An investigation into the varieties of extended difficulties following psychedelic drug use: Duration, severity and helpful coping strategies

Abstract Psychedelic drugs show promising therapeutic potential; however, some users experience extended difficulties following their use. This study investigated the prevalence, severity, duration, and associated coping strategies of post-psychedelic difficulties. We conducted an online survey of 159 participants, all of whom reported experiencing difficulties lasting more than one day after psychedelic use within the past 2–10 years. Participants rated the severity and duration of 11 types of difficulties and indicated effective coping strategies. Results revealed that social disconnection (72%), anxiety and panic attacks (68%), and existential struggle (65%) were the most prevalent difficulties. Anxiety and panic attacks were rated as most severe, while existential struggle and diminished self-esteem persisted the longest, with mean durations exceeding 15 months. Derealization and depersonalization, despite being common, were consistently rated as less severe than other difficulties. Self-education emerged as the predominant coping strategy for multiple difficulties, including social disconnection and existential struggle. Professional therapy was most effective for depression and diminished self-esteem, while peer and family support were particularly beneficial for managing anxiety and panic attacks. These findings highlight the diverse nature of post-psychedelic difficulties and the varying effectiveness of different coping strategies. Our results contribute to the development of more nuanced, effective approaches to harm reduction and integration in psychedelic use, emphasizing the importance of multifaceted support systems that include professional, educational, and community-based resources.