As the use of psychedelics—a class of hallucinogens including psilocybin, LSD, DMT (Ayahuasca), and MDMA (Ecstasy)—gains popularity in both recreational and therapeutic contexts across North America, a new study from researchers at ICES, The Ottawa Hospital, University of Ottawa’s Department of Family Medicine, and Bruyère Health Research Institute highlights a significant risk. Individuals who have sought emergency department care for hallucinogen-related issues are at a substantially increased risk of developing schizophrenia.
Hallucinogens, also known as psychedelics, are a group of drugs that alter a person’s perception of reality. They can cause hallucinations, which are sensations and images that seem real but aren’t. People may hear, feel, or see things that aren’t really there. The effects of hallucinogens can vary depending on the type of drug, the dose, and the individual’s personal characteristics.
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The study, which followed over 9.2 million individuals in Ontario, Canada, found that those with a hallucinogen-related emergency department (ED) visit had a 21-fold increased risk of developing schizophrenia compared to the general population.
Even after considering an individual’s co-occurring substance use and mental health disorders, the study found a 3.5-fold increased risk of schizophrenia.
“Our findings underscore a concerning link between hallucinogen use that requires care in the emergency room and increased risk of schizophrenia,” says Dr. Daniel Myran, a Canada Research Chair in Social Accountability at the University of Ottawa, ICES Adjunct Scientist, Investigator at the Bruyère Health Research Institute, and Clinician Investigator at The Ottawa Hospital.
“While there is enormous enthusiasm for psychedelic-assisted therapy as a new mental health treatment, we need to remember how early and limited the data remains for both the benefits and the risks,” adds Myran.
The study examined trends in emergency department (ED) visits related to hallucinogen use and their association with subsequent schizophrenia diagnoses. While the annual rate of such ED visits remained steady between 2008 and 2012, it surged by 86% from 2013 to 2021. A concerning finding emerged: individuals who experienced a hallucinogen-related ED visit were 21 times more likely to be diagnosed with schizophrenia within three years compared to the general population. This risk was significantly higher than those who visited the ED for alcohol or cannabis-related issues, with a 4.7 and 1.5 times increased risk, respectively.
The authors emphasize that their findings do not establish a causal link between hallucinogen use and schizophrenia and that much more information is needed about risks associated with different types and use patterns of hallucinogens. However, the study highlights risks associated with hallucinogen use that requires ED care and potentially in individuals with underlying susceptibility to psychosis or schizophrenia. The authors also emphasize the importance of further studies and public health measures to better understand and mitigate these risks.
“Clinical trials of psychedelic-assisted psychotherapy have safeguards, such as excluding individuals with a personal or family history of schizophrenia and close monitoring while participants use hallucinogens. Our findings provide a timely caution about potential risks of hallucinogen use outside of trial settings,” says Myran.
