Recent research reveals significant health risks associated with psychedelic use requiring emergency medical intervention, raising important questions about the safety of these substances outside controlled clinical settings.
Doubled Mortality Risk Following Psychedelic-Related ER Visits
People who require emergency room treatment after using hallucinogens face a 2.6 times higher risk of death from any cause within five years compared to the general population, according to a new study published in the Canadian Medical Association Journal.
The research, led by Dr. Marco Solmi and Dr. Daniel Myran from the University of Ottawa, analyzed records of emergency room visits and hospitalizations among more than 11.4 million Ontario residents aged 15 and older between 2006 and 2022.
"Despite the growing popularity of hallucinogen use, we know surprisingly little about potential adverse effects of hallucinogens, such as mortality risks," said Dr. Myran, research chair in social accountability at the University of Ottawa.
The study found particularly elevated risks for specific causes of death among those treated for hallucinogen use:
- 5.2 times increased risk for suicide
- 2.9 times increased risk for cancer
- 2.5 times increased risk for lung disease
- 2.0 times increased risk for overdose
These mortality risks were higher than those associated with alcohol-related emergency care but lower than risks linked to opioid or stimulant use.
The researchers noted that when they excluded individuals with pre-existing mental health or substance use disorders from their analysis, the overall mortality risk was even higher—3.2-fold above the general population.
Psychedelics and Schizophrenia: A Concerning Connection
A separate study published in JAMA Psychiatry has identified another serious risk associated with hallucinogen use. The research found that patients who visit emergency rooms following psychedelic use have a 21-fold higher risk of developing schizophrenia compared to the general population.
Even after controlling for existing substance use and mental health disorders, there remained a 3.5-fold increased risk of schizophrenia following emergency treatment for psychedelic use.
The study analyzed health data for more than 9.2 million Ontario residents aged 14 to 65 between 2008 and 2021. Approximately 4% of people were diagnosed with schizophrenia within three years of an ER visit involving hallucinogens, compared to only 0.15% of the general population during the study period.
"Our findings underscore a concerning link between hallucinogen use that requires care in the emergency room and increased risk of schizophrenia," Dr. Myran explained.
Rising Prevalence Amid Growing Therapeutic Interest
Both studies come at a time when psychedelic use is increasing significantly. The percentage of U.S. residents reporting hallucinogen use more than doubled from nearly 4% in 2016 to almost 9% in 2021. Similarly, annual rates of emergency room visits involving hallucinogens in Ontario increased by 86% between 2014 and 2021.
This rise coincides with growing scientific interest in the therapeutic potential of substances like ketamine, psilocybin, LSD, ayahuasca, and MDMA for treating mental health and substance use disorders.
Dr. Solmi emphasized the need for balanced communication: "The findings highlight the need for ongoing investigation of and communication about both potential benefits and risks from hallucinogen use, particularly use outside clinical trial settings, given rapid increases in general population use."
Contextualizing the Risks
The researchers noted important demographic and health factors that may contribute to these elevated risks. People who needed hospital care for hallucinogen use were more likely to:
- Live in low-income neighborhoods
- Have experienced homelessness
- Have chronic health problems
- Have been treated for mental health or substance use disorders in the previous three years
Both research teams acknowledged that their findings cannot establish a direct causal relationship between psychedelic use and the observed health risks. The studies specifically examined cases serious enough to require emergency medical attention, which may represent more extreme scenarios than typical recreational use.
Clinical Implications and Safety Considerations
The researchers emphasized the contrast between their findings and the safety profile observed in controlled clinical trials of psychedelic-assisted therapy.
"Contemporary clinical trials have not observed any short-term increase in risk of severe adverse events, including death, for trial participants," Dr. Myran noted. "However, these studies involve careful supervision and therapy for trial participants and exclude people at high risk of adverse outcomes."
Clinical trials typically implement important safeguards, such as excluding individuals with personal or family histories of schizophrenia and providing close monitoring during psychedelic experiences.
The findings serve as a timely reminder about the potential risks of hallucinogen use outside of carefully controlled settings, particularly as public interest in these substances continues to grow. They also highlight the importance of emergency physicians being aware of the mental health risks faced by patients who present after psychedelic use.
As research into both the therapeutic potential and risks of psychedelics continues, these studies provide valuable data to inform public health approaches and clinical practice regarding these increasingly popular substances.
