Perceived Risk of Trying Lysergic Acid Diethylamide in the United States from 2015 to 2019: Are Americans Assessing Lysergic Acid Diethylamide's Risk Profile More Favorably?
Restricted accessResearch articleFirst published online June, 2024
Perceived Risk of Trying Lysergic Acid Diethylamide in the United States from 2015 to 2019: Are Americans Assessing Lysergic Acid Diethylamide's Risk Profile More Favorably?
Though lysergic acid diethylamide (LSD) use is rising in the United States amid expanding research into the therapeutic potential of psychedelics, little scholarly work exists on whether perceived risk of trying LSD (prLSD) is changing or factors influencing prLSD among the general public. Therefore, we sought to investigate changes in prLSD from 2015 to 2019 and identify characteristics associated with prLSD among respondents to the National Survey on Drug Use and Health (NSDUH).
Methods:
Using NDSUH data from 2015 to 2019, we investigated correlates of and temporal trends in prLSD, reporting results for the entire sample, as well under age 18 (<18) and age 18 and older (18+) subgroups. Orthogonal polynomial contrasts were used to evaluate trends across survey years. Multivariable models were constructed to identify factors associated with prLSD.
Results:
On multivariable modeling for respondents age 18+, lower prLSD had statistically significant associations with later survey year, personal LSD use, younger age, higher education level, male gender, identifying as a sexual minority, past year psychological distress, and other factors. Higher prLSD was associated with identifying as Black or Hispanic, past year suicide attempt, and having children in the home. Notable differences in the age <18 subgroup were no association between prLSD and identifying as Hispanic and male gender being associated with higher prLSD. From 2015 to 2019, there was a statistically significant linear decreasing trend in proportion of respondents who perceived “great” risk in trying LSD [from 70.5% to 64.8%; (p < 0.0001)]. Similar trends were observed in most subgroups that were analyzed.
Conclusions:
We observed differences in prLSD among subgroups, suggesting that factors such as age, gender, race, ethnicity, and personal history of LSD may be related to prLSD. Overall, Americans appear to be assessing LSD's risk profile more favorably in recent years, though most Americans still perceive great risk in trying LSD.
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References
1.
NawiAM, IsmailR, IbrahimF, et al.Risk and protective factors of drug abuse among adolescents: A systematic review. BMC Public Health, 2021; 21(1):2088; doi: 10.1186/s12889-021-11906-2
2.
NargisoJE, BallardEL, SkeerMR. A systematic review of risk and protective factors associated with nonmedical use of prescription drugs among youth in the United States: A social ecological perspective. J Stud Alcohol Drugs, 2015; 76(1):5–20.
3.
ZimmermanGM, FarrellC. Parents, peers, perceived risk of harm, and the neighborhood: Contextualizing key influences on adolescent substance use. J Youth Adolesc, 2017; 46(1):228–247; doi: 10.1007/s10964-016-0475-5
4.
FeldmanM, BoyerB, KumarVK, et al.Personality, drug preference, drug use, and drug availability. J Drug Educ, 2011; 41(1):45–63; doi: 10.2190/DE.41.1.c
5.
AbadiMH, ShamblenSR, ThompsonK, et al.Influence of risk and protective factors on substance use outcomes across developmental periods: A comparison of youth and young adults. Subst Use Misuse, 2011; 46(13):1604–1612; doi: 10.3109/10826084.2011.598598
6.
LipariR, AhrnsbrakRD, PembertonMR, et al.Risk and Protective Factors and Estimates of Substance Use Initiation: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration: Rockville, MD; 2017.
7.
PacekLR, McClernonFJ. Risk perceptions regarding cigarette smoking in the United States continue to decline. Drug Alcohol Depend, 2020; 209:107887; doi: 10.1016/j.drugalcdep.2020.107887
8.
PacekLR, McClernonFJ. Decline in the perceived risk of cigarette smoking between 2006 and 2015: Findings from a U.S. nationally representative sample. Drug Alcohol Depend, 2018; 185:406–410; doi: 10.1016/j.drugalcdep.2018.01.002
9.
LevyNS, MauroPM, MauroCM, et al.Joint perceptions of the risk and availability of Cannabis in the United States, 2002–2018. Drug Alcohol Depend, 2021; 226:108873; doi: 10.1016/j.drugalcdep.2021.108873
10.
WaddellJT.Age-varying time trends in cannabis- and alcohol-related risk perceptions 2002–2019. Addict Behav, 2022; 124:107091; doi: 10.1016/j.addbeh.2021.107091
11.
YockeyRA, VidourekRA, KingKA. Trends in LSD use among US adults: 2015–2018. Drug Alcohol Depend, 2020; 212:108071; doi: 10.1016/j.drugalcdep.2020.108071
12.
Substance Abuse and Mental Health Services Administration. 2019. National Survey on Drug Use and Health Detailed Tables. 3.1B. Substance Abuse and Mental Health Services Administration: Rockville, MD; 2019.
13.
LipariR, RTIInternational, KroutilL, et al.Risk and Protective Factors and Initiation of Substance Use: Results from the 2014 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration: Rockville, MD; 2015.
14.
LivneO, ShmulewitzD, WalshC, et al.Adolescent and adult time trends in US hallucinogen use, 2002-19: Any use, and use of ecstasy, LSD and PCP. Addiction, 2022; 117(12):3099–3109; doi: 10.1111/add.15987
15.
Substance Abuse and Mental Health Services Administration. 2019. National Survey on Drug Use and Health Detailed Tables. 3.2A-3.4B. Rockville, MD; 2019.
16.
NuttDJ, KingLA, PhillipsLD. Drug harms in the UK: A multicriteria decision analysis. Lancet, 2010; 376(9752):1558–1565; doi: 10.1016/S0140-6736(10)61462-6
17.
LeonardJB, AndersonB, Klein-SchwartzW. Does getting high hurt? Characterization of cases of LSD and psilocybin-containing mushroom exposures to national poison centers between 2000 and 2016. J Psychopharmacol, 2018; 32(12):1286–1294; doi: 10.1177/0269881118793086
18.
KopraEI, FerrisJA, RuckerJJ, et al.Adverse experiences resulting in emergency medical treatment seeking following the use of lysergic acid diethylamide (LSD). J Psychopharmacol, 2022; 36(8):956–964; doi: 10.1177/02698811221099650
19.
KlockJC, BoernerU, BeckerCE. Coma, hyperthermia and bleeding associated with massive LSD overdose. A report of eight cases. West J Med, 1974; 120(3):183–188.
20.
HadenM, WoodsB. LSD overdoses: Three case reports. J Stud Alcohol Drugs, 2020; 81(1):115–118.
21.
GableRS.Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction, 2004; 99(6):686–696; doi: 10.1111/j.1360-0443.2004.00744.x
22.
HoffmeisterF.Negative reinforcing properties of some psychotropic drugs in drug-naive rhesus monkeys. J Pharmacol Exp Ther, 1975; 192(2):468–477.
23.
ModakT, BhadR, RaoR. A rare case of physical dependence with psychedelic LSD—A case report. J Subst Use, 2019; 24(20):1–3; doi: 10.1080/14659891.2019.1581286
24.
BarnettBS, ZieglerK, DoblinR, et al.Is psychedelic use associated with cancer?: Interrogating a half-century-old claim using contemporary population-level data. J Psychopharmacol, 2022; 36(10):1118–1128; doi: 10.1177/02698811221117536
25.
SimonssonO, SextonJD, HendricksPS. Associations between lifetime classic psychedelic use and markers of physical health. J Psychopharmacol, 2021; 35(4):447–452; doi: 10.1177/0269881121996863
26.
BodeauS, BennisY, RégnautO, et al.Case report LSD instead of 25I-NBOMe: The revival of LSD? A case report. Toxicol Anal Clin, 2017; 29(1):139–143; doi: 10.1016/j.toxac.2016.12.007
27.
PrahlowJA, RossKF, LeneWJ, et al.Accidental sharp force injury fatalities. Am J Forensic Med Pathol, 2001; 22(4):358–366; doi: 10.1097/00000433-200112000-00005
28.
FyshRR, OonMC, RobinsonKN, et al.A fatal poisoning with LSD. Forensic Sci Int, 1985; 28(2):109–113; doi: 10.1016/0379-0738(85)90067-2
CohenS.Lysergic acid diethylamide: Side effects and complications. J Nerv Ment Dis, 1960; 130:30–40; doi: 10.1097/00005053-196001000-00005
31.
SmartRG, BatemanK. Unfavourable reactions to LSD: A review and analysis of the available case reports. Can Med Assoc J, 1967; 97(20):1214–1221.
32.
MallesonN.Acute adverse reactions to LSD in clinical and experimental use in the United Kingdom. Br J Psychiatry, 1971; 118(543):229–230; doi: 10.1192/bjp.118.543.229
33.
BlachaC, SchmidMM, GahrM, et al.Self-inflicted testicular amputation in first lysergic acid diethylamide use. J Addict Med, 2013; 7(1):83–84; doi: 10.1097/ADM.0b013e318279737b
34.
FullerDG.Severe solar maculopathy associated with the use of lysergic acid diethylamide (LSD). Am J Ophthalmol, 1976; 81(4):413–416; doi: 10.1016/0002-9394(76)90295-6
35.
PereraKM, FerraroA, PintoMR. Catatonia LSD induced?. Aust N Z J Psychiatry, 1995; 29(2):324–327; doi: 10.1080/00048679509075930
36.
MartinottiG, SantacroceR, PettorrusoM, et al.Hallucinogen persisting perception disorder: Etiology, clinical features, and therapeutic perspectives. Brain Sci, 2018; 8(3):47; doi: 10.3390/brainsci8030047
37.
SimonssonO, GoldbergSB, ChambersR, et al.Prevalence and associations of classic psychedelic-related seizures in a population-based sample. Drug Alcohol Depend, 2022; 239:109586; doi: 10.1016/j.drugalcdep.2022.109586
NepalC, PatelS, AhmadN, et al.Out of Hospital Cardiac Arrest Triggered by LSD in a Patient with Suspected Brugada Syndrome. In: B55. Critical Care Case Reports: Drug Overdoses. American Thoracic Society International Conference Abstracts American Thoracic Society;, 2017; pp. A3773–A3773; doi: 10.1164/ajrccm-conference.2017.195.1_MeetingAbstracts.A3773
40.
LiakoniE, DolderPC, RentschK, et al.Acute health problems due to recreational drug use in patients presenting to an Urban Emergency Department in Switzerland. Swiss Med Wkly, 2015; 145:w14166; doi: 10.4414/smw.2015.14166
41.
LiebermanAN, BloomW, KishorePS, et al.Carotid artery occlusion following ingestion of LSD. Stroke, 1974; 5(2):213–215; doi: 10.1161/01.str.5.2.213
RavalMV, GabaRC, BrownK, et al.Percutaneous transluminal angioplasty in the treatment of extensive LSD-induced lower extremity vasospasm refractory to pharmacologic therapy. J Vasc Interv Radiol, 2008; 19(8):1227–1230; doi: 10.1016/j.jvir.2008.05.008
44.
Vermont General Assembly. Chapter 084: Possession and Control of Regulated Drugs. n.d.
45.
National Drug Intelligence Center. Intelligence Bulletin LSD Trafficking and Abuse. United States Department of Justice; 2004.
46.
Bureau of Justice Statistics. Drug Offenders in Federal Prison: Estimates of Characteristics Based on Linked Data. 2015.
47.
JohnstonL, MiechR, O'MalleyP, et al.Monitoring the Future National Survey Results on Drug Use 1975–2021: Overview, Key Findings on Adolescent Drug Use. Institute for Social Research, University of Michigan: Ann Arbor, MI; 2022.
48.
HolzeF, GasserP, MüllerF, et al.Lysergic acid diethylamide-assisted therapy in patients with anxiety with and without a life-threatening illness: A Randomized, Double-Blind, Placebo-Controlled Phase II Study. Biol Psychiatry, 2023; 93(3):215–223; doi: 10.1016/j.biopsych.2022.08.025
49.
GasserP, HolsteinD, MichelY, et al.Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases. J Nerv Ment Dis, 2014; 202(7):513–520; doi: 10.1097/NMD.0000000000000113
Substance Abuse and Mental Health Services Administration. 2019. National Survey on Drug Use and Health (NSDUH): Methodological Resource Book, Section 8, Data Collection Final Report. Substance Abuse and Mental Health Services Administration: Rockville, MD; 2020.
52.
Substance Abuse and Mental Health Services Administration. 2019. National Survey on Drug Use and Health (NSDUH) Methodological Resource Book: Section 2: Sample Design Report. Substance Abuse and Mental Health Services Administration: Rockville, MD; 2020.
53.
Substance Abuse and Mental Health Services Administration. 2020. National Survey on Drug Use and Health Public Use File Codebook. Substance Abuse and Mental Health Services Administration: Rockville, MD; 2021.
54.
Center for Behavioral Health Statistics and Quality. An Overview of Trend Testing Methods and Applications in NSDUH and Other Studies. Substance Abuse and Mental Health Services Administration: Rockville, MD; 2017.
55.
JohnstonR, JonesK, ManleyD. Confounding and collinearity in regression analysis: A cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour. Qual Quant, 2018; 52(4):1957–1976; doi: 10.1007/s11135-017-0584-6
HosmerD, LemeshowS.Applied Logistic Regression. Wiley: New York, NY; 2000.
58.
ClarkeTC, BlackLI, StussmanBJ, et al.Trends in the use of complementary health approaches among adults: United States, 2002–2012. Natl Health Stat Rep, 2015;(79):1–16.
59.
HubertLJ.The use of orthogonal polynomials for trend analysis. Am Educ Res J, 1973; 10(3):241–244; doi: 10.2307/1161887
60.
SchauerGL, BergCJ, KeglerMC, et al.Differences in tobacco product use among past month adult marijuana users and nonusers: Findings from the 2003–2012 National Survey on Drug Use and Health. Nicotine Tob Res, 2016; 18(3):281–288; doi: 10.1093/ntr/ntv093
61.
SchauerGL, PetersEN. Correlates and trends in youth co-use of marijuana and tobacco in the United States, 2005–2014. Drug Alcohol Depend, 2018; 185:238–244; doi: 10.1016/j.drugalcdep.2017.12.007
62.
BormannNL, WeberAN, MiskleB, et al.Perceived risk of LSD varies with age and race: Evidence from 2019 United States cross-sectional data. Soc Psychiatry Psychiatr Epidemiol, 2023; In Press; doi: 10.1007/s00127-023-02448-6
63.
JahnZW, LopezJ, de la SalleS, et al.Racial/ethnic differences in prevalence of hallucinogen use by age cohort: Findings from the 2018 National Survey on Drug Use and Health. J Psychedelic Stud, 2021; 5(2):69–82; doi: 10.1556/2054.2021.00166
64.
PalamarJJ, LeA, Mateu-GelabertP. Perceived risk of heroin in relation to other drug use in a Representative US Sample. J Psychoact Drugs, 2019; 51(5):463–472; doi: 10.1080/02791072.2019.1632506
65.
PacekLR, MauroPM, MartinsSS. Perceived risk of regular cannabis use in the United States from 2002 to 2012: Differences by sex, age, and race/ethnicity. Drug Alcohol Depend, 2015; 149:232–244; doi: 10.1016/j.drugalcdep.2015.02.009
66.
OjedaVD, PattersonTL, StrathdeeSA. The influence of perceived risk to health and immigration-related characteristics on substance use among Latino and other immigrants. Am J Public Health, 2008; 98(5):862–868; doi: 10.2105/AJPH.2006.108142
67.
StraussD, de la SalleS, SloshowerJ, et al.Research abuses against people of colour and other vulnerable groups in early psychedelic research. J Med Ethics, 2021;medethics-2021-107262; In Press; doi: 10.1136/medethics-2021-107262
68.
TilleyC.MDMA “Will Be Rolled Out in US Hospitals by 2024.”. Daily Mail; 2022.
69.
LeeY.How a Family's Struggle to Help Their Son Gave Rise to Controversial $400 Million Psychedelics Giant Compass Pathways. Business Insider; 2023.
70.
CheetaS, HalilA, KennyM, et al.Does perception of drug-related harm change with age? A cross-sectional online survey of young and older people. BMJ Open, 2018; 8(11):e021109; doi: 10.1136/bmjopen-2017-021109
71.
RickertVI, SiqueiraLM, DaleT, et al.Prevalence and risk factors for LSD use among young women. J Pediatr Adolesc Gynecol, 2003; 16(2):67–75; doi: 10.1016/S1083-3188(03)00012-3
72.
SchulerMS, Evans-PolceRJ. Perceived substance use risks among never users: Sexual identity differences in a sample of U.S. young adults. Am J Prev Med, 2023; 11(2):72; doi: 10.1016/j.amepre.2022.07.003
73.
ThorntonLK, BakerAL, JohnsonMP, et al.Perceived risk associated with tobacco, alcohol and cannabis use among people with and without psychotic disorders. Addict Behav, 2013; 38(6):2246–2251; doi: 10.1016/j.addbeh.2013.02.003
74.
LinLA, IlgenMA, JannauschM, et al.Comparing adults who use cannabis medically with those who use recreationally: Results from a national sample. Addict Behav, 2016; 61:99–103; doi: 10.1016/j.addbeh.2016.05.015
75.
WeinbergerAH, PacekLR, ShefferCE, et al.Serious psychological distress and daily cannabis use, 2008 to 2016: Potential implications for mental health?. Drug Alcohol Depend, 2019; 197:134–140; doi: 10.1016/j.drugalcdep.2019.01.010
76.
KillionB, HaiAH, AlsolamiA, et al.LSD use in the United States: Trends, correlates, and a typology of us. Drug Alcohol Depend, 2021; 223:108715; doi: 10.1016/j.drugalcdep.2021.108715
77.
HanB, BlancoC, EinsteinEB, et al.Mental health conditions and receipt of mental health care by illicit lysergic acid diethylamide (LSD) use status among young adults in the United States. Addiction, 2022; 117(6):1794–1800; doi: 10.1111/add.15789
78.
GrossmanDH, HendricksPS. Shedding light on classic psychedelics and self-harm. J Clin Psychiatry, 2022; 83(2):21com14268; doi: 10.4088/JCP.21com14268
79.
KeelerMH, ReiflerCB. Suicide during an LSD reaction. Am J Psychiatry, 1967; 123(7):884–885; doi: 10.1176/ajp.123.7.884
80.
ShewanD, DalgarnoP, ReithG. Perceived risk and risk reduction among ecstasy users: The role of drug, set, and setting. Int J Drug Policy, 2000; 10(6):431–453; doi: 10.1016/S0955-3959(99)00038-9
81.
HartogsohnI.Set and setting, psychedelics and the placebo response: An extra-pharmacological perspective on psychopharmacology. J Psychopharmacol, 2016; 30(12):1259–1267; doi: 10.1177/0269881116677852
82.
GrevensteinD, NagyE, Kroeninger-JungaberleH. Development of risk perception and substance use of tobacco, alcohol and cannabis among adolescents and emerging adults: Evidence of directional influences. Subst Use Misuse, 2015; 50(3):376–386; doi: 10.3109/10826084.2014.984847
83.
GoldMS.The epidemiology, attitudes, and pharmacology of LSD use in the 1990s. Psychiatr Ann, 1994; 24(3):124–126; doi: 10.3928/0048-5713-19940301-05
84.
JohnstonL, O'MalleyP, BachmanJ, et al.Monitoring the Future National Survey Results on Drug Use, 1975–2009 Volume II: College Students & Adults Ages 19–50. University of Michigan Institute for Social Research: Ann Arbor, MI; 2009.
85.
Kollath-CattanoC, HattebergSJ, KooperA. Illicit drug use among college students: The role of social norms and risk perceptions. Addict Behav, 2020; 105:106289; doi: 10.1016/j.addbeh.2020.106289
86.
AasHN, LeighBC, AnderssenN, et al.Two-year longitudinal study of alcohol expectancies and drinking among Norwegian adolescents. Addiction, 1998; 93(3):373–384; doi: 10.1046/j.1360-0443.1998.9333736.x
87.
KilmerJR, HuntSB, LeeCM, et al.Marijuana use, risk perception, and consequences: Is perceived risk congruent with reality?. Addict Behav, 2007; 32(12):3026–3033; doi: 10.1016/j.addbeh.2007.07.009
88.
HendricksPS, CopesH, FamilyN, et al.Perceptions of safety, subjective effects, and beliefs about the clinical utility of lysergic acid diethylamide in healthy participants within a novel intervention paradigm: Qualitative results from a proof-of-concept study. J Psychopharmacol, 2022; 36(3):337–347; doi: 10.1177/02698811211055855
HarrisonL, MartinS, EnevT, et al.Comparing Drug Testing and Self-Report of Drug Use Among Youths and Young Adults in the General Population. Substance Abuse and Mental Health Services Administration: Rockville, MD; 2007; doi: 10.1037/e637122007-001
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