The Rise of Psilocybin Use in the United States: A Multisource Observational Study
Annals of Internal Medicine April 21, 2025 Karilynn Rockhill, Joshua C. Black, Michael S. Ladka et al. 29 citations
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Andrew A. Monte
Denver Health Medical Center
5 papers in the library · 40 citations · publishing 2024-2026
Papers
Optimizing real-world benefit and risk of new psychedelic medications: the need for innovative postmarket surveillance
Nature Mental Health May 1, 2024 Joshua C. Black, Andrew A. Monte, Nabarun Dasgupta et al. 5 citations
As psychedelic-assisted psychotherapy nears FDA approval and broader use in the USA, current postmarket surveillance systems are ill-suited to monitor its real-world safety and effectiveness. Without a fit-for-purpose program, risks include misattributing adverse events to illicit psychedelics and failing to achieve equitable patient access. A successful surveillance mosaic should incorporate environmental, personal, and outcome domains to ensure safe, appropriate, and equitable care. The authors argue for intentionally designed data systems to proactively monitor utilization and inform reasonable limitations.
Comparing Substance Use Consequences between Serotonergic Psychedelics, MDMA, and other Drugs of Abuse Among United States Adults with History of Psychiatric Illness
International Journal of Mental Health and Addiction April 1, 2025 Joshua C. Black, Nicole Schow, Hannah L. Burkett et al. 3 citations
Among US adults with a history of anxiety, major depression, PTSD, or bipolar disorder, past use of serotonergic psychedelics or MDMA is more common than in the general population—for example, 9.2% of those with bipolar disorder report such use versus 2.6% overall. Using a validated screening tool, psychedelic use was linked to higher scores indicating more severe substance use disorder risk, even after accounting for other drug use. However, the increase in risk was smaller than that associated with opioids or stimulants. The authors suggest that managing substance use disorder risks in psychedelic-assisted therapy may require different approaches than those used for other drugs.
Psilocybin Trends in States That Decriminalized Use
JAMA March 12, 2026 Joshua C. Black, Gabrielle E. Bau, Ryan R. Cook et al. 2 citations
After Oregon and Colorado decriminalized psilocybin, 12-month use of the substance increased in both states. The survey data show that the estimated prevalence of past-year psilocybin use rose in Oregon and Colorado compared with the period before decriminalization. The findings suggest that decriminalization policies are associated with higher rates of psilocybin use.
Commentary on Darkeet al.: Expanded psychedelic access requires new safety monitoring systems
Addiction June 17, 2024 P. Todd Korthuis, Adrianne R. Wilson‐poe, Joshua C. Black et al. 1 citation
As psychedelic use expands, adverse effects will increase proportionally. Darke et al. characterized 33 LSD and 10 psilocybin-related deaths in Australia between 2000 and 2023, finding that traumatic accidents and physical self-harm in private settings accounted for most deaths. The 43 deaths over 24 years are rare compared to the more than 325,000 Australians who reported using hallucinogens in 2019 alone. Co-use of other substances was common: 75% of LSD cases and 80% of psilocybin cases involved other substances. The findings suggest regulated services must consider harm reduction, including skilled supervision, screening for comorbidities, and counseling against other drug use. Better population-level monitoring frameworks are urgently needed as legal frameworks for psychedelic services expand.