Microdosing psychedelics: Demographics, practices, and psychiatric comorbidities

Daniel Rosenbaum, Cory Weissman, Thomas Anderson, Rotem Petranker, Le-Anh Dinh-Williams, Katrina Hui and Emma Hapke

Journal of Psychopharmacology, 2020, 1-11.

doi.org/10.1177/0269881120908004

 

Abstract

Rationale : Microdosing psychedelics – the practice of consuming small, sub-hallucinogenic doses of substances such as LSD or psilocybin – is gaining attention in popular media but remains poorly characterized. Contemporary studies of psychedelic microdosing have yet to report the basic psychiatric descriptors of psychedelic microdosers.

Objectives : To examine the practices and demographics of a population of psychedelic microdosers – including their psychiatric diagnoses, prescription medications, and recreational substance use patterns – to develop a foundation on which to conduct future clinical research.

Methods : Participants (n = 909; Mage = 26.9, SD = 8.6; male = 83.2%; White/European = 79.1%) recruited primarily from the online forum Reddit completed an anonymous online survey. Respondents who reported using LSD, psilocybin, or both for microdosing were grouped and compared with non microdosing respondents using exploratory odds ratio testing on demographic variables, rates of psychiatric diagnoses, and past-year recreational substance use.

Results : Of microdosers, most reported using LSD (59.3%; Mdose = 13 mcg, or 11.3% of one tab) or psilocybin (25.9%; Mdose = 0.3 g of dried psilocybin mushrooms) on a one-day-on, two-days-off schedule. Compared with non-microdosers, microdosers were significantly less likely to report a history of substance use disorders (SUDs; OR = 0.17 (95% CI: 0.05–0.56)) or anxiety disorders (OR = 0.61 (95% CI: 0.41–0.91)). Microdosers were also more likely to report recent recreational substance use compared with non-microdosers (OR = 5.2 (95% CI: 2.7–10.8)).

Conclusions : Well-designed randomized controlled trials are needed to evaluate the safety and tolerability of this practice in clinical populations and to test claims about potential benefits.

Keywords : Psychedelics, microdosing, psilocybin, LSD, substance use

 

Introduction

Microdosing refers to the use of a low, typically sub-perceptual dose of a pharmacological substance. In the context of the use of classic psychedelic drugs – for example lysergic acid diethylamide (LSD) and psilocybin (psilocin) – microdosing refers to ingesting sub-hallucinogenic amounts of the substance, approximately 1/10th of what would be considered a standard psychoactive dose (Fadiman, 2011; Kuypers et al., 2019). The classic psychedelics are a group of compounds that share 5-HT2A receptor agonist properties, and which, at higher doses, induce profound alterations in thought, perception, and emotion (Halberstadt, 2015; Nichols, 2016; Rickli et al., 2016), along with experiences of ego dissolution (Letheby and Gerrans, 2017; Milliere, 2017), and/or mystical-type experiences (Griffiths et al., 2011; Liechti et al., 2017). Various studies have demonstrated the safety and low addiction potential of psychedelics in healthy and clinical populations (Johnson et al., 2018; Nichols, 2016). In addition, recent studies have reported the potential efficacy of psychedelic-assisted psychotherapy for patients with anxiety associated with advanced cancer and other life-threatening illnesses (Gasser et al., 2014; Griffiths et al., 2016; Grob et al., 2011; Ross et al., 2016), alcohol use disorder (Bogenschutz
et al., 2015), tobacco use disorder (Johnson et al., 2014), and major depressive disorder (Carhart-Harris et al., 2016).

Coverage of microdosing in popular media in recent years – including features in Rolling Stone (2015), Wired (2016), and The New York Times (2017) – has described some purported benefits of microdosing psychedelics, such as alleviating depression, migraines, and chronic-fatigue syndrome; improving concentration and reducing anxiety; and enhancing creativity (Leonard, 2015; Solon, 2016; Waldman, 2017a). In addition, anecdotal reports suggest that microdosing may improve cognitive performance (Waldman, 2017b; Wong, 2017). Despite these reports, there remains a dearth of academic research describing the practice of microdosing, including the specific substances consumed, doses and dosing schedules, and relevant demographic data of microdosers. Few scientific articles on microdosing among human subjects have been published, including two by our group (Anderson et al., 2018, 2019). Where relevant to our findings, these studies are discussed in greater detail below. There have yet to be controlled clinical studies of psychedelic microdosing, and while this growing literature provides a valuable base from which to conduct future studies, it does not yet address the important relationships between participants’ microdosing practices and their psychiatric diagnoses, prescription medications, and recreational substance use patterns.

Here we report on results of a cross-sectional observational study describing the characteristics and practices of a sentinel population of psychedelic drug microdosers identified through an anonymous online survey. The primary aim of this study is to describe the demographics, practices, and basic psychiatric descriptors of a large group of English-speaking adult microdosers. This report is part of a broader examination of survey response data that included testing of pre-registered hypotheses about microdosing and personality variables (Anderson et al., 2018), which showed that current and former microdosers scored lower on measures of dysfunctional attitudes and negative emotionality and higher on wisdom, open-mindedness, and creativity when compared with non-microdosing respondents. A qualitative analysis of open-ended survey responses pertaining to microdosing benefits and drawbacks was also performed, which found that improved mood and focus were the most commonly-reported beneficial outcomes, whereas physiolgical discomfort and increased anxiety were most commonly reported as challenging outcomes (Anderson et al., 2019).

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