Abstract
Motives are a highly influential force in substance use and vary depending on the substance or dose being used. Little research has compared motives across different doses of psilocybin. Psilocybin is often ingested in microdoses (0.1–0.4 g) or macrodoses (1 g+), each producing unique perceptual and mood effects. The current study examined whether motives for microdose and macrodose psilocybin use differ. An online survey was employed to examine differences in motives using an adapted Marijuana Motives Measure. A thematic analysis was conducted to further explore motives for each dose, and to determine if motives differ for initiating and continuing psilocybin use. As hypothesized, there were statistically significant differences in motives for microdose and macrodose use (p < .001). Qualitative results also indicated differences in motives depending on dosage, and differences in reasons for initiating and continuing use. These findings have important implications for harm reduction and public policy.
Introduction
Motives have been shown to play a significant role in shaping human behaviour and are commonly cited as a highly influential force in substance use (Cooper et al., 2016; Votaw & Witkiewitz, 2021). Broadly defined, motives are thought of as an individual’s reason for engaging in a behaviour. Historically, research has assessed substance use motives using a four-factor model that includes coping, conformity, social, and enhancement motives (Basedow & Kuitunen-Paul, 2022; Becker, 1953; Benschop et al., 2015, 2020; Bogenschutz et al., 2022; Bonomo et al., 2019; Cakic et al., 2010; Carbonaro et al., 2016; Carhart-Harris & Goodwin, 2017; Chi & Gold, 2020; Cooper et al., 2016). Coping motives refer to using a substance to alleviate a negative experience or state (e.g., reduce anxiety). Conformity motives are driven by a need to fit into a social situation or increase likability and acceptance from peers. Social motives involve using a substance to improve social interactions or behaviour (e.g., to be more outgoing), and enhancement motives reflect a desire to amplify an aspect of an existing state, such as increasing creativity, productivity, and fun. Interestingly, research has also found that an additional motive termed “expansion” is necessary to capture the subjective experiences of cannabis and psychedelic users (Basedow & Kuitunen-Paul, 2022; Benschop et al., 2020; Fatur, 2021). Expansion motives refer to using a substance with the desire to increase self-awareness or self-knowledge (Basedow & Kuitunen-Paul, 2022). Understanding motives that drive substance use is critical, as motives have been shown to impact initiation, continuation, and outcomes of use (Votaw & Witkiewitz, 2021).
Previous studies have indicated that motives for substance use may vary depending on the substance (Basedow & Kuitunen-Paul, 2022; Benschop et al., 2020; Soussan & Kjellgren, 2016). Soussan and Kjellgren (2016) examined differences in motives for using various psychoactive substances. They found that stimulant use was often driven by a desire for mental and physical enhancement, while many used opioids for purposes related to coping with physical pain, boredom, and psychological problems (e.g., anxiety). Further, hallucinogens were commonly used for spiritual enhancement and self-exploration (Soussan & Kjellgren, 2016). Other literature also suggests that motives may vary by substance, with tobacco and benzodiazepines often being used for coping reasons, alcohol for social purposes, and cannabis and 3, 4-methylenedioxymethamphetamine (MDMA) for enhancement purposes (Basedow & Kuitunen-Paul, 2022). Taken together, the existing literature supports the notion that different substances are associated with unique patterns of motives (Basedow & Kuitunen-Paul, 2022; Benschop et al., 2020). Given these findings, further research aimed at understanding motives may aid in harm reduction efforts and help to develop education and prevention programs that are tailored to unique substances (Soussan & Kjellgren, 2016). Further, understanding substance use motives may also inform social policy and substance regulation efforts.
Psychedelic Use Motives
Despite several decades of research exploring the motives for some of the most commonly used substances (e.g., alcohol, nicotine), motives for the use of psychedelics are vastly understudied. The extant research suggests that individuals are often motivated to use psychedelic substances because of the potential for expansion and possible therapeutic benefit (Basedow & Kuitunen-Paul, 2022; Benschop et al., 2020; Cakic et al., 2010; Johnstad, 2022; Soussan & Kjellgren, 2016; Uthaug et al., 2022). Basedow and Kuitunen-Paul (2022) conducted a systematic review of the motives for serotonergic psychedelic use and found that 78% of included studies reported expansion as a prominent motive. Similarly, Johnstad (2022) examined motives for using classic psychedelics (mescaline, psilocybin, lysergic acid diethylamide [LSD], and dimethyltryptamine [DMT]) and found that 69% of respondents indicated that their psychedelic use was motivated by a desire for spiritual expansion. Finally, Uthaug and colleagues explored motives for mescaline use and found that 74% of participants reported spiritual motives for consumption (2022).
Therapeutic motives, in other words, using psychedelics to improve psychological well-being, were also reported in two additional studies (Cakic et al., 2010; Johnstad, 2022). Johnstad (2022) found that 53% of spiritually motivated participants endorsed motives related to a desire to heal psychological issues and “personal problems” (p. 8). In addition, 24% of non-spiritually motivated users reported psychedelic use for therapeutic purposes, indicating that psychedelics were often consumed with the goal of managing or mitigating mental health concerns (Johnstad, 2022).
Psilocybin Use Motives
Considering that motives driving psychedelic use vary widely, it may be that reasons for use differ depending on the type of psychedelic being consumed. Although interest and research on the potential benefits of psilocybin is increasing (Davis et al., 2021; Hearn et al., 2022), a paucity of literature has examined motives specific to psilocybin. Psilocybin is often ingested as either a macrodose or a microdose. Typically, the greater the dose, the greater the psychedelic effect. A full dose or macrodose of psilocybin mushrooms is often reported as ingesting between 1 to 4 g of the dried substance, which causes a variety of hallucinations, perceptual alterations, and mood changes (Fatur, 2021; Lea et al., 2020b). Microdosing refers to taking a small amount of psilocybin mushrooms, usually between 0.1 g to 0.5 g, which rarely elicits hallucinations or perceptual changes but often causes sub-perceptual alterations in mood, energy, and concentration (Hutten et al., 2019; Lea et al., 2020b). Given that macrodosing and microdosing are known to produce different effects, it stands that individuals may be using more or less psilocybin for different purposes.
Full Dose Motives
At the time of the current study, scarce literature exists on the motives for macrodose psilocybin use. The research that does exist indicates that motives for use vary among users. A recent study by Lea et al. (2020a) found that 67% of participants took full doses of psilocybin recreationally, whereas 65% of participants used psilocybin for therapeutic reasons. When research examines reasons for initiating use, curiosity motives have been noted in the literature and are thought to reflect an initial exploration and experimentation with psilocybin (Fatur, 2021; Hallock et al., 2013). In addition, those taking macrodoses of psilocybin also report personal growth, spiritual growth, and enhancement motives (Hallock et al., 2013; Lea et al., 2020a). Enhancement of pleasure, creativity, and self-knowledge were commonly stated reasons for macrodose psilocybin use (Hallock et al., 2013; Lea et al., 2020a). Despite this initial exploratory research, motives for using a macrodose of psilocybin remain to be fully examined.
Microdose Motives
While limited literature has explored the motives for macrodose psilocybin use, more research has examined the motivations for microdosing. Many studies report that microdosing is often driven by enhancement motives (Hutten et al., 2019; Johnstad, 2018; Lea et al., 2020a, 2020a, 2020b; Rootman et al., 2021; Ryan et al., 2023; Webb et al., 2019). Many users microdose psilocybin to improve productivity and performance, enhance creativity, increase mood, and improve overall well-being (Hutten et al., 2019; Lea et al., 2020a, 2020). Participants also report taking microdoses of psilocybin to enhance mindfulness and as a means of improving interpersonal relationships and connections (Lea et al., 2020b; Rootman et al., 2021; Ryan et al., 2023).
Along with enhancement motives, recent studies have found that participants often microdose for therapeutic reasons (Hutten et al., 2019; Johnstad, 2018; Lea et al., 2020c). In a study by Lea and colleagues (2020c), 39% of participants reported primarily taking microdoses to manage mental health conditions including depression, anxiety, post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), and substance use. Microdosing to improve depression and anxiety is commonly reported across studies (Hutten et al., 2019; Johnstad, 2018; Lea et al., 2020b; Webb et al., 2019). Rootman and colleagues (2021) found that participants with self-reported mental health concerns including anxiety, depression, PTSD, panic attacks, substance use, bipolar disorder, eating disorders, and schizophrenia reported increased therapeutic motives for use relative to those who did not report a psychological disorder. This research suggests that one’s mental health history may influence their motives for psilocybin use.
Similarly, a subreddit analysis found that forum users commonly microdosed psilocybin as a replacement for psychiatric medications (Lea et al., 2020b). Some participants report discontinuing their psychiatric medication to try microdosing without consulting a mental health professional, which may lead to dangerous outcomes and increase the risk of medication withdrawal, suicidal ideation, and relapse of psychiatric symptoms (Lea et al., 2020b). In addition to using psilocybin as a replacement for psychiatric medications, research has reported that participants use psilocybin as an adjunct treatment alongside other mental health interventions for conditions such as depression and anxiety (Lea et al., 2020a, 2020b). Further, some participants endorse microdosing to alleviate physical symptoms, such as menstrual discomfort, headaches, and pain following injury (Hutten et al., 2019; Webb et al., 2019). Taken together, the extant literature suggests that psilocybin users may be using microdoses in an attempt to improve their physical and mental health.
Despite some similarities in motives for micro and macrodose psilocybin users, some motives for use appear to differ depending on the dose being used. Therapeutic, growth, and enhancement motives were commonly reported for users of both macrodose and microdoses of psilocybin (Hutten et al., 2019; Johnstad, 2018; Lea et al., 2020a, 2020c). However, the type of enhancement participants sought differed based on dosage. While enhancing creativity was a motive for both levels of dose, increasing mood and productivity appears to be related to microdosing (Hallock et al., 2013; Hutten et al., 2019; Lea et al., 2020a). Increasing pleasure is often exclusively reported by full dose users (Lea et al., 2020a). Similarly, spirituality and curiosity motives were endorsed much less commonly for microdose use than for macrodose use (Basedow & Kuitunen-Paul, 2022; Hutten et al., 2019; Johnstad, 2022; Lea et al., 2020a).
Current Study
Despite the small body of literature examining motives for psilocybin use, little research has directly compared motives for taking microdoses with motives for taking full doses of psilocybin. Since the dose size elicits different psychedelic, mood, and perceptual effects (Fatur, 2021; Hutten et al., 2019; Lea et al., 2020b), it is possible that users who regularly take microdoses are driven by different motives than those who prefer full doses. Thus, this study explored whether motives differ for microdose and macrodose psilocybin use. In addition, existing research that examines reasons for psilocybin use often focuses on motives at one time point. However, motives can change over time, and motives driving continued use may differ from motives that drive initial experimentation (Basedow & Kuitunen-Paul, 2022; Fatur, 2021). As such, the current study also examined qualitative responses to understand differences between motives for initial psilocybin use and motives for continued psilocybin use.
Methods
Participants
Participant Demographics.
Note. n = 134.
Measures
Marijuana Motives Measure (Simons et al., 1998)
The Marijuana Motives Measure (MMM) is a 25-item scale that assesses motives for cannabis use. The MMM utilizes the five-factor motives model which includes enhancement, coping, conformity, social, and expansion motives. Participants are asked to indicate their motives for use on a 5-point Likert scale ranging from almost never/never (1) to almost always/always (5). Individual scale scores are calculated by averaging participant’s responses across scale items (Benschop et al., 2015). The MMM has shown adequate validity and good internal consistency (Benschop et al., 2015; Zvolensky et al., 2007). In the current study, language on the MMM was adapted to capture the motives of psilocybin users. Psilocybin-specific wording was utilized for the prompt question and statements (e.g., “Thinking of all the times you have taken a microdose [macrodose] of psilocybin, how often have you used for the following reasons?”). See full scale in the Appendix.
Qualitative Questions
Participants were asked qualitative questions to assess their motives for initial and continued psilocybin use. All participants who indicated a history of psilocybin use were asked: (1) What were your motives for taking your first microdose (or full dose) of psilocybin? Those who endorsed using psilocybin on multiple occasions were asked an additional question: (2) What were your motives for continuing to take microdoses (or full doses) of psilocybin? Participants who indicated both macrodose and microdose use responded to these questions for each dose level.
Procedures
This study was approved by the university’s Human Research Ethics Board (Certificate #: 23-0378). The study was completed virtually via an online survey using Qualtrics survey software. Prior to beginning the survey, participants provided informed consent to participate and were notified of their right to withdraw from the study without penalty. The survey included demographic questions querying age, gender, level of education, religion, and political orientation. Additionally, participants were asked a series of questions about their psilocybin use including their age of initiation, preferred method of ingestion (capsule, dried mushrooms, chocolate, tea, or other), ideal setting (indoor, outdoor, alone, or with company), preferred dose (primarily microdose, primarily full dose, equally microdose and full dose), and history and frequency of use (microdose and/or full dose).
Depending on their preferred dose and frequency of use, participants also responded to qualitative questions, as described above, to assess motives. Quantitative data examining motives was collected by administering the adapted MMM. Participants who reported using both microdoses and macrodoses provided separate qualitative and quantitative motives for each dosage level. After completing the survey, participants were directed to a webpage that offered a list of mental health resources and debriefing explanation prior to ending the study.
Analysis Plan
A mixed-method analysis was conducted to explore participants’ motives for psilocybin use. Qualitative data was analyzed on NVivo software using an inductive thematic analysis approach. Responses were coded by the primary coder into categories derived directly from the data. Quantitative data analysis occurred in four stages using IBM SPSS. First, the data was cleaned and examined for errors by calculating descriptive statistics and frequencies. Minimum and maximum values were examined to ensure responses fell within the range of possibility. Additionally, users self-reported preferred psilocybin dosage (primarily full dose, primarily microdose, or equally microdose and full dose) was compared to their responses indicating frequency of microdose and full dose use to ensure consistency in responses. Upon examination, sixteen out of eighteen individuals who reported “equal microdose and full dose” indicated using one dosage more than the other on the frequency scale, and thus, were recategorized to either primarily microdose or primarily full dose to more accurately capture their usage patterns. Only two participants consistently indicated equal usage across doses. Therefore, the authors removed the “equally microdose and full dose” category from the analysis.
Second, a missing data inquiry was conducted on SPSS to ensure data was missing completely at random. To address missing data, we used the SPSS exclude case pairwise function for analyses, which excluded participants who lacked the necessary responses for each specific analysis, rather than removing the entire case (Pallant, 2010). Third, descriptive statistics and frequencies were calculated for relevant demographic variables. Fourth, a two-way between groups MANOVA was conducted to examine differences in motives for microdose and macrodose psilocybin use.
Results
MANOVA Results
Of the final sample (N = 134), eight participants were excluded from the quantitative analysis, either through the exclude case pairwise function, or because they indicated equal microdose and macrodose use, and thus, could not be categorized into either level of the independent variable. Responses from a total of 126 psilocybin users were included in the MANOVA. The independent variable in the analyses the was dosage (primarily microdose, primarily full dose) and the dependent variables were scores on the five motive subscales on the adapted MMM: social, coping, enhancement, conformity, and expansion (Simons et al., 1998). An alpha value of 0.05 was set for this analysis, and preliminary analyses were conducted to test the assumptions of linearity, normality, outliers, and homogeneity of variances.
Differences in Motives for Microdose and Full Dose Psilocybin Use.
Note. M = mean. SD = standard deviation. * indicates significant results.
Qualitative Themes
Curiosity Motives
Both macrodose and microdose users commonly reported curiosity as a primary reason for initiating psilocybin use. Some participants reported just wanting “to try it out,” whereas other individuals were curious about specific psychedelic effects including altered cognitions, perceptual changes, and mood effects. One microdose user stated they wanted to try psilocybin to “experiment with how it affects the quality of my thoughts and feelings.” Similarly, a macrodose user stated they initiated use because they were “super fascinated by altered states and reports of personal growth, [and] mind expansion… resulting from mushroom use.” As could be expected, curiosity motives were cited less frequently for continued psilocybin use.
Social Motives
Social motives were also commonly discussed when asked about initiating and continuing psilocybin use. Participants stated that they used psilocybin to connect with friends and family, and to attend specific social events (e.g., a party, a group camping trip). When asked about motives for initiating macrodose use one participant said, “I took it to connect with peers that were much older than me.” Another participant stated they continued use partially because psilocybin is “a great way to bond with friends.” Notably, macrodose users reported more social motives than microdose users.
Enhancement Motives
Participants commonly reported using both micro and macrodoses of psilocybin for enhancement reasons. Individuals stated that they used psilocybin to enhance cognition (e.g., creativity, clarity, focus), to enhance environments (e.g., nature experience), and to increase energy and mood. When asked about motives for continued use, one participant stated they take microdoses to “improve mood and creativity throughout the day.” Similarly, one participant stated that using macrodoses helps them “think more clearly and creatively without mental blocks.” Enhancement of pleasure and enjoyment was an especially common motive, with participants stating that they enjoyed how psilocybin makes them feel as well as the experience of the “high,” and they found that psilocybin enhances fun experiences with friends. One participant reported that they continued macrodose use because “it was a fun and enjoyable experience the first time, and my friends agreed, so we took them again. This goes for just about every time.”
Therapeutic Motives
Therapeutic motives were endorsed for both microdose and macrodose use, however, they were more prevalent amongst microdose users. One participant reported initiating microdose use to “help with depression, ADHD and anxiety.” Others reported using psilocybin to help with symptoms of PTSD, to work through trauma, to reduce stress, to alleviate headaches, and to promote a sense of calm or ease. Further, several users who initiated macrodose use for curiosity or social reasons endorsed continuing use because of the benefits for their mental health or mood. One participant said they continued to use “after discovering the immediate effects and lasting effects after the trip helped me deal with my mental health issues, specifically depression and PTSD.”
Expansion Motives
Expansion motives were endorsed more often by macrodose users and were reported more commonly as reasons for continuing rather than initiating psilocybin use. Individuals mentioned taking macrodoses to gain insight into oneself and the world and to aid in personal growth. Further, some mentioned using psilocybin for spiritual expansion to increase one’s connection with the Earth or a higher power, or to communicate with deceased loved ones. Interestingly, a portion of participants who initiated full dose usage out of curiosity continued using psilocybin for personal growth and insight. One participant stated, “at first it was recreational, but then I began taking it to learn about myself.”
Did Not Experience Desired Effects
An important theme that emerged for microdose users was that some participants who initiated use for therapeutic or enhancement reasons did not experience any desired effects (e.g., mood improvements, enhanced cognition). When asked about motives for continuing microdose use, one participant stated they wanted to “try again because the first time I didn’t take enough…to feel anything.” A small portion of the sample also indicated discontinuation of microdose use. One participant reported discontinuing use “because there was no positive outcome,” suggesting microdose use may not be effective or achieve desired goals for all individuals.
Discussion
This study hypothesized that motives would differ for macrodose and microdose psilocybin use, which was supported by both qualitative and quantitative results. Motives for psilocybin use were found to differ depending on the dose. Specifically, expansion and enhancement motives were more common reasons for macrodose use than microdose use. This finding adds nuance to the existing literature that has suggested enhancement motives are common across doses, and that expansion is a common reason for psychedelic use (Benschop et al., 2020; Hallock et al., 2013; Hutten et al., 2019; Johnstad, 2018; Lea et al., 2020a).
The qualitative exploration in this study further supports that enhancement and expansion motives are prominent factors in psilocybin use. Participants reported enhancement motives for initiating and continuing use, with macrodose users commonly taking psilocybin to enhance fun or specific environments (e.g., a music festival) and microdose users taking psilocybin to enhance creativity, mood, or focus. These results suggest that individuals use microdoses and macrodoses of psilocybin for different types of enhancement. However, macrodose users endorse enhancement motives more commonly. Consistent with the quantitative results, macrodose users also often reported using psilocybin for expansion reasons, such as for personal or spiritual growth, and to gain insight and perspective. This finding adds support to the existing literature examining motives for psychedelic use (Benschop et al., 2020; Johnstad, 2018).
In addition to expansion and enhancement motives, qualitative responses revealed that participants commonly initiate psilocybin use because they are curious about the effects, such as hallucinations and altered mood states. This finding is consistent with previous research that indicates exploratory motives may be common reasons for starting psilocybin use (Fatur, 2021; Hallock et al., 2013). Interestingly, some of these users continue their psilocybin use for other reasons (e.g., therapeutic use). A further theme that emerged in the data was that individuals often use psilocybin for therapeutic reasons. Participants endorsed taking psilocybin to alleviate a variety of mental health concerns (e.g., anxiety), to work through trauma, and to reduce headaches. These results suggest that participants perceive psilocybin as having therapeutic value outside of clinical settings (e.g., psilocybin-assisted therapy) and are using the substance as a non-prescribed and independently administered mental health treatment.
Qualitatively, participants also often endorsed using psilocybin for social purposes, such as to connect with friends. This contrasts with the quantitative results found in this study, which suggested low social motives for use. These findings also contradict some of the extant literature that indicated social motives were common reasons for using other substances but were rarely endorsed for psychedelic use (Benschop et al., 2020). These findings may suggest that current quantitative measures of motives are not adequately capturing the motives of psilocybin use. Finally, another novel theme that emerged in the qualitative data was that several microdose users reported limited desired effects (e.g., lack of improved mood). As a result, it appears that these users either continued psilocybin use in the hope that they would experience the benefits or discontinued their use altogether. Future research should clarify factors that impact the decision to discontinue psilocybin use.
Limitations
Due to participant recruitment methods, the sample in this study primarily consisted of psychology students from a liberal, Western academic institution. As such, participants have homogeneous demographics (primarily female-identifying, young, and liberal), and these results may not generalize to other populations. Future research could reassess differences in motives for microdosing and macrodosing psilocybin in a more generalizable sample or in specific samples of interest. Despite this, these findings are important considering that many young people experiment with substance use while in their early to mid-twenties or in a university setting.
Further, this study did not ask about race, ethnicity, or culture. However, it is known that individuals from different racial, ethnic, and cultural backgrounds may use substances for unique reasons. When considering psychedelics, it is crucial to acknowledge that some Indigenous communities have historically used psilocybin in traditional ceremonies to help heal emotional, spiritual, and physical pain (Van Court et al., 2022). This study does not capture the unique and nuanced cultural motives that have guided historical and present-day psilocybin use. Further, this study did not examine the co-optation of these cultural practices, nor did we study the how the implementation of certain social policies (e.g., criminalization and medicalization of psilocybin) may have disproportionately negative impacts on Indigenous communities (Jacobs et al., 2024) and other marginalized groups. Future research must comprehensively examine how motivations for psilocybin (and all substance use) use differ based on culture, race, and ethnicity. Without this information, we risk creating policy changes and harm reduction efforts that are too generalized, with little respect for traditional knowledge.
An additional limitation in this study is the reliance on self-report data. It is possible that participants inaccurately reported their preferred dosage of psilocybin. If participants were not weighing their doses, are inexperienced, or don’t know about the potency variations in different psilocybin-containing mushroom species, it is possible that they may be unaware of how much psilocybin they were consuming. Thus, individuals may have unknowingly miscategorized their macrodose or microdose use. However, since different doses have distinct perceptual effects (Lea et al., 2020a; Lea et al., 2020b) and often come in different forms (e.g., dried ground mushrooms vs. capsules), it is likely that participants were reporting accurately when indicating their preferred dose.
A final limitation of this study was the use of the adapted MMM (Simons et al., 1998) to assess attitudes. The MMM was created to measure cannabis use and, despite being adapted to have psilocybin-specific statements, the scale may not adequately capture motives for psilocybin use given that the qualitative responses in this study suggest that the MMM does not fully illustrate the reasons people macrodose and microdose psilocybin. The MMM analyzes social, coping, conformity, enhancement, and expansion motives, but it does not reflect the motives of individuals who are using psilocybin for therapeutic or curiosity reasons. Thus, the quantitative results may not fully represent participants’ motives for using psilocybin. To mitigate this limitation, this study included qualitative questions to allow for a more comprehensive and nuanced examination of additional reasons for macrodose and microdose psilocybin use. Future research should focus on developing and validating a psilocybin-specific motives measure to better capture the motives that were found in the qualitative analyses in this study.
Strengths
A notable strength of this study was the inclusion of qualitative questions about psilocybin use. A substantial portion of existing psilocybin research is conducted in clinical settings using quantitative measures. However, quantitative measures may not adequately capture the nuances of participants’ relationships with a substance. Including qualitative responses allowed the researchers in this study to engage directly with participant narratives, drawing on their lived experiences and perspectives which highlighted complex and layered motives for psilocybin use. This qualitative examination fills a gap in the existing literature and adds depth to the understanding of individual relationship with psilocybin. This study provides a mixed-methods model that may be utilized by future researchers to comprehensively examine motives for psychedelic use more broadly.
An additional strength in this study is the focus on real-world psilocybin use. Current research on psilocybin is often conducted with participants in highly regulated clinical trials. However, most psilocybin use occurs outside of strict, controlled experiments. Thus, research has highlighted a need for studies examining naturalistic psilocybin use (Jacobs et al., 2024). The current study explored the use of psilocybin in everyday environments, recognizing and representing the use of psilocybin outside of medical or clinical spaces. As such, this study captured the perspectives of individuals using psilocybin recreationally and validated the experiences of those using psilocybin for therapeutic and spiritual reasons without clinical supervision. These results offer insight into naturalistic patterns of psilocybin use, and provide context for practical, real-world harm reduction strategies and educational efforts.
Implications
The findings in this study suggest that individuals use psilocybin for various reasons, including for enhancement, expansion, and therapeutic purposes. These results have implications for harm reduction efforts, psychedelic-assisted therapy, and public policy. It is critical to acknowledge and address that individuals are using psilocybin to work through trauma and treat mental health symptoms outside of controlled, supervised, or psychiatric environments. At the time of writing, the field is engaged in an active debate regarding the medicalization and decriminalization of psychedelics such as psilocybin. Some researchers and policy makers argue that keeping psychedelics within a controlled, medicalized environment is necessary to minimize risks and maximize benefits for those using psychedelics for therapeutic reasons (Carhart-Harris & Goodwin, 2017; Marks, 2023; Siegel et al., 2023). This perspective emphasizes the need for controlled doses and clinical supervision to ensure safety and reduce adverse psychological reactions (e.g., psychosis). However, others suggest that psychiatric oversight may be unnecessary to experience therapeutic benefits from psychedelics considering the long history and widespread use in natural, non-clinical settings. They argue that the mechanism of change is the substance itself and that great benefits can be attained through self-administration in safe and supportive environments (Goodwin et al., 2024). Proponents of full decriminalization maintain that restrictive policies, including the medicalization of psilocybin, may limit accessibility and dismiss the potential cultural, spiritual, and therapeutic benefits of naturalistic psychedelic use (Carhart-Harris & Goodwin, 2017; Marks, 2023; Siegel et al., 2023).
Consistent with the decriminalization model, findings of the current study suggest that naturalistic psilocybin use may provide a range of valuable benefits to those who engage with this substance. Participants reported continuing macrodose and microdose psilocybin use because it reduced symptoms of depression and anxiety, enhanced cognition, and promoted spiritual expansion. This data suggests that psilocybin may have strong healing potential outside of controlled, medical environments. Similarly, it is critical to acknowledge that psilocybin has been used to heal anxiety, promote introspection and growth, and treat physical ailments in some Indigenous communities for many years (Van Court et al., 2022). This traditional knowledge should be respected when engaging in discussions of psychedelic policies, psychedelic-assisted therapy, and psychedelic harm reduction (Jacobs et al., 2024). It is a necessity to include Indigenous knowledge keepers in decision-making processes regarding the restriction of psychedelics.
Despite the potential benefits and relative safety of psilocybin in comparison to other substances (Bonomo et al., 2019; Johnson et al., 2018; Van Amsterdam et al., 2015), there are risks associated with psilocybin use. Potential harms include the onset of psychosis, extreme distress or anxiety from a “bad trip,” and feelings of instability or loss of control (Carbonaro et al., 2016). Given this, accessible harm reduction and education efforts about using psilocybin safely have been suggested to mitigate potential risks of naturalistic psilocybin use (Hartogsohn, 2020). In an article by Becker (1953), entitled Becoming a Marihuana User
The findings of the current study highlight the need to expand education efforts, research, and public policies to meet the needs of naturalistic users. However, this does not negate the potential value of medically monitored psilocybin-assisted therapies. Many participants reported using psilocybin for therapeutic reasons, suggesting a need for additional research and increased accessibility of psychedelic-assisted therapy for those unwilling to engage in psilocybin use without a medical professional present. Current evidence shows promising results for psychedelic-assisted therapy as a supervised treatment for various mental health conditions including depression, end of life anxiety, and alcohol and tobacco use disorders (Bogenschutz et al., 2022; Chi & Gold, 2020; Davis et al., 2021). However, psychedelic-assisted therapy is currently inaccessible, often costing thousands of dollars and requiring medical exemptions given psilocybin’s current legal status (MacCallum et al., 2022). If research continues to support the efficacy of psychedelic-assisted therapy, increasing accessibility of these therapies could reduce harms and increase agency for those using psilocybin as a self-administered mental health treatment. The findings in this study support the expansion of research and the availability of psychedelic-assisted therapy, while also highlighting the need for policy changes and harm reduction efforts that target naturalistic psilocybin use.
In summary, this study found that motives for psilocybin use differ depending on the dose ingested. Results indicate that macrodose users have higher expansion, enhancement, and social motives than microdose users while microdose users endorse more therapeutic motives. In addition, the results of the thematic analysis offer evidence that motives may differ for initiating and continuing psilocybin use. Notably, a subset of participants who initiated psilocybin use for curiosity and social reasons continued using because of perceived enhancement, expansion, or therapeutic benefits. These findings add to the limited existing literature on everyday psilocybin use and suggest a need to increase accessibility of psychedelic-assisted therapy, and expand education efforts, harm reduction strategies, and public policies to capture the needs of naturalistic users.
Footnotes
Acknowledgements
We would like to acknowledge that this research was conducted on the traditional and unceded territories of the Lekwungen-speaking peoples (Songhees and Esquimalt) and WSÁNEĆ peoples.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Ethical Statement
Data Availability Statement
The datasets generated during and/or analyzed during the current study are not publicly available, as participants in this study did not provide informed consent for public data sharing. However, data is available from the corresponding author on reasonable request.