Latent Classes of Lifetime Use of Seven Hallucinogens in the United States

Among U.S. adults who have ever used a hallucinogen, four distinct patterns of lifetime use emerge: a group primarily using psilocybin (16%), a larger group using both LSD and psilocybin (46%), a group mainly using ecstasy (23%), and a group using multiple hallucinogens (15%). Older age is associated with higher odds of being in the LSD/psilocybin class compared with the psilocybin-only class, and non-White participants have higher odds of being in the ecstasy class. These overlapping use patterns suggest that clinical trials and future policies should account for polysubstance hallucinogen experiences.

Study at a glance

Abstract

Interest in and use of hallucinogens appears to be growing in the United States, yet less is known about the use of multiple hallucinogens. The aims of this study are to characterize subgroups of lifetime hallucinogen use and to identify sociodemographic correlates of these subgroups. Latent class models were fit using 2021-2022 National Survey on Drug Use and Health (NSDUH) data on a sub-sample of individuals who reported having ever used any hallucinogen (n = 17,977). A four-class model identified the following subgroup classes: Psilocybin (16%), LSD/Psilocybin (46%), Ecstasy (23%), and a fourth class (15%) labeled Multiple substances, with high probabilities of use of psilocybin, LCD, and ecstasy, in addition to moderate probabilities of use of other hallucinogens. In survey-weighted multinomial logistic regression analyses, compared to the Psilocybin class, the adjusted odds of being in the LSD/Psilocybin class increased with age-group level (AORs = 1.5-6.4, 95% CIs:1.3-8.7), and non-White participants had higher odds of being in the Ecstasy class (AORs = 1.7-3.2, 95% CIs:1.1-4.4). As policies regulating and clinical practice with hallucinogens continue to evolve, these patterns of lifetime hallucinogen use demonstrate the overlapping nature of hallucinogen experiences in the U.S. population, which has implications for expanding clinical trial inclusion criteria and establishing a baseline for future trends.