MDMA/ecstasy use and psilocybin use are associated with lowered odds of psychological distress and suicidal thoughts in a sample of US adults

J Psychopharmacol. 2022 Jan;36(1):46-56. doi: 10.1177/02698811211058923. Epub 2022 Jan 5.

Abstract

Background: Suicide is one of the leading causes of death worldwide and rates within the United States have risen over the past two decades. Hence, there is a critical need for novel tools to treat suicidal ideation and related mental health conditions. 3,4-Methylenedioxymethamphetamine (MDMA)/ecstasy and classic psychedelics may be two such tools.

Aims: The aim of this study was to assess non-causal associations between MDMA/ecstasy and classic psychedelic use and psychological distress and suicide risk.

Methods: In this study, we examined the aforementioned associations among 484,732 adult participants in the National Survey on Drug Use and Health (2008-2019).

Results: Lifetime MDMA/ecstasy use was associated with reduced odds of past year suicidal thinking (10% reduced odds; odds ratio (OR) = 0.90; 95% confidence interval, CI = (0.84-0.97); p < 0.01) and past year suicidal planning (OR = 0.88; 95% CI = (0.78-0.99); p < 0.05). Furthermore, lifetime psilocybin use was associated with reduced odds of past month psychological distress (OR = 0.78; 95% CI = (0.73-0.84); p < 0.001) and past year suicidal thinking (OR = 0.90; 95% CI = (0.83-0.96); p < 0.01). Finally, lysergic acid diethylamide (LSD) was associated with increased odds of past year suicidal thinking (OR = 1.07; 95% CI = (1.00-1.15); p < 0.05).

Conclusion: MDMA/ecstasy and psilocybin use are associated with reduced odds of suicidal thinking and related outcomes-though experimental studies are needed to determine whether these associations are causal. These findings call for more research into the efficacy of MDMA/ecstasy and classic psychedelics for treating psychological distress and suicidal thoughts and behaviors, and for updated drug legislation that allows for further investigation into these substances.

Keywords: Ecstasy; LSD; MDMA; NSDUH; psilocybin; psychedelics; suicide.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Hallucinogens / administration & dosage
  • Hallucinogens / pharmacology
  • Health Surveys
  • Humans
  • Lysergic Acid Diethylamide / administration & dosage
  • Lysergic Acid Diethylamide / pharmacology
  • Male
  • Middle Aged
  • N-Methyl-3,4-methylenedioxyamphetamine / administration & dosage
  • N-Methyl-3,4-methylenedioxyamphetamine / pharmacology*
  • Psilocybin / administration & dosage
  • Psilocybin / pharmacology*
  • Stress, Psychological / psychology*
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Suicidal Ideation*
  • United States
  • Young Adult

Substances

  • Hallucinogens
  • Psilocybin
  • Lysergic Acid Diethylamide
  • N-Methyl-3,4-methylenedioxyamphetamine