Multi-State Medicaid databases.
These databases provide a comprehensive view of healthcare claims from a diverse population across the country. The study period spanned seven years, covering data from 2016 through 2023. The investigators specifically focused on individuals between the ages of 16 and 64 years.
This age range captures the demographic groups most likely to engage in substance use. The researchers focused on identifying specific medical codes associated with hallucinogen-related disorders. They used the International Statistical Classification of Diseases, Tenth Revision, known as ICD-10.
Specifically, they looked for the code F16, which denotes hallucinogen-related issues in medical records. The team calculated the monthly rate of these admissions to track changes over time. They expressed this rate as a proportion of all substance-related emergency or hospital admissions.
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