A cross-sectional survey of 3,168 U.S. adults with lifetime psychedelic use found that most (87.9%) reported no difficulties. Among those who did, 6.4% experienced post-acute difficulties lasting more than one day, and 1.3% for more than one year. The most common difficulties were general anxiety, negative changes in self-concept, and social disconnection. Childhood adversity was associated with higher odds of psychedelic-related difficulties: individuals with 2, 3, or 4 or more adverse childhood experiences had roughly double to nearly triple the odds of difficulties compared to those with none. Those with 4 or more ACEs also had higher odds of difficulties persisting beyond one day or one week.
Lifetime MDMA use was not significantly associated with meaning in life overall, but a significant interaction emerged: among Swedish adults with a history of childhood trauma, those who had ever used MDMA reported higher meaning in life than those who had not. Meaning in life was measured using the presence subscale of the Meaning in Life Questionnaire. The findings suggest MDMA use may relate to psychological resilience in trauma-exposed populations, though further longitudinal and experimental research is needed to test causal direction.