With regard to rodent models of PTSD, using psychedelics in combination with or fear extinction training could possibly strengthen these specific circuits to mitigate fear responses. A) Percentage of respondents who stopped using at least 1 psychedelic substance in a regular dose (white bar) or a microdose (black bar) depicted per reason. (B) Percentage of respondents who experienced negative side effects and currently microdose (light grey bar) or who experience negative side effects and stopped microdosing (dark grey bar) depicted per type effect. (C) Percentage of respondents who experienced negative side effects and currently microdose (light grey bar) or who experienced negative side effects and stopped microdosing (dark grey bar) depicted per effect onset. An online questionnaire was advertised to psychedelic users on several psychedelic websites and fora between March and July 2018.
Additionally, comparison of effectiveness of different kind of psychedelics was not possible due to the low cell count for some of the separate substances. Future studies might focus on the effectiveness of LSD compared to psilocybin, for example, as anecdotal reports state that microdosing with LSD produces more stimulating effects compared to psilocybin (11). LSD could therefore be less suited in the treatment of anxiety disorders, as anxiety is already a state of hyperarousal (33), and more suitable in disorders characterized by biological hypo-arousal which is the case in ADHD (34). In addition, the sample was too small in order to make a comparison between microdosing and the different kind of offered treatments, such as medication or therapy sessions. The promotion of mindfulness was the most highly endorsed motivation for microdosing among respondents who did not report mental health conditions, which suggests that efforts to enhance psychological well-being are primary even among those who are not microdosing to address more pronounced psychological distress.
- The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
- One small study did find glimmers of an effect of small LSD doses on vigor and elation in people with mild depression when compared with a placebo.
- Additionally, unavailability of an Android OS version of the QC application at the time of study limited participation to those with access to Apple devices.
- However, there is a limited number of evaluated harm reduction interventions for users of psychedelic drugs to date.
Table 5.
This analysis was supplemented with a 2 × 2 univariate ANOVA with microdose status (Microdosers/Non-microdosers) and gender (Male/Female). Further supplementary analyses were conducted with the sample limited to participants who reported a previous experience with large-dose psychedelics in order to control for potential influence of larger dose psychedelic use on DASS-21 scores. Mental health was assessed with the questions “Do you currently have any psychological, mental health or addiction concerns? ” Participants who endorsed concerns identified specific mental health and substance use categories from a drop down menu, and were allowed to select more than one category. Motives were assessed through the question “Why did you start microdosing”, 18 response options were provided to participants including one opportunity to enter a free text response.
Furthermore, as a dose-specific difference in SRE of neurodevelopmental and physiological disorders was not seen, it could be hypothesized that such an experience is not necessary for these disorders, suggesting a different mode of therapeutic action. However, future clinical studies need to properly assess this, as well as further explore whether effects are specific and not due to other currently unmeasured components of psychedelic therapy (28), and investigate the neurobiological mechanisms underlying the acute quality of the experience. The present study aimed to investigate, by means of an online questionnaire, the self-rated effectiveness (SRE) of self-medication with psychedelic microdoses for diagnosed mental and physiological disorders, compared to conventional treatments and regular doses of psychedelics. Overall, findings showed that SRE of MDP on all three effectiveness questions (“Did it work?”, “Did symptoms disappear?”, “Did your quality of life improve?”) was higher compared to that of conventional treatments for both mental and physiological diagnoses. In contrast, SRE of microdoses was lower compared to that of regular psychedelic doses for mental disorders, while for physiological disorders no difference was shown. Specifically, compared to conventional treatments, further analysis demonstrated that MDP was only rated more beneficial on all three effectiveness questions for neurodevelopmental and anxiety disorders, ad hoc analyses revealed that only ADHD/ADD accounted for the results for neurodevelopmental disorders.
This finding shows some alignment with the conditions curated in psychedelic assisted therapy, where the patient has the experience individually, under supervision of therapist, and is encouraged to focus their attention inward using eyeshades to reduce external distraction 16. On the contrary, other users who report expansion intentions describe having the experience outside in nature, or in ceremonial settings with other participants present. Studies which focused on hedonistic motives for psychedelic use spoke about the pleasures of the experience itself, and the different ways of being and behaving with others and in nature, which may not be accessible to the individual when sober 42. Harm reduction interventions which are flexible in nature and consider the intention and desired experience of the user may reach a broader range of people who take psychedelics in naturalistic settings. In total, 1116 of the respondents were either currently microdosing (79.5%) or microdosed in the past (20.5%). Lysergic acid diethylamide (10 mcg) and psilocybin (0.5 g) were the most commonly used psychedelics with a microdosing frequency between 2 and 4 times per week.
- As such, we were limited in our ability to speak to the potential influence of more long standing microdosing practices among current microdosers and those with a history of microdosing.
- Preparation strategies undertaken prior to the psychedelic experience were commonly reported by users and show alignment to historical and clinical research with psychedelic drugs.
- The first article described and evaluated KomsiCare (KC), a crisis intervention service designed for a psychedelic user who may require support whilst attending Boom festival in Portugal 49.
- This dearth of effective treatments has led many individuals to self-medicate and seek alternative forms of treatment.
What are people who microdose reporting?
Further studies may wish to directly address the difference between microdosing and fully hallucinogenic doses on mood, anxiety, and other cognitive functions, preferably using a rigorous testing method as part of placebo-controlled trials. The substances now broadly classified as psychedelics have a very long history of salutary use among Indigenous peoples of the Americas/Turtle Island, including the Mazatec, Huichol, Shipibo, and other nations as well as the pre-Columbian Maya, Olmec, Zapotec, and Aztec societies1. These long-standing Indigenous health technologies have been subject to centuries of aggressive suppression, first through colonization and the Inquisition of the Americas and later by the US-led “war on drugs”2.
Associated Data
One-half of the microdosers (47.6%) indicated to have microdosed while working, of which studying and computer/office work were the most prevalent daily occupations. The motives to microdose in descending order were for performance enhancement (37%), mood enhancement (29%), out of curiosity (15%), and for self-medication (14%). The most reported side effects while microdosing were psychological in nature and occurred acutely.
Table 2.
When used in therapeutic settings for the purpose of mental health treatment, therapists also place high emphasis on ensuring that the patient has adequate psychological preparation, and the environmental setting is controlled and comfortable 59. There is congruence in the literature that set and setting variables impart a strong influence on the psychedelic experience, and our review shows that users in naturalistic settings demonstrate behaviours which reflect an awareness of this. Although users of psychedelic drugs seek information through a variety of sources, there has been limited formally evaluated harm reduction interventions developed and implemented for this population, highlighting a gap in the literature. Currently evaluated interventions have focussed on providing care during the psychedelic experience 49, 55. Drug checking services, although still valuable for detecting adulterations in psychedelics appear to be more widely adopted for drugs such as cocaine or MDMA which may carry higher physical risk profiles, particularly when substance purity is compromised 52. The digital preparation intervention developed through co-design with people who have taken psilocybin in naturalistic settings appears to be the most comprehensive intervention aimed to prepare users for their experience to date 35.
Responses that were reported in the “other” category were moved into one of the main categories in case of a match; in case there was no fitting category, they remained in the “other” category. Furthermore, frequency is reported for respondents that microdosed to work, followed by the frequency of their daily occupation. Outliers, defined as 3 SD away from the mean of the average amount used per psychedelic per route of administration, were calculated using z-scores for regular doses and microdoses. Considering the wide range (min-max) in reported doses (Tables 2 and 3), mode is given for dose per psychedelic. Respondent demographics were categorized into those who currently microdose and those who used to microdose. Frequencies were reported for age, gender, education, continent of origin, daily occupation, psychiatric/neurological/physical diagnoses, and psychedelic use history.
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In general, our findings highlight the diversity of practices gathered under the umbrella of microdosing. Indeed, although the present examination provides the most detailed account to date of the practice of stacking, our conclusions are nonetheless limited by a need for more fine grained detail regarding stacking practices. As such, disambiguating the form of Lion’s Mane consumed by participants is an important distinction for future studies in order to minimize potentially contradictory effects. Further, the literature on stacking substances independent of psychedelic substances is itself limited, particularly with respect to clinical trials with human subjects53,54. In light of the limitations inherent in generalizing from animal to human models, proposals regarding the mechanisms underlying stacking remain speculative and warrant cautious interpretation. Thus, a promising avenue motives and side-effects of microdosing with psychedelics among users pmc for future microdosing studies would be to distinguish the independent effects and synergies of psychedelic and stacked substances.
These limitations are counterbalanced by several strengths, including a substantially larger sample of microdosers than has been examined by prior research and that allowed for the more granular examination of relationships within and between distinct subgroups of microdosers. The inclusion of a large and comparable group of non-microdosers for the purpose of comparison is another strength and allowed a detailed examination of the associations between microdosing and mental health. More generally, these results highlight the potential and feasibility of studying microdosing and other potentially invisible or difficult to track substance use behaviors using a bespoke, mobile application which allows for the anonymous participation, self-enrolment, and the completion of assessments over time. While psychedelic microdosing produces antidepressant effects in the forced swim test and facilitates fear extinction learning, it does not seem to impact general anxiety levels in rodents (Cameron et al. 2019; Horsley et al. 2018).
Rand estimates that 8 million people in the U.S. used psilocybin in 2023 and half of them reported microdosing the last time they used it. Use of music during the psychedelic experience to reduce distress was reported in four out of the 27 studies 43, 47, 51, 53. Some users reported approaches such as preparing a specific playlist before the experience, and others found that changing the music during an experience could be a helpful de- escalation strategy to reduce strong uncomfortable emotions, due to its ability to amplify or shift emotional states 43. Motivation to microdose was assessed by summing the total amount of responses for each of the 5 main motivation categories.
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Given the unique psychological risk profile of psychedelics, and the rapid increase of users in Australia, the application and evaluation of specific harm reduction interventions for this population is urgently needed to reduce the risk of potential psychological harms. Differing motivations and intentions for psychedelic use were identified, which appeared to interact with the social setting of drug ingestion and potential harm minimisation strategies identified. For example, one study found that those who had intentions for self-treatment were more likely to report having the psychedelic experience in a solo setting either with or without a sober guide 54.
However, some findings suggest that, like psychedelic users more broadly, microdosers are disproportionately male and lower in education and income relative to non-microdosers9,30. Interestingly, microdosers report higher levels of past year substance use but lower levels of substance use disorders, anxiety disorders, and negative emotionality3,15. An extensive range of harm reduction or benefit enhancing strategies are reported by people who take psychedelic drugs in naturalistic settings 51, 53.
