Psychedelic Science Newsletter
Issue #26March 2, 20267 studies

73% of young adults who use hallucinogens are microdosing them

Psychedelic research hit a major milestone this week with comprehensive reviews showing these treatments are advancing through Phase 3 trials. But the most surprising finding came from looking at how young adults are actually using these substances outside clinical settings.

🧬 Most hallucinogen users are taking tiny doses, not tripping

  • 9.5% of young adults (ages 19-30) reported using hallucinogens in the past year, but 73% of those users engaged in microdosing rather than full psychedelic experiences

  • Among the 6.8% who microdosed, 85.8% also used cannabis frequently (3+ times per year) and 72.4% drank alcohol regularly (10+ occasions per year)

  • Black respondents were 57% less likely to microdose compared to white respondents, suggesting significant demographic differences in usage patterns

Why it matters: This is the largest national study showing microdosing has become the dominant way young adults use psychedelics, challenging assumptions that most recreational use involves intense trips. The high overlap with other substances raises questions about whether microdosing occurs in isolation or as part of broader polysubstance use patterns.

Top 20% journal 🔗 Drug and alcohol review 🗓️ Feb 26

Key Findings

🎯 Your therapist matters way more if you're a patient vs. healthy volunteer

  • Session facilitators (the people guiding psilocybin experiences) accounted for only 0.8% of the variation in effects among healthy volunteers

  • But in clinical patients, facilitators explained 13.6% of the variation in psychedelic experiences—comparable to therapist effects in traditional psychotherapy (around 8%)

  • The analysis included 298 participants across 670 dosing sessions with 60 different facilitators

💡 Clinical patients may be more vulnerable to facilitator influence, suggesting training standards could significantly impact treatment outcomes.
🎖️ Top 10% journal 🔗 Psychiatry research 🗓️ Feb 26

🔬 Psilocybin shows promise for post-Lyme disease symptoms

  • 20 patients with post-treatment Lyme disease received two psilocybin sessions (15-25mg) with psychological support over 8 weeks

  • General symptom burden decreased 40% at 6 months follow-up, with both mental and physical quality of life scores improving 13%

  • 90% experienced transient high blood pressure during sessions, but no serious adverse events occurred

💡 This pilot suggests psilocybin may help chronic post-infectious syndromes, opening potential applications beyond traditional psychiatric conditions.
Top 20% journal 🔗 Scientific reports 🗓️ Feb 25

💡 Higher blood pressure during ketamine predicts better depression outcomes

  • 39 patients with depression received single ketamine infusions (0.54 mg/kg), with responders showing significantly higher blood pressure during treatment

  • Dissociative experiences and psychological symptoms during infusion didn't predict antidepressant response at day 7

  • Patients taking antipsychotic medications had both lower blood pressure responses and worse depression outcomes

💡 Sympathetic nervous system activation, not psychological effects, may be key to ketamine's antidepressant benefits.
Top 20% journal 🔗 Therapeutic advances in psychopharmacology 🗓️ Feb 24

🧪 Multiple psychedelics trigger similar genetic changes in lab-grown neurons

  • Neurons derived from patients with treatment-resistant depression and healthy volunteers were treated with ketamine metabolite HNK, psilocybin, LSD, and DOI

  • Despite targeting different brain receptors initially, all compounds showed highly correlated gene expression changes at matching time points

  • The drugs converged on pathways involving inflammation, cellular growth, and mTOR signaling

💡 Different psychedelics may work through shared downstream molecular mechanisms, regardless of their initial pharmacological targets.
🔗 Research square 🗓️ Feb 26

🎯 Injectable ketamine may be safer than nasal esketamine

  • Analysis of 4,505 esketamine users and 197,694 injectable ketamine users found esketamine linked to 24% higher risk of suicidal thoughts

  • Esketamine users also showed 55% higher risk of anxiety disorders and 57% higher risk of cardiac arrest compared to injectable ketamine

  • However, esketamine was more effective than oral antidepressants for reducing suicide risk (29% lower) and suicide attempts (29% lower)

💡 The route and formulation of ketamine treatment may significantly impact both safety and effectiveness profiles.
🥉 Top 5% journal 🔗 Journal of affective disorders 🗓️ Feb 25

🔬 Chaplains may be missing from psychedelic therapy teams

  • Participants in psychedelic trials consistently report mystical experiences, yet few studies include spiritual care professionals

  • Professional chaplains are trained in spiritual inquiry, empathic presence, and helping people make meaning of transformative experiences

  • The authors propose specific competencies chaplains would need for psychedelic therapy, including specialized education beyond standard training

💡 The spiritual dimensions of psychedelic experiences may require dedicated expertise that current therapy teams lack.
Top 20% journal 🔗 Journal of Religion and Health 🗓️ Feb 27

Implications

This week's research reveals a field rapidly maturing beyond early enthusiasm, with studies now focusing on optimizing delivery, understanding mechanisms, and addressing practical implementation challenges. The convergence of different psychedelics on similar molecular pathways suggests these treatments may share fundamental therapeutic mechanisms, while the importance of facilitators and spiritual care highlights that the human elements of treatment may be as crucial as the drugs themselves.

Studies in this issue

Primary sources used for this newsletter.

  1. How Common Is Hallucinogen Microdosing Among Young Adults in the United States
    main storyDrug and alcohol review2026-02-26PMID 41748121
  2. Session guides strongly influence psychedelic experiences in patients but not in healthy people
    key findingPsychiatry research2026-02-26PMID 41747432
  3. Comparing the benefits and risks of esketamine, injectable ketamine, and oral antidepressants for major depression in a large population study
    key findingJournal of affective disorders2026-02-25PMID 41740756
  4. Ketamine's lasting antidepressant effect is linked to increased stress system activity but not feeling detached
    key findingTherapeutic advances in psychopharmacology2026-02-24PMID 41732712
  5. Timing of Rapid Antidepressant Effects in Lab-Grown Nerve Cells from People with Hard-to-Treat Depression and Healthy Controls
    key findingResearch square2026-02-26PMID 41743330
  6. The Role and Skills of Spiritual Guides in Psychedelic Therapy
    key findingJournal of religion and health2026-02-27PMID 41760871
  7. Early study of psilocybin use in people with ongoing symptoms after Lyme disease treatment
    key findingScientific reports2026-02-25PMID 41741501

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