Rural-urban divide in risk perception of LSD: Implications for psychedelic-assisted therapy

J Rural Health. 2025 Jan;41(1):e12906. doi: 10.1111/jrh.12906.

Abstract

Background: Recent legislative initiatives in the United States have focused on the medical and legal status of psychedelics, prompting interest in understanding public perceptions of their risks. This study investigates rural-urban differences in the perception of LSD and cannabis risks using national survey data.

Methods: Data from the National Survey of Drug Use and Health (NSDUH) between 2015 and 2021 were analyzed. Logistic regression models were used to compare risk perceptions of LSD and cannabis between rural and urban respondents, adjusting for relevant factors.

Results: Rural residents were 1.2 to 1.4 times more likely to perceive using LSD once or twice as of great risk compared to urban residents during the survey period. However, the perception of monthly cannabis use as having great risk was slightly higher among rural residents only until 2019, with no significant differences observed in 2020 and 2021.

Conclusion: The study highlights a significant rural-urban divide in the perception of LSD risk, which could impact policymaking on psychedelic therapies. Understanding these differences is crucial for developing effective and equitable policies regarding psychedelic substances and treatments.

Keywords: drug law; policy; psychedelics; public health; rural‐urban divide.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Hallucinogens* / therapeutic use
  • Humans
  • Logistic Models
  • Lysergic Acid Diethylamide* / therapeutic use
  • Male
  • Middle Aged
  • Perception
  • Rural Population* / statistics & numerical data
  • Surveys and Questionnaires
  • United States
  • Urban Population* / statistics & numerical data

Substances

  • Hallucinogens
  • Lysergic Acid Diethylamide