Motives and side-effects of microdosing with psychedelics among users

Microdosing, defined as repeatedly taking a low dose of psychedelics such as LSD or psilocybin without inducing overt perceptual changes, has received substantial media attention as a putative performance enhancer. Earlier research on low doses exists but is limited, and key features of current microdosing practice — including exact doses, schedules, prevalence across substances and workplaces, motives, and possible adverse effects — remain incompletely characterised. Small placebo-controlled laboratory studies have so far produced mixed or null findings on some subjective outcomes, and anecdotal reports dominate public discourse. Hutten and colleagues set out to address this gap by conducting an online questionnaire survey of people with psychedelic experience to quantify lifetime psychedelic use, microdosing practices (dose, frequency, route and how schedules were obtained), motives for microdosing, prevalence of microdosing at work, and the occurrence and timing of negative effects. The stated aim was descriptive: to provide detailed user-reported data that can inform future experimental and clinical investigations of efficacy and safety of microdosing.

The study used an anonymous online questionnaire administered via Qualtrics and advertised on multiple psychedelic-focused websites and internet fora between March and July 2018. The advertisement did not specifically mention microdosing; eligibility required being aged 18 years or older and having prior experience with a psychedelic substance. Respondents provided informed consent and the project received ethics approval from the relevant university committee. Survey items covered demographics (age, gender, continent, daily occupation, highest education) and whether respondents had received a medical diagnosis for psychiatric, neurological, or physical disorders. Psychedelic substance history asked about regular (full-dose) and microdose use across a wide list of compounds (including LSD, 1P-LSD, ALD-52/1A-LSD, psilocybin-containing truffles/mushrooms, ayahuasca, DMT, 5-MeO-DMT, salvinorin A, mescaline, MDMA, NBOMes, 2Cs and others). For each substance respondents reported current versus past use and average amounts; respondents who did not know their dose were instructed to indicate this. Microdosing-specific questions included whether the respondent had microdosed with each listed substance, route of administration, frequency of use, and where they obtained their microdosing schedule (self-designed, internet, friend, book, retreat, other). Motivation to microdose was assessed by a forced-choice item (one of eight preset answers or free text), later clustered into five categories: performance enhancement, mood enhancement, symptom alleviation, curiosity, and other; respondents were also asked whether they microdosed to go to work. Reasons for stopping either regular or microdose use were listed as choices (including negative experience, inability to obtain the substance, having met the purpose, loss of interest, lifestyle change), with an added option of “not effective” for microdosing. Negative effects were assessed by asking whether respondents ever experienced adverse side-effects while microdosing and, if so, whether these were physical, psychological, or both; examples were provided but respondents could not specify particular symptoms, nor identify cause. Analyses were performed in SPSS version 24.0. Respondents who reported never having microdosed were excluded. Outliers in reported doses were identified using z-scores (values more than 3 standard deviations from the mean) and removed for dose-related summary statistics; because reported dose ranges were wide, the mode was presented for dose-per-psychedelic. Frequencies described routes, motivations, workplace microdosing and reasons to stop. Chi-square tests of independence compared categorical outcomes between current and past microdosers and compared reasons to stop between regular and microdosing. The extracted text notes that some detailed methodological information (for example exact item wording for all questions) was reported in tables that are not part of the extracted prose.

From 5,681 people who saw the advertisement, 3,590 respondents consented and completed the questionnaire. After removing two implausible responses and excluding 2,472 respondents who reported never having microdosed, the analysed sample comprised 1,116 respondents (20% of those who initially consented). The extracted text refers to tables for detailed demographics but reports some sample characteristics later (discussed in the Discussion section). All included respondents reported at least one regular (full-dose) psychedelic experience. For regular-dose history the most commonly used substances were psilocybin (n = 954; 85.5%), LSD (n = 910; 81.5%), and MDMA/ecstasy (n = 746; 66.8%); the least frequently reported were 5-MeO-DMT (n = 66; 5.9%), ALD-52/1A-LSD (n = 99; 8.9%), and ayahuasca (n = 113; 10.1%). For microdosing, the most used substances were LSD (n = 666; 59.7%), psilocybin (n = 645; 57.8%), and 1P-LSD (n = 129; 11.6%); the least used were 5-MeO-DMT (n = 5; 0.4%), NBOMes (n = 9; 0.8%), and ayahuasca (n = 15; 1.3%). Regarding dosing and schedules, the modal microdoses reported were 10 mcg for LSD and 0.5 g for psilocybin, and many respondents reported microdosing several times per week. For LSD and psilocybin between 57% and 78% of users reported microdosing multiple times per week, typically 2–4 times weekly; overall reported frequencies ranged from 2 to 7 times per week depending on substance. Nearly one-half of respondents who microdosed (n = 546; 48.9%) reported designing their own microdosing schedule, while others used schedules found on the internet (n = 371; 33.2%), received schedules from a friend (n = 96; 8.6%), read them in a book (n = 38; 3.4%), or used other sources. The extracted text also emphasises that many respondents (up to 67% for some substances) indicated not knowing the exact dose they consumed. Motives to microdose were dominated by performance-oriented reasons: 409 respondents (36.6%) selected performance enhancement (for example increased energy, concentration or creativity). Other motives were mood enhancement (n = 325; 29.1%), curiosity (n = 170; 15.2%), symptom relief (n = 156; 14.0%), and other reasons such as enhancing empathy or spirituality (n = 56; 5.0%). Almost one-half of the sample (n = 531; 47.6%) reported microdosing to go to work; the most common occupations among those who microdosed at work were studying (31.8%) and computer/office work (29.9%), followed by working with people, creative work, physical work and travelling. About one-fifth of microdosers (n = 229; 20.5%) reported having stopped microdosing altogether. In total, 57.0% (n = 636) had stopped using at least one psychedelic at regular doses, and 30.1% (n = 336) had stopped microdosing with at least one psychedelic. Chi-square tests comparing reasons to stop between regular and microdosing showed that negative experiences (χ2(1) = 40.86, P < .01) and loss of interest (χ2(1) = 50.77, P < .01) were more frequently reported reasons to stop regular dosing than microdosing; no statistically significant dose-related differences were observed for other stated reasons to stop. Concerning adverse effects, 225 respondents (20.2%) reported experiencing negative effects while microdosing. These were most commonly psychological in nature and typically occurred acutely, i.e. while under the influence. A chi-square test found that reporting both psychological and physical side-effects differed between past and current microdosers (χ2(1) = 7.52, P < .01), with the co-occurrence reported more often among those who had stopped microdosing. No significant differences between current and past users were found for reporting only psychological effects (χ2(1) = 0.27, P = .61) or only physical effects (χ2(1) < 0.01, P = .98). The timing of negative effects (acute, long term, or both) did not differ between past and current users (acute χ2(1) = 0.77, P = .38; long term χ2(1) = 2.31, P = .13; both χ2(1) = 0.85, P = .36). Only a small minority (reported as about 1–3% in the Discussion) indicated negative effects that lasted for days after dosing.

Hutten and colleagues interpret the results as supporting the anecdotal picture that microdosing is commonly practised with LSD and psilocybin and is frequently motivated by perceived performance enhancement. The modal microdoses reported (10 mcg LSD; 0.5 g psilocybin) are consistent with the oft-cited ‘‘one-tenth of a regular dose’’ rule of thumb, but the investigators emphasise that a large proportion of respondents did not know the doses they were taking, which undermines precision in self-reported dosing. Regular microdosing several times per week was common in this self-selected sample, and almost one-half reported doing so while working, notably in study or office/computer-based occupations. The study team highlights that about 20% of microdosers reported negative effects, most commonly acute psychological symptoms, and that co-occurrence of psychological and physical effects was associated with having stopped microdosing. Nevertheless, the principal reason respondents cited for ceasing microdosing was perceived lack of efficacy rather than adverse events. The authors place these findings alongside mixed results from small placebo-controlled trials and preclinical reports suggesting possible adverse behavioural outcomes, arguing that placebo-controlled experimental studies are required to determine whether self-reported performance enhancements are measurable and to assess acute and longer-term safety. Several limitations are acknowledged. The sample was recruited from psychedelic-focused online fora and therefore is not representative of the general population or of all microdosing users; people who microdose without prior full-dose experience or those who left the community after negative experiences may be underrepresented. Self-report introduces uncertainty in dosing (including apparent reporting errors and unit confusion) and in the precise nature of negative effects because the survey did not permit specification of particular symptoms (for example anxiety versus depression). Causes of adverse events cannot be determined from the data; possible contributors include unintended higher dosing, set and setting, or substance impurity. The authors recommend that future research use more structured dosing questions (for example multiple-choice dose ranges), probe methods used to measure doses, allow specification of adverse symptom types, and employ placebo-controlled designs to quantify efficacy and monitor both acute and long-term adverse effects.