The Canadian Psychedelic Survey: Characteristics, Patterns of Use, and Access in a Large Sample of People Who Use Psychedelic Drugs

Psychedelic substances produce altered states of consciousness and have re-emerged as objects of scientific and public interest after decades of restrictive regulation. Classic compounds such as psilocybin and LSD act primarily at serotonin 5-HT2A receptors, while drugs often described as non-classic psychedelics (for example MDMA and ketamine) act via other mechanisms. Previous clinical research has reported promising short- and long-term effects for a range of psychiatric conditions but has been limited by small sample sizes and restrictive legal frameworks. At the same time, public acceptance and regulatory change in some jurisdictions have increased, yet detailed, contemporary information about how psychedelics are used in Canada—who uses them, for what reasons, by what routes of access, and with what acute effects—remains scarce. Liebert and colleagues developed the Canadian Psychedelic Survey (CPS) to gather real-world evidence about psychedelic use in Canada. The survey aimed to characterise respondents, document sources of access, describe substance-specific patterns, motives, and contexts of use, and contextualise intense positive and challenging psychedelic experiences. The study therefore sought descriptive population-level data plus analytic models identifying socio-demographic and use-related correlates of reporting intense positive or challenging experiences.

The CPS was an anonymous, online, cross-sectional survey administered in January 2022. Eligible respondents were aged 19 or older, reported past or current use of psychedelics, could consent for themselves, and could read and write English. Informed consent was obtained online; participants could optionally enter a draw for gift cards with email addresses destroyed after the draw. Ethics approval was obtained from Advarra (protocol # Pro00059863). The dataset was cleaned by removing invalid Canadian postal codes, deduplicating probable duplicate entries using combinations of postal code and demographic variables, and excluding respondents who did not report lifetime or past-year use of any pre-specified psychedelic. Survey content captured socio-demographic variables (age, province, race, gender, relationship and employment status, education, income) and lifetime/past-year use of non-psychedelic substances. Questions about general psychedelic use included age at first use, past-year frequency, monthly spending categories, and self-rated psychedelic knowledge/experience on a 0–100 sliding scale. Motivations for use and sources of access (both actual past-year sources and preferred sources under ideal conditions) were collected with multi-select response lists. For substance-specific data, participants reported lifetime and past-year microdose and regular-dose use for 11 named psychedelics and could add others. Those reporting ever using a regular dose of a listed substance were asked follow-up items on estimated total times used, typical frequency, most common access source, primary motivation for that substance, and typical social and environmental setting. Intense experiences were captured by asking whether participants ever had an "intense but largely positive psychedelic experience" or a "challenging psychedelic experience (i.e., a bad trip)"; affirmative respondents provided drug involved, setting, companions, and rated the intensity of their most intense episode on a 1–100 scale. Positive-experience respondents completed the Awe Experiences Scale (AWE-S), a validated 30-item instrument grouped into six factors (altered time perception, self-diminishment, connectedness, perceived vastness, physical sensations, need for accommodation). Those reporting challenging experiences selected psychological and physical symptoms experienced and indicated agreement with whether "some good came out" of the episode, with follow-up on the nature of any benefit. Analyses were primarily descriptive. The investigators used bivariable and multivariable logistic regression to identify correlates of (1) reporting an intense positive trip and (2) reporting an intense challenging trip. Candidate socio-demographic covariates included age, gender, and education. Psychedelic-related covariates comprised self-perceived psychedelic experience, past-year psychedelic use, motivations for use (each dichotomised yes/no), and the psychedelic most typically used (categorized as ketamine, LSD, MDMA, or Other versus psilocybin). The authors note that follow-up question branching produced item-level missingness (ranging by substance) and that perceived experience was used as a proxy for lifetime use frequency where direct counts were unavailable.

Of 2,869 survey responses, 2,384 remained after removal of invalid and duplicate entries; 2,045 respondents (85.8% of retained responses) provided information about past or current use of a specified psychedelic and were analysed. The mean age was 38.4 years and 56.2% identified as women. Lifetime use of other substances was common in this sample: 99.4% reported lifetime alcohol use and 98.1% reported lifetime cannabis use, with over 70% reporting past-year use of each. Self-rated psychedelic knowledge/experience averaged over 60 on a 0–100 scale. More than 90% of respondents had used a regular dose sufficient to produce a "trip"; 6.6% reported only microdosing. Three-quarters (74.9%) reported past-year psychedelic use, and most past-year users (67.7%) used less than once per month. Motivations for use were dominated by non-medical reasons: 76.5% reported use "for fun," 73.3% for spiritual or psychological self-exploration, 62.4% for general mental wellbeing, and 60.5% for personal growth. Smaller proportions reported using psychedelics to reduce prescription (11.2%) or non-prescription (10.6%) substance use. Among past-year users (n = 1,525), current and preferred sources of psychedelics differed. Friends or acquaintances were the most common current source (62.8%) but only 33.4% identified friends as a preferred source under ideal conditions. Street dealers or the black market were reported by 15.2% as a current source and were least preferred (3.3%). Online sources were used by 48.1% and were the most preferred under ideal conditions (64.0%). Physical retail settings (8.7% current vs 56.5% preferred) and clinics/healthcare professionals (5.2% current vs 50.6% preferred) were much more desired than currently reported, reflecting legal and regulatory constraints on access. Psilocybin was the most commonly used psychedelic: 92.3% reported lifetime use and 59.1% past-year use. MDMA and LSD also had high lifetime prevalence (>60%) and approximately one-quarter reported past-year use. Ibogaine was rare (2.3% lifetime). Substance-specific motives varied: recreational motives predominated for 2C‑B, ketamine, LSD, MDMA, nitrous oxide, psilocybin, and salvia, whereas self-exploration/mind expansion was the top motive for ayahuasca, DMT, ibogaine, and mescaline. Typical settings likewise varied by substance; many substances were most often used at home or outdoors, while MDMA, ketamine and related drugs were more often used at large public gatherings. Most respondents (>50%) reported preferentially using several psychedelics with companions; DMT users commonly reported either companions or a sober "trip-sitter," and 42.9% of ibogaine users reported use with an unlicensed therapist, shaman, or trip guide. Intense positive experiences: of 1,724 respondents answering that item, 82.1% endorsed ever having an intense but largely positive psychedelic experience. The mean total AWE-S score for the most intense positive experience was 5.3 (SD = 1.1) on a 1–7 scale, with particularly high subscale scores for altered time perception, connectedness, and perceived vastness. Psilocybin, LSD, and MDMA accounted for over 80% of reported most intense positive experiences; ayahuasca accounted for about 5%. Most intense positive experiences occurred at home (45.6%) or outdoors (30.1%) and typically with companions (57.1%). Intense challenging experiences: of 1,708 respondents to that item, 52.2% reported an intense challenging psychedelic experience. The most frequently reported symptoms during the most intense challenging episode were mental or sensory overload (61.1%) and social paranoia (51.7%). The same three substances (psilocybin, LSD, MDMA) accounted for over 80% of most intense challenging episodes, with ayahuasca cited in 4% of cases. Challenging episodes most often occurred at home (55.1%) and with companions (54.8%). Just over half (55.9%) of those who had a challenging experience agreed that "some good" ultimately came from it; commonly reported benefits included gaining insight into a problem or life issue (59.6%), overcoming personal fears (46.0%), and resolving a challenging situation or emotion (reported proportion appears truncated in the extract). Multivariable analyses identified correlates of these outcomes. Higher self-perceived psychedelic experience was independently associated with increased odds of reporting both intense positive and intense challenging experiences. Motivations differed by outcome: fun and self-exploration motivations were independently associated with intense positive experiences, whereas trauma management, boredom, and fun were associated with intense challenging experiences. Past-year psychedelic use was negatively associated with experiencing an intense challenging trip (adjusted odds ratio = 0.68, 95% CI: 0.50–0.91). The extract does not provide the full set of regression coefficients or all model fit statistics.

Liebert and colleagues interpret the CPS findings as providing a broad, contemporary portrait of psychedelic use among a large sample of people who use psychedelics in Canada. They emphasise that psilocybin, MDMA, and LSD are the most commonly used substances and that most reported use occurs in familiar social and environmental settings, typically at home or outdoors and often with companions. Despite renewed clinical interest in psychedelic therapies, the majority of respondents reported non-medical motivations such as fun and personal exploration; nevertheless, about one in ten respondents endorsed using psychedelics to reduce or stop other substance use, indicating an informal trend that may warrant clinical guidance and further study. The investigators note strong interest among respondents for safer, regulated sources of psychedelics: while friends and online sources currently predominate, many participants expressed preference for online retail, physical retail, pharmacies, or clinic-based access under ideal conditions. In terms of acute experiences, most participants reported intense positive experiences with high scores on the AWE-S connectedness subscale, which the authors link to prior literature showing connectedness can mediate positive mood effects. Challenging experiences were also common and sometimes existentially threatening for participants—35% felt they would "never be the same" and 26% feared they might die during an episode—but a majority of those reporting a challenging experience nevertheless felt some positive outcome followed, such as insight or overcoming fears. The authors discuss how correlates of intense positive versus challenging experiences diverged: self-rated psychedelic experience increased odds of both outcomes, but motivations mattered—personal exploration tended to predict positive outcomes whereas trauma management, boredom, and substance-reduction motives predicted more challenging episodes. The paper situates these associations within the "set and setting" framework (mindset, expectations, and physical/social environment) and cites prior reviews linking baseline personality traits to differential acute responses. Key limitations acknowledged by the investigators include the self-selected nature of the sample, under-representation of Black, Indigenous, and other people of colour, recruitment channels that may over-represent respondents favourable to legal access, reliance on self-report and retrospective recall, inability to confirm identity or purity of substances used, cross-sectional design that precludes causal inference, and item-level missingness produced by survey branching. The authors also note that total number of lifetime uses was not directly available and that perceived experience served as a proxy. They conclude by calling for further research to explore causally informative designs, more representative samples, and deeper investigation into the contexts and outcomes of informal clinical uses such as attempts to reduce other substance use.

The authors conclude that the CPS is the first comprehensive national survey documenting psychedelic use in Canada and that it reveals diverse patterns of use, widespread non-clinical motivations, and substantial interest in regulated access channels. They highlight the coexistence of frequent intense positive experiences and a substantial prevalence of challenging experiences—many of which participants retrospectively find meaningful—and stress the need for improved guidance, research, and policy responses that reflect how psychedelics are currently accessed and used in Canada.