Creativity and Psychoactive Substance Use: A Systematic Review

Creativity and the use of psychoactive substances have long been linked in both cultural narratives and scientific inquiry, with particular interest since the discovery of LSD. Earlier literature and anecdotal reports suggest artists may use substances to access altered perceptual states, depersonalization, derealization, regressive or ecstatic inspiration phases, or to provoke unusual cognitive modes. Such substance use has been proposed as a form of self-medication to regulate emotions, manage interpersonal relations, or alleviate internal tension during the creative process. Historical examples cited include mescaline and LSD experiences reported by well-known writers and painters, and theoretical propositions that psychoactive drugs might both stimulate experiential phases of inspiration and assist in subsequent reorganisation of material created during those states. Iszáj and colleagues set out to systematically review empirical studies and case reports published in peer-reviewed outlets that examine the relationship between psychoactive substance use and creativity or the artistic creative process. The objective was to collate and evaluate available evidence about whether and how different substances relate to creative performance, creative style, or artistic production, and to identify methodological gaps in the literature. The review therefore focuses on empirical papers and case studies across substance classes, artistic domains, and study designs rather than on anecdote or non-empirical commentary.

The investigators conducted a systematic search of PsycINFO, MEDLINE, PubMed, ScienceDirect, Web of Science, and EBSCO using two clusters of keywords: one for substances (drug*, psychoactive substance use, psychedel*, psychotrop*, hallucinogen*, LSD, magic mushroom, mescaline, peyote, psilocybin) and one for creativity (creativ*, art*). The electronic search was supplemented by manual checking of reference lists from retrieved studies to capture additional relevant papers. Initial screening identified 327 items from the keyword combination plus one additional reference from manual searching. Exclusion criteria removed papers in which art* referred to non-artistic terms (n = 179), studies addressing other topics such as art therapy (n = 97), book reviews (n = 2), a doctoral dissertation (n = 1), non-English studies (n = 6), literature reviews without original data (n = 22), and studies examining alcohol effects (n = 2). After filtering, 19 publications met inclusion criteria: 14 empirical studies and five case reports. The included studies spanned several decades, with a cluster from the 1960s–1970s and a resurgence of publications since 2003. Geographically, the USA accounted for a majority overall (58%), particularly among earlier studies, but post-2000 empirical papers came from a broader set of countries. Study samples were predominantly adult and non-clinical (15 of 19), with four clinical studies. Substances studied included psychedelics (LSD, psilocybin, mescaline, ayahuasca), cannabis, and heterogeneous mixtures of substances in some samples. Methodologically, the empirical work used three main approaches: questionnaire-based assessments (seven studies), psychometric creativity tests (TTCT appeared in three studies, alongside tasks such as the Remote Associates Test, Purdue Creativity Test, Consequences Test, and other measures), and analysis of artworks or written output produced in normal versus altered states. Several studies analysed drawings, handwriting or texts created during intoxication. The extracted text indicates that reporting and methods varied substantially across studies; in some cases key procedural details (for example, precise sample sizes or full test batteries) were not clearly reported in the available extraction.

The authors organised results by substance type and study approach. Across the 14 empirical studies and five case reports, evidence was heterogeneous and frequently inconsistent. Psychedelics: Five empirical studies and three case reports focused on psychedelics. One controlled study of 27 male professionals reported enhanced creative problem solving during mescaline or LSD ingestion and persisting reports of elevated problem-solving modes for at least a few weeks after a single session; follow-up was limited to two weeks. Janiger's large LSD programme included a subset of 20 professional artists whose drawings before and during LSD were formally rated; evaluators found changes in dominant style, colour intensity, linear and textural characteristics, with alteration and fragmentation most changed and a tendency to focus on parts rather than wholes. Artists reported greater freedom from ‘‘prescribed mental sets’’ and more associations and synesthesia, and later judged works created under LSD to be aesthetically superior. A small psilocybin study of 21 college volunteers found that psilocybin ‘‘aroused’’ creative performance but tended to amplify pre-existing individual characteristics. An ayahuasca study (n = 40; 17 males) found significantly higher originality scores on the Torrance Test of Creative Thinking compared with a university control group (n = 21; 10 males). Several psychedelic reports were qualitative and, where reported, sometimes lacked methodological detail. Cannabis: A within-subject study of 160 cannabis users tested participants on an intoxicated day and a non-intoxicated day. Two extreme subgroups were created (low creativity, n = 47; high creativity, n = 43). The high creative group showed no performance change across sessions, whereas the low creative group improved significantly on a verbal fluency task when intoxicated, suggesting selective enhancement of divergent verbal production for lower-baseline performers. Mixed and other substances: Seven studies examined heterogeneous substance use or several substances concurrently. Correlational analyses in large non-clinical samples sometimes showed low but significant positive correlations between substance use and creativity; authors cautioned against inferring causality and proposed shared traits such as risk-taking as common factors. In clinical comparisons, Edwards (1993) studied 15 substance-abusing adolescents and 15 controls and found lower flexibility and overall creativity on the TTCT in the substance-using group. Another study reported chronic cannabis users produced more ‘‘rare-creative’’ responses than controls, while ecstasy/MDMA users did not differ. Preti and Vellante found artists scored higher on a psychosis-proneness inventory and reported greater use of psychoactive substances than controls. Studies comparing artists across genres found few genre-specific differences, though musicians reported higher cannabis and cocaine use. A comparison including actors, alcohol-dependent, polydrug-dependent and student control groups found greater originality and reduced latent inhibition among actors and polydrug users. Case studies: Five case reports described individual trajectories. Three psychedelic-focused cases included an LSD-assisted psychotherapy case of a depressed writer who reportedly regained the ability to work after three months, a content analysis of cartoonist Robert Crumb showing stylistic changes during and after LSD use, and an analysis of two linguists' writings under psilocybin that became more concrete and syntactically simpler with greater alteration. Two musician-focused biographies reported mixed effects: Brian Wilson's cannabis and LSD use were linked to auditory alterations and stylistic changes respectively, whereas Jim Morrison's heavy alcohol and drug use was reported to hinder creativity and relationships and to impair writing while intoxicated.

The study team concluded that the reviewed literature yields limited convergence and does not support a clear, generalisable claim that psychoactive substances directly enhance creativity. Heterogeneity across objectives, methods, samples, measures and substances was the principal obstacle to firm conclusions. Where associations were observed, the reviewers note several patterns: substance use is more common among people with higher creativity; substances may indirectly affect the creative process by enhancing sensory or emotional experience, loosening conscious control, or altering aesthetic qualities without necessarily increasing the underlying capacity for creativity; and substance use may amplify pre-existing personality traits rather than create new creative abilities. The authors also distinguish between acute experimental effects observed in controlled settings and patterns apparent in chronic users and artistic producers; these are fundamentally different questions that yield different kinds of evidence. Acute administration studies may reveal transient changes in specific cognitive functions, while chronic-use and correlational studies reflect longer-term behavioural, personality or lifestyle associations. The reviewers emphasise that some studies suggest substances can change artistic style or certain components of creative output, but such changes do not equate to an overall enhancement of creativity. Methodological limitations are emphasised: small and unrepresentative samples, reliance on self-report, non-standardised or varied creativity measures, speculative questions, and incomplete reporting in several studies. The relatively small number of empirical studies (n = 14) further limits the evidence base. Given these constraints, the authors call for future research with clearer hypotheses, improved methodology, standardised creativity assessments, and better-controlled designs to clarify whether any causal role exists and to disentangle acute from chronic effects and trait from state influences on creativity.