Slouching towards engagement: interactions between people using psychedelics naturalistically and their healthcare providers

Frontiers in Psychiatry

Psychiatry

Kasey Cox¹  Kevin F. Boehnke²  Christopher W. Fields³  Nicolas Glynos³  Nicholas Kolbman³  Daniel J. Kruger⁴  Julie Barron⁵  Cody Weston⁶  Moss Herberholz⁷ 

[1] Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, United States;Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, United States;Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, MI, United States;Michigan Psychedelic Center, University of Michigan, Ann Arbor, MI, United States;Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, United States;Michigan Psychedelic Center, University of Michigan, Ann Arbor, MI, United States;Anesthesiology Department, University of Michigan Medical School, Ann Arbor, MI, United States;Michigan Psychedelic Center, University of Michigan, Ann Arbor, MI, United States;Population Studies Center, University of Michigan, Ann Arbor, MI, United States;Blue Sage Health Consulting, Ann Arbor, MI, United States;Michigan Psychedelic Society, Ann Arbor, MI, United States;Decriminalize Nature Ann Arbor, Ann Arbor, MI, United States;Psychiatry Department, University of Michigan Medical School, Ann Arbor, MI, United States;The Radical Well-Being Center, Southfield, MI, United States;

关键词: psychedelics;    psychiatrist;    antidepressants;    mental health;    psilocybin;    primary care physician;   

DOI  :  10.3389/fpsyt.2023.1224551

 received in 2023-05-17, accepted in 2023-07-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionThere is substantial public interest in psychedelics as potential treatments for psychiatric conditions. However, most psychedelics are criminalized under federal law in the USA, so it is unclear whether use occurs with clinical support. Our objective was to assess whether naturalistic psychedelic use occurs with clinical support, interactions between those using psychedelics and healthcare providers (psychiatrist, therapist, or primary physicians), and use characteristics.MethodsWe conducted an online, anonymous, confidential, cross-sectional survey of adults reporting psychedelic use (N = 1221) through a psychedelics advocacy event and social media between 9/18/2022 and 11/5/2022. We assessed participant disclosure of psychedelic use with their psychiatric care provider (PsyCP) and/or primary care provider (PCP), desire for provider support, access to support, and rate of taking prescribed psychoactive medications alongside psychedelics.ResultsAmong participants with such care providers, 22% disclosed psychedelic use to their PCP vs. 58% to their PsyCP. Participants were less confident in PCP vs. PsyCP ability to integrate psychedelics into treatment. Common reasons for nondisclosure included stigma, inadequate provider knowledge, and legal concerns. 23% reported taking psychedelics on the same day as potentially interacting psychiatric medications (e.g., anxiolytics, antidepressants). Despite 81% of participants desiring therapist support during psychedelic experiences, only 15% had received such support.DiscussionOur results show that psychedelic use is generally disconnected from primary and psychiatric clinical care. This disconnection may result in safety issues, including inadequate screening for contraindicated conditions, lack of support during emergent adverse events, and drug interactions. Enhanced clinical education and orienting drug policy towards known harms and benefits of psychedelics is needed.

【 授权许可】

Unknown   
Copyright © 2023 Boehnke, Cox, Weston, Herberholz, Glynos, Kolbman, Fields, Barron and Kruger.