{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:29:00Z","timestamp":1791386940199,"version":"4.3.3"},"reference-count":85,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine associations between psychedelic use and adverse health outcomes, including overdose, relapse, mental health crises, and hospitalizations, among individuals with substance use disorders (SUD), and to compare these outcomes across different treatment modalities including anesthetics and outpatient SUD services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study using propensity score-weighted quasi-Poisson regression models to estimate adjusted incidence rate ratios (aIRRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data were drawn from Oracle EHR Real-World Data\u2122 comprising 138 U.S. health systems restricted to those \u226512 years old from January 1, 2000, to August 31, 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>3,209,798 patients with a documented SUD diagnosis from 2000 to 2023. Patients with a prior history of psychedelic use or hallucinogen-related diagnoses were excluded. The final cohort included 8,514 new psychedelic users and over 3.2 million non-users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Exposures were captured during a 3-month post-index period and included outpatient psychedelic prescriptions or procedures (primarily ketamine), general anesthetic outpatient prescriptions, and outpatient SUD services. Outcomes, assessed over 2 years, included SUD-related hospitalizations\/emergency department (ED) visits, mental health crises, all-drug overdoses, and relapse. Propensity scores accounted for demographic, clinical, and behavioral confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Psychedelic use was associated with significantly reduced rates of all adverse outcomes, including all-drug overdose (aIRR F;= F;0.48; 95% CI: 0.37-0.63), relapse (aIRR F;= F;0.68; 0.60-0.77), SUD hospitalizations\/ED visits (aIRR F;= F;0.76; 0.69-0.82), and mental health crises (aIRR F;= F;0.82; 0.73-0.92), compared to no treatment. The combination of psychedelics, anesthetics, and outpatient services was associated with the strongest reduction in mental health crises (aIRR F;= F;0.21; 0.06-0.77). Trends were consistent in sensitivity analyses including patients with mental health conditions and comparisons to medication-assisted treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large national cohort, psychedelic use, particularly when combined with anesthetic and outpatient care, was associated with reduced adverse health outcomes among people with SUD. These findings support further investigation into psychedelic-based interventions within integrated treatment frameworks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1648104","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T10:01:04Z","timestamp":1761300064000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Associations between psychedelic use and adverse outcomes in substance use disorders: a real-world EHR-based cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Fares","family":"Qeadan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlie","family":"McCunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Tingey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Thielking","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"B1","unstructured":"Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health\n          \n          \n          Rockville, MD\n          Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration\n          \n          2024"},{"key":"B2","unstructured":"Drug Overdose Deaths in the United States, 2002-2022\n          \n          \n            \n              Spencer\n              MR\n            \n            \n              Garnett\n              MF\n            \n            \n              Mini\u00f1o\n              AM\n            \n          \n          \n          2023"},{"key":"B3","volume-title":"Principles of drug addiction treatment: A research-based guide","author":"Volkow","year":"2011"},{"key":"B4","volume-title":"Substance Use Disorders Treatment Options","author":"Gollinge","year":"2025"},{"key":"B5","unstructured":"Focus Area: Substance Use Disorders\n          \n          \n          US Food and Drug Administration\n          \n          2022"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1177\/11782218221118462","article-title":"Barriers and facilitators to substance use disorder treatment: an overview of systematic reviews","volume":"16","author":"Farhoudian","year":"2022","journal-title":"Subst Abuse: Res Treat"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/adm.0000000000000400","article-title":"Gaps in the substance use disorder treatment referral process: provider perceptions","volume":"12","author":"Blevins","year":"2018","journal-title":"J Addict Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108341","article-title":"Difficult binds: A systematic review of facilitators and barriers to treatment among mothers with substance use disorders","volume":"126","author":"Barnett","year":"2021","journal-title":"J Subst Abuse Treat"},{"key":"B9","volume-title":"Barriers to broader use of medications to treat opioid use disorder. 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