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The Relationship Between Psychedelic Use and Alcohol Use Disorder in a Nationally Representative Sample.

James M Zech, Jérémie Richard, Grant M Jones

Journal of psychoactive drugs November 9, 2025 DOI: 10.1080/02791072.2025.2583967 via PubMed

Summary

AI-generated from the abstract

In a nationally representative sample of 139,524 adults, past-year LSD use was linked to 30% lower odds of alcohol use disorder (AUD) and 15.7% fewer AUD symptoms, while MDMA and ketamine use showed no significant association with AUD or its symptoms. The findings suggest that different psychedelics relate differently to AUD risk, with LSD specifically associated with reduced alcohol-related problems.

Study at a glance

Characteristics Observational cross-sectional study Randomized Peer reviewed
Sample size 139,524
Population Nationally representative sample of US adults
Topics Ketamine LSD MDMA Psilocybin
Keywords Aud Alcohol
Key finding Past-year LSD use was associated with lower odds of AUD and fewer AUD symptoms, whereas MDMA and ketamine use were not significantly associated with AUD.

Abstract

Psychedelic-assisted interventions are emerging as potential treatments for substance use disorders, including alcohol use disorder (AUD). While recent randomized controlled trials suggest efficacy for certain psychedelics and related compounds in treating AUD, the impact of naturalistic psychedelic use on problematic alcohol consumption remains underexplored. This study examines associations between psychedelic use and AUD in a nationally representative sample (N = 139,524). Logistic regression was used to examine the association between AUD and past-year use of LSD, MDMA, and ketamine, controlling for demographics and comorbid substance use. Past-year LSD use was significantly associated with lower odds of AUD (adjusted odds ratio [aOR] = 0.70, p = .006). However, use of MDMA (aOR = 1.17, p = .229) and ketamine (aOR = 1.28, p = .235) was not associated with AUD. In a quasi-Poisson regression analysis, past-year LSD use was found to be associated with 15.7% fewer AUD symptoms (IRR = 0.84, 95% CI: 0.72 - 0.98, p = .033), but neither past-year MDMA nor past-year ketamine use were significantly associated with AUD symptoms (MDMA: IRR = 0.97, 95% CI: 0.83 - 1.13, p = .731; ketamine: IRR = 1.21, 95% CI: 0.93 - 1.57, p = .139). Taken together, these findings indicate differential associations between specific psychedelics and AUD, with LSD use linked to a reduced risk of AUD. The results underscore the need for further research into the mechanisms by which LSD may influence alcohol use and AUD risk.

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