Associations Between Psychedelic Use and Cannabis Use Disorder in a Nationally Representative Sample

Cannabis Use Disorder (CUD) is an increasingly prevalent disorder affecting millions of Americans each year. Psychedelic compounds have recently been investigated for their therapeutic potential in treating substance use disorders, yet no prior work has examined the relationship between naturalistic use of specific psychedelic compounds and rates of disordered cannabis use. Using a nationally representative sample of U.S adults from the National Survey on Drug Use and Health (2015 – 2019, 2021 – 2022), we used a series of survey-weighted multivariable logistic regressions to examine the association between past year disordered cannabis use and use of several classic psychedelics (i.e., LSD, psilocybin, mescaline, peyote, DMT) and non-classic psychedelics (i.e., ketamine, MDMA). lifetime psilocybin use as well as past year LSD use were both associated with higher rates of past year DSM-5 CUD (adjusted risk ratio [aRR] range: 1.89 – 2.04), controlling for a variety of sociodemographic factors. These associations remained significant in the case of moderate-to-severe past year CUD (aRR range: 1.65 – 2.07). Past year LSD use also predicted three of eleven CUD symptoms among individuals with past year cannabis use (aRR range: 1.45 – 1.73). Despite preliminary findings regarding the potential for psychedelic substances to help treat substance use disorders, our findings suggest a relationship between psychedelic use and disordered cannabis use, suggesting that certain psychedelic substances used in certain naturalistic settings are an indicator of greater risk of maladaptive cannabis use. Future directions to further disentangle these relationships are discussed. •Lifetime LSD and psilocybin use were each associated with higher rates of past year CUD.•Psilocybin had the strongest association with pathological cannabis use of all studied drugs.•Critically, we are unable to infer a causal link from psychedelic use to pathological cannabis use.