Self-therapeutic use of psilocybin, MDMA and ketamine among Dutch nightlife attendees.
Background: 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.
Methods: 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.
Results: It was found that the majority of the respondents were aware of the (research on the) 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 for self-therapeutic purposes (i.e. to reduce psychological or emotional problems). Self-therapeutic use of these substances seems to be higher among those who are aware of (the research on) the therapeutic applications of these substances compared to those who are not (17.0% versus 7.0% for psilocybin; 7.2% versus 5.2% for MDMA; 7.1% versus 3.0% for ketamine). Reasons for self-therapeutic use were previous experiences with the (therapeutic) effects of these substances, and knowledge about their (therapeutic) effects. Almost all (80-90%) of respondents who had used one of these substances self-therapeutically indicated that this helped them. According to these participants, self-therapeutic use can enhance self-insight. Furthermore, self-therapeutic use can help reduce symptoms of stress or depression, and increase feelings of happiness (i.e. positive coping), or it can be used to numb, or disappear from reality (i.e. negative coping). It is notable, however, that many respondents indicated that the positive effects of self-therapeutic use were temporary. In some cases, self-therapeutic use seems to cause or aggravate problems (e.g. anxiety, panic attacks, palpitations). Severe adverse effects (e.g. depression, suicidality, addiction) are mentioned by a few.
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.
