Examining associations between MDMA/ecstasy and classic psychedelic use and impairments in social functioning in a U.S. adult sample

Social functioning problems are common in mental health disorders, but effective treatments are limited. Analyzing data from a large U.S. national survey (2015–2019, over 214,000 adults), lifetime use of MDMA/ecstasy was linked to lower odds of three social difficulties: dealing with strangers (9% lower odds), participating in social activities (10% lower odds), and being prevented from social activities (16% lower odds). Lifetime mescaline use was also linked to lower odds of difficulty with strangers (15% lower odds). Other psychedelics showed no benefit or were associated with increased social difficulties. The authors note that experimental studies are needed to determine if these relationships are causal.

Study at a glance

Abstract

Abstract Impairment in social functioning is a common source of morbidity across many mental health disorders, yet there is a dearth of effective and easily implemented interventions to support social functioning. MDMA/ecstasy and classic psychedelics (psilocybin, LSD, peyote, mescaline) represent two potential treatments for impairments in social functioning, as evidence suggests these compounds may be supportive for alleviating social difficulties. Using a nationally representative sample of U.S. adults from the National Survey on Drug Use and Health (2015–2019) ( N = 214,505) , we used survey-weighted multivariable ordinal and logistic regression to examine the associations between lifetime use of the aforementioned compounds and impairments in social functioning in the past year. Lifetime MDMA/ecstasy use was associated with lowered odds of three of our four social impairment outcomes: difficulty dealing with strangers (aOR 0.92), difficulty participating in social activities (aOR 0.90), and being prevented from participating in social activities (aOR 0.84). Lifetime mescaline use was also associated with lowered odds of difficulty dealing with strangers (aOR 0.85). All other substances either shared no relationship with impairments in social functioning or conferred increased odds of our outcomes. Future experimental studies can assess whether these relationships are causal.