Latin American adults who regularly use macrodoses of psychedelics: a cross-sectional study

doi:10.21203/rs.3.rs-4706910/v1

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Latin American adults who regularly use macrodoses of psychedelics: a cross-sectional study

https://doi.org/10.21203/rs.3.rs-4706910/v1

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published 13 Oct, 2024

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Psychedelics have a complex history marked by traditional use among indigenous cultures, early scientific interest, and subsequent prohibition. Despite their classification as controlled substances, recent decades have witnessed a resurgence of research into their therapeutic potential for various mental health conditions. However, most studies have focused on controlled clinical settings, leaving a significant gap in understanding how these substances are used in naturalistic contexts, particularly in Latin America. This study investigates the regular use of macrodoses of psychedelics among Latin American adults. We aimed to characterize the sociodemographic profiles, consumption practices, and subjective effects experienced by individuals who use psychedelics regularly. Data were collected via an online survey from 4,270 participants across several Latin American countries. Results indicated a diverse user base with varied motivations, predominantly psychological and spiritual well-being. The most frequently used substance was psilocybin mushrooms, with significant associations found between demographic variables and specific psychedelics used. The study provides new insights into the naturalistic use of psychedelics in Latin America, highlighting the need for informed, safe, and legal use frameworks.

Psychedelics

macrodoses

well-being

consumption practices

psilocybin

According to the United Nations World Drug Report 2023, an estimated 13.2 million people used drugs in 2021 (1). In this context, psychedelics are consistently associated with recreational and illicit use, however they have a long history of safe use among the indigenous cultures of the Americas (2) and Eurasia (3). The interest of allopathic medicine in these substances arose with the discovery of Lysergic Acid Diethylamide (LSD) by Albert Hoffman in 1943 and its therapeutic potential for mental health (4). The unsafe use of these substances outside the experimental and/or clinical context, as well as the political revolution of the countercultural movement of the 1960s, led the United States government to declare a federal ban on the use of psychedelics in 1968, a pronouncement ratified globally by the United Nation Convention on Narcotics in 1971 (4).

Even though research with psychedelic substances has been conducted over the past three decades (4) Griffiths’ 2006 study started the scientific psychedelic renaissance (4, 6) which was enhanced by Carhart-Harris and Nutt's 2012 neuroimaging studies (6).

Additionally, in recent years, several scientific reports have showed its therapeutic potential to address, for example, depression and anxiety (7, 8, 9), post-traumatic stress disorder (10, 11, 12), alcohol addiction (13), heroin addiction and opioid withdrawal symptoms (14, 15, 16), abstinence from alcohol, barbiturates, sedatives, cocaine, amphetamines, and solvents (17), etc.

As mentioned above, empirical studies in this decade have focused on the therapeutic potential of these substances in mental health and its neurodynamic correlates, but we have little knowledge of how psychedelics are used in naturalistic settings (18). By this date, there is no research in the Latin American context that characterizes the use of these substances and/or the people who use it.

The present study aims to contribute to the characterization of the regular consumption of macrodoses of psychedelics in the Latin Americas community, as well as the practices associated with the use of these substances, considering sociodemographic variables and variables related to the consumption itself.

The study was approved by the Scientific Ethics Committee of the Universidad Católica del Norte (resolution n° 013/2023) and adhered to the principles of the Declaration of Helsinki and Singapore. Electronic informed consent was obtained from all participants before they responded to the survey.

The study had an exploratory and cross-sectional design, and considered adults who regularly use psychedelics. In the absence of a single and clear definition of what is considered regular use, this criterion was operationalized as people who have been using psychedelics for at least three years with a frequency of at least four times per year (once per quarter).

The inclusion criteria considered persons 18 years of age or older who could read and understand Spanish and who met the operationalization of habitual consumption. To encourage participation, the survey did not collect any personal identification data (e.g., name, national identification number, email, etc.). Given this design feature, the inclusion criteria could not be verified beyond the information provided by the participants themselves.

We collected data between April 2023 and March 2024 from self-selected participants recruited through web-based announcements on social media services (Instagram and Facebook), advertisements, and interviews published in digital information channels of broadcasters, universities, and Non-Governmental Organizations related to psychedelics. The required sample size was determined with G*Power v3 for a large effect size (Effect size w = 0.1; α err prob = 0.01; Power = 0.99; Df = 5) which results in a sample size of 3641 participants.

The online survey was developed by the research team and pilot-tested with a group of 50 people (to assess linguistic comprehension, correct functioning of the digital platform, etc.) and subsequently reviewed by a group of subject matter experts composed of clinicians and psychologists. The survey considered three dimensions related to sociodemographic information, information on the first consumption experience, and information on regular use. For this publication, data from the first and last dimensions described above were considered. To ensure that the answers given by the participants were the result of reading and not of randomly filling options, an attentional control question was included in every five questions (for example, “in this question we asked you to mark the triangle option”, “in this question select the option that represents the result of 3 + 3”, etc.).

The regular psychedelics use considers the variable “purpose” which was operationalized as follows: recreational purpose defined as the search for pleasure, fun, and/or curiosity; medicinal purpose defined as the search to address a symptom and/or clinical condition of physical or psychological health; spiritual purpose defined as the search for connection with a higher and/or transpersonal dimension. The purpose of Psychedelic-Assisted Psychotherapy (PAP) is clear by itself. Additionally, the regular use dimension considers the variable “frequency of consumption” which was operationalized as follows: daily defined as every day of the week; weekly defined as every week, but not every day of the week; monthly defined as only some days of the month; and annually defined as at least four times a year, but not every month.

Statistical analyses. We used descriptive statistics and the X² statistic to compare demographic and regular use variables. All X² significance test contrasts were performed at the p < 0.01 level on SPSS v25 Software. To address the multiple comparison problem in our analysis using multiple chi-square tests, all data were corrected using the False Discovery Rate (FDR) method (19).

Demographics. The online survey was completed by 4270 participants from Chile (53%, n = 2263), Colombia (16%, n = 683), Perú (10%, n = 427), Argentina (7%, n = 299), Bolivia (6%, n = 256), Ecuador (4%, n = 171), and Uruguay (4%, n = 171). The mean age of the participants was 31.9 years (SD = 8.4). Table 1 shows the distribution of participants according to sociodemographic variables.

Table 1

Distribution of participants according to sociodemographic variables
Gender
Female	56% (2391)
Male	39.6% (1691)
Non-binary	4.4% (188)
Age
18–29	45.2% (1930)
30–64	54.6% (2331)
65+	0.2% (9)
Sexual orientation
Heterosexual	72.1% (3079)
2SLGBTQIA+	27.9% (1191)
Sex-affective relationship
Monogamous	56% (2391)
Polygamous	0.9% (38)
Open relationship	6.1% (260)
Don’t have couple	37% (1580)
Occupation/Employment
Out of Work	5.2% (222)
Homeowner	1.2% (51)
Student	16.2% (692)
Dependent Worker	34.7% (1482)
Self-employed Worker	21.5% (918)
Politician	0.2% (9)
Psychedelic-Assisted Psychotherapy Practitioner or Psychedelic Experiences Facilitator	6.1% (260)
Dependent and Self-employed Worker	6.3% (269)
Student and Dependent Worker	7.7% (329)
Student, Dependent and Self-employed Worker	0.7% (30)
Pensionate	0.2% (9)
Personal monthly income (in USD)
$0 to $698	49.6% (2118)
$699 to $1423	31.4% (1341)
$1424 to $3583	15.7% (670)
Above $3584	3.3% (141)
Education
0–8 years	0% (0)
9–12 years	7.2% (333)
13–17 years	39.9% (1678)
Above 18 years	52.9% (2259)
Religion/Creed
Catholic	6.6% (282)
Buddhist	2.6% (111)
Evangelical	1.4% (60)
Christian	1.4% (60)
Agnostic	1.2% (51)
Gnostic	0.5% (21)
Hare Krishna	0.2% (9)
Something higher	3.7% (158)
Shamanism or Ancestry	1.9% (81)
God/Jesus	0.7% (30)
Nothing (no religion or creed)	79.9% (3412)

(Paste Table 1 here)

Regular psychedelics use. The mean age of the first consumption was 24.2 years (SD = 7.6) with a minimum age of 12 years and a maximum age of 67 years. On average, people have consumed 3 (SD = 1.85) different psychedelics during their lifetime. Table 2 shows the distribution of the quantity of substances consumed, as well as the distribution of each substance.

Table 2

Distribution of substances and the quantity consumed.
Number of substances consumed
Just 1	33% (1409)
2	20.1% (858)
3	17.8% (760)
4	12.2% (521)
5	8.4% (359)
6	4% (171)
7	2.1% (90)
8	1.4% (60)
9	0.2% (9)
10 +	0.7% (30)
Substance distribution
Psilocybin mushrooms	88.8% (3792)
MDMA	48.2% (2058)
LSD	40.3% (1721)
2C-B	15.2% (649)
San Pedro cactus	16.4% (700)
Ketamine	15.2% (649)
DMT	13.8% (589)
Ayahuasca	12.2% (521)
Salvia	4.7% (201)
Peyote	4.2% (179)
Floripondium	3.3% (141)
Ibogaine	1.4% (60)
Tepezcohuite	1.4% (60)
Anandenanthera Colubrina	0.5% (21)

(Paste Table 2 here)

We observed 12 reasons why people decided to continue using psychedelics on a regular basis (Table 3). The main reason was “psychological well-being I experience when using” (65.3%, n = 2788). Additionally, 78.8% (n = 3360) of people describe two or more reasons for regular consumption.

Table 3

Reasons for using psychedelics on a regular basis.
Reasons for continued use
Psychological well-being I experience when using	65.3% (2788)
Spiritual well-being I experience when using	59% (2519)
The feeling of calm that lingers after use	50.6% (2161)
Curiosity to explore what else can be experienced under the effects of the substance	47.3% (2020)
The published scientific reports on the benefits of these substances	38.9% (1657)
The reduction or elimination of the psychological symptoms experienced prior to consumption	24.4% (1042)
The call of the substance itself, although I don't really know how to explain it	18% (769)
The invitation of people closes to me who regularly consume	13.6% (581)
The loss of fear of death	7% (299)
The suggestion of a professional, as part of treatment	5.9% (252)
The suggestion of a facilitator (e.g., Shaman, Paje, Taita, Machi, Medicine Man, etc.)	5.2% (222)
To continue the path of self-knowledge and/or the expansion of my consciousness	3.3% (141)
I had a bad trip the first time and wanted to have a better experience	2.8% (120)
To remain in contact with the whole, with the unity, with the divine, with the mystery	1.6% (68)
To continue to access information that appears in this modified state of consciousness	1.2% (51)
To seek inspiration and/or enhance my creativity	0.2% (9)

(Paste Table 3 here)

Regarding the purposes for which psychedelics are consumed, 67.9% (n = 2899) do so for recreational purposes, 32.3% (n = 1379) for medicinal purposes, 61.8% (n = 2639) for spiritual purposes, and 6.8% (n = 290) for PAP purposes. 52.5% (n = 2242) of the participants stated more than one purpose at the basis of their consumption.

Annual consumption frequency represents the highest percentage (64.9%, n = 2771), followed by monthly (20.6%, n = 880), weekly (11%, n = 470), and daily (3.5%, n = 149).

The contexts of consumption consider own house (65.1%, n = 2780), outdoors (64.4%, n = 2750), acquaintance's house (39.3%, n = 1678), stranger’s house (4.9%, n = 209), educational institution (3.5%, n = 149), party (30.4%, n = 1298), ceremony or retreat (20.4%, n = 871), PAP (2.3%, n = 98), and workplace (2.1%, n = 90).

Regarding the company of consumption, it was observed that the most frequent was with friends (72.4%, n = 3091). The remaining percentages are distributed as follows: alone (49.2%, n = 2101), with partner (41.9%, n = 1789), with facilitator or professional (16.9%, n = 722), with family members (15.9%, n = 679), with strangers (7.7%, n = 329), and with dealer (4%, n = 171).

The most frequent source of acquisition of the substance was dealer (63%, n = 2690), followed by friends (58.1%, n = 2481), homegrowing (22%, n = 939), facilitator or professional (16.6%, n = 709), partner (7.7%, n = 329), purchased through an application (7.7%, n = 329), and family member (5.2%, n = 222). Most people know the amount of substance consumed (81.5%, n = 3480), while 18.5% (n = 790) do not. Participants spend an average of $135 (SD = 425,1) per year on psychedelic use.

The changes experienced subjectively because of regular consumption are shown in Table 4.

Table 4

Subjective changes reported.
Subjective changes reported
Decreased memory capacity	10.1% (431)
Improved mood	61.6% (2630)
Worse mood	4.7% (201)
Spiritual growth	53.2% (2272)
Personal growth	55.7% (2378)
Physical well-being (e.g., decrease of ailments that used to be frequent)	34% (1452)
Physical discomfort (e.g., frequent onset of post-consumption discomfort)	4% (171)
Increased capacity of self-observation (e.g., more attentive to what I feel, think and/or do)	67.7% (2891)
Increased creativity	43.6% (1862)
Increased problem-solving skills	40% (1708)
Decrease in anxiety and/or distress	53,4% (2280)
General reduction of fears	36,5% (1559)
Decreased fear of dying and/or of losing something/someone	21,5% (918)
Increased difficulty in concentrating on work and/or day-to-day activities	8,7% (371)
Increased questioning of my work, relationships and/or habits, without discomfort	23,9% (1020)
Increased questioning of my work, relationships and/or habits with discomfort	11,7% (500)
Some degree of discomfort when sharing with groups of people (known or unknown),	16,9% (722)
Distancing from people with whom I used to share frequently, without discomfort	22,5% (961)
Positive changes in my eating, hygiene and/or self-care habits	39,1% (1670)
Negative changes in my eating, hygiene and/or self-care habits	3,5% (149)
Changes in my recreational interests (e.g., music, sports, movies, literature, etc.)	29,5% (1260)
Heightened sensitivity (e.g., I feel more connected to my emotions and/or those of other people)	54,8% (2340)
Decreased sensitivity (e.g., I feel less connected to my emotions and/or those of other people)	1,6% (68)
No significant change, everything remains as usual	6,3% (269)

(Paste Table 4 here)

Regular psychedelics use and demographics. The results show significant relationships between sociodemographic variables and regular psychedelic use.

Gender. Female gender is related to the regular use of LSD (χ² = 54.36, p < 0.01), and ketamine (χ² = 41.28, p < 0.01), while male gender is related to the regular use of DMT (χ² = 34.81, p < 0.01), LSD (χ² = 55.44, p < 0.01), and ketamine (χ² = 38.01, p < 0.01).

Occupation. Student is related to the regular use of Psilocybin mushrooms (χ² = 44.80, p < 0.01), and LSD (χ² = 35.97, p < 0.01), and being a psychedelic experiences facilitator is related to the consumption of Ayahuasca (χ² = 47.88, p < 0.01), and Tepezcohuite (χ² = 37.89, p < 0.01).

Education. Psilocybin mushroom consumption is related to the groups of 13–17 years of education (χ² = 36.47, p < 0.01), and above 18 years of education (χ² = 40.20, p < 0.01).

Religion or creed. Not belonging to any religion and/or not professing any creed is related to the regular use of Psilocybin mushrooms (χ² = 50.13, p < 0.01), Ayahuasca (χ² = 47.71, p < 0.01), LSD (χ² = 47.69, p < 0.01), and 2C-B (χ² = 45.38, p < 0.01), while shamanism/ancestry creed is related to San Pedro cactus (χ² = 46.71, p < 0.01), Peyote (χ² = 38.72, p < 0.01), and Ayahuasca (χ² = 49.30, p < 0.01) use. Believe in something higher is related to regular use of San Pedro cactus (χ² = 45.40, p < 0.01), Peyote (χ² = 48.69, p < 0.01), and Ayahuasca (χ² = 65.49, p < 0.01).

Income. A monthly income lower than $648 is related to regular use of Psilocybin mushrooms (χ² = 33.90, p < 0.01), and 2C-B (χ² = 35.53, p < 0.01), while a monthly income above $3584 is related to Ketamine (χ² = 34.70, p < 0.01), MDMA (χ² = 35.83, p < 0.01), and Ibogaine (χ² = 47.33, p < 0.01) use.

Regular psychedelics use and consumption variables. Moreover, we also observed significant relationships between the substance regularly consumed and certain consumption variables.

Consumption context. Outdoors is related to Psilocybin mushrooms (χ² = 44.53, p < 0.01), LSD (χ² = 42.28, p < 0.01), San Pedro cactus (χ² = 35.92, p < 0.01), MDMA (χ² = 37.43, p < 0.01), and DMT (χ² = 40.38, p < 0.01). Own house consumption context is related just to Psilocybin mushrooms (χ² = 38.41, p < 0.01). Ceremony context is related to Psilocybin mushrooms (χ² = 36.65, p < 0.01), Peyote (χ² = 68.16, p < 0.01), San Pedro cactus (χ² = 123.12, p < 0.01), Ayahuasca (χ² = 146.70, p < 0.01), DMT (χ² = 47.39, p < 0.01), Tepezcohuite (χ² = 63.78, p < 0.01), and Anadenanthera Colubrina (χ² = 37.85, p < 0.01). Acquaintance's house context is related to LSD (χ² = 44.46, p < 0.01), San Pedro cactus (χ² = 41.11, p < 0.01), MDMA (χ² = 45.24, p < 0.01), DMT (χ² = 36.36, p < 0.01), and 2C-B (χ² = 45.82, p < 0.01). Party context is related to LSD (χ² = 37.81, p < 0.01), Ketamine (χ² = 68.55, p < 0.01), MDMA (χ² = 88.38, p < 0.01), and 2C-B (χ² = 68.55, p < 0.01). Educational context is related just to 2C-B (χ² = 47.49, p < 0.01).

Consumption purpose. We observed a significant relationship between consumption for recreational purposes and consumption for spiritual purposes (χ² = 76.46, p < 0.01).

Consumer company. Consuming alone is related to San Pedro cactus (χ² = 36.26, p < 0.01), Salvia (χ² = 37.97, p < 0.01), and Psilocybin mushrooms (χ² = 45.22, p < 0.01). Consuming with couple is related to LSD (χ² = 36.15, p < 0.01), Psilocybin mushrooms (χ² = 44.16, p < 0.01), Ketamine (χ² = 35.70, p < 0.01), MDMA (χ² = 37.72, p < 0.01), DMT (χ² = 36.93, p < 0.01), Ibogaine (χ² = 38.43, p < 0.01), and Tepezcohuite (χ² = 38.43, p < 0.01). Consuming with friends is related to LSD (χ² = 56.85, p < 0.01), Ketamine (χ² = 42.98, p < 0.01), MDMA (χ² = 56.95, p < 0.01), Salvia (χ² = 35.24, p < 0.01), and 2C-B (χ² = 47.69, p < 0.01). Consuming with strangers is related only to 2C-B (χ² = 55.32, p < 0.01). Consuming in company of a facilitator is related to Psilocybin mushrooms (χ² = 34.34, p < 0.01), Peyote (χ² = 71.08, p < 0.01), San Pedro cactus (χ² = 95.58, p < 0.01), Ayahuasca (χ² = 172.76, p < 0.01), Tepezcohuite (χ² = 60.01, p < 0.01), and Anadenanthera Colubrina (χ² = 39.90 p < 0.01). Consuming in company of a dealer is related to Ketamine (χ² = 63.59, p < 0.01), MDMA (χ² = 34.39, p < 0.01), and 2C-B (χ² = 56.08, p < 0.01).

Acquisition. Regarding the sources of acquisition of psychedelics, through a dealer is related to regular use of Psilocybin mushrooms (χ² = 36.83, p < 0.01), LSD (χ² = 40.59, p < 0.01), Ketamine (χ² = 37.86, p < 0.01), MDMA (χ² = 38.95, p < 0.01), and 2C-B (χ² = 34.70, p < 0.01), while through a dealer via mobile application is related to Ketamine (χ² = 42.38, p < 0.01), and 2C-B (χ² = 39.09, p < 0.01) use. Acquisition through friends is related to the consumption of Ketamine (χ² = 36.37, p < 0.01), MDMA (χ² = 40.30, p < 0.01), and 2C-B (χ² = 36.37, p < 0.01). Acquisition through a facilitator is related to the consumption of Peyote (χ² = 63.94, p < 0.01), San Pedro cactus (χ² = 81.09, p < 0.01), Ayahuasca (χ² = 166.10, p < 0.01), Salvia (χ² = 35.10, p < 0.01), Tepezcohuite (χ² = 60.51, p < 0.01), and Anadenanthera Colubrina (χ² = 40.07, p < 0.01). Acquisition through couple (χ² = 38.11, p < 0.01) and/or a family member (χ² = 35.26, p < 0.01) is related to the consumption of MDMA. Homegrowing is only related with San Pedro cactus use (χ² = 41.16, p < 0.01).

Considering that the use of psychedelics should consider the analysis of extra pharmacological variables, described as set and setting (20, 21, 22, 23, 24), we set out to explore the relationship between the consumption of each substance and variables associated with consumption. We observed a significant relationship between ceremonial context, the company of a facilitator, and Ayahuasca (χ2 = 252.36, p < 0.01), San Pedro cactus (χ2 = 251.88, p < 0.01), and Peyote (χ2 = 248.81, p < 0.01) consumption. At the same time, significant relationships were found between consumption in the company of friends in the context of a party and MDMA (χ2 = 56.95, p < 0.01), 2C-B (χ2 = 57.69, p < 0.01), Ketamine (χ2 = 52.98, p < 0.01), and LSD (χ2 = 56.85, p < 0.01).

Regular psychedelics use and perceived changes. It can be observed that there are significant relationships between the positive perceived changes and the psychedelic regularly consumed (Table 5) as well as between negative perceived changes and the psychedelic regularly consumed (Table 6).

Table 5

Positive changes reported and psychedelics used on regular basis.
Positive changes reported	Psychedelics
Improved mood	Psilocybin mushrooms (χ² = 43.26, p < 0.01)
Improved mood	San Pedro cactus (χ² = 35.70, p < 0.01)
Spiritual growth	Psilocybin mushrooms (χ² = 55.71, p < 0.01)
	Peyote (χ² = 39.63, p < 0.01)
	San Pedro cactus (χ² = 54.22, p < 0.01)
	Ayahuasca (χ² = 53.52, p < 0.01)
	DMT (χ² = 40.69, p < 0.01)
	Floripondium (χ² = 36.16, p < 0.01)
	Tepezcohuite (χ² = 35.36, p < 0.01)
Personal growth	Psilocybin mushrooms (χ² = 67.12, p < 0.01)
	LSD (χ² = 36.60, p < 0.01)
	San Pedro cactus (χ² = 43.54, p < 0.01)
	Ayahuasca (χ² = 47.43, p < 0.01)
	DMT (χ² = 35.24, p < 0.01)
	Floripondium (χ² = 35.27, p < 0.01)
Physical well-being	Peyote (χ² = 38.96, p < 0.01)
	San Pedro cactus (χ² = 43.33, p < 0.01)
	Ayahuasca (χ² = 42.56, p < 0.01)
	DMT (χ² = 35.56, p < 0.01)
	Floripondium (χ² = 35.93, p < 0.01)
	Tepezcohuite (χ² = 41.83, p < 0.01)
Increased capacity of self-observation	Psilocybin mushrooms (χ² = 70.79, p < 0.01)
	LSD (χ² = 39.11, p < 0.01)
	San Pedro cactus (χ² = 42.44, p < 0.01)
	Ayahuasca (χ² = 39.62, p < 0.01)
	MDMA (χ² = 35.97, p < 0.01)
	DMT (χ² = 45.35, p < 0.01)
	Floripondium (χ² = 34.19, p < 0.01)
Increased creativity	Peyote (χ² = 42.09, p < 0.01)
Increased creativity	San Pedro cactus (χ² = 44.62, p < 0.01)
Increased problem-solving skills	Psilocybin mushrooms (χ² = 52.65, p < 0.01)
	San Pedro cactus (χ² = 38.56, p < 0.01)
	Ayahuasca (χ² = 36.09, p < 0.01)
	DMT (χ² = 38.81, p < 0.01)
	Tepezcohuite (χ² = 39.11, p < 0.01)
Decrease in anxiety and/or distress	Psilocybin mushrooms (χ² = 40.65, p < 0.01)
Decrease in anxiety and/or distress	Tepezcohuite (χ² = 35.31, p < 0.01)
General reduction of fears	Psilocybin mushrooms (χ² = 57.68, p < 0.01)
	LSD (χ² = 36.56, p < 0.01)
	Ayahuasca (χ² = 37.65, p < 0.01)
	DMT (χ² = 34.70, p < 0.01)
	Floripondium (χ² = 34.80, p < 0.01)
	Tepezcohuite (χ² = 40.57, p < 0.01)
Decreased fear of dying and/or of losing something/someone	Psilocybin mushrooms (χ² = 39.66, p < 0.01)
	LSD (χ² = 35.13, p < 0.01)
	Peyote (χ² = 42.85, p < 0.01)
	San Pedro cactus (χ² = 34.83, p < 0.01)
	Ayahuasca (χ² = 42.43, p < 0.01)
	DMT (χ² = 42.31, p < 0.01)
	Tepezcohuite (χ² = 43.74, p < 0.01)
Increased questioning of my work, relationships and/or habits, without discomfort	Psilocybin mushrooms (χ² = 40.41, p < 0.01)
	LSD (χ² = 35.57, p < 0.01)
	San Pedro cactus (χ² = 34.86, p < 0.01)
	MDMA (χ² = 36.92, p < 0.01)
	DMT (χ² = 44.49, p < 0.01)
Distancing from people with whom I used to share frequently, without discomfort	Psilocybin mushrooms (χ² = 44.51, p < 0.01)
	Peyote (χ² = 31.79, p < 0.01)
	San Pedro cactus (χ² = 42.43, p < 0.01)
	Ayahuasca (χ² = 46.07, p < 0.01)
	DMT (χ² = 35.11, p < 0.01)
	Tepezcohuite (χ² = 50.98, p < 0.01)
Positive changes in my eating, hygiene and/or self-care habits	Psilocybin mushrooms (χ² = 43.66, p < 0.01)
Changes in my recreational interests	Psilocybin mushrooms (χ² = 41.65, p < 0.01)
	LSD (χ² = 34.70, p < 0.01)
	Peyote (χ² = 46.48, p < 0.01)
	San Pedro cactus (χ² = 35.71, p < 0.01)
	Ayahuasca (χ² = 37.88, p < 0.01)
	MDMA (χ² = 40.87, p < 0.01)
	DMT (χ² = 34.10, p < 0.01)
	Tepezcohuite (χ² = 38.47, p < 0.01)
Heightened sensitivity	Psilocybin mushrooms (χ² = 61.75, p < 0.01)
	San Pedro cactus (χ² = 42.83, p < 0.01)
	Ayahuasca (χ² = 36.39, p < 0.01)
	DMT (χ² = 37.42, p < 0.01)
	Tepezcohuite (χ² = 35.01, p < 0.01)
All X² significance test contrasts were performed at the p < 0.01

Table 6

Negative changes reported and psychedelics used on regular basis.
Negative changes reported	Psychedelics
Decreased memory capacity	Ketamine (χ² = 61.08, p < 0.01)
Decreased memory capacity	2C-B (χ² = 71.86, p < 0.01)
Worse mood	2C-B (χ2 = 36.36, p < 0.01)
Physical discomfort	Ketamine (χ² = 39.24, p < 0.01)
Physical discomfort	2C-B (χ² = 49.51, p < 0.01)
Increased difficulty in concentrating on work and/or day-to-day activities	2C-B (χ² = 42.44, p < 0.01)
Negative changes in my eating, hygiene and/or self-care habits	Ketamine (χ² = 37.39, p < 0.01)
	2C-B (χ² = 41.91, p < 0.01)
Increased questioning of my work, relationships and/or habits, with discomfort	2C-B (χ² = 39.33, p < 0.01)
Some degree of discomfort when sharing with groups of people (known or unknown)	San Pedro cactus (χ² = 20.30, p < 0.01)
	DMT (χ² = 24.17, p < 0.01)
	2C-B (χ² = 23.04, p < 0.01)
All X² significance test contrasts were performed at the p < 0.01

(Paste Table 5 here)

(Paste Table 6 here)

In addition, “changes in my recreational interests” are related to female gender (χ² = 36.06, p < 0.01), and male gender (χ² = 35.83, p < 0.01).

The present study aimed to characterize the variables associated with the regular use of macrodoses of psychedelic in the Latin American context.

Our findings on the age of first consumption differ from previous studies (25, 26), which suggest that the onset of substance use occurs between 14 and 18 years of age. According to our findings the first consumption experience happens around the age of 24 years. This data could suggest that people could make consumption decisions with greater maturity and awareness, possibly supported by a broader knowledge about the substances involved. Even though psychedelics are considered drugs, it seems that their use implies a different pattern of onset than that of substances such as cocaine, opiates, etc.

Previous findings (27) link the use of substances such as MDMA and Ketamine to the 2SLGBTQ + community, however, our findings show no relationship between sexual orientation and psychedelic use. About gender, previous reports (28) show that LSD use is higher in men than in women. We observed that LSD and Ketamine use is associated with both women and men, while DMT use is only associated with men. The non-binary gender did not present any association with the consumption of any substance.

Our results show that 92.8% of the participants have technical and/or university studies, as well as 93.6% work and/or study. This finding contrasts with one of the most common misconceptions in the general community, which states that psychedelic users are people with a low educational level and no job potential (29). At the same time, our findings show certain relationships between occupation and regularly used substances, we observed that students are related to the consumption of Psilocybin Mushrooms and LSD, while being a facilitator of psychedelic experiences is related to the consumption of Ayahuasca, DMT, and Tepezcohuite. Only the use of Psilocybin mushrooms was associated with 13 or more years of education.

Regarding socioeconomic status, previous findings associate substance use with low family socioeconomic levels (30), we can observe that the monthly income of each participant is related to the type of substance consumed, thus we can see that monthly incomes up to $698 are associated with the consumption of Psilocybin mushrooms and 2C-B, while the consumption of substances such as MDMA and Ketamine are associated with monthly incomes above $3584. In this context, it can be hypothesized that the socioeconomic level is related to the type of substance to which people have access, rather than to the consumption itself.

About religion variable, previous evidence shows connection between this variable and substance use, whether illicit or licit, showing that a higher level of religiosity/spirituality is associated with lower substance use (31). Our results partially coincide with this evidence, since on the one hand most of the participants do not belong to any formal religion and this is associated with the consumption of Psilocybin Mushrooms, Ayahuasca, Salvia and 2C-B, but on the other hand, people who profess a shamanic creed are associated with the consumption of Ayahuasca, Peyote and San Pedro cactus, which is logical considering the substances involved, the context of consumption (ceremony or retreat) and their connection with the practices of Native American cultures, context in which these substances are considered to be sacred medicines and their consumption is part of their cosmovision.

Global reports on the prevalence of each substance used vary greatly. The 2023 World Drug Report mentions that in Australia and New Zealand the demand for MDMA is the most prevalent (1), while in the USA 9.68% of the population consumes psilocybin mushrooms (32). Our results coincide with those described, considering that in the Latin American context Psilocybin mushrooms are the most consumed substance, followed by MDMA. It should be noted that these findings do not consider aspects related to the supply and demand of these psychedelics in the illegal market, representing only indicators of those substances that people prefer to consume.

There appear to be no empirical reports describing the motivations of people who choose to use psychedelics in macrodoses. Previous findings highlight that those who consume microdoses of psychedelics do so in pursuit of improved mental health, personal development, and cognitive enhancement (33). Apparently, according to our results, the motivations for macrodosing are also mainly related to the psychological and spiritual well-being that people experience post-consumption. Additionally, we can observe that consumption for recreational purposes is the most frequent, however, consumption for spiritual purposes also represents a very high percentage. At the same time, considering that a significant percentage of participants describe more than one purpose basis of regular consumption, the statistics show a significant relationship between these two purposes.

Like previous findings (25), our results show that most people prefer to consume psychedelics in the company of other people, it can be hypothesized that given the complexity of the psychological experience induced by psychedelics, the company of third parties provides security, containment, and support. On the other hand, we also observed that 49.2% of the participants practice solitary consumption.

The results show significant relationships between certain contexts of consumption and the substance consumed, which highlights the importance of considering variables associated with the setting. Previous reports describe a preference for ceremonial contexts (25), while our findings describe a preference for own house and outdoor consumption. In addition, we can observe significant relationships between the substance consumed, the context of consumption, and the company. It is evident that consuming Ayahuasca, San Pedro cactus, and/or Peyote is related to the ceremonial context, and therefore, to the company of a facilitator, while the use of Ketamine, MDMA, LSD, and/or 2C-B is related to partying and being with friends.

North American users have been reported to use psychedelics frequently (34). In the absence of a clear representation of frequency of use, the results show that most participants prefer to use psychedelics only a few times a year. The difficulty in uniquely operationalizing the concept of frequency may be related to the differences observed between studies.

There are no known global reports associated with the detailed sources of acquisition of psychedelics. Our results show that most people obtain substances through a dealer and/or a third party. This is logical in the Latin American context where the adult and responsible use of psychedelics is prohibited by the legal framework of the countries. The findings show that these prohibitive frameworks do not prevent people from consuming, but rather favor illicit trafficking and the potential social and health consequences associated with illegal consumption, increasing the health risks to the population.

Regarding the subjective changes associated with the regular use of psychedelics, we find it interesting to note that those considered negative are less frequent than those considered positive. At the same time, the negative perception of subjective effects is mainly associated with the regular use of psychedelics of synthetic origin, specifically 2C-B and Ketamine. On the other hand, the effects considered positive are mainly associated with psychedelics of organic origin. Within the relationships described, Psilocybin mushrooms are the psychedelic with the most significant numbers of relationships between use and experienced well-being.

Considering the design of the study, the relationships presented here are of an exploratory nature; therefore, we consider that these findings provide a basis for future lines of research that delve deeper into these and other interactions, in terms of moderation, mediation or explanatory models of these relationships.

Future research should focus on longitudinal studies to understand the long-term effects of regular psychedelic use and explore comparative studies between different regions to uncover cultural and socioeconomic influences. Detailed analysis of set and setting in psychedelic experiences, particularly in naturalistic settings, can offer insights into their therapeutic potential. Additionally, examining microdosing practices alongside macrodosing can provide a comprehensive view of dosing impacts. Developing harm reduction strategies based on these findings will be crucial for safe consumption. Finally, investigating the impact of regular psychedelic use on community and social dynamics through interdisciplinary and ethnographic studies will deepen our understanding of its broader social implications.

The production of this knowledge would help to generate an informed dialogue based on evidence, favoring a paradigm shift to lay the foundations for informed, safe, and legal use of these substances, in addition to breaking down stigmas, misconceptions, and prejudices associated with this practices, giving way to new research on this issue in the Latin American context. This information is relevant for Latin American governments to review the current regulatory frameworks on the use of psychedelics, considering the variables associated with consumption as well as the promising results regarding their therapeutic potential.

Acknowledgments.

We are very grateful to all the people who answered the survey. We also thank the institutions that collaborated with the dissemination of the study, especially the lovely team of Mantra Foundation.

Author contributions statements.

V-G O. Contribution: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Supervision, Validation, and Writing - review & editing the first, subsequent, and final version of the manuscript.

DM. Contribution: Data curation, Formal analysis, Methodology, and Writing - review & editing the first, subsequent, and final version of the manuscript.

The authors declare no competing interests.

Data availability.

Data is available upon reasonable request to the corresponding author.

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No competing interests reported.

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Latin American adults who regularly use macrodoses of psychedelics: a cross-sectional study

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