Contrary to therapeutic potential claims, psilocybin and LSD use were associated with approximately double the risk of cannabis use disorder in a nationally representative sample.
Psychedelic researchers, addiction specialists, cannabis users interested in psychedelics, and policymakers evaluating psychedelic therapy regulations.
What the researchers found
Lifetime psilocybin and past-year LSD use were both associated with 1.89-2.04 times higher rates of past-year DSM-5 cannabis use disorder. Past-year LSD also predicted three specific CUD symptoms among cannabis users.
Why it matters
While psychedelics are being investigated as treatments for substance use disorders, this population-level data suggests that in naturalistic settings, psychedelic use actually co-occurs with more problematic cannabis use — complicating the therapeutic narrative.
The numbers in context
Psilocybin use: aRR 1.89-2.04 for CUD. Past-year LSD: aRR 1.89-2.04 for CUD. LSD predicted 3 of 11 CUD symptoms (aRR 1.45-1.73). Moderate-to-severe CUD: aRR 1.65-2.07.
How the study worked
Survey-weighted multivariable logistic regressions analyzing NSDUH data (2015-2019, 2021-2022) examining associations between classic and non-classic psychedelic use and disordered cannabis use.
What this study cannot tell us
Cross-sectional design — people who use psychedelics may simply be more likely to use cannabis heavily for reasons unrelated to the psychedelic experience. Cannot distinguish therapeutic from recreational psychedelic use.
How to read the evidence
Large nationally representative sample with appropriate controls, but cross-sectional design limits causal interpretation.
When this study was published
Recent analysis spanning 2015-2022 NSDUH data, capturing the period of growing psychedelic interest and use.
The bigger picture
The psychedelic therapy movement has generated enthusiasm for treating addiction, but real-world data shows psychedelic users have more cannabis problems, not fewer. This distinction between controlled therapeutic use and naturalistic use is critical.
Questions still open
- Does therapeutic psychedelic use in controlled settings show different associations with cannabis use? Is the correlation simply reflecting a general substance use predisposition?
Common questions
Can psychedelics help treat cannabis addiction?
Why would psychedelic users have more cannabis problems?
Read the original research
Associations between psychedelic use and cannabis use disorder in a nationally representative sample.
Drug and alcohol dependence, 266, 112502
Citation
Zech, James M; Yaden, David B; Jones, Grant M. (2025). Associations between psychedelic use and cannabis use disorder in a nationally representative sample.. Drug and alcohol dependence, 266, 112502. https://doi.org/10.1016/j.drugalcdep.2024.112502
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