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Journal of Psychedelic Studies
Beyond prohibition: A public health analysis of naturalistic psychedelic use
MARK HADEN, SARAH A. PASCHALL and BIRGITTA WOODS
Published July 2025
ABSTRACT
Psychedelic drug use is experiencing a global resurgence, both in clinical research and community
settings. This paper presents a comprehensive public health analysis of the naturalistic use of
psychedelics—defined as use outside clinical or research environments. Drawing on a review of 104
peer-reviewed articles, this analysis evaluates the mental, physical, and social outcomes associated with
substances such as psilocybin, LSD, MDMA, mescaline, and 5-MeO-DMT. Findings indicate that
naturalistic psychedelic use is associated with reductions in depression, anxiety, PTSD, substance use
disorders, interpersonal violence, and suicidality, while enhancing emotional well-being, social
connectedness, spirituality, nature relatedness, psychological flexibility and physical health. These
benefits are observed across diverse populations in many countries, including individuals with trauma,
addictions, and chronic pain, as well as in older adults and marginalized groups. Importantly, while
adverse effects can occur, they are typically short-lived and often associated with identifiable risk factors
such as youth, high doses, psychological vulnerability, and poor set and setting. Drawing on harm
reduction principles and Indigenous cultural models, the paper outlines how public education and safe
use guidelines—emphasizing mindset, environment, and dosage—can mitigate risks. The data suggest
that current prohibitionist drug policies are both outdated and harmful and that a shift toward legalization,
regulated access, and evidence-informed education is not only justified but urgently needed.
A public health approach to psychedelics, one grounded in safety, inclusion, and scientific evidence,
offers the most rational path forward.
Sincerely,
Mark Haden
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