A survey of THC-O-acetate users found that the semi-synthetic cannabinoid produces low to moderate cognitive distortions—altered sense of time, concentration difficulties, and short-term memory problems—with few visuals or hallucinations. Scores on the Mystical Experience Questionnaire were significantly below the threshold for a complete mystical experience across all four dimensions. Users who had previously used classic psychedelics (5-HT2A agonists) scored lower on all dimensions. When asked directly, 79% of respondents said using THC-O-acetate is "not at all" or "a little" of a psychedelic experience. Some reports of psychedelic effects may stem from expectations or contaminants.
Most people who use THCO, a semisynthetic cannabinoid derived from hemp, vape it (74.9%), while about a quarter dab it (24.3%) and tend to use higher temperatures than those who vape. A small portion of users (12.0%) expressed concerns about the risk of ketene gas, which can form when THCO is heated and is harmful to the lungs. Because multiple factors influence ketene formation and consumer temperature choices may enable it, more research is needed to understand the harm profile of hemp-derived substances like THCO.