Clinical Characteristics of Emergency Visits Related to Recreational Psychedelic Use.
Kush V Bhatt, Joseph Friedman, Lindsay Benster, Rekha Narasimhan, Kevin Yang, Jyoti Mishra, Cory R Weissman, Dhakshin Ramanathan
Community mental health journal April 1, 2026 Peer reviewed DOI: 10.1007/s10597-026-01620-x via PubMed
Summary
Emergency department visits related to recreational psychedelic use were analyzed, identifying 232 cases primarily involving LSD, MDMA, and psilocybin. Common symptoms included agitation in 25.9% of cases and anxiety in 24.6%. About 11.2% required psychiatric hospitalization, with increased odds linked to concurrent cannabis use and histories of bipolar or primary psychotic disorders. Most presentations were manageable, but specific factors indicated a higher risk for severe outcomes.
Study at a glance
| Design | retrospective chart review |
|---|---|
| Sample size | 232 |
| Population | patients visiting the emergency department due to recreational psychedelic use |
| Key finding | Concurrent cannabis use and histories of bipolar or primary psychotic disorders are associated with increased odds of psychiatric hospitalization following psychedelic use. |
Abstract
Recreational psychedelic use is increasing, yet data on adverse events remains limited. This study characterized emergency department (ED) visits associated with recreational psychedelic use at UC San Diego Medical Center. We conducted a retrospective chart review of ED encounters (2010–2023). Cases were identified using ICD-10 hallucinogen-related codes and confirmed through manual review. Multivariable logistic regression was employed to identify factors associated with psychiatric hospitalization. We identified 232 cases, primarily related to LSD (35.0%), MDMA (30.2%), and psilocybin (24.0%). The cohort was predominantly young, white, and male. Common psychiatric symptoms included agitation (25.9%) and anxiety (24.6%). Common nonpsychiatric symptoms included nausea/vomiting (9.5%) and diaphoresis (5.2%). 11.2% of cases required psychiatric hospitalization. Factors associated with psychiatric hospitalization included concurrent cannabis use (OR = 10.9, 95% CI 3.37–39.64), history of bipolar disorder (OR = 12.67, 95% CI 2.35–70.43), and history of a primary psychotic disorder (OR = 17.10, 95% CI 2.01–187.49). Psychedelic-associated emergency visits present with various clinical characteristics. While most recreational psychedelic presentations are effectively managed in the emergency department, specific factors predict severe outcomes. Concurrent cannabis use and pre-existing psychotic or bipolar disorders are associated with increased odds of psychiatric hospitalization, underscoring the importance of targeted risk assessment in patients with these vulnerabilities.