A recent research study examined the connection between hallucinogen-related hospital admissions and subsequent psychosis, and whether preexisting psychiatric conditions could explain the observed association. The study, published in the Journal of Clinical Psychiatry used data from MarketScan Medicaid and commercial claims databases collected over the period spanning from 2015 to 2019.

The study sample included 273,466 individuals receiving treatment for substance use disorders who had experienced a substance-related emergency department visit or hospitalization. Researchers compared psychosis-related admissions occurring between 30 days and six months after the initial event among individuals with hallucinogen-related admissions and those with admissions related to other substances.

It was found that among the participants, psychosis diagnoses were observed more frequently after hallucinogen-related admissions than after admissions involving other substances (16.4% of participants compared with 6.6%). In addition, initial analyses indicated an increased risk of psychosis among individuals with hallucinogen-related admissions, but this apparent association disappeared after demographic and clinical factors were taken into account.

“If a patient presents with psychosis after using a psychedelic, our data suggests that the first move should not be to attribute the symptoms to the substance alone,” said the study’s lead author, Dr. Jacob Steinle, in an Author Insights video published on the journal’s website. “Essentially, the risk of subsequent psychotic disorder diagnosis vanished once we accounted for the fact that the people experiencing this adverse reaction were disproportionately likely to have a pre-existing psychiatric vulnerability.”

Based on their research findings, the authors suggested that caution is needed when interpreting epidemiological associations between hallucinogen use and psychosis. “Apparent associations between hallucinogen use and psychosis appear largely attributable to baseline psychiatric comorbidities rather than direct causal effects,” they wrote in the study’s conclusion. “These findings carry implications for evidence-based policy development, suggesting that observed epidemiological associations may reflect underlying vulnerability factors rather than hallucinogen-induced psychosis. Policymakers should consider these results when interpreting population-level data regarding hallucinogen safety profiles and regulatory frameworks.”