Magic mushrooms are the most commonly used psychedelic drug

Psilocybin mushrooms are the most widely used psychedelic substance in the U.S., with their popularity surpassing other psychedelic drugs such as MDMA (known as ecstasy), according to a new RAND report.

Based on a new national survey, researchers found that about 12% of respondents reported using psilocybin at some point in their lives and 3.1% had used the substance in the past year. An estimated 8 million American adults used psilocybin in 2023.

Psychedelic substances such as psilocybin mushrooms and MDMA have long been touted as promising for the treatment of various mental health conditions, with enthusiasm for the substances increasing over the past decade. While clinical research continues to grow, less attention has been paid to the changing policy landscape for some psychedelics.

The report, which takes a broad look at emerging issues surrounding the use and supply of psychedelics for nonclinical purposes, suggests that as state and local officials relax regulations on these substances, federal policymakers must decide whether they want psychedelics to follow in their footsteps of the US government. make a profit on the cannabis model or take a different path.

“The current situation with psychedelics reminds me of where we were with cannabis policy 12 years ago,” said Beau Kilmer, lead author of the report and senior policy researcher at RAND, a nonprofit research organization. “Now is the time for federal policymakers to decide whether they want to shape these policy changes or sit on the sidelines.”

Researchers warn there are concerns that if efforts to expand the non-clinical supply of psychedelics do not go well, it could cause a backlash that could have a chilling effect on research and potential therapeutic applications.

“Based on what happened with clinical research on psychedelics after the 1960s, this is not an idle concern,” said Kilmer, co-director of the RAND Drug Policy Research Center.

The RAND report draws on several sources of information, including a December 2023 survey of a representative sample of 3,791 U.S. adults who were asked about their use of a variety of substances, including psychedelics. The survey included several questions specifically related to the use of psilocybin and how it was obtained. The researchers also analyzed data from the National Survey on Drug Use and Health and the National Incident-Based Reporting System.

Researchers interviewed legal experts, policy advocates, regulators, clinical researchers, mental health providers, and representatives from organizations working in the emerging psychedelics industry in the US and abroad. The work also included discussions with members of indigenous communities about their spiritual medicines.

“Policy changes could impact indigenous peoples who have a long tradition of using certain spiritual medicines commonly called psychedelics,” said Michelle Priest, co-author of the report and assistant policy researcher at RAND. “Interacting respectfully with Indigenous community members who are qualified to speak on these topics can help develop policies that benefit from generations of wisdom while protecting the rights of Indigenous people.”

Despite federal bans on supply and possession outside of approved clinical research and some religious exemptions, some state and local governments are relaxing their approach to psychedelics, including approaches that legalize some forms of supply to adults for any reason.

For states considering alternatives to banning the supply of psychedelics, the report highlights that there are many options beyond the for-profit approach. For example, states could allow people to grow or raise their own food, or allow them to join nonprofit collectives or cooperatives. There is also the controlled use model that is active in Oregon for psilocybin and expected to be operational in Colorado by 2025.

One difference from cannabis policy debates, the researchers note, is the role of oversight in policy discussions surrounding psychedelics. Even in places that do not adopt the supervisory model being implemented in Oregon and Colorado, policymakers will likely face many decisions about the regulation of facilitators and supervisory situations.

The RAND report shows that, unlike people who use cannabis and many other drugs, those who use psychedelics tend to do so infrequently. The RAND survey found that 0.9% of respondents reported using psilocybin in the past month, compared to 20% of respondents who reported cannabis use in the past month.

Researchers estimate that among all U.S. adults, the total number of days of use in the most recent month for cannabis was on the order of 650 million, while the comparable figure for hallucinogens was closer to 7 million.

Of those who reported using psilocybin in the past year in the RAND survey, 47% reported microdosing the last time they used psilocybin. Microdosing uses small amounts of psilocybin or other psychedelics, often 1/10th to 1/20th of a usual dose.

Researchers say one takeaway from the analysis is the extent to which rare users are driving the psychedelics market. For cannabis, the market for infrequent users is negligible, accounting for approximately 5% of total days of use in the past month. For psychedelics, that figure is closer to 60%.

“While price is an important policy tool when we think about regulating cannabis and alcohol, it is likely to play a much smaller role for psychedelics as infrequent users currently dominate the market and they tend to spend relatively little on these substances,” says Rajeev Ramchand. co-author of the report and co-director of the RAND Epstein Family Veterans Policy Research Institute.

The researchers found that when they wrote the report, it became clear how little has been published about the markets and usage patterns for many psychedelics, especially psilocybin. They offer ideas for improving existing surveys, such as the National Survey on Drug Use and Health, and recommend conducting qualitative research (ideally longitudinal) among those who use psychedelics and those who produce and distribute these substances in legal or illegal settings.