Past-Year Psilocybin and Alcohol Co-Use: Associations With Mental Health Symptoms

Interest has grown in the effects of psilocybin on mental health, but little is known about its naturalistic use alongside alcohol and its relationship to depression and/or anxiety symptoms. Data from the nationally-representative 2024 National Survey Investigating Hallucinogenic Trends of participants who did (n = 1234) or did not (n = 1607) report past-year psilocybin and alcohol co-use were compared on depressive and anxiety symptoms and poor mental health days. Weighted regressions adjusted for age, sex, survey collection period, race, ethnicity, and past-year cannabis and other psychedelic use. Individuals with psilocybin and alcohol co-use had fewer depressive symptoms (B(SE) = −.57(.28), β = −.04, p = .043) than those who used alcohol without psilocybin, suggesting potential benefits of psilocybin in individuals with co-use. After removing cannabis and other psychedelic use covariates, psilocybin use was also related to lower anxiety symptoms. However, given the observational and self-report study design, causal inferences cannot be made. Thus, longitudinal and experimental studies are needed.