Self-therapeutic use of Psychedelics

In recent years, there appears to be a growing trends in so-called “self-therapeutic” use of psychedelics for a variety of psychological and emotional problems. Self-therapeutic use of psychedelics refers to the use of substances like MDMA, psilocybin and ketamine for therapeutic purposes, outside of a medical context. Earlier this year, the Trimbos-Institute published the Large Nightlife Survey which included a chapter on self-therapeutic use of psychedelics, showing data on this relatively new phenomenon for the first time.

The research on the therapeutic applications of psychedelics is widely covered in the popular media. There are concerns that these communications may have an impact on nonmedical use. Moreover, it is unclear to what extent recreational users use psychedelics self-therapeutically. This study sought to explore self-therapeutic use of psilocybin, MDMA and ketamine among Dutch nightlife attendees. Data used for analyses were from the Big Nightlife Survey 2023. The total sample consisted of 7,012 past year nightlife attendees aged 16-35. A mixed-method approach was used. Descriptive analyses were conducted for quantitative data. Qualitative responses were coded, and emerging themes were identified and described. The majority of the respondents was aware of the (potential) therapeutic applications of MDMA (65.6%), psilocybin (64.9%), and ketamine (51.8%). Among the past year users of psilocybin (n=690), MDMA (n=3,583) and ketamine (n=1,491), respectively 15.7%, 6.7% and 5.7% applied the substance self-therapeutically (i.e. to reduce psychological or emotional problems). Almost all (80-90%) respondents who had used one of these substances self-therapeutically indicated that this (temporarily) helped them. However, in some cases, self-therapeutic use seemed to cause or aggravate (severe) problems.

Conclusions: The media coverage of the therapeutic applications of psychedelics reaches Dutch nightlife attendees, and some of them use these substances for therapeutic purposes. The effects seem to be temporary, and in a small group self-therapeutic use leads to a worsening of problems. Potential negative effects of nonmedical psychedelic use on (mental) health should be clearly communicated when discussing the benefits in a therapeutic context.

Frederiek Schutten (MSc) is a young and passionate interdisciplinary social scientist, engaged in research on psychoactive substances: including drug use and related problems, as well as drug market developments, crime and legislation and policy. In particular, she is interested in psychedelics, especially at the intersection of recreational and therapeutic use. She works as a junior researcher at the Trimbos Institute, a Dutch organization that focuses on mental health, addiction and substance use.