A framework to assess risks for non-medical use of psychedelics: The liability for abuse of psychedelics questionnaire (LAPQ)

As psychedelic research moves forward, trial design could benefit from assessments of potential risks of treatment. One such risk is future abuse or misuse of the drug or other drugs of abuse. Like the ketamine literature, psychedelic studies to date have not included measures designed to thoroughly address this risk. With aims to fill this gap, we previously developed a ketamine/esketamine drug liking and craving questionnaire (DLCQ), which primarily considered level of drug liking as a risk factor for potential future misuse or abuse. In adapting this for use with psychedelics, several considerations arose, including the likelihood that the psychedelic experience may be more universally pleasurable, and that desire to use psychedelics again may carry several underlying reasons. Here, we describe the Liability for Abuse of Psychedelics Questionnaire (LAPQ), which provides a framework incorporating 3 domains; substance use history, liking and craving for the drug in question, and subsequent changes in substance use patterns after exposure to the drug. While not a validated instrument, we propose this framework may be used in conjunction with other side effect tracking tools to more comprehensively address risks in psychedelic studies. • Psychedelic drugs are known for misuse and abuse. Clinical trials investigating the use of psychedelic drugs in psychiatry must responsibly aim to assess abuse liability as a risk of the intervention. • Multiple questionnaires exist to assess various aspects of the psychedelic experience and outcomes, but to date, there has been no readily available questionnaire to address abuse liability. • The Liability for Abuse of Psychiatric Drugs Questionnaire (LAP-Q) was created after consideration of important aspects to consider in regard to abuse liability. It provides a framework to collect data in 3 dimensions – substance abuse history, liking of the psychedelic experience and desire to use the drug again, and subsequent substance use patterns.