Microdosing psychedelics : Motivations, subjective effects and harm reduction

Toby Lea, Nicole Amada, Henrik Jungaberl, Henrike Schecke, Michael Klein

International Journal of Drug Policy, 2020, 75, 102600, 9 p.

Doi : 10.1016/j.drugpo.2019.11.008

A B S T R A C T

Background : In recent years there has been growing media attention on microdosing psychedelics (e.g., LSD, psilocybin). This refers to people routinely taking small doses of psychedelic substances to improve mental health and wellbeing, or to enhance cognitive performance. Research evidence is currently limited. This paper examines microdosing motivations, dosing practices, perceived short-term benefits, unwanted effects, and harm reduction practices.

Methods : An international online survey was conducted in 2018 examining people’s experiences of using psychedelics. Eligible participants were aged 16 years or older, had used psychedelics and could comprehend written English. This paper focuses on 525 participants who were microdosing psychedelics at the time of the survey.

Results : Participants were primarily motivated to microdose to improve mental health (40%), for personal development (31%) and cognitive enhancement (18%). Most were microdosing with psilocybin (55%) or LSD/1PLSD (48%). Principal components analysis generated three factors examining perceived short-term benefits of microdosing: improved mood and anxiety, enhanced connection to others and environment, and cognitive enhancement; and three factors examining negative and potentially unwanted effects: stronger-than-expected psychedelic effects, anxiety-related effects, and physical adverse effects. Most participants (78%) reported at least one harm reduction practice they routinely performed while microdosing.

Conclusion : Our findings suggest that people microdosing are commonly doing so as a self-managed therapy for mental health, either as an alternative or adjunct to conventional treatments. This is despite psychedelics remaining prohibited substances in most jurisdictions. Recent findings from clinical trials with standard psychedelic doses for depression and anxiety suggest that a neurobiological effect beyond placebo is not unreasonable. Randomised controlled trials are needed, complemented by mixed methods social science research and the development of novel resources on microdosing harm reduction.

Keywords : Microdose, LSD, Psilocybin, Mental health, Cognition, Treatment

 

Introduction

Over the past decade, there has been renewed interest in the use of psychedelics to treat mental and substance use disorders, leading to clinical trials of psilocybin and ayahuasca for treatment-resistant depression (Carhart-Harris et al., 2018; Palhano-Fontes et al., 2019), psilocybin for alcohol dependence (Bogenschutz et al., 2015) and nicotine dependence (Johnson, Garcia-Romeu & Griffiths, 2017), and
psilocybin and lysergic acid diethylamide (LSD) for end-of-life anxiety in terminally ill patients (Gasser et al., 2014; Griffiths et al., 2016; Liechti, 2017). Administered on a small number of occasions in a therapeutic setting, phase II studies have shown positive results and few adverse effects (Nichols, 2016; Reiche et al., 2018). The US Food and Drug Administration has recently granted psilocybin “breakthrough therapy” designation to expedite its clinical development and review, which could lead to psychedelic therapy as a legally available treatment for some mental disorders in the next decade (COMPASS Pathways, 2018).

Coinciding with the resurgence of clinical psychedelic research, microdosing” has gained considerable media attention in recent years. Microdosing refers to the ingestion of low to very low doses of psychedelics (typically between 5 and 10 percent of a standard dose) on a routine schedule (e.g., every third day) without the intention of experiencing noticeable drug effects (Fadiman, 2011; Kuypers et al., 2019; Liechti, 2019). Although a recent randomised controlled trial reported 13mcg of LSD as a threshold microdose (Bershad, Schepers, Bremmer, Lee, & de Wit, 2019), there is currently no scientific consensus about what dose ranges constitute LSD and psilocybin microdoses (Kuypers et al., 2019; Passie, 2019). News and popular media articles have described it as a workplace trend, first reported among technology professionals in Silicon Valley who microdosed as a cognitive “biohack” to enhance productivity, focus and creative problemsolving (Dean, 2017; Glatter, 2015). Perhaps driven to some extent by the promising findings of clinical research with larger doses, there have also been increasing reports of people microdosing as a self-managed treatment for depression, anxiety and other mental disorders (Hutten, Mason, Dolder & Kuypers, 2019; Waldman, 2017).

While some research on small LSD doses was conducted before psychedelics were banned in the USA in 1970 (Passie, 2019), contemporary research on microdosing is in its infancy. Two recent randomised controlled trials of LSD microdosing have shown changes in time perception following LSD administration (Yanakieva et al., 2019), and dose-related increases in ratings of “vigor” (Bershad, Schepers, Bremmer, Lee, & de Wit, 2019). A naturalistic experimental study found improved performance on problem-solving tasks after taking a nonblinded microdose of psilocybin truffles (Prochazkova et al., 2018). In addition, observational online studies have reported improved mood, wellbeing and cognitive performance on days when a microdose is ingested (Anderson et al., 2019; Fadiman & Korb, 2019; Politi & Stevenson, 2019), and fewer symptoms of depression and stress after six weeks of microdosing (Politi & Stevenson, 2019). An online interview study reported perceived improvements in mood and creativity with few adverse effects (Johnstad, 2018), while another qualitative study reported that interviewees rationalised microdosing as a functional form of drug use akin to taking a supplement, in order to be “the best possible version of themselves” (Webb, Copes & Hendricks, 2019, p. 35).

People are motivated to use psychedelics at standard doses for a range of reasons including to enhance pleasure, as treatments for mental and physical health concerns, for self-exploration and development, and spiritual growth (Móró, Simon, Bárd & Racz, 2011; Prepeliczay, 2002). At standard doses, LSD and psilocybin induce enduring improvements in mood and well-being, positive attitudes towards life, social connectedness and empathy, according to self-report, irrespective of their motivations for use (Carhart Harris et al., 2016; Lerner & Lyvers, 2006; Schmid & Liechti, 2018; Watts, Day, Krzanowski, Nutt & Carhart-Harris, 2017). While much has been published about harm reduction practices among MDMA users – with MDMA categorised as a stimulant or entactogen – relatively little has been published about psychedelic harm reduction (Allott & Redman, 2006; Bøhling, 2017; Global Drug Survey, 2015; Van Schipstal, Mishra, Berning & Murray, 2016).

This paper aims to describe the motivations, dosing practices, shortterm perceived benefits and unwanted effects, and harm reduction practices of people microdosing psychedelics. A secondary aim was to determine whether different microdosing motivations and microdosed substances were associated with perceived benefits and unwanted effects.

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