Depression, Suicidality and Co-Occurring Substance Use Among Adolescent Hallucinogen Users

Document Type

Abstract

Publication Date

3-1-2023

Abstract

Hallucinogens have received renewed attention in recent years, exploring their potential role in the treatment of psychiatric disorders such as anxiety, depression, and PTSD. Despite these positive developments, hallucinogens remain one of the recreational substances with inconclusive evidence of such positive effects when used in nontherapeutic settings. Thus, we decided to analyze YRBSS' 2001-2019 to explore the prevalence and trends of hallucinogen use among school-going American adolescents. Additionally, we explored the prevalence of depression, suicidality, and co-occurring substance use among hallucinogen users. We found an overall decreasing trend in hallucinogen use. We found a high prevalence of depression, suicidality, and co-occurring substance use among hallucinogen users. In adjusted regression, we found that hallucinogen use was associated with high odds of feeling sad, hopeless, and considering/planning suicide but not an actual suicide attempt. With our study, we highlight the need for further research in exploring the effects of both recreational and therapeutic hallucinogen use among the adolescent population. Background: Hallucinogens have received renewed attention in recent years, exploring their potential role in the treatment of psychiatric disorders. In a therapeutic setting under supervision hallucinogens such as psilocybin have been found to be safe and promising for the treatment of psychiatric disorders such as anxiety, depression, and posttraumatic stress disorder. In a parallel setting, there is increasing popularity of microdosing illicitly purchased hallucinogen drugs in a nontherapeutic setting, as a form of selfmedication to decrease anxiety and depression, and improve cognition despite the lack of conclusive evidence for such effects. Such unsupervised use could lead to adverse experiences, especially with high doses, such as bad trips and acute exacerbations of preexisting psychiatric illnesses. Additionally, the effects of recreational hallucinogen use on the developing brains of adolescents remain poorly studied. Learning Objective 1: Identify the prevalence and trends of hallucinogen use among US adolescents. Learning Objective 2: Identify the prevalence of depression, suicidality, and co-occurring substance use among adolescent hallucinogen users. Learning Objective 3: Identify the association between depression, suicidality, and hallucinogen use among US adolescents. Methods: We performed a retrospective analysis of CDC's YRBSS 2001-2019 data that nationally represents the school-going US adolescents. We identified hallucinogen use using the survey question exploring the use of LSD, acid, PCP, angel dust, mescaline, and mushrooms. We used univariate analysis to identify the prevalence and trends of hallucinogen use as well as depression, suicidality, and co-occurring substance use among hallucinogen users using the Rao-Scott χ2 test for categorical variables and unpaired t-test for continuous variables. Multivariable logistic regression analysis was performed to establish an association between depression, suicidality, and hallucinogen use after adjusting for sociodemographics and co-occurring substance use. Results: Out of a total of 125,550 participants, 8.4% reported ever using hallucinogens. Overall, the trend of hallucinogen use decreased from 13.3% (2001) to 7.0% (2019) (pTrend < 0.0001). A higher percentage of male participants reported hallucinogen use than females (10.3% vs. 6.3%; p < .0001). Compared to adolescents without hallucinogen use, adolescents with hallucinogen use were found to have a higher prevalence of feeling hopeless (48.4 vs. 27.8%), considering suicide (36.3% vs. 15.1%), and attempting suicide that required medical attention (12.0 vs. 1.5%) (p < .0001 for all). Additionally, adolescent hallucinogen users had a higher prevalence of alcohol, cigarette, e-cigarette, marijuana, synthetic marijuana, inhalants, heroin, cocaine, methamphetamine, and ecstasy use. In regression, hallucinogen users were at high odds of feeling sad and hopeless (adjusted odds ratio: 1.38; 95% confidence interval: 1.19-1.60; p < .0001), considering suicide (1.31; 1.02-1.69; p = .03), and planning suicide (1.44; 1.13-1.83; p = .003). Conclusion: We found an overall decreasing trend of hallucinogen use among American Adolescents. We found a high prevalence of depression, suicidality, and co-occurring substance use among hallucinogen users. In adjusted regression, we found that hallucinogen users were at high odds of feeling sad, hopeless, and considering and planning suicide. However, we did not find an association between hallucinogen use and suicide attempts. The cross-sectional nature of our study can only identify association, not causation. Further research is needed to explore the effects of recreational hallucinogen use among the adolescent population. Scientific Significance:We found a high prevalence of depression, suicidality, and co-occurring substance use among adolescent hallucinogen users. Due to the cross-sectional nature of our study, it was not possible to identify the direction of this association. It is possible that hallucinogen use could lead to depression and suicidal ideation among the adolescent population. At the same time, there remains a possibility that depressed and suicidal adolescents may use hallucinogens as a form of self-medication/coping. We highlight the need for further research in exploring the effects of both recreational and therapeutic hallucinogen use among the adolescent population.

Publication Title

American Journal on Addictions

Volume

32

Issue

2

First Page

205

Last Page

206

Comments

33rd Annual Meeting and Scientific Symposium of the American Academy of Addiction Psychiatry, AAAP 2022. Held 2022-12-08 to 2022-12-11 in Naples, FL, USA.

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